University of Michigan Medical School, Ann Arbor, Michigan, USA
McKelvey School of Engineering, Washington University in St. Louis, St. Louis, Missouri, USA.
Emerg Med J. 2021 Jan;38(1):40-46. doi: 10.1136/emermed-2020-210076. Epub 2020 Oct 30.
The WHO recommends training lay first responders (LFRs) as the first step towards establishing emergency medical services (EMS) in low-income and middle-income countries. Understanding social and financial benefits associated with responder involvement is essential for LFR programme continuity and may inform sustainable development.
A mixed-methods follow-up study was conducted in July 2019 with 239 motorcycle taxi drivers, including 115 (75%) of 154 initial participants in a Ugandan LFR course from July 2016, to evaluate LFR training on participants. Semi-structured interviews and surveys were administered to samples of initial participants to assess social and economic implications of training, and non-trained motorcycle taxi drivers to gauge interest in LFR training. Themes were determined on a per-question basis and coded by extracting keywords from each response until thematic saturation was achieved.
Three years post-course, initial participants reported new knowledge and skills, the ability to help others, and confidence gain as the main benefits motivating continued programme involvement. Participant outlook was unanimously positive and 96.5% (111/115) of initial participants surveyed used skills since training. Many reported sensing an identity change, now identifying as first responders in addition to motorcycle taxi drivers. Drivers reported they believe this led to greater respect from the Ugandan public and a prevailing belief that they are responsible transportation providers, increasing subsequent customer acquisition. Motorcycle taxi drivers who participated in the course reported a median weekly income value that is 24.39% higher than non-trained motorcycle taxi counterparts (p<0.0001).
A simultaneous delivery of sustained social and perceived financial benefits to LFRs are likely to motivate continued voluntary participation. These benefits appear to be a potential mechanism that may be leveraged to contribute to the sustainability of future LFR programmes to deliver basic prehospital emergency care in resource-limited settings.
世界卫生组织（WHO）建议培训非专业急救人员（LFR）作为在低收入和中等收入国家建立紧急医疗服务（EMS）的第一步。了解与响应者参与相关的社会和经济利益对于 LFR 计划的连续性至关重要，并且可能为可持续发展提供信息。
在 2019 年 7 月，对 239 名摩托车出租车司机进行了一项混合方法的随访研究，其中包括 2016 年 7 月乌干达 LFR 课程的 154 名初始参与者中的 115 名（75％），以评估 LFR 培训对参与者的影响。对初始参与者的样本进行了半结构化访谈和调查，以评估培训的社会和经济影响，并对未受过 LFR 培训的摩托车出租车司机进行了调查，以了解他们对 LFR 培训的兴趣。在每个问题的基础上确定主题，并通过从每个回复中提取关键词对主题进行编码，直到达到主题饱和。
在课程结束三年后，初始参与者报告说，新知识和技能，帮助他人的能力以及信心的提高是激励他们继续参与该计划的主要好处。参与者的观点一致为积极，并且调查的 115 名初始参与者中有 96.5％（111/115）自培训以来使用了技能。许多人报告说，他们感觉到自己的身份发生了变化，现在除了摩托车出租车司机外，还将自己视为急救人员。司机们报告说，他们认为这导致了乌干达公众的更大尊重，并且普遍认为他们是负责任的交通提供者，从而增加了随后的客户获取量。参加过该课程的摩托车出租车司机报告说，他们的周收入中位数比未受过培训的摩托车出租车司机高 24.39％（p<0.0001）。
同时向 LFR 提供持续的社会和可感知的经济利益可能会激励他们继续自愿参与。这些好处似乎是一种潜在的机制，可用于为未来的 LFR 计划提供可持续性，以在资源有限的环境中提供基本的现场急救护理。
