Data-Driven Lay First Responder Program in Cameroon (K-LFR Project)

Implementation of a Data-Driven Pre-Hospital Lay First Responder Program in Cameroon

Cameroon experiences a high burden of injury-related morbidity and mortality and currently lacks a formal pre-hospital care system. Lay First Responder (LFR) programs have been implemented in several low-and middle-income countries to improve early injury care by training non-medical community members with high exposure to injury, such as commercial drivers, in basic first aid and safe transport of injured patients.

The study aims to implement and evaluate a data-driven, context-adapted LFR program in Cameroon using an implementation science approach. Quantitative trauma registry data and qualitative stakeholder interviews will be used to adapt the LFR curriculum to local injury patterns and care gaps. LFR program implementation will be associated with increased chances of survival on presentation and improved trauma outcomes.

The study is an interrupted time series evaluation of an LFR intervention where prehospital care rates and clinical patterns in the Cameroon Trauma Registry (CTR) patients at Limbe Regional hospital will be compared between historical pre-implementation controls and post-implementation of a data-driven lay first responder training program (the intervention).

Study Overview

• Status: Not yet recruiting
• Conditions: Trauma; Injury
• Intervention / Treatment: Behavioral: Lay First Responder (LFR) training

Detailed Description

Injury accounts for a substantial proportion of preventable mortality in Cameroon, where no organized prehospital emergency medical system currently exists. Evidence suggests that effective prehospital care could prevent up to 45% of injury-related deaths. Lay First Responder (LFR) programs represent a pragmatic strategy for improving early trauma care in resource-limited settings by training lay persons who are frequently present at injury scenes.

Despite promising early results in other settings, rigorous evaluation of LFR programs has been limited, particularly regarding their impact on patient-level outcomes. This study aim to test the contextual feasibility of the lay first responder program in Cameroon, after it has been successful in other Sub-Saharan nations.

This study seeks to address these gaps by implementing a data-driven LFR program informed by trauma registry analysis and stakeholder engagement, and by evaluating feasibility, acceptability, and effectiveness within Cameroonian context.

The Cameroon Trauma Registry (CTR) gathers prospective data on patient demographics, injury characteristics, receipt of prehospital care, clinical findings and management, disposition and outcomes on patients admitted for injuries at ten trauma hospitals in Cameroon. Each hospital has a full-time research assistant overseen by an MPH-level field supervisor. Patients are followed from presentation through hospital discharge. This study will be implemented in Limbe municipality, Cameroon and will utilize data from the Limbe Regional Hospital site of the CTR.

The LFR intervention: An LFR curriculum adapted for the Cameroon context using a two-stage, mixed-methods approach (quantitative analysis of prospective CTR data and qualitative semi-structured interviews of target stakeholders) will be used to train LFR providers (commercial drivers and community members) over a 3-month training and transition period.

The primary metric of program feasibility will be percent change in the proportion of trauma patients receiving prehospital care in the post-intervention cohort compared to pre-intervention historical controls. The secondary outcomes for program effectiveness will be injury severity-stratified percentage change in the proportion of CTR patients presenting with normal vital signs (systolic blood pressure, heart rate, respiratory rate) in the post-intervention cohort compared to the pre-intervention cohort.

• Study Type: Interventional
• Enrollment (Estimated): 1812
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: S.Ariane Christie, BA, MD; Phone Number: 808-430-9678; Email: s.ariane.christie@gmail.com
• Study Contact Backup: Name: Isaac Obeng-Gyasi, MBChB, MPH; Phone Number: 202-500-4230; Email: iobeng@mednet.ucla.edu

Study Locations

• Cameroon
  • Southwest
    • Limbe, Southwest, Cameroon
      • Limbe Health District
      • Contact: Frida E Nganje, MD, MPH; Phone Number: +237676641543; Email: fridaembolo@gmail.com

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

- Trauma patients presenting to Limbe Regional Hospital and enrolled in the Cameroon Trauma Registry

Exclusion Criteria

- Trauma patients not included in the Cameroon trauma registry at Limbe regional hospital.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Health Services Research
• Allocation: Non-Randomized
• Interventional Model: Sequential Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
No Intervention: Pre-LFR implementation CTR cohort; Historic data of trauma patients enrolled during an 18-month pre-implementation period in Limbe Regional Hospital before the LFR training program commences.
Experimental: Post-LFR implementation CTR cohort; Trauma patients enrolled in the 18- month post-implementation period in Limbe Regional Hospital after the 3-month LFR provider training program and transition period has ended.	Behavioral: Lay First Responder (LFR) training; Training of LFR providers using a data driven, pretested curriculum adapted for the Cameroon context over a 3-month training and transition period.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Prehospital care rate	Proportion of hospitalized trauma patients who received prehospital care prior to arrival at participating hospitals, compared between pre- and post implementation LFR cohorts.	From enrollment through the 18-month post implementation period.

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Systolic blood pressure at presentation	Median systolic blood pressure (mmHg) measured at hospital presentation among injured patients, compared between pre- and post implementation LFR cohorts	From enrollment through the 18-month post implementation period.
Respiratory rate greater than 8 and less than 20 breaths per minute	Percentage change in the proportion of CTR patients presenting with respiratory rate greater than 8 and less than 20 breaths per minute compared between pre- and post implementation LFR cohorts.	From enrollment through the 18-month post-implementation period
Proportion of trauma patients with heart rate between 60 and 100 beats per minute	Percent change in the proportion of trauma patients with heart rate between 60 and 100 beats per minute compared between pre- and post implementation LFR cohorts.	From enrollment through the 18-month post implementation period.
In-hospital mortality	All-cause in-hospital mortality among injured patients, compared between pre- and post implementation LFR cohorts.	From enrollment through the 18-month post-implementation period.
24-hour mortality	All-cause mortality within 24 hours of hospital presentation among injured patients, compared between pre- and post implementation LFR cohorts.	From enrollment through the 18-month post implementation period.
Blood transfusion	Proportion of injured patients receiving blood transfusion during hospitalization, compared between pre- and post implementation LFR cohorts.	From enrollment through 18-month post implementation period.
Operative intervention	Proportion of injured patients requiring surgical intervention during hospitalization, compared between pre- and post implementation LFR cohorts.	From enrollment through 18-month post implementation period.

Collaborators and Investigators

• Sponsor: Sabrinah Christie
• Collaborators: University of California, Los Angeles; Fogarty International Center of the National Institute of Health; University of Buea

Study record dates

Study Major Dates

• Study Start (Estimated): September 1, 2026
• Primary Completion (Estimated): June 1, 2028
• Study Completion (Estimated): September 1, 2028

Study Registration Dates

• First Submitted: April 15, 2026
• First Submitted That Met QC Criteria: May 5, 2026
• First Posted (Actual): May 12, 2026

Study Record Updates

• Last Update Posted (Actual): May 12, 2026
• Last Update Submitted That Met QC Criteria: May 5, 2026
• Last Verified: May 1, 2026

More Information

Terms related to this study

• Keywords: Trauma; Emergency Care; Road Traffic Injury; Trauma systems; Lay First Resposnder; Pre-Hospital care; By-stander response
• Additional Relevant MeSH Terms: Wounds and Injuries
• Other Study ID Numbers: K01TW012689 (U.S. NIH Grant/Contract)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No