Translation and psychometric validation of the Intent-to-Aid survey for bystander response among French-speaking...

Bystander cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) use are critical determinants of survival after out-of-hospital cardiac arrest (OHCA). These behaviors are influenced not only by knowledge and skills but also by affective determinants such as confidence, attitudes, and social norms. The Intent-to-Aid (I2A) survey was developed to measure these constructs. The European Resuscitation Council (ERC) has highlighted the need for tools to evaluate resuscitation education outcomes in non-English-speaking populations to support equitable access to training.

To translate, culturally adapt, and psychometrically validate the I2A for French-speaking CPR-trained individuals.

The I2A was translated using forward-backward procedures, expert review, and cognitive debriefing. In a cross-sectional study of French-speaking CPR-trained adults in Switzerland (N = 378), confirmatory factor analyses (CFA) were conducted at parcel and item levels. Internal consistency was assessed using Cronbach's alpha and McDonald's omega, and associations between Theory of Planned Behavior constructs were examined to assess theoretical coherence.

The original four-factor structure (Attitudes, Norms, Confidence, Intentions) was replicated in parcel-based CFA, demonstrating excellent overall model fit. Item-level CFA supported the same structure after removing one item with extreme ceiling effects. Internal consistency ranged from acceptable to excellent (α = 0.66-0.87; ω = 0.75-0.90). Confidence and Norms explained most variance in Intentions, highlighting potential targets for resuscitation education.

The I2A-French demonstrates robust structural validity, satisfactory reliability, and theoretical coherence in highly trained CPR populations, supporting its use for evaluating affective determinants of bystander CPR response.