Changes in knowledge and attitude after community-based first-aid training: a prospective study with a 12-month...

This study aims to evaluate the immediate and 12-month effects of community-based first-aid training on public knowledge and attitude, assess satisfaction, and identify factors associated with score changes.

This was a prospective study. In 2022-2023, a total of 2,010 community residents in Hainan Province received first-aid training and completed structured questionnaires at baseline, immediately after training, and at 3, 6, and 12 months after training. First-aid knowledge was assessed through 33 items, with a maximum total score of 33. First-aid attitude was evaluated using seven items, totaling a maximum score of 21. Satisfaction was measured on a 5-point Likert scale. Paired-sample t-tests were used to compare baseline and post-training scores, repeated-measures analysis of variance (ANOVA) was used to examine time effects, and multiple linear regression was used to analyze factors associated with score changes.

The satisfaction score with the training was high (mean score>4.3 for all items). The first-aid knowledge and attitude scores increased significantly after training (first-aid knowledge at baseline, 14.90±7.63; immediately after training, 20.70±5.72, P<0.001; and attitude at baseline, 17.52±2.29; immediately after training, 17.89±1.54, P<0.001). At 12 months after training, knowledge scores declined slightly compared with those immediately after training but remained above baseline (time effect P<0.001), whereas attitude scores remained stable (time effect P<0.001). Knowledge improvement was greater among middle-income participants and less among participants with lower levels of education, those in professional occupations, widowed individuals, or those who had previously received first-aid training. Attitude improvements were more pronounced among male participants, younger participants, and those in the agriculture or sales/service sectors.

Community-based first-aid training improved public first-aid knowledge and attitude and was well received by participants. While knowledge levels declined somewhat over time, attitude remained relatively stable, highlighting the importance of continuous reinforcement training. Personalized reinforcement strategies may be particularly beneficial for individuals with lower levels of education, specific professional backgrounds, widowhood, or prior training experience to further enhance training effectiveness.