Implementation of a data-driven pre-hospital lay first responder program in Cameroon

项目摘要/摘要 实施有效的院前医疗护理可以防止超过一半的伤害相关死亡。作为第一步 为了发展院前护理系统，几个低收入和中等收入国家(LMIC)在次 撒哈拉非洲(SSA)建立了非医疗专业人员的非医疗急救员(LFR)培训计划 具有高暴露伤的急救和安全运送伤员的特点。虽然有希望，但缺乏 SSA的研究基础设施和医疗记录对可行性和 实施LFR在提高院前护理质量方面的有效性。喀麦隆是不成比例的 受伤害影响，缺乏院前护理系统，可能导致治疗延误，是可以预防的 发病率和死亡率。制定基层第一响应者计划可以增加获得 院前护理和促进及时治疗受伤，但只有在可行和有效的情况下 喀麦隆的情况。这项研究的长期目标是减少与伤害相关的负担 喀麦隆。这项研究的总体目标是在喀麦隆增加获得高质量院前创伤护理的机会 通过使用实施科学方法来开发和评估数据驱动的LFR计划 喀麦隆。研究假设是，数据适配层First Responder计划的实施是一个 增加喀麦隆受伤患者获得院前护理的可行和有效方法。 为了实现我们的目标，本研究将追求三个具体目标：1)开发适合喀麦隆的LFR 使用两阶段、混合方法的方案；2)评估LFR方案实施的可行性 喀麦隆的情况；以及3)评估在喀麦隆实施LFR方案的有效性 背景。验证LFR是增加院前护理机会的可行手段将消除主要的 在提供及时的创伤护理方面遇到障碍，并为减少 对这群人的伤害。了解LFR实施、生理参数之间的关联 结果将使LFR培训能够在了解数据的情况下反复改进。一种可重现材料的研制 可以迅速扩展LFR的上下文适应方法，以便在整个喀麦隆更广泛地实施 并在其他LMIC上下文和扇区中进行验证。

Project Summary/Abstract Implementing effective prehospital medical care could prevent over half of injury-related deaths. As a first step toward development of prehospital care systems, several low- and middle-income countries (LMIC) in sub- Saharan Africa (SSA) have instituted lay first responder (LFR) programs training non-medical professionals with high exposure to injury in first aid and safe transport of injured patients. Although promising, lack of research infrastructure and medical records in SSA has limited prior evaluation of the feasibility and effectiveness of LFR implementation in increasing quality prehospital care. Cameroon is disproportionately affected by injury and lacks a prehospital care system, likely contributing to treatment delays and preventable morbidity and mortality. Development of a lay first responder program could increase access to prehospital care and facilitate timely treatment of injuries but only if it is feasible and effective for the Cameroonian context. The long-term goal of this research is to reduce the burden associated with injury in Cameroon. This study’s overall objective is to increase access to quality prehospital trauma care in Cameroon by using an implementation science approach to develop and evaluate a data-driven LFR program in Cameroon. The study hypothesis is that is implementation of a data-adapted lay first responder program is a feasible and effective method of increasing access to prehospital care among injured Cameroonian patients. To accomplish our objective, this study will pursue three specific aims: 1) Develop a Cameroon-adapted LFR program using a two-stage, mixed-methods approach; 2) Evaluate feasibility of LFR program implementation in the Cameroonian context; and 3) Evaluate effectiveness of LFR program implementation in the Cameroonian context. Validating LFR as a feasible means to increase access to prehospital care will remove a major roadblock in delivering timely trauma care and provide a critical target for reducing the detrimental impact of injury on this population. Understanding associations between LFR implementation, physiologic parameters and outcomes will allow data-informed, iterative improvement of LFR training. Development of a reproducible method for context-adaptation of LFR could be rapidly scaled for wider implementation throughout Cameroon and validated in other LMIC contexts and sectors.