Abstract
BackgroundCommunity 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.MethodsWe 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.ResultsProgram 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.ConclusionsResults 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.
Highlights
700 women in the United States die due to pregnancy or delivery-related complications each year [1]
Results demonstrate Project Swaddle helped women connect with other healthcare providers, including increased access to mental health services
Effective interventions must move beyond purely medical solutions to these issues and focus on more socioecological influences, which is the focus of community paramedicine programs
Summary
700 women in the United States die due to pregnancy or delivery-related complications each year [1]. A recent report based on the findings of maternal mortality review teams that investigate causes of maternal deaths determined over 60% of pregnancy-related deaths in the United States are preventable [7] These teams identified specific opportunities for prevention that may have a substantial impact on reducing pregnancy-related deaths, including improving access to appropriate levels of care, patient/provider communication, coordination between providers, and policies supporting patient coordination and prevention initiatives [7]. The purpose of this process evaluation was to describe women’s experiences in Project Swaddle—a community paramedicine program for mothers and their infants that seeks to address the physical, mental, social, and economic needs of its participants. Our work begins to build the foundation for similar programs and future examinations of the efficacy and effectiveness of these approaches
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