The CP@clinic Program (Community Paramedicine at Clinic), formerly known as the Community Health Assessment Program through Emergency Medical Services (CHAPEMS), is a chronic disease prevention and health promotion program where seniors living in subsidized housing can attend weekly drop-in sessions led by paramedics within their building. Paramedics provide health assessments, make referrals to community-based resources, and engage participants in healthy lifestyle conversations
Health assessments include:
- Cardiovascular Disease (CVD),
- Blood Pressure (BP) monitoring,
- Diabetes Risk Score (CANRISK),
- Falls Risk (TUG test),
- Quality of Life (EQ-5D-5L Health Questionnaire),
- Poverty (Food and Income Security)
- Social Isolation and Loneliness (Three-Item Loneliness Scale ).
CP@clinic targets leading chronic conditions and health issues in senior populations by providing health assessments for cardiovascular disease, diabetes, and risk of falls. In addition, this program better connects participants to the primary care system by faxing participant’s repeat blood pressure measures to their family physician. CP@clinic seeks to improve participants health, quality of life, social isolation, better connect them to existing healthcare resources in their community, and reduce their economic burden on the emergency care system.
CP@clinic began as a pilot program in 2011 in Hamilton, Ontario. After determining the feasibility of the program and its potential to impact seniors health, the program transitioned into the randomized control trial (RCT) phase in 2013. This project was funded by the Canadian Institutes of Health Research (CIHR) from 2013 to 2017. CP@clinic continues to be implemented and is currently in the scale-up and on-going program evaluation phase.
Step 1: Waiting Room
· Participants wait in a designated common space in their building.
· The sessions occur in a private room near the common space to ensure confidentiality.
Step 2: Informed Consent
· The consent form contains the required elements to ensure that the individual has all the information to make a fully informed decision to participate .
· It allows the McMaster CP team to communicate their security measures regarding participants’ personal data, and disclose the parties that will potentially have access to their data .
Step 3: Risk Factor Questions
· Questions investigate participant’s cardiovascular and diabetes risk, risk of falling, and risk or currently experiencing social isolation, loneliness, income and/or food insecurity and quality of life.
· Paramedics enter the information into the secure CP@clinic database.
Step 4: Waist and Weight Measurements
· These measures are used to calculate BMI and inform the paramedic of the participants risk factors.
Step 5: Blood Pressure Measurement
· The paramedic will use an automated blood pressure machine.
· CP@clinic allows older adults to monitor their blood pressure without visiting the doctor’s office, and to investigate their risk of developing cardiovascular disease.
Step 6: The Timed Up and Go Test (TUG)
· To assess falls risk.
· The participant is asked to sit in a chair, raise from the chair, walk three meter, turn around and return to the chair.
Step 7: Risk Factor Discussion
· Occurs after completing the assessments.
· Paramedics link participants to accessible community resources tailored to their health goals and needs.
· Participants are encouraged to continue attending CP@clinic sessions to follow up on chronic disease risk factors and program referrals.
· Follow up visits motivate participants to remain accountable for their health goals.