What question did this study set out to answer?

This study aims to identify psychological and environmental factors influencing bystander CPR willingness in African American communities.

April 25, 2026Open Access

Reducing Racial Disparities in Bystander CPR: Psychological and Environmental Determinants of Hands-Only CPR Willingness in African American Communities

Key Points

This study aims to identify psychological and environmental factors influencing bystander CPR willingness in African American communities.
Cross-sectional analysis using survey data from 372 adults in a health education program.
Binary logistic regression assessed CPR comfort and response confidence among participants.
64.5% of participants identified as Black or African American.
Participants with sufficient CPR information were more likely to report comfort in performing CPR on family (OR = 5.36, p < .001) and strangers (OR = 6.79, p < .001).
Uncertainty regarding CPR technique negatively impacted willingness across models.
Presence of workplace defibrillators and training increased willingness and response confidence.

Abstract

Racial disparities in out-of-hospital cardiac arrest (OHCA) survival remain a persistent public health equity concern in the United States. African Americans are less likely to receive bystander cardiopulmonary resuscitation (CPR) and experience lower survival to hospital discharge compared to White individuals. While structural inequities contribute to these disparities, less is known about modifiable psychological, informational, and environmental determinants of CPR willingness within community-based African American populations. This study examined predictors of Hands-Only CPR comfort and response confidence among participants in a culturally tailored cardiovascular health program. A cross-sectional analysis was conducted using survey data from 372 adults who completed a Hands-Only CPR educational module within the HeartSmarts Community Health Education Program; 64.5% identified as Black or African American. Binary logistic regression was used to assess predictors of comfort performing CPR on family members and strangers, and confidence in responding to sudden cardiac arrest. Perceived informational sufficiency emerged as the most consistent predictor across outcomes. Participants reporting sufficient information were significantly more likely to report comfort performing CPR on family members (OR = 5.36, p < .001) and strangers (OR = 6.79, p < .001). Uncertainty regarding CPR technique was a strong negative predictor across models. Absence of concerns, workplace defibrillator presence, and defibrillator training were also independently associated with greater willingness and response confidence. Findings highlight modifiable pathways linking perceived capability, environmental preparedness, and intervention readiness. Community-based, culturally responsive strategies that strengthen informational sufficiency and address fear-related barriers may reduce racial disparities in bystander CPR and improve OHCA survival equity.

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