Effect of population-based training programs on bystander willingness to perform cardiopulmonary resuscitation

Objective. This study was performed to determine the factors related to unwillingness of bystanders to perform cardiopulmonary resuscitation (CPR), and improvement of willingness among the lay public after CPR training. Design. Retrospective design Methods. We collected questionnaires received from laypersons attending CPR training courses implemented by the CPR Improvement Program of Chang Gung Memorial Foundation. Pre- and post-training questionnaires were given to participants attending CPR training courses between September 2013 and January 2014. Results. Among the 401 respondents at pre-training, higher educational level (odds ratio, 3.605; 95% confidence interval [CI], 3.055 – 8.284) and previous CPR training (odds ratio, 1.754; 95% CI, 1.049 – 2.932) were significantly associated with willingness to perform bystander CPR. Significant improvements in willingness to perform conventional CPR and hands-only CPR on a stranger were observed after training (P = 0.016 and P < 0.0001, respectively). Approximately half of the respondents claimed that fear of doing further harm was the primary reason for their lack of willingness to admin- ister conventional CPR on a stranger. Conclusions. We showed that CPR training significantly increased the rate of willingness to perform CPR on strangers as well as acquaintances among the lay public. This study also showed that fear of doing further harm was the most significant barrier after training. This concern should be addressed in future training programs.