Analysis of potential factors influencing the willingness of Chinese freshmen to perform out-of-hospital CPR and use AED: a cross-sectional survey.

BACKGROUND

Out-of-hospital cardiac arrest (OHCA) is a major public health issue in China. The average emergency response time of 16 min exceeds the 5-min "golden window." Bystander CPR/AED use is crucial for survival. College freshmen are a key group for first-aid popularization, but their CPR/AED awareness, proficiency, willingness, and influencing factors are unclear. To investigate CPR/AED awareness, operational proficiency, rescue willingness, and influencing factors among college freshmen in Gansu, to inform optimized first-aid education.

METHODS

A cross-sectional study was conducted via convenience sampling on 1,443 first-year freshmen (August 30-September 1, 2023, Gansu). Eligible participants were officially enrolled freshmen with independent questionnaire completion ability; those with cognitive/language impairments were excluded. A structured questionnaire (referencing 2020 American Heart Association (AHA) Guidelines, reviewed by 3 associate senior experts) covered 5 sections. Distributed on-site during orientation, collected immediately (100% effective). Data were double-entered via EpiData 3.1, analyzed with SPSS 25.0.

RESULTS

Awareness was high (CPR: 87.87%; AED: 74.29%), but operational mastery was low (CPR: 34.37%; AED: 19.75%). Only 19.20% had prior training. Willingness to rescue was 59.60% (860/1443), with main barriers among unwilling participants being lack of skill (79.42%, 463/583) and perceived lack of first-aid qualifications (45.97%, 268/583). Multivariate analysis showed willingness to participate in future CPR training was positively associated with knowledge mastery (OR = 1.39, 95%CI: 1.09-1.76, p = 0.008), while prior training was a protective factor for knowledge mastery. For rescue willingness, protective factors included being female, mastering CPR/AED operation, understanding legal protections, and willingness for future training.

CONCLUSION

Freshmen demonstrated high awareness but low proficiency and training coverage, with moderate rescue willingness. Recommendations include mandatory first-aid courses, increased AED deployment, and legal education. Study limitations include single-center design and self-reported data, which may lead to social desirability bias and limit the generalizability of the findings to universities in other regions of China.