Evaluation of a community paramedicine health promotion and lifestyle risk assessment program for older adults who live in social housing: a cluster randomized trial

Agarwal, Gina; Angeles, Ricardo; Pirrie, Melissa; McLeod, Brent; Marzanek, Francine; Parascandalo, Jenna; Thabane, Lehana

doi:10.1503/cmaj.170740

Cited by 62 publications

(93 citation statements)

References 25 publications

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“…From the participants, 15% managed to drop one Canadian Diabetes Risk assessment (CANRISK) score during the intervention. During 2 years, the EMS calls from those apartments decreased 25% . Abrashkin et al.…”

Section: Resultsmentioning

confidence: 99%

“…The long-term patients have been frequently transported to ED which could have been an uncomfortable and unfamiliar environment, with risks of acute infection including lengthy periods waiting on the uncomfortable ambulance stretcher. Community paramedics either took care of the patient at home or transported him/her direct to receiving unit or department; avoiding waiting time in ED (11,22,27,29,30,(32)(33)(34)(35).…”

Section: Patient-centred Preventionmentioning

confidence: 99%

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The core components of Community Paramedicine – integrated care in primary care setting: a scoping review

Rasku

Kaunonen

Thyer

et al. 2019

Scandinavian Caring Sciences

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Background Since the beginning of 2000, the primary healthcare services around the globe are challenged between demands of home care and number of staff delivering it. The delivery of healthcare needs new models to reduce the costs, patient's readmission and increase their possibilities to stay at home. Several paramedicine programmes have been developed to deliver home care as an integral part of the local healthcare system. The programmes varied in nature and the concept of Community Paramedicine (CP) has not been established, demanding clarity. The aim of this review was to identify and describe the core components of CP, and identify research gaps for the further study. Method A scoping review was performed using five electronic databases: Medline; CINAHL; Academic Search Premier; PubMed and the Cochrane Library for the period 2005 – June 2018. The references of articles were checked, and papers were assessed against inclusion criteria and appraised for quality. Results From 803 initial articles, 21 met the criteria and were included. Inductive content analysis was carried out. The four core components of Community Paramedicine emerged (a) Community engagement, (b) Multi‐agency collaboration, (c) Patient‐centred prevention and (d) Outcomes of programme: cost‐effectiveness and patients’ experiences. Conclusion The Community Paramedicine programmes are perceived to be promising. However, Community Paramedicine research data are lacking. Further research is required to understand whether this novel model of healthcare is reducing costs, improving health and enhancing people's experiences.

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Section: Resultsmentioning

confidence: 99%

Section: Patient-centred Preventionmentioning

confidence: 99%

The core components of Community Paramedicine – integrated care in primary care setting: a scoping review

Rasku

Kaunonen

Thyer

et al. 2019

Scandinavian Caring Sciences

View full text Add to dashboard Cite

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“…7 The study by Agarwal and colleagues shows that patients with chronic conditions can benefit from improved access to health care resources and services in a familiar setting through the establishment of trusting relationships with local providers of paramedic services. 6 The trial further highlights the potential value of deploying a low-cost community paramedicine intervention in a high-risk social-housing setting, because it showed a significant difference in the number of ambulance calls between participants who received the intervention (i.e., attending the CP@ clinic) and controls.…”

mentioning

confidence: 95%

“…1,5 In linked research, Agarwal and colleagues describe a cluster randomized trial of a preventive wellness clinic-based model of community paramedicine within social-housing buildings. 6 The trial's Community Paramedicine at Clinic (CP@clinic) chronic disease risk assessment and management program is a unique example of a partnership between community paramedics, primary care and providers of social housing to address a variety of unmet patient needs among a vulnerable population that are frequent users of 911 services and characterized as having higher mortality rates and poorer health-related quality of life and health because of higher rates of chronic disease among this population. This trial contributes further empiric evidence about the effect and potential for widespread adoption of community paramedicine programs.…”

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confidence: 99%

Community paramedicine is growing in impact and potential

Nolan

Sinha

2018

CMAJ

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“…Implementing a health promotion program targeting the elderly tenants in subsidized housing has many challenges (6)(7)(8). Social Network Analysis (SNA) can be a useful method to understand the role of interpersonal dynamics between residents and their impact on attendance in health promotion programs such as CHAP (9).…”

Section: Introductionmentioning

confidence: 99%

Participation in Cardiovascular Health Awareness Program (CHAP) by the Elderly Residents of Social Housing in Quebec: Social Network Analysis

Deville‐Stoetzel¹,

Kaczorowski

Agarwal

et al. 2020

Preprint

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Background: The Cardiovascular Health Awareness Program (CHAP) was originally developed and evaluated as a community-based cardiovascular disease (CVD) prevention program in small to medium size communities in Ontario. Recently, CHAP has been adapted to target older individuals living in 14 social housing buildings in Ontario (7) and Quebec (7). The participation rates in the 10-months program varied across buildings in Quebec from 23.5% to 49.1%. Social network analysis (SNA) has been successfully used to assess and strengthen participation in health promotion programs. We applied SNA methods to investigate whether interpersonal relationships between tenants within buildings influence the participation in CHAP. Methods: We used sociometric questionnaires and complete network analysis, supplemented by qualitative interviews to examine relational dynamics of two buildings in Quebec with a low and a high attendance rates. All residents of the two buildings were eligible to be interviewed for the sociometric questionnaire. The participants for the qualitative part of the study were selected at random. Results: In total, 69 seniors participated in the study, including qualitative interviews. Among study participants selected for qualitative interviews, 10 attended almost all CHAP sessions, 10 attended once and 12 did not attend any. Quantitative results helped to identify well-known and appreciated local leaders. In building 1 which had a high attendance rate (34.3%), there was a main leader (In-degree or ‘named by others’ frequency 23.2%) who attended all sessions. In building 2 which had a low attendance rate (23.9%), none of the leaders had participated in CHAP sessions. Qualitative analysis showed that tenants who did not attend CHAP sessions (or other activities in the building) generally preferred to avoid conflicts, retaliation and gossip and did not want to get involved in clans and politics within the buildings. Conclusion: In order to increase attendance at CHAP sessions among residents of subsidized housings for seniors, we identified 4 potential strategies: increase participant confidentiality; deploy community peer-networks to enhance recruitment; pair attendants to ensure their future participation; intervene through an opinion leader or through bridging individuals.

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Evaluation of a community paramedicine health promotion and lifestyle risk assessment program for older adults who live in social housing: a cluster randomized trial

Cited by 62 publications

References 25 publications

The core components of Community Paramedicine – integrated care in primary care setting: a scoping review

The core components of Community Paramedicine – integrated care in primary care setting: a scoping review

Community paramedicine is growing in impact and potential

Participation in Cardiovascular Health Awareness Program (CHAP) by the Elderly Residents of Social Housing in Quebec: Social Network Analysis

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