Socio-Economic Status Has a Limited Association with Knowledge and Attitudes Towards Bystander Cardiopulmonary Resuscitation: A Cross-Sectional Study in North England

Abstract

Background: Bystander cardiopulmonary resuscitation (BCPR) is a critical link in the ‘Chain of Survival’, yet in the UK, is undertaken in only 40% of out of hospital cardiac arrests (OHCAs). Lower rates of BCPR have been correlated with lower socio-economic status (SES). This study aimed to explore how knowledge and attitudes about BCPR linked to SES across North East and North Cumbria in England.

Methods: Cross-sectional study between July-December 2021 surveying individuals from areas of varying SES.

Results: Six hundred and one individuals completed the survey instrument (mean age=51.9 years, range=18-95, standard deviation=17.7; 52.2% (n=313) female). Increased age was associated with being less willing to call 999 (p<0.001) and follow call handler advice (p<0.001). Female respondents were less comfortable performing BCPR than male respondents (p=0.006). Individuals from least deprived areas were less likely to report comfort performing CPR, (p=0.016) and less likely to know what a Public Access Defibrillator (PAD) is for, (p=0.025). Higher education level was associated with increased ability to recognise OHCA (p=0.005) and understanding of what a PAD is for (p<0.001). Individuals with higher income were more likely to follow advice regarding BCPR (p=0.017) and report comfort using a PAD (p=0.029).

Conclusion: SES is a poor indicator of knowledge, willingness, and perceived competency to perform BCPR. Policy makers should avoid using SES alone to target interventions and focus more on individual characteristics such as age and ethnicity. Future research should examine how cultural identity and social cohesion intersect with these characteristics to influence willingness to perform BCPR.

Note:

Funding Information: The study was funded by the National Institute for Health Research (NIHR) Applied Research Collaboration (ARC) North East and North Cumbria (NENC).

Declaration of Interests: None.

Ethics Approval Statement: Health Research Authority approval was not required as participants were members of the public in non-healthcare settings, and were not patients (IRAS: 299065, 4th May 2021). The study received ethical approval from NEAS Research Ethics Committee on 1st July 2021 (NEAS/2021/299065). Willing participants provided verbal consent prior to completion of the survey instrument.

Keywords: Cardio pulmonary resuscitation, bystander help, defibrillator, deprivation