Sociocultural Barriers to Effective Bystander CPR: Challenges and Opportunities for Community-Based Education Programs
Abstract Body: Introduction Bystander cardiopulmonary resuscitation (bCPR) can double or triple survival yet only 40% of out-of-hospital sudden cardiac arrest (SCA) victims receive bCPR before paramedics arrive. Despite its life-saving potential, cultural norms, gender-related discomfort, and the lack of inclusive training deter individuals from intervening, contributing to persistent disparities in SCA outcomes.
Research Questions How do gender, body image, cultural and language barriers impact administration of bCPR? Can video-based community CPR education be tailored to overcome sociocultural barriers and improve confidence, efficacy and administration of bCPR in underserved populations?
Goals Analyze key sociocultural barriers and their intersectionality in bCPR. Review the efficacy of community and video-based CPR interventions in diverse populations. Propose an informed framework of an inclusive, community CPR education initiative, focusing on accessibility, cultural competence, and public engagement.
Methods Following PRISMA guidelines, articles described public attitudes or studied interventions surrounding video efficacy in bCPR training, community CPR initiatives, and/or demographic differences in SCA outcomes were included.
Results Of 643 initial publications, 54 were indexed: 18 on gender and body image, 16 on cultural and linguistic barriers, 8 on video training, 12 bystander training. Inequities in the administration and efficacy of bCPR for women, those with non-lean body habitus, or cultural minorities were found in 87% of reviewed papers. Perceived barriers included concerns about chest exposure, fear of victim injury, inadequate culturally adapted training on female or non-lean manikins, limited English proficiency, and fear of system distrust. Although video interventions successfully build skills with similar performance of CPR to instructor-led training, they do not address public perceptions around bCPR.
Conclusion Women and those with non-normative bodies are less likely to receive CPR due to social discomfort and non-inclusive training. Racial minorities face additional barriers including limited access to CPR education, language obstacles, and system distrust. While video resources improve skills and confidence, they often overlook critical sociocultural factors. Culturally tailored, inclusive, and sustainable programs are essential to improving CPR uptake and survival after cardiac arrest.
Leininger, Lyrissa
( UCLA DGSOM
, Los Angeles
, California
, United States
)
Agarwal, Savi
( UCLA DGSOM
, Los Angeles
, California
, United States
)
Harris, David
( UCLA DGSOM
, Los Angeles
, California
, United States
)
Author Disclosures:
Lyrissa Leininger:DO NOT have relevant financial relationships
| Savi Agarwal:DO NOT have relevant financial relationships
| David Harris:DO NOT have relevant financial relationships