title: The CHAP-EMS health promotion program: a qualitative study on participants' views of the role of paramedics.
abstract: Expanded roles for paramedics, commonly termed community paramedicine, are becoming increasingly common. Paramedics working in community paramedicine roles represent a distinct departure away from the traditional emergency paradigm of paramedic services. Despite this, little research has addressed how community paramedics are perceived by their clients.
  
  
  
  This study took an interpretivist qualitative approach to examine participants' perceptions of paramedics providing a community paramedicine program, named the Community Health Assessment Program through Emergency Medical Services (CHAP-EMS). Both participant observation and semi-structured interviews conducted with program participants were used to gain insight into the on-the-ground experiences of the program. Thematic analysis was employed to analyze all data.
  
  
  
  Three themes emerged: i) Caring and trusting relationships; ii) paramedics as health advocates; iii) the added value of EMS skills. Paramedics were perceived by residents as having dual identities: first in a novel role as health advocates and secondly in a traditional role as emergency experts despite lacking contextual features associated with emergency response.
  
  
  
  From this exploratory, qualitative study we present an emerging framework in which to conceptualize paramedic roles in community paramedicine settings. Future research should address the saliency of these roles in different contexts and how these roles relate to paramedic practice.
authors.affiliation: Department of Health, Aging & Society, McMaster University, 1280 Main St W, Hamilton, ON, Canada.
authors.forename: Madison
authors.initials: M
authors.lastname: Brydges
authors.affiliation: Department of Health, Aging & Society, McMaster University, 1280 Main St W, Hamilton, ON, Canada.
authors.forename: Margaret
authors.initials: M
authors.lastname: Denton
authors.affiliation: Department of Family Medicine, David Braley Health Sciences Centre, McMaster University, 100 Main Street West, 5th Floor, Hamilton, ON, L8P 1H6, Canada. gina.agarwal@gmail.com.|Department of Clinical Epidemiology and Biostatistics, McMaster University, 1280 Main St W, Hamilton, ON, Canada. gina.agarwal@gmail.com.
authors.forename: Gina
authors.initials: G
authors.lastname: Agarwal
mesh_terms: D000368:Aged; D000488:Allied Health Personnel; D001294:Attitude to Health; D003153:Community Health Services / Q000379:methods*; D004632:Emergency Medical Services / Q000706:statistics & numerical data; D004634:Emergency Medical Technicians; D005260:Female; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008297:Male; D009864:Ontario; D024382:Professional Role; D011369:Professional-Patient Relations; D015397:Program Evaluation; D011634:Public Health; D036301:Qualitative Research
keywords: Community paramedicine; Paramedic roles; Qualitative research