Assessing Attitudes and Perceptions of High-risk, Low-resource Communities towards Cardiopulmonary Resuscitation and Public-access Defibrillation

Background: Layperson cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) use are vital for improving survival rates after out-of-hospital cardiac arrest (OHCA), yet their application varies by community demographics. We evaluated the concerns and factors influencing willingness to perform CPR and use AEDs among laypersons in high-risk, low-resource communities. Methods: From April 2022 to March 2024, laypersons in Northern Manhattan's Community District 12 completed surveys assessing their attitudes toward CPR and AED use before attending Hands-Only CPR training. Fisher's Exact Test assessed differences in concerns and willingness to perform CPR and AED use across racial-ethnic groups and compared low-resource communities with high-resource groups consisting of non-clinical staff across eight ambulatory sites. Results: Among 669 respondents, 64% identified as Hispanic, 58% were under 40, and 67% were female. Significant knowledge gaps were identified: 62% had never learned CPR, and 77% were unfamiliar with AEDs. Common concerns included fear of incorrect performance (67%), causing harm (56%), and legal repercussions (53%). Willingness to perform CPR was most influenced by familiarity with the victim (55% family vs. 67% non-family). The main barrier to AED use was a lack of operational knowledge (66%). Non-Hispanic Black participants expressed significantly greater concerns than their non-Hispanic White and Hispanic counterparts. Participants in high-resource settings (n=309) showed higher CPR and AED training rates with similar concerns. Conclusions: Concerns regarding CPR and AED use stem from a lack of confidence and training. Targeted, culturally sensitive community interventions are essential to address these barriers, enhance preparedness, and improve OHCA survival rates.