A prospective cohort study of the one-year mental health outcomes among lay first responders in Lagos, Nigeria

Injuries are a significant global health concern, particularly in low- and middle-income countries (LMICs), where road traffic injuries (RTIs) substantially contribute to injury-related mortality. LMICs may lack access to robust emergency medical services (EMS), making the training of lay first responders (LFRs) critical to supporting ongoing EMS development. While some evidence for the effectiveness of LFR programs exists, little is known about the mental health impacts of being an LFR, as well as the psychosocial characteristics of people who volunteer to become LFRs. This exploratory study reports baseline psychosocial characteristics and one-year follow-up outcomes from a planned five-year prospective cohort of LFRs in Lagos, Nigeria. The study collected data including demographic information, mental health status, social support, self-efficacy, exposure to prior traumatic experiences, and altruism from 25 lay first responders in Lagos. Results show that LFRs reported high levels of positive mental health, self-efficacy, and social support. Men indicated higher levels of social support (B = 2.42, p  = 0.026) and self-efficacy (B = 1.77, p  = 0.045) than women, and prior exposure to trauma was negatively associated with self efficacy at follow-up (B = -0.17, p  = 0.037) (simple linear model, gender coded 0 = female, 1 = male). These findings demonstrate the feasibility of longitudinal psychosocial assessment and analysis in LFR populations in LMIC settings, and may assist in identifying ‘super-responders’, assessing the risk of psychological distress, helping improve LFR training programs in LMIC settings.