Community First Responders' Role in the Current and Future Rural Health and Care Workforce

NCT04279262 | Completed

• 1 other identifier: 20002
• Study Type: observational
• Target: 83,995
• Locations: 1 country
• Sites: 1

Brief Summary

Community First Responders (CFRs) are trained members of the public, lay people or off-duty healthcare staff who volunteer to provide first aid. CFRs help ambulance services to provide care for people having health emergencies, from falls to road accidents to heart attacks, at home or in public places. CFRs are particularly important in rural areas where it is more difficult to provide or access emergency care, and where they are an important part of the care workforce. CFRs are broadly perceived to be positive, however evidence is needed about how they contribute to rural health services, which patients/conditions they attend, what care they provide, how effective they are and at what cost, how they are perceived by patients and other health workers, and how they could be developed to improve care for rural communities. The investigators aim to develop recommendations for rural CFRs, by exploring their contribution to rural care, evaluating their value for money, understanding experiences and views of patients, CFRs and other healthcare staff, and exploring the potential for CFRs to provide new services.

Conditions

Emergency Medical Services

Keywords

Community first responder; Rural health; Ambulance service

Outcome Measures

Primary Outcomes (5)

• Number of ambulance calls that CFRs attend in one year

  We will establish how many people CFRs attended and work out the proportion of ambulance calls attended.

  we will evaluate all emergency attendances during one year

• The type of cases treated by CFRs

  characteristics of people (age, sex, condition) attended

  we will evaluate all emergency attendances during one year

• How quickly cases are dealt with

  how quickly they attend

  we will evaluate all emergency attendances during one year

• Treatments given and transfer to hospital

  we will evaluate the treatments provided and the number of cases transferred to hospital

  we will evaluate all emergency attendances during one year

• Locations

  We will describe rurality and location (eg. at home or elsewhere) where CFRs give treatment.

  we will evaluate all emergency attendances during one year

Secondary Outcomes (1)

• Perceptions of CFR schemes

  participants will have been involved in a CFR attendance in the previous 6 months

Study Arms (5)

Anonymised records from 6 ambulance services

The total available sample for analysis for this cohort is estimated to be at least 50,000 incidents across 6 ambulance trusts. The investigators will describe the epidemiology of CFR provision to rural health areas using an anonymised dataset.

Other: attendance by community first responders for medical emergencies

Interviews with patients (and/or relatives)

The investigators will interview about 15-20 patients (and/or relatives) who have been attended by CFRs.

Other: attendance by community first responders for medical emergencies

Interviews with CFRs

The investigators will interview about 15-20 CFRs/ CFR scheme leaders.

Interviews with Ambulance staff

The investigators will interview about 15-20 ambulance staff who have experience of working with CFRs.

Interviews with GPs and commisioners

The investigators will interview about 10-15 GPs and ambulance service commissioners.

Interventions

attendance by community first responders for medical emergencies OTHER

The investigators will purposively sample patients, relatives, and ambulance staff identified from records of patients who have been attended by a CFR in a rural location in the previous six months. Where possible the investigators will interview patients, relatives, CFRs and ambulance staff attending the same event. GPs will be purposively sampled from rural areas of the ambulance services involved. Investigators will recruit a maximum variation sample of patients (according to age, sex, condition, and ethnicity), ambulance staff (sex, experience, ethnicity and role), CFR (sex, ethnicity, length of experience, skill level) and CFR scheme leads (independent charity and ambulance trust overseen schemes).

Anonymised records from 6 ambulance services; Interviews with patients (and/or relatives)

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

For the interview studies the investigators will purposively sample patients, relatives, and ambulance staff identified from records of patients who have been attended by a CFR in a rural location in the previous six months. Where possible the investigators will interview patients, relatives, CFRs and ambulance staff attending the same event. GPs will be purposively sampled from rural areas of the ambulance services involved. The investigators will recruit a maximum variation sample of patients (according to age, sex, condition, and ethnicity), ambulance staff (sex, experience, ethnicity and role), CFR (sex, ethnicity, length of experience, skill level) and CFR scheme leads (independent charity and ambulance trust overseen schemes).

You may qualify if:

• Adults capable of giving informed consent. The investigators will recruit a maximum variation sample of patients (according to age, sex, condition, and ethnicity), ambulance staff (sex, experience, ethnicity and role), CFR (sex, ethnicity, length of experience, skill level) and CFR scheme leads (independent charity and ambulance trust overseen schemes).

You may not qualify if:

• The investigators will exclude children and adults who are unable to give informed consent from this study.
• London Ambulance Service NHS Trust is not included as it is mainly urban; East of England Ambulance Service and North East Ambulance Service are not included because of lack of electronic data.

Sponsors & Collaborators

• University of Lincoln: lead

Study Sites (1)

Community and Health Research Unit, University of Lincoln

Lincoln, Lincolnshire, LN5 7AY, United Kingdom

Location

Related Publications (1)

• Siriwardena AN, Patel G, Botan V, Smith MD, Phung VH, Pattinson J, Trueman I, Ridyard C, Hosseini MP, Asghar Z, Orner R, Brewster A, Mountain P, Rowan E, Spaight R. Community First Responders' role in the current and future rural health and care workforce: a mixed-methods study. Health Soc Care Deliv Res. 2024 Jul;12(18):1-101. doi: 10.3310/JYRT8674.

  PMID: 39054745 DERIVED

Study Officials

• Niro Siriwardena

  University of Lincoln, UK

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: January 23, 2020
• First Posted: February 21, 2020
• Study Start: June 1, 2020
• Primary Completion: May 1, 2022
• Study Completion: December 3, 2022
• Last Updated: December 16, 2024

Record last verified: 2022-05

Data Sharing

• IPD Sharing: Will not share

Locations

GB (1)