{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T17:27:07Z","timestamp":1787074027448,"version":"build-2736575974"},"reference-count":20,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T00:00:00Z","timestamp":1786406400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study examined psychological and contextual determinants of public willingness to perform cardiopulmonary resuscitation (CPR) in Hubei Province using an extended theory of planned behavior (ETPB) framework and explored training-associated changes after standardized first-aid training.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A theory-driven cross-sectional survey with supplementary within-group pre-post training evaluation was conducted. Adults in Hubei Province were recruited between July 2022 and March 2023. The ETPB model included behavioral attitude, subjective norm, perceived behavioral control, implementation context, and facilitating conditions as predictors of CPR rescue intention. Confirmatory factor analysis and structural equation modeling were used to evaluate the theory-driven model. A supplementary exploratory multi-group SEM and path-by-path critical-ratio comparison were conducted to examine whether previous CPR\/AED training experience moderated specific ETPB pathways. Training-associated changes were assessed among participants attending an 8-h Hubei Red Cross first-aider program.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 2,156 valid questionnaires were analyzed. The ETPB scale showed acceptable preliminary reliability and validity. The structural model demonstrated acceptable fit and identified facilitating conditions and perceived behavioral control as the strongest predictors of CPR rescue intention, followed by subjective norm and behavioral attitude; implementation context was not significant. In the supplementary training evaluation, 652 participants completed paired assessments. Post-training improvements were observed in CPR\/AED knowledge, practical performance, confidence, AED-use willingness, and ETPB domain scores related to CPR rescue intention. The path-by-path critical-ratio comparison identified two moderated pathways: perceived behavioral control to CPR rescue intention was stronger among trained participants, whereas facilitating conditions to CPR rescue intention was stronger among untrained participants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Public CPR rescue intention in Hubei Province was shaped mainly by perceived competence and enabling conditions rather than by attitude alone. Previous CPR\/AED training experience moderated two key ETPB pathways. CPR promotion strategies should therefore strengthen perceived competence and confidence among trained laypeople, while improving accessible training opportunities and supportive learning conditions among untrained laypeople.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1851252","type":"journal-article","created":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T05:34:55Z","timestamp":1786426495000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Psychological and contextual determinants of public CPR intention in Hubei Province: an extended theory of planned behavior study"],"prefix":"10.3389","volume":"14","author":[{"given":"Kaiqi","family":"Chen","sequence":"first","affiliation":[{"name":"Union Hospital, Tongji Medical College, Huazhong University of Science and Technology","place":["Wuhan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruijing","family":"Xu","sequence":"additional","affiliation":[{"name":"Union Hospital, Tongji Medical College, Huazhong University of Science and Technology","place":["Wuhan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huiwen","family":"Wang","sequence":"additional","affiliation":[{"name":"Union Hospital, Tongji Medical College, Huazhong University of Science and Technology","place":["Wuhan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,11]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"846","DOI":"10.3969\/j.issn.1000-3614.2019.09.003","article-title":"Health China Action Promotion Committee (2019-2030): general requirements, major actions, and main indicators","volume":"34","year":"2019","journal-title":"Chin Circ J"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1005","DOI":"10.3969\/j.issn.1000-3614.2023.10.002","article-title":"Summary of the China cardiac arrest and cardiopulmonary resuscitation report (2022 edition)","volume":"38","year":"2023","journal-title":"Chin Circ J."},{"key":"ref3","doi-asserted-by":"publisher","first-page":"S366","DOI":"10.1161\/CIR.0000000000000916","article-title":"Part 3: adult basic and advanced life support: 2020 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care","volume":"142","author":"Panchal","year":"2020","journal-title":"Circulation"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"255","DOI":"10.15441\/ceem.21.066","article-title":"Global prevalence of cardiopulmonary resuscitation training among the general public: a scoping review","volume":"8","author":"Birkun","year":"2021","journal-title":"Clin Exp Emerg Med"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"e0193391","DOI":"10.1371\/journal.pone.0193391","article-title":"Attitudes towards bystander cardiopulmonary resuscitation: results from a cross-sectional general population survey","volume":"13","author":"Dobbie","year":"2018","journal-title":"PLoS One"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"e038712","DOI":"10.1136\/bmjopen-2020-038712","article-title":"Attitudes and willingness toward out-of-hospital cardiopulmonary resuscitation: a questionnaire study among the public trained online in China","volume":"10","author":"Jiang","year":"2020","journal-title":"BMJ Open"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1682","DOI":"10.1253\/circj.CJ-19-0065","article-title":"Public-access defibrillation and survival of out-of-hospital cardiac arrest in public vs residential locations in Japan","volume":"83","author":"Kiguchi","year":"2019","journal-title":"Circ J"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"e36928","DOI":"10.1097\/MD.0000000000036928","article-title":"Public knowledge and willingness in the use of public access defibrillation of Hubei Province in China: a cross-sectional study","volume":"103","author":"Chen","year":"2024","journal-title":"Medicine (Baltimore)"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"216","DOI":"10.1027\/2151-2604\/a000255","article-title":"How effective are behavior change interventions based on the theory of planned behavior? 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