Empowering Bystanders to Intervene: Trauma Responders Unify to Empower (TRUE) Communities

J Surg Res. 2019 Jun:238:255-264. doi: 10.1016/j.jss.2019.02.029.

Abstract

Background: Timely and effective bystander first aid can improve outcomes for trauma victims. Bystanders are present at most traumas and are more likely to assist with prior training.

Materials and methods: An evidence-based course was created for the general public in high-risk Chicago neighborhoods focused on basic traumatic first aid, including scene management, hemorrhage control, and mitigating the psychological impact of trauma to overcome the bystander effect. Prospectively, participants completed knowledge-based and self-efficacy assessments precourse, postcourse, and 6 mo follow-up. The change in self-efficacy and knowledge scores was analyzed.

Results: Over 32 courses, 503 participants were taught; 474 and 460 participants completed precourse and postcourse surveys, respectively, whereas 60 of 327 who consented for follow-up completed the 6-mo survey. Postcourse, participants were more likely to assist trauma victims and felt more confident in the quality of care they could provide; the effect remained significant at 6 mo (all P < 0.001). All seven self-efficacy empowerment-based questions individually demonstrated improvement from precourse to postcourse (P < 0.001), with an overall mean (SD) increase of 2.8 (2.1, P < 0.001); six maintained significance at follow-up with an overall mean increase of 2.8 (1.9, P < 0.001). Knowledge scores improved from 6.2 of 10 to 7.2 postcourse and 7.7 at follow-up (P < 0.001). Most improved were the ability to render first aid and apply tourniquets.

Conclusions: The TFRC increased self-efficacy, successfully teaching initial trauma care, particularly hemorrhage control and scene safety, suggesting that a grassroots approach to trauma care may improve outcomes in communities that experience high violence rates.

Keywords: Bystander effect; Immediate responders; Self-efficacy; Tourniquets; Trauma care.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Chicago
  • Child
  • Education, Nonprofessional / methods
  • Education, Nonprofessional / organization & administration*
  • Emergency Responders / education*
  • Emergency Responders / psychology
  • Empowerment*
  • Female
  • First Aid / psychology*
  • Follow-Up Studies
  • Health Plan Implementation
  • Humans
  • Male
  • Middle Aged
  • Program Development
  • Program Evaluation
  • Prospective Studies
  • Self Efficacy
  • Self-Assessment
  • Time Factors
  • Wounds and Injuries / therapy*
  • Young Adult