Health effects of training laypeople to deliver emergency care in underserviced populations: a systematic review protocol

Authors : Aaron M Orkin, Jeffrey D Curran, Melanie K Fortune, Allison McArthur, Emma J Mew1, Stephen D Ritchie, Stijn Van de Velde, David VanderBurgh



The Disease Control Priorities Project recommends emergency care training for laypersons in low-resource settings, but evidence for these interventions has not yet been systematically reviewed. This review will identify the individual and community health effects of educating laypeople to deliver prehospital emergency care interventions in low-resource settings.

Methods and analysis

This systematic review addresses the following question: in underserviced populations and low-resource settings (P), does first aid or emergency care training or education for laypeople (I) confer any individual or community health benefit for emergency health conditions (O), in comparison with no training or other forms of education (C)? We restrict this review to studies reporting quantitatively measurable outcomes, and search 12 electronic bibliographic databases and grey literature sources. A team of expert content and methodology reviewers will conduct title and abstract screening and full-text review, using a custom-built online platform. Two investigators will independently extract methodological variables and outcomes related to patient-level morbidity and mortality and community-level effects on resilience or emergency care capacity. Two investigators will independently assess external validity, selection bias, performance bias, measurement bias, attrition bias and confounding. We will summarise the findings using a narrative approach to highlight similarities and differences between the gathered studies.

Ethics and dissemination Formal ethical approval is not required.


The results will be disseminated through a peer-reviewed publication and knowledge translation strategy.

Citation: Aaron M Orkin, Jeffrey D Curran, Melanie K Fortune, Allison McArthur Health effects of training laypeople to deliver emergency care in underserviced populations: a systematic review protocol
BMJ Open 2016;6:e010609 doi:10.1136/bmjopen-2015-010609

Received: 22 November 2015 Revised: 15 March 2016 Accepted: 5 April 2016 Published: 18 May 2016

Copyright: This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:


AMO, DV, SDR and SVV developed the study concept and question. AMO and DV provided overall project leadership and management. JDC, AM and AMO developed the initial draft of the protocol, and all authors reviewed and refined the protocol manuscript. AM, DV, AMO and MKF developed and executed the search strategy. MKF, JDC and AMO developed and revised the protocol for PROSPERO registration. EJM and JDC developed the online review interface and reviewer training materials and managed manuscript submission.


This project received financial support from the Northern Ontario Academic Medicine Association Innovation Fund (Project #A-15-07).

Competing interests

AMO and DV declare a non-financial conflict of interest through their affiliation with the Remote Health Initiative, a non-profit entity dedicated to enhancing care in remote settings. SVV declares an intellectual conflict of interest through his authorship of the African First Aid Guideline.