A difference-in-differences analysis evaluated whether a year-long regional hands-only CPR community training initiative increased bystander CPR rates after OHCA in one large intervention county vs. two control counties, using CARES registry data from January 2022 to December 2024 (n=20,414; health-care-facility arrests excluded).
Overall bystander CPR rates rose from 37.4% to 42.5% in the intervention region, but the adjusted model found no significant overall effect (+2.94 percentage points; 95% CI −0.95 to 6.83). In public locations only, a significant +8.59 percentage-point increase was identified (95% CI 0.22 to 16.96); no significant effect was seen for home arrests or for survival to hospital discharge or neurologically intact survival.
Single intervention county limits generalizability. A concurrent rising trend in bystander CPR across all regions makes it hard to isolate the intervention's effect. The study cannot confirm whether the public-location finding reflects true causation or residual confounding.
Community CPR training programs may meaningfully increase bystander CPR in public settings, so targeting high-footfall public spaces could maximize impact. Reaching people for home cardiac arrests—where most OHCAs occur—remains an unsolved challenge that warrants separate strategies.
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