A Community Health Awareness Program in Subsidized Seniors Homes: Using CANRISK as a Risk Assessment and Health Promotion Tool

Abstract

Older adults are at risk of developing diabetes (DM) and its complications, leading to emergency medical service (EMS) calls and emergency room visits. Community-based risk-assessment/lifestyle modification programs linking with primary care for older adults, may reduce EMS calls. To evaluate uptake and feasibility of the Community Health Awareness Program through EMS (CHAP-EMS) for subsidized seniors housing. Pilot study. Residents in Hamilton subsidized apartment (n=280), comprised of low income, seniors, from multicultural backgrounds and frequently calling EMS. Two trained paramedics provided weekly drop-in sessions, assessed diabetes risk using the CANRISK questionnaire, discussed lifestyle change. Participants returned for fasting capillary glucose test (CBG) if their CANRISK score was “high.” Blood pressure (BP), lifestyle risk status was collected. Descriptive analyses: number of participants attending sessions, CANRISK and CBG test status, modifiable risk factor status, BP and EMS calls. After 5 months, 45 residents attended; 37 had multiple visits; 72% were female; 85% were ≥65 years; 10 were previously diagnosed with DM, 9 had concomitant HTN; CANRISK for non-diabetics showed 52% were at high risk of developing DM, 14% had moderate risk. From CBG, 1 had diabetes, 1 prediabetes. Modifiable risk factor status included smoking 33.3%, high salt intake 30.9%, low fruit/vegetable intake 33.3%, low physical activity 45.2%, high BMI 61.9%, elevated BP 66.7%. EMS calls reduced by 32%. CHAP-EMS is feasible intervention for programming in seniors housing in urban areas, detecting at-risk population for diabetes, providing a vehicle for discussing lifestyle change.