A Community Paramedicine Initiative for Older Adults Living in Subsidized Housing (CHAP-EMS/CP@Clinic)

Study Overview
=================
Brief Summary
-----------------
Older adults living in subsidized housing report poorer health. Their age and low income make it harder for them to use community services. Many older adults have heart disease and diabetes, which lead to frequent emergency calls and hospital admissions. To decrease the costs of treating heart disease and diabetes through emergency and hospitalization, improved screening and health education is needed. Our program will take place in communal areas within housing buildings of older adults and deliver a heart disease, diabetes, and falls risk check-up with health education. This is expected to improve the health of older adults leading to fewer emergency calls and hospital visits.

Official Title
-----------------
A Community Paramedicine Initiative for Older Adults Living in Subsidized Housing (CHAP-EMS/Renamed to CP@Clinic)

Conditions
-----------------
Diabetes Mellitus, Cardiovascular Diseases

Intervention / Treatment
-----------------
* Behavioral: CHAP-EMS/CP@clinic


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: 55 years and older Resides in subsidized apartment building Exclusion Criteria: - None

Ages Eligible for Study
-----------------
Minimum Age: 55 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
Accepts Healthy Volunteers

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: CHAP-EMS/CP@clinic Program Intervention<br>12 month implementation of the intervention | Behavioral: CHAP-EMS/CP@clinic<br>* Community Paramedicine program to assess cardiovascular, diabetes, and fall risk; discuss lifestyle changes and goals; and refer to appropriate resources.<br>|
| No Intervention: Control<br>Will complete a survey at baseline and at 1 year, no program or intervention provided | |

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Canadian Diabetes Risk (CANRISK) Score | The CANRISK tool provides a 10-year risk of diabetes score and will be administered by the paramedic during the CHAP-EMS session. | Baseline and 1 year | 
| Change in Blood Pressure | Since the participants are invited to attend the intervention weekly, but are not required to attend, the number of assessments and time of assessments will vary. Multilevel analysis will be conducted that accounts for this variance in repeated measures. | Baseline and after each assessment (up to one year) | 
| Change in health perceptions, behaviours, and knowledge of resources | A face-to-face survey will be administered to determine participant health perceptions, behaviours, and knowledge. | Baseline and 1 year | 
| Change in Health Care Utilization | Health Care Utilization will be assessed through administrative databases (e.g. hospital visits). Utilization by residents in the intervention apartment buildings will be compared to baseline and compared to the control apartment buildings. | Baseline and 1 year | 
| Change in rate of EMS Calls | Rate EMS calls by residents in the intervention apartment buildings will be compared to baseline and compared to the control apartment buildings. | Baseline and 1 year | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
Emergency Medical Services, Elderly