The Effect of Psychological First Aid Training on Knowledge and Understanding about Psychosocial Support Principles: A Cluster-Randomized Controlled Trial.

Marit Sijbrandij,Joop De Jong,Kimberly Stam,Rebecca Esliker,Rebecca Horn,Leontien Ruttenberg,Fiona O'May,Relinde Reiffers,Alastair Ager

doi:10.3390/ijerph17020484

Abstract

Psychological first aid (PFA) is a world-wide implemented approach to helping people affected by an emergency, disaster, or other adverse event. Controlled evaluations of PFA’s training effects are lacking. We evaluated the effectiveness of a one-day PFA training on the acquisition and retention of knowledge of appropriate responses and skills in the acute aftermath of adversity in Peripheral Health Units (PHUs) in post-Ebola Sierra Leone. Secondary outcomes were professional quality of life, confidence in supporting a distressed person, and professional attitude. PHUs in Sierra Leone (n = 129) were cluster-randomized across PFA (206 participants) and control (202 participants) in March 2017. Knowledge and understanding of psychosocial support principles and skills were measured with a questionnaire and two patient scenarios to which participants described helpful responses. Professional attitude, confidence, and professional quality of life were assessed using self-report instruments. Assessments took place at baseline and at three- and six-months post-baseline. The PFA group had a stronger increase in PFA knowledge and understanding at the post-PFA training assessment (d = 0.50; p < 0.001) and at follow-up (d = 0.43; p = 0.001). In addition, the PFA group showed better responses to the scenarios at six-months follow-up (d = 0.38; p = 0.0002) but not at the post-assessment (d = 0.04; p = 0.26). No overall significant differences were found for professional attitude, confidence, and professional quality of life. In conclusion, PFA training improved acquisition and retention of knowledge and understanding of appropriate psychosocial responses and skills in providing support to individuals exposed to acute adversity. Our data support the use of PFA trainings to strengthen capacity for psychosocial support in contexts of disaster and humanitarian crisis. Future studies should examine the effects of PFA on psychosocial outcomes for people affected by crises.

Highlights

Psychological first aid (PFA) is an approach for assisting people in the immediate aftermath of disaster and humanitarian crisis to reduce initial distress and to foster short and long-term adaptive functioning [1]
This cluster-randomized controlled trial in Sierra Leone was part of a larger mixed-methods study on the effectiveness of the PFA training conducted in Liberia and Sierra
Our study evaluated whether PFA training, administered in community-based peripheral health care services in post-Ebola Sierra Leone, effectively impacted acquisition and retention of knowledge and understanding of appropriate psychosocial responses to individuals exposed to acute disaster and crisis, and improved knowledge on skills of how to apply these strategies

Summary

Introduction

Psychological first aid (PFA) is an approach for assisting people in the immediate aftermath of disaster and humanitarian crisis to reduce initial distress and to foster short and long-term adaptive functioning [1]. PFA is largely intended for use by helpers in contact with people recently impacted by distressing events. They may include staff or volunteers such as health workers not specialized in mental health and psychosocial support, community health workers, and teachers [2]. It is designed to promote elements that, according to expert consensus [8], are most crucial in the early aftermath of crisis. These elements are a sense of safety, calm, self-and community efficacy, connectedness, and hope [8]

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