“They’re very passionate about making sure that women stay healthy”: a qualitative examination of women’s experiences participating in a community paramedicine program

Abstract

Background Community paramedicine programs (i.e., physician-directed preventive care by emergency medical services personnel embedded in communities) offer a novel approach to community-based health care. Project Swaddle, a community paramedicine program for mothers and their infants, seeks to address (directly or through referrals) the physical, mental, social, and economic needs of its participants. The objective of this process evaluation was to describe women’s experiences in Project Swaddle. By understanding their experiences, our work begins to build the foundation for similar programs and future examinations of the efficacy and effectiveness of these approaches. Methods We completed 21 interviews with women living in Indiana (July 2019–February 2020) who were currently participating in or had graduated from Project Swaddle. Interviews were audio-recorded, transcribed, and analyzed using a six-phase approach to thematic analysis. Results Program enrollment was influenced by the community paramedics’ experience and connections, as well as information received in the community from related clinics or organizations. Participants viewed the community paramedic as a trusted provider who supplied necessary health information and support and served as their advocate. In their role as physician extenders, the community paramedics enhanced patient care through monitoring critical situations, facilitating communication with other providers, and supporting routine healthcare. Women noted how community paramedics connected them to outside resources (i.e., other experts, tangible goods), which aimed to support their holistic health and wellbeing. Conclusions Results demonstrate Project Swaddle helped women connect with other healthcare providers, including increased access to mental health services. The community paramedics were able to help women establish care with primary care providers and pediatricians, then facilitate communication with these providers. Women were supported through their early motherhood experience, received education on parenting and taking control of their health, and gained access to resources that met their diverse needs.

The development of community paramedicine; a restricted review

“…Paramedics working in community paramedicine programmes were found to value the role and enjoyed the novel approach to care that impacted positive patient outcomes (Whalen et al, 2018 ) and they felt accepted to work in non‐traditional ambulance roles by other health professionals (Clarke, 2019 ). Paramedics felt that the key to the success of community paramedicine programmes and their role was dependent on interprofessional relationship building (Adio et al, 2020 ; Harvey et al, 2021 ; Martin et al, 2016 ; Schwab‐Reese et al, 2021 ). There were reports of opportunities to improve the experience of community paramedics such as by increasing clinically focussed graduate‐level education (Cooper et al, 2007 ; Martin & O'Meara, 2019 ), improving the communication from management staff and better communication about the role of community paramedics with other paramedic staff and allied health partners (Martin & O'Meara, 2019 ; Schwab‐Reese et al, 2021 ).…”

“…Paramedics working in community paramedicine programmes were found to value the role and enjoyed the novel approach to care that impacted positive patient outcomes (Whalen et al, 2018) and they felt accepted to work in non-traditional ambulance roles by other health professionals (Clarke, 2019). Paramedics felt that the key to the success of community paramedicine programmes and their role was dependent on interprofessional relationship building (Adio et al, 2020;Harvey et al, 2021;Martin et al, 2016;Schwab-Reese et al, 2021). There…”

The general attributes and competence for nurses in a single responder unit. A modified Delphi study.

“…According to Adio et al [42], a calm encounter without haste provides a basis for good social interaction within SRUs. As in this study, previous research has identi ed that broad professional experience and social competence are necessary competencies within the SRU [11,14,37]. The nurses need, in addition to advanced clinical competence, skills in assessing and managing chronic diseases and mental illness and in mapping social needs [38,39,40].…”

The definition of a community paramedic: An international consensus

“…Previous research has highlighted that the non-traditional and unique aspects of the community paramedic role, are routinely misunderstood, not only by external stakeholders but by other Paramedics and direct managers. 14,36 With a consistent definition, the role, scope, and purpose of a community paramedic, could be better understood by health industry leaders and program funders. This will support those developing and implementing community paramedic roles, and advocate the advantages, explaining how they differ from traditional Paramedic roles while standardising the professional view of community paramedic roles.…”