title: The experience of community first responders in co-producing rural health care: in the liminal gap between citizen and professional.
abstract: BACKGROUND
  The involvement of community first responders (CFRs) in medical emergencies in Scotland, and particularly in remote and rural areas, has expanded rapidly in recent years in response to geographical and organisational challenges of emergency medical service access. In 2013 there were over 120 active or developing schemes in a wide variety of settings. Community first responders are volunteers trained in First Person on the Scene (FPOS) first aid, administered prior to the arrival of an ambulance. Although there is limited literature which describes the role of first response, little academic literature has been published about the complexities of their specific role in both the community and organisational contexts.
  
  
  METHODS
  Here we reflect on data from two mixed-methods studies into the role of CFRs in Scotland.
  
  
  RESULTS
  We highlight findings that explore the liminal and complex role of the first responder as both 'practitioner' and community member, and how this contributes to a sense of communitas within the study areas. The rural context encompasses additional complexity in relation to the role of emergency care volunteer, having the highest levels of volunteering and this paper questions assumptions that rural areas, are more accepting of volunteerism.
  
  
  CONCLUSIONS
  Complexities arising from the experience of blurred voluntary/practitioner boundaries emerge as a key feature of voluntary participation in medical emergencies in this setting.
authors.affiliation: The Centre for Rural Health, Centre for Health Science, University of Aberdeen, Inverness IV2 3JH, Aberdeen, UK. a.roberts@abdn.ac.uk.
authors.forename: Anne
authors.initials: A
authors.lastname: Roberts
authors.forename: Amy
authors.initials: A
authors.lastname: Nimegeer
authors.forename: Jane
authors.initials: J
authors.lastname: Farmer
authors.forename: David J
authors.initials: DJ
authors.lastname: Heaney
mesh_terms: D000328:Adult; D004632:Emergency Medical Services; D005260:Female; D017144:Focus Groups; D006302:Health Services Research; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D009042:Motivation; D012380:Role; D019035:Rural Health Services; D012606:Scotland; D013997:Time Factors; D014838:Volunteers; D000078329:Workforce