Department of Family Medicine, McMaster University, Hamilton, ON, Canada.
Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, ON, Canada.
BMC Geriatr. 2024 Nov 28;24(1):974. doi: 10.1186/s12877-024-05549-2.
COVID-19 has changed healthcare access and delivery, especially impacting older adults. The Community Paramedicine at Clinic (CP@clinic) program is a chronic disease prevention, management, and health promotion program for community-dwelling low-income older adults. We investigated a telephone-based CP@clinic program adaptation during the pandemic.
Community paramedics delivered CP@clinic via telephone to residents of 36 social housing buildings. They conducted screening for COVID-19, emergency preparedness, and social health factors. Community paramedics provided education on staying safe, self-isolating, self-monitoring, and preparing for pandemics using governmental infographics. Descriptive analysis was conducted on assessments completed between March and June 2020. Paramedic documentation was thematically analyzed to identify common themes.
All 191 participants had ≥ 1 telephone visit and 34.6% had ≥ 2 telephone visits, 82.8% were aged 65 years and older, 30.9% had internet access, and 57.9% had cable TV (limiting exposure to COVID-19 information). The CP@clinic program infrastructure provided a platform for paramedics to swiftly contact many vulnerable older adults to screen for COVID-19, educate on safe practices, and facilitate healthcare access. One-quarter of participants screened positive for social isolation. Thematic analysis described participants' experiences adapting to daily life in the pandemic, emotional experience during the pandemic, and paramedics supporting participants during the pandemic.
Public health interventions are needed for low-income or hard-to-reach older adults, especially during pandemics. Community paramedics were able to support vulnerable older adults living in social housing through the unique CP@clinic adaptation. This innovative program delivery increased vulnerable populations' access to public health services and information at a time of great health need.
COVID-19 改变了医疗保健的可及性和提供方式，尤其是对老年人的影响。诊所社区护理员（CP@clinic）计划是一项针对社区居住的低收入老年人的慢性病预防、管理和健康促进计划。我们调查了在大流行期间对电话为基础的 CP@clinic 计划的调整。
社区护理员通过电话向 36 栋社会住房大楼的居民提供 CP@clinic 服务。他们对 COVID-19、应急准备和社会健康因素进行了筛查。社区护理员使用政府制作的图表为居民提供了关于保持安全、自我隔离、自我监测和为大流行做准备的教育。对 2020 年 3 月至 6 月期间完成的评估进行了描述性分析。对护理员的记录进行了主题分析，以确定常见的主题。
所有 191 名参与者都进行了≥1 次电话访问，34.6%的参与者进行了≥2 次电话访问，82.8%的参与者年龄在 65 岁及以上，30.9%的参与者有互联网接入，57.9%的参与者有有线电视（限制接触 COVID-19 信息）。CP@clinic 计划的基础设施为护理员提供了一个平台，以便迅速联系许多脆弱的老年人，对他们进行 COVID-19 筛查，提供安全实践方面的教育，并促进医疗保健的获取。四分之一的参与者被筛查出存在社交孤立问题。主题分析描述了参与者在大流行期间适应日常生活、大流行期间的情绪体验以及护理员在大流行期间对参与者的支持。
需要为低收入或难以接触到的老年人提供公共卫生干预措施，尤其是在大流行期间。社区护理员能够通过独特的 CP@clinic 调整，为居住在社会住房中的弱势老年人提供支持。这种创新的服务提供方式在健康需求巨大的时候增加了弱势群体获得公共卫生服务和信息的机会。
