Gina Agarwal|Ricardo Angeles|Melissa Pirrie|Brent McLeod|Francine Marzanek|Jenna Parascandalo|Lehana Thabane
Evaluation of a community paramedicine health promotion and lifestyle risk assessment program for older adults who live in social housing: a cluster randomized trial
St. Joseph’s Healthcare Hamilton|McMaster University|Impact|St. Joseph’s Healthcare Hamilton|McMaster University|Impact|St. Joseph’s Healthcare Hamilton|McMaster University|Impact|St. Joseph’s Healthcare Hamilton|McMaster University|Impact|St. Joseph’s Healthcare Hamilton|McMaster University|Impact|St. Joseph’s Healthcare Hamilton|McMaster University|Impact|St. Joseph’s Healthcare Hamilton|McMaster University|Impact
h3backgroundh3 lowincome older adults live subsidized housing higher mortality morbidity aimed determine community paramedicine program paramedics provide health care services outside traditional emergency response reduced number ambulance calls subsidized housing older adults h3methodsh3 conducted openlabel pragmatic clusterrandomized controlled trial rct parallel intervention control groups subsidized apartment buildings older adults selected 6 buildings using predefined criteria randomly assigned intervention community paramedicine clinic cpclinic 1 yr control usual health care using computergenerated paired randomization cpclinic paramedicled communitybased health promotion program prevent diabetes cardiovascular disease falls residents 55 years age older primary outcome buildinglevel mean monthly ambulance calls secondary outcomes individuallevel changes blood pressure health behaviours risk diabetes assessed using canadian diabetes risk questionnaire analyzed data using generalized estimating equations hierarchical linear modelling h3resultsh3 3 intervention 3 control buildings 455 637 residents respectively mean monthly ambulance calls intervention buildings 311 standard deviation sd 130 calls per 100 unitsmo significantly lower 088 95 confidence interval ci 045 130 control buildings 399 sd 117 calls per 100 unitsmo adjusted baseline calls building pairs survey participation 284 ini 129 203 ini 129 intervention control buildings respectively residents living intervention buildings showed significant improvement compared living control buildings qualityadjusted life years qalys mean difference 009 95 ci 001 017 ability perform usual activities odds ratio 26 95 ci 12 58 received intervention significant decrease systolic mean change 50 95 ci 10 90 diastolic mean change 48 95 ci 19 76 blood pressure h3interpretationh3 paramedicled communitybased health promotion program cpclinic significantly lowered number ambulance calls improved qalys ability perform usual activities lowered systolic blood pressure among older adults living subsidized housing btrial registrationb clinicaltrialsgov nct02152891