Factors Associated With the Adoption of a Patient Education Intervention Among First Responders, King County, Washington, 2010–2011

Abstract

IntroductionThis study investigated facilitators and barriers to adoption of an at-scene patient education program by firefighter emergency medical technicians (EMTs) in King County, Washington.MethodsWe 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.ResultsAdoption 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.ConclusionAttributes of chronic disease prevention programs and encouragement from peers and supervisors are necessary in diffusion of patient education interventions in the prehospital care setting.

Older Adult Falls Seen by Emergency Medical Service Providers

“…King County in Washington State utilized firefighter–EMTs and found that non-transported patients were receptive to a health education program. 19 These EMTs provided four types of health information that included a referral source for fall prevention programs. Wake County EMS providers have also developed a program to manage falls in skilled nursing facilities.…”

Coordinating Care for Falls via Emergency Responders: A Feasibility Study of a Brief At-Scene Intervention

“…Furthermore, because EMS programs are typically emergency-services-oriented, EMS leadership must endorse a more preventive role to allow for a shift in the traditional paradigm to occur. Adoption of this new role by EMTs depends on leadership buy-in, encouragement, and change in perceptions of an expanded mission of EMS (10). …”

“…A tear-off sheet with information about the locally available programs was developed specifically for the project with input from EMS advisors (Figure 1) (10). One program was a home-based program; the other was a falls assessment clinic operating at the county hospital.…”

Frequent 911 Fall Calls in Older Adults: Opportunity for Injury Prevention Strategies

“…Although the information left at the scene statistically increased enrollment of people in a fall prevention program, fewer than 35% of individuals given the information reported that they had EMS discuss falls with them at the time of 911 call, and only 3% more individuals given the information than in the control group enrolled in fall‐prevention programs. Although only a few individuals enrolled in a fall‐prevention program after EMS education after a fall, this strategy was cost effective, was supported by EMS providers, and has the potential to create a new pathway for activating fall prevention strategies and education . These concepts build on the SAFER trials performed in the United Kingdom that concluded that involving EMS in fall reduction strategies is feasible and effective, but further work on timing of the intervention, whether to activate fall prevention strategies and education at the scene or at a later date, may prove to be more effective.…”

“…Although only a few individuals enrolled in a fall-prevention program after EMS education after a fall, this strategy was cost effective, was supported by EMS providers, and has the potential to create a new pathway for activating fall prevention strategies and education. 35,36 These concepts build on the SAFER trials performed in the United Kingdom that concluded that involving EMS in fall reduction strategies is feasible and effective, but further work on timing of the intervention, whether to activate fall prevention strategies and education at the scene or at a later date, may prove to be more effective. Comprehensive systemlevel strategies that help coordinate care among care providers, individuals, and community programs may help change the paradigm of care for older adults and bridge some of the gaps in fall prevention strategies for older adults.…”