General population’s intentions to perform public CPR: a structural equation modeling analysis based on the theory of planned behavior

Background Bystander cardiopulmonary resuscitation (CPR) plays a significant role in boosting survival rates among victims of out-of-hospital cardiac arrests. This study aimed to identify the key factors influencing the public’s intentions to perform CPR based on the Theory of Planned Behavior (TPB). Methods A cross-sectional survey was conducted in Shanghai, China, from May 1 to June 20, 2023. Structural equation modeling (SEM) was employed to analyze the relationships between the components of the Theory of Planned Behavior (TPB)—attitude, subjective norms (SN), and perceived behavioral control (PBC)—and CPR intention. Results Six hundred eighty-two participants were included in the study. All TPB constructs were found to have significant positive correlations with CPR intention ( r 2 > 0.36, p < 0.05). The SEM results confirmed that a favorable attitude was a strong predictor of intention ( β = 0.72). SN were significantly associated with both positive attitudes ( β = 0.65) and higher levels of PBC ( β = 0.58). The model exhibited good fit ( χ 2 /df < 3.0, RMSEA < 0.07, GFI/IFI/AGFI/CFI > 0.90). Furthermore, subgroup analyses revealed significant differences in attitude scores by gender (females: 90.3% ± 15.8% vs. males: 86.6% ± 21.9%, p = 0.01) and in intention scores by educational level (senior high school: 88.4% ± 14.3% vs. undergraduate: 78.7% ± 26.0%, p = 0.004). Conclusion Attitude and SN are the primary determinants of the public’s intention to perform CPR, with SN indirectly shaping intention via attitude and PBC. These findings provide support for TPB-guided interventions aimed at enhancing bystander readiness to perform CPR.