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Effect of Psychological First-Aid Training on Psychological First-Aid Knowledge among Community Health Workers in Nigeria

Abstract

Psychological distress may occur following emergencies, disasters, violence, accidents, disease outbreaks, displacement, bereavement, and other adverse events, making early psychosocial support an important component of community health and emergency response. Community health workers are often among the first health personnel to interact with individuals and families experiencing distress, particularly in communities where access to specialized mental health professionals is limited. However, inadequate training in psychological first aid may limit community health workers' ability to recognize acute psychological distress, communicate appropriately, provide basic supportive assistance, and facilitate referral to appropriate services. Psychological first-aid training provides an opportunity to strengthen community health workers' knowledge and preparedness for providing immediate, humane, practical, and culturally appropriate psychosocial support. Against this background, this study investigates the effect of psychological first-aid training on psychological first-aid knowledge among community health workers in Nigeria. The study will be anchored on Social Cognitive Theory, Experiential Learning Theory, and the Health Belief Model. Social Cognitive Theory emphasizes the roles of knowledge, self-efficacy, observational learning, and environmental influences in shaping community health workers' preparedness to provide psychological first aid. Experiential Learning Theory emphasizes learning through practical demonstrations, guided practice, reflection, and application, making it relevant to psychological first-aid training. The Health Belief Model explains how health workers' perceptions of psychological emergencies, perceived severity of psychological distress, perceived benefits of psychological first-aid training, perceived barriers, and cues to action may influence their willingness to acquire and apply psychological first-aid knowledge. Collectively, these theoretical perspectives provide a suitable framework for explaining how psychological first-aid training may influence psychological first-aid knowledge among community health workers in Nigeria. The study will adopt a quantitative quasi-experimental or analytical cross-sectional research design. The study population will comprise community health workers providing services in selected communities and primary healthcare settings across Nigeria. A multistage sampling technique will be used to select states, local government areas, communities, primary healthcare centres, and eligible community health workers. Psychological first-aid training will be measured using indicators such as exposure to structured training, training duration, number of training sessions, theoretical instruction, practical demonstrations, role-playing exercises, scenario-based learning, recognition of psychological distress, principles of psychological first aid, appropriate communication, active listening, emotional support, practical assistance, safety assessment, referral procedures, self-care, confidentiality, cultural sensitivity, and access to training materials. Psychological first-aid knowledge will be assessed using indicators such as knowledge of the principles of psychological first aid, recognition of acute psychological distress, appropriate communication techniques, active listening, identification of immediate needs, provision of practical support, promotion of safety, appropriate referral, maintenance of confidentiality, recognition of situations requiring specialized professional intervention, and awareness of limitations of psychological first aid. Data will be collected using structured questionnaires and appropriately validated psychological first-aid knowledge assessment instruments administered before and after the training intervention where a quasi-experimental design is used. Descriptive statistics will be used to summarize participants' demographic and professional characteristics, previous psychological first-aid exposure, baseline knowledge, and post-training knowledge levels. Inferential statistical techniques, including paired or independent sample tests, chi-square tests, correlation analysis, and multiple regression analysis where appropriate, will be used to determine the effect of psychological first-aid training on psychological first-aid knowledge. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that psychological first-aid training has a significant positive effect on psychological first-aid knowledge among community health workers in Nigeria. Community health workers exposed to structured psychological first-aid training are expected to demonstrate improved knowledge of psychological distress recognition, supportive communication, active listening, immediate needs assessment, practical assistance, safety promotion, referral procedures, confidentiality, and culturally appropriate support compared with their baseline knowledge or health workers without similar training. Practical demonstrations, role-playing, and scenario-based learning are expected to strengthen participants' understanding and confidence in applying psychological first-aid principles in real-world situations. Improved knowledge may enhance community health workers' preparedness to provide appropriate initial support while connecting distressed individuals with family, community, primary healthcare, or specialized mental health services as required. However, limited access to trained instructors, inadequate training resources, heavy workloads, insufficient refresher training, limited referral services, and misconceptions about psychological first aid may affect the sustainability and application of acquired knowledge. The study therefore expects structured, practical, culturally appropriate, and periodic psychological first-aid training to contribute significantly to improved psychological first-aid knowledge among community health workers in Nigeria. The study is expected to contribute to the literature on psychological first-aid training, psychological first-aid knowledge, community health workers, community mental health, emergency preparedness, psychosocial support, mental health promotion, disaster response, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, National Primary Health Care Development Agency, state ministries of health, primary healthcare centres, community health worker programmes, emergency management agencies, mental health professionals, public health practitioners, humanitarian organizations, development partners, and policymakers regarding strategies for strengthening community-level psychosocial support. The study will also provide evidence-based recommendations for integrating psychological first-aid training into community health worker education and continuing professional development, strengthening practical and scenario-based training, providing refresher courses, improving referral pathways, increasing access to training materials, promoting culturally appropriate psychosocial support, and establishing sustainable community-based psychological first-aid capacity across Nigeria.

Keywords: Psychological first-aid training, psychological first-aid knowledge, community health workers, psychosocial support, community mental health, emergency preparedness, mental health promotion, psychological distress, health-worker training, Nigeria, public health.