ABSTRACTS
Sociocultural Barriers to Effective Bystander CPRAuthor: Savi Agarwal | Medical Student | UCLA David Geffen School of Medicine Associate Authors: Leininger, Lyrissa
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. This review aims to analyze key sociocultural barriers and their intersectionality in bCPR, review the efficacy of community and video-based CPR interventions in diverse populations, and propose an informed framework of an inclusive, community CPR education initiative, focusing on accessibility, cultural competence, and public engagement. Methods Following PRISMA guidelines, we included articles describing public attitudes or studied interventions surrounding gender, body image, cultural and language barriers impact, video efficacy in bCPR training, community CPR initiatives, and/or demographic differences in SCA outcomes. Publications were analyzed to understand key sociocultural barriers and their intersectionality in bCPR and the efficacy of community and video-based CPR interventions in diverse populations. Results From 643 initial publications, 51 were indexed: 18 on gender and body image, 16 on cultural and linguistic barriers, 8 on video training, 12 on 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 current video interventions successfully build skills with similar CPR performance 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.
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