Abstract
OBJECTIVE: Schools are high-risk environments for children's accidents, and teachers, as first responders, play a crucial role in providing timely assistance. Given the low incidence of bystander cardiopulmonary resuscitation (CPR) in China, this study aims to evaluate the CPR knowledge and intention to perform CPR among school staff and identify influencing factors. METHODS: A cross-sectional online survey was conducted from April to June 2022 among 639 kindergarten staff in Changsha, China. The questionnaire evaluated demographics, prior CPR training, knowledge levels, and factors influencing the intention to perform CPR using the Theory of Planned Behavior (TPB). RESULTS: Among participants, 77.6% reported prior CPR training, predominantly workplace-organized (64.4%) and combining theoretical-practical instruction (72.3%). Knowledge levels averaged 4.7/10, with pronounced deficiencies in AED application (18.8% accuracy). Willingness to perform CPR on strangers was expressed by 71.7% of respondents. Multivariate analysis identified stronger CPR intention among staff aged 35-44 years, those with familial cardiac risk factors, and individuals with superior knowledge (p < 0.05). Structural equation modeling revealed that perceived behavioral control (β = 0.371, p < 0.001), subjective norms (β = 0.368, p < 0.001), and attitudes (β = 0.078, p = 0.031) significantly predicted CPR intention (total R (2) = 49.9%), while perceived risk had no significant effect (β = -0.007, p = 0.840). CONCLUSIONS: Changsha's kindergarten staff exhibit substantial CPR knowledge, strongly linked to prior training. The findings underscore the necessity for standardized, recurrent CPR education programs and enhanced legal protections to optimize bystander intervention rates in school settings.