Evaluating Culturally Tailored Cardiopulmonary Resuscitation (CPR) Training in Racial and Ethnically Diverse...

Bystander cardiopulmonary resuscitation (CPR) is a critical determinant of survival following out-of-hospital cardiac arrest (OHCA). However, racial and ethnic minority populations in the United States are less likely to receive bystander CPR and experience disproportionately poorer outcomes.

The objective of this study was to pilot and evaluate the feasibility of a culturally tailored hands-only CPR curriculum and assess changes in self-reported confidence and perceived difficulty of CPR among Indian American, Chinese American, and African American participants.

We conducted a single-cohort pre-post study among three groups. Community-specific focus groups informed cultural adaptations to a standard emergency services hands-only CPR curriculum, and trainings were delivered at Hindu temples, Chinese language schools, and African American churches. Primary outcomes, measured by 10-point Likert scales, were changes in confidence in four main CPR skills and perceived difficulty of CPR.

The study included 104 participants: 47 (45%) Indian American, 23 (22%) Chinese American, and 34 (33%) African American participants. Confidence increased across the four main CPR skills, with the largest improvements observed in the connect an automated external defibrillator (AED) skill (+4.5; 95% confidence interval [CI]: 3.80-5.22). Perceived difficulty of CPR also decreased (-2.65; 95% CI: 1.97-3.33).

This pilot study provides preliminary evidence for the feasibility and acceptability of culturally tailored hands-only CPR training in community settings, with participants reporting improved confidence and reduced perceived difficulty of CPR after training. These exploratory findings warrant further evaluation in adequately powered comparative studies to determine whether cultural tailoring offers benefit beyond standard CPR instruction for racial and ethnic minority communities and can contribute to reducing disparities in cardiac arrest outcomes.