Investigation and analysis of the situation and demand for first aid education in schools of Guangxi, China

To date, no study has systematically assessed the overall state of school‑based first‑aid education in Guangxi, China. This study investigated first‑aid education across diverse school types in Guangxi to address this research gap. A cross‑sectional epidemiological study was conducted. Stratified cluster sampling was used to enroll 2,783 teachers and students from 56 schools spanning 13 cities in Guangxi between June 2022 and March 2024. Data were collected via a self‑developed structured questionnaire with good reliability and validity (Cronbach’s α = 0.82; KMO = 0.90). The questionnaire covered five domains: sociodemographic characteristics, current status of school‑delivered first‑aid education, first‑aid knowledge and skill proficiency, training needs, and willingness to provide first aid. Descriptive statistics, chi‑square tests, and binary logistic regression were applied for data analysis to identify independent correlates of willingness to provide first aid. Substantial deficiencies exist in school-based first-aid education in Guangxi. Excluding medical colleges, no more than 25% of schools at other educational levels were equipped with automated external defibrillators (AEDs); 19.0% of respondents had never received first-aid training. Kindergarten personnel achieved a first-aid knowledge accuracy rate of only 43.2%, which was significantly lower than that of participants from other educational stages ( P < 0.01). Overall, 99% of participants reported a need for first-aid training, with cardiopulmonary resuscitation (CPR) as the most frequently requested topic, and over 60% were aware of Article 184 of the Civil Code of China. School type, availability of on-site first-aid facilities, prior training experience, and knowledge-acquisition channels were significantly associated with first-aid knowledge levels ( P < 0.05). Binary logistic regression revealed that medical schools (OR = 2.682), availability of emergency training facilities at school (OR = 1.335), participation in first-aid training within the past 2 years (OR = 2.631), learning pathways including paper materials (OR = 1.255), on-site training (OR = 1.460), first‑aid knowledge accuracy ≥ 80% (OR = 1.441), and awareness of Article 184 of the Civil Code of China (OR = 1.554) were independent influencing factors for willingness to provide first aid ( P < 0.05). Despite relatively high willingness to provide first aid and strong training demand among teachers and students, school-based first-aid education in Guangxi is hampered by incomplete curricular coverage, insufficient first-aid supplies and equipment, under-professionalized instructors, and fragmented training systems. Closing equipment shortages, implementing tiered first-aid training for all educational levels, building instructor capacity, adopting blended online-offline instruction, and improving public understanding of legal safeguards for good-faith rescue can effectively boost first-aid knowledge and on-scene first-aid willingness. These constitute core strategies for advancing the quality of school-based first-aid education in Guangxi.