title: Development of a community health and wellness pilot in a subsidised seniors' apartment building in Hamilton, Ontario: Community Health Awareness Program delivered by Emergency Medical Services (CHAP-EMS).
abstract: BACKGROUND
  Older adults have higher risk of developing cardiovascular disease, diabetes and falls, leading to costly emergency medical service (EMS) calls and emergency room visits. We developed the Community Health Assessment Program through EMS (CHAP-EMS) that focuses on health promotion/prevention of hypertension and diabetes, links with primary care practitioners, targets seniors living in subsidized housing, and aims to reduce morbidity from these conditions, thereby reducing EMS calls. In this pilot study, we evaluated the feasibility of implementing the CHAP-EMS, attendance rates, prevalence of high blood pressure and cardiovascular risk factors.
  
  
  METHODS
  In this pilot study the CHAP-EMS was implemented in the intervention site over a 12 month period. BP, lifestyle, cardiovascular risk and EMS call rates were collected and descriptive analyses performed. Participants were residents (low income seniors) of a subsidized housing complex in Hamilton, Ontario. Two paramedics provided once-weekly sessions, measuring BP, assessing diabetes/lifestyle risk (CANRISK questionnaire) and discussed prevention/local wellness activities in the intervention site. Follow up was invited.
  
  
  RESULTS
  A total of 1365 visits with 79 unique participants occurred; 48 (25.2%) visited at least twice; mean age was 72.2; 87.2% were 65 years of age and older and 68.1% were female; 90.3% had a family doctor. Overall, 45.2% had elevated BP initially from the total; 50.0% of participants previously diagnosed with hypertension had elevated BP while 33.3% not previously diagnosed had elevated BP. Almost 1 in 5 (19.4%) had diabetes; 66.7% had moderate to high risk of developing diabetes.
  
  
  CONCLUSIONS
  This pilot study indicates that CHAP-EMS is a feasible program that could have impact on BP, lifestyle factors, diabetes risk and EMS calls in the buildings in which it was implemented.
authors.affiliation: Department of Family Medicine, Faculty of Health Sciences, McMaster University, McMaster Innovation Park, 175 Longwood Road South, Suite 201A, Hamilton, ON, L8P 0A1, Canada. gina.agarwal@gmail.com.
authors.forename: Gina
authors.initials: G
authors.lastname: Agarwal
authors.affiliation: Department of Family Medicine, Faculty of Health Sciences, McMaster University, McMaster Innovation Park, 175 Longwood Road South, Suite 201A, Hamilton, ON, L8P 0A1, Canada. angelesric@gmail.com.
authors.forename: Ricardo N
authors.initials: RN
authors.lastname: Angeles
authors.affiliation: City of Hamilton, Public Health Services, Unit 8-1447 Upper Ottawa, Hamilton, ON, L8W 3J6, Canada. mcdonb@mcmaster.ca.
authors.forename: Beatrice
authors.initials: B
authors.lastname: McDonough
authors.affiliation: Hamilton Paramedic Services, 1227 Stone Church East, Hamilton, Ontario, L8W 2C6, Canada. brent.mcleod@hamilton.ca.
authors.forename: Brent
authors.initials: B
authors.lastname: McLeod
authors.affiliation: Department of Family Medicine, Faculty of Health Sciences, McMaster University, McMaster Innovation Park, 175 Longwood Road South, Suite 201A, Hamilton, ON, L8P 0A1, Canada. mlefebv@mcmaster.ca.
authors.forename: Francine
authors.initials: F
authors.lastname: Marzanek
authors.affiliation: Department of Family Medicine, Faculty of Health Sciences, McMaster University, McMaster Innovation Park, 175 Longwood Road South, Suite 201A, Hamilton, ON, L8P 0A1, Canada. pirrie@mcmaster.ca.
authors.forename: Melissa
authors.initials: M
authors.lastname: Pirrie
authors.affiliation: Department of Family Medicine, Faculty of Health Sciences, McMaster University, McMaster Innovation Park, 175 Longwood Road South, Suite 201A, Hamilton, ON, L8P 0A1, Canada. dolovic@mcmaster.ca.|Centre for Evaluation of Medicines, 105 Main Street East, Level P1, Hamilton, ON, L8N 1G6, Canada. dolovic@mcmaster.ca.
authors.forename: Lisa
authors.initials: L
authors.lastname: Dolovich
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control; D000368:Aged; D000369:Aged, 80 and over; D001364:Awareness; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000517:prevention & control; D003153:Community Health Services / Q000379:methods*; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000517:prevention & control; D004632:Emergency Medical Services / Q000379:methods*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000458:organization & administration*; D061889:Healthcare Financing; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D009864:Ontario; D010865:Pilot Projects; D011634:Public Health; D012307:Risk Factors