Latent profile analysis identified four distinct psychosocial profiles related to bystander resuscitation willingness among Macao residents, with perceived behavioral control playing a central role and prior training and younger age associated with membership in the proactive profile.
Key Findings
Results
Latent profile analysis identified four distinct psychosocial profiles related to bystander resuscitation among Macao community residents.
The four profiles were labeled: reluctant, socially inhibited, technically constrained, and proactive.
The study used a cross-sectional online survey recruiting 579 community-dwelling adults through convenience and snowball sampling.
Profiles were derived using Theory of Planned Behavior (TPB) constructs as indicator variables.
A person-centered analytic approach was used rather than the more common variable-centered approach to capture individual-level heterogeneity.
Results
Willingness to provide bystander resuscitation varied significantly across the four psychosocial profiles.
The proactive group demonstrated the highest willingness to provide bystander resuscitation.
The reluctant group demonstrated the lowest willingness to provide bystander resuscitation.
Profiles differed in their combinations of attitudes, subjective norms, and perceived behavioral control (PBC).
The variation across profiles underscores that aggregate variable-centered approaches may mask meaningful subgroup differences.
Results
Socially inhibited individuals showed high perceived behavioral control despite low subjective norms.
This profile suggests individuals who feel technically capable but lack social or normative support for performing bystander resuscitation.
Low subjective norms indicate these individuals perceive limited social pressure or encouragement from others to act.
This pattern highlights that social influence factors operate independently from perceived capability in some subgroups.
This profile represents a distinct combination of TPB constructs not easily captured by variable-centered methods.
Results
Technically constrained individuals demonstrated low perceived behavioral control despite favorable attitudes and subjective norms.
This profile describes individuals who are motivated and socially encouraged to perform bystander resuscitation but lack confidence in their ability to do so.
Low PBC in this group suggests perceived skill deficits or lack of training as primary barriers.
Despite positive attitudes and supportive subjective norms, low PBC appears to suppress willingness to act.
This finding highlights PBC as a potentially critical modifiable target for intervention in this subgroup.
Results
Lack of prior resuscitation training was associated with lower odds of belonging to the proactive profile.
Multinomial logistic regression was used to examine socio-demographic factors associated with profile membership.
Prior resuscitation training was a significant predictor of proactive profile membership.
Individuals without prior training were less likely to be classified in the proactive group compared to those with training.
This finding supports the role of formal training in shaping psychosocial readiness for bystander resuscitation.
Results
Older age was associated with lower odds of belonging to the proactive bystander resuscitation profile.
Age was identified as a significant socio-demographic predictor of profile membership in multinomial logistic regression.
Older residents were less likely to be classified in the proactive group.
This finding suggests age-specific barriers to bystander resuscitation willingness that may need to be addressed through tailored strategies.
The authors highlight the value of 'profile- and age-specific training strategies to enhance community bystander resuscitation willingness.'
Results
Perceived behavioral control was identified as playing a central role across bystander resuscitation psychosocial profiles.
PBC distinguished profiles in important ways: it was high in the socially inhibited group and low in the technically constrained group.
The proactive group was characterized by favorable combinations of all TPB constructs including PBC.
The reluctant group had the least favorable psychosocial profile overall.
The authors conclude that findings 'underscore the central role of PBC' in bystander resuscitation willingness.
Background
The study was conducted in Macao, a region where rates of bystander CPR and public access defibrillation remain suboptimal.
Macao is identified as an Asian region where BCPR and PAD rates are suboptimal.
The study recruited 579 community-dwelling adults through convenience and snowball sampling.
The survey was conducted online using a cross-sectional design.
The authors note that suboptimal BCPR and PAD rates are a broader problem across many Asian regions.
What This Means
This research suggests that people's willingness to perform CPR or use a defibrillator on a stranger in an emergency is not uniform — it clusters into distinct psychological types. Using a survey of 579 adults in Macao and a statistical method called latent profile analysis, the researchers identified four groups: 'reluctant' people who had generally low motivation and confidence; 'socially inhibited' people who felt capable but didn't feel social pressure to act; 'technically constrained' people who wanted to help and felt socially supported but lacked confidence in their skills; and 'proactive' people who scored well across all psychological factors and showed the highest willingness to act. This person-centered approach revealed that different people face different psychological barriers to bystander resuscitation, which a simple one-size-fits-all analysis might miss.
Two key factors predicted whether someone belonged to the proactive group: having received prior resuscitation training and being younger. People without prior CPR training and older adults were significantly less likely to fall into the proactive category. A particularly important finding was that 'perceived behavioral control' — essentially, a person's confidence in their ability to actually perform resuscitation — was the psychosocial factor that most clearly differentiated the groups. For instance, technically constrained individuals had positive attitudes and social support but still held back because they didn't trust their own skills, while socially inhibited individuals were confident but lacked a sense that others expected them to act.
This research suggests that public health campaigns and training programs aimed at increasing bystander CPR rates should not use a single universal approach. Instead, interventions may be more effective if they target the specific psychological barriers each group faces — for example, skill-building training for technically constrained individuals, and social norm messaging for socially inhibited individuals. The findings also suggest that age-tailored strategies may be needed to engage older community members, and that expanding access to resuscitation training could meaningfully shift more people into the proactive category.
Wong K, Che S, Mao A, Chao K. (2026). Psychosocial profiles of bystander resuscitation among Macao residents: a latent profile analysis.. Frontiers in public health. https://doi.org/10.3389/fpubh.2026.1867128