Harnessing Fear and Promoting Self-Efficacy in Response to Mass Casualty Scenarios: Evaluating Stop the Bleed at an Urban University.

Emergency situations range from everyday traffic accidents to incidents of mass gun violence and require individuals to be prepared and willing to act in times of crisis. To encourage people to help one another during such emergencies, the American College of Surgeons developed the Stop the Bleed (STB), a public health program based on the premise that bystanders who are properly trained to treat a victim's bleed injuries have greater chance of preventing hemorrhagic death rather than waiting for first responders to arrive. This study examined the uptake of STB among 117 urban university students located in the Midwestern United States who often feel the pressures of public safety as participants in surrounding city life. Guided by protection motivation theory (PMT), we explored how students' fear of potential mass casualty incidents, threat appraisals, and efficacy appraisals related to their bleed control knowledge acquisition immediately after completing STB training, as well as retention 12 weeks after the training concluded. Results indicated that participation in STB raised students' fears of mass casualty events and self-efficacy. Both factors significantly correlated with bleed control learning outcomes assessed immediately after the STB class; however, they did not predict later retention. We discuss our study's contributions to fear appeals research and PMT theory, before offering recommendations for future hemorrhage control programs, public safety, and prevention research.