Factors associated with the adoption of a patient education intervention among first responders, King County, Washington, 2010-2011.
BACKGROUND
This study investigated facilitators and barriers to adoption of an at-scene patient education program by firefighter emergency medical technicians (EMTs) in King County, Washington.


METHODS
We consulted providers of emergency medical services (EMS) to develop a patient education pamphlet in the form of a tear-off sheet that could be attached to the EMT medical incident report. The pamphlet included resources for at-scene patient education on high blood pressure, blood glucose, falls, and social services. The program was launched in 29 fire departments in King County, Washington, on January 1, 2010, and a formal evaluation was conducted in late 2011. We developed a survey based on diffusion theory to assess 1) awareness of the pamphlet, 2) evaluation of the pamphlet attributes, 3) encouragement by peers and superiors for handing out the pamphlet, 4) perceived behavioral norms, and 5) demographic variables associated with self-reported adoption of the at-scene patient education program. The survey was completed by 822 (40.1%) of 2,047 firefighter emergency medical technicians. We conducted bivariate and multivariable analyses to assess associations between independent variables and self-reported adoption of the program.


RESULTS
Adoption of the at-scene patient education intervention was significantly associated with positive evaluation of the pamphlet, encouragement from peers and superiors, and perceived behavioral norms. EMS providers reported they were most likely to hand out the pamphlet to patients in private residences who were treated and left at the scene.


CONCLUSIONS
Attributes of chronic disease prevention programs and encouragement from peers and supervisors are necessary in diffusion of patient education interventions in the prehospital care setting.
Department of Health Services, University of Washington, Box 357660, Seattle, WA 98195. E-mail: hendrika@u.washington.edu.
Hendrika
H
Meischke
Seattle and King County Division of Emergency Medical Services, Seattle, Washington.
Benjamin
B
Stubbs
Seattle and King County Division of Emergency Medical Services, Seattle, Washington.
Carol
C
Fahrenbruch
Department of Medicine, University of Washington, Seattle, Washington.
Elizabeth
E
Phelan
D003153:Community Health Services; D003625:Data Collection; D004632:Emergency Medical Services / Q000458:organization & administration*; D060731:Emergency Responders; D006801:Humans; D010174:Pamphlets; D010353:Patient Education as Topic / Q000379:methods*; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014861:Washington