Development of a community health and wellness pilot in a subsidised seniors' apartment building in Hamilton, Ontario: Community Health Awareness Program delivered by Emergency Medical Services (CHAP-EMS)

Gina Agarwal1*, Ricardo N Angeles1, Beatrice McDonough2, Brent McLeod3, Francine Marzanek1, Melissa Pirrie1 and Lisa Dolovich1,4


Abstract
Background: Older adults have higher risk of developing cardiovascular disease, diabetes and falls, leading to
costly emergency medical service (EMS) calls and emergency room visits. We developed the Community Health
Assessment Program through EMS (CHAP-EMS) that focuses on health promotion/prevention of hypertension and
diabetes, links with primary care practitioners, targets seniors living in subsidized housing, and aims to reduce
morbidity from these conditions, thereby reducing EMS calls. In this pilot study, we evaluated the feasibility of
implementing the CHAP-EMS, attendance rates, prevalence of high blood pressure and cardiovascular risk factors.

Methods: In this pilot study the CHAP-EMS was implemented in the intervention site over a 12 month period. BP,
lifestyle, cardiovascular risk and EMS call rates were collected and descriptive analyses performed. Participants were
residents (low income seniors) of a subsidized housing complex in Hamilton, Ontario. Two paramedics provided
once-weekly sessions, measuring BP, assessing diabetes/lifestyle risk (CANRISK questionnaire) and discussed
prevention/local wellness activities in the intervention site. Follow up was invited.

Results: A total of 1365 visits with 79 unique participants occurred; 48 (25.2%) visited at least twice; mean age
was 72.2; 87.2% were 65 years of age and older and 68.1% were female; 90.3% had a family doctor. Overall, 45.2% had
elevated BP initially from the total; 50.0% of participants previously diagnosed with hypertension had elevated BP while
33.3% not previously diagnosed had elevated BP. Almost 1 in 5 (19.4%) had diabetes; 66.7% had moderate to high risk
of developing diabetes.

Conclusion: This pilot study indicates that CHAP-EMS is a feasible program that could have impact on BP, lifestyle
factors, diabetes risk and EMS calls in the buildings in which it was implemented.
Keywords: Community paramedicine, Cardiovascular health, Diabetes risk, Falls risk, Health promotion, Lifestyle risk
screening, Older adults, EMS calls, Health assessment, Seniors housing

* Correspondence: gina.agarwal@gmail.com
1Department of Family Medicine, Faculty of Health Sciences, McMaster
University, McMaster Innovation Park, 175 Longwood Road South, Suite
201A, Hamilton, ON L8P 0A1, Canada
Full list of author information is available at the end of the article

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