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).
Visão geral do estudo
Status
Condições
Intervenção / Tratamento
Descrição detalhada
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.
Tipo de estudo
Inscrição (Estimado)
Estágio
- Não aplicável
Contactos e Locais
Contato de estudo
- Nome: S.Ariane Christie, BA, MD
- Número de telefone: 808-430-9678
- E-mail: s.ariane.christie@gmail.com
Estude backup de contato
- Nome: Isaac Obeng-Gyasi, MBChB, MPH
- Número de telefone: 202-500-4230
- E-mail: iobeng@mednet.ucla.edu
Locais de estudo
-
-
Southwest
-
Limbe, Southwest, Camarões
- Limbe Health District
-
Contato:
- Frida E Nganje, MD, MPH
- Número de telefone: +237676641543
- E-mail: fridaembolo@gmail.com
-
-
Critérios de participação
Critérios de elegibilidade
Idades elegíveis para estudo
- Filho
- Adulto
- Adulto mais velho
Aceita Voluntários Saudáveis
Descrição
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.
Plano de estudo
Como o estudo é projetado?
Detalhes do projeto
- Finalidade Principal: Pesquisa de serviços de saúde
- Alocação: Não randomizado
- Modelo Intervencional: Atribuição sequencial
- Mascaramento: Nenhum (rótulo aberto)
Armas e Intervenções
Grupo de Participantes / Braço |
Intervenção / Tratamento |
|---|---|
|
Sem intervenção: 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.
|
Training of LFR providers using a data driven, pretested curriculum adapted for the Cameroon context over a 3-month training and transition period.
|
O que o estudo está medindo?
Medidas de resultados primários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
|
Prehospital care rate
Prazo: From enrollment through the 18-month post implementation period.
|
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.
|
Medidas de resultados secundários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
|
Systolic blood pressure at presentation
Prazo: From enrollment through the 18-month post implementation period.
|
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
Prazo: From enrollment through the 18-month post-implementation period
|
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
Prazo: From enrollment through the 18-month post implementation period.
|
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
Prazo: From enrollment through the 18-month post-implementation period.
|
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
Prazo: From enrollment through the 18-month post implementation period.
|
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
Prazo: From enrollment through 18-month post implementation period.
|
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
Prazo: From enrollment through 18-month post implementation period.
|
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.
|
Colaboradores e Investigadores
Datas de registro do estudo
Datas Principais do Estudo
Início do estudo (Estimado)
Conclusão Primária (Estimado)
Conclusão do estudo (Estimado)
Datas de inscrição no estudo
Enviado pela primeira vez
Enviado pela primeira vez que atendeu aos critérios de CQ
Primeira postagem (Real)
Atualizações de registro de estudo
Última Atualização Postada (Real)
Última atualização enviada que atendeu aos critérios de controle de qualidade
Última verificação
Mais Informações
Termos relacionados a este estudo
Palavras-chave
Termos MeSH relevantes adicionais
Outros números de identificação do estudo
- K01TW012689 (Concessão/Contrato do NIH dos EUA)
Plano para dados de participantes individuais (IPD)
Planeja compartilhar dados de participantes individuais (IPD)?
Informações sobre medicamentos e dispositivos, documentos de estudo
Estuda um medicamento regulamentado pela FDA dos EUA
Estuda um produto de dispositivo regulamentado pela FDA dos EUA
Essas informações foram obtidas diretamente do site clinicaltrials.gov sem nenhuma alteração. Se você tiver alguma solicitação para alterar, remover ou atualizar os detalhes do seu estudo, entre em contato com register@clinicaltrials.gov. Assim que uma alteração for implementada em clinicaltrials.gov, ela também será atualizada automaticamente em nosso site .
Ensaios clínicos em Lay First Responder (LFR) training
-
Madonna Rehabilitation HospitalAtivo, não recrutandoLesão Neurológica | Doenças ou Condições NeurológicasEstados Unidos