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Published on: January 15, 2017
Behavioral Determinants Potentially Relevant to First-Witness Responses in Prehospital Stroke Care: A COM-B-Based
Keying Xu1,2, Chengxia Wei3, Hui Ni3
1Graduate School, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China.
Healthcare (Basel, Switzerland)
|July 15, 2026
Summary
First witnesses
Area of Science:
- Prehospital care research
- Behavioral science in public health
Background:
- Prehospital stroke care delays are influenced by first witnesses.
- Factors shaping witness responses are not well understood.
Purpose of the Study:
- To synthesize factors influencing first witness responses to stroke.
- To map these factors onto the Capability-Opportunity-Motivation-Behavior (COM-B) model.
Main Methods:
- Scoping review following PRISMA-ScR guidelines (2019-2024).
- Searched eight international and Chinese databases.
- Interpreted factors from patient/public studies for relevance to first witnesses.
Main Results:
- 48 studies included, covering all COM-B domains.
- Physical opportunity (24.6%) and psychological capability (19.4%) were most frequent.
- Barriers: low stroke knowledge, poor emergency access, delayed urgency perception.
Conclusions:
- Identified behavioral factors influencing prehospital stroke response.
- Delays linked to combined limited capability, opportunity, and motivation.
- Behavior-informed strategies can improve stroke response and reduce delays.