Volunteer Agencies Research Articles

Building capacity and promoting health through online volunteering

Purpose Significant changes to in-person volunteering were necessary during the COVID-19 pandemic. Health Volunteers Overseas (HVO) responded to the pandemic by developing an online education platform and pivoting to online volunteering. This qualitative study explores the dynamics of online volunteering and provides visibility to this novel trend in the training of health professionals in resource-scarce countries. Methodology/approach Barriers and facilitators, actual and potential outcomes, and recommendations for online volunteering were addressed through a comparative case study approach focusing on three HVO global projects: physical therapy in Rwanda and Ghana, oral health in Nepal, and anesthesiology—a multi-country collaboration between Bhutan, Cambodia, and Laos. Findings A total of 15 participants, including project directors, host country representatives, and teaching volunteers, were interviewed online. Three themes emerged through the online interviews with HVO volunteers, project directors, and host country directors: Creating Space, the Future is Hybrid, and Geographical Expansion. Research implications Online volunteering provides a new opportunity for volunteers to expand their networks, learn new skills, and meet the needs of the host country participants. There is also an opportunity to expand projects beyond national boundaries, but logistical, cultural, and linguistic challenges must be considered. Practical implications Online volunteering is a feasible approach for building teaching and research capacity globally, and volunteer agencies should consider a hybrid model combining online volunteering with in-person volunteering. Originality Online volunteering provides support to meet the needs of both volunteers and in-country program participants. Limitations This study focused on the volunteer, project director, and host coordinator experience and not on the learner. More research is needed to investigate how online and in-person dynamics coalesce.

A Different Class of Refugee: University Scholarships and Developmentalism in Late 1960s Africa

Using documents assembled in connection with the 1967 Conference on the Legal, Economic and Social Aspects of African Refugee Problems, this article discusses African refugee higher-education discourses in the 1960s at the level of international organizations, volunteer agencies, and government representatives. Education and development history have recently been studied together, but this article focuses on the history of refugee higher education, which, it argues, needs to be understood within the development framework of human-capital theory, meant to support political pan-African concerns for a decolonized continent and merged with humanitarian arguments to create a hybrid form of humanitarian developmentalism. The article zooms in on higher-education scholarships, above all for refugees from Southern Africa, as a means of support for human-capital development. It shows that refugee higher education was both a result and a driver of increased international exchanges, as evidenced at the 1967 conference.

Volunteering and the response to COVID-19 in the UK

This article provides an insight into the voluntary sector’s response to the COVID-19 pandemic in one UK region, using qualitative evidence from a rapid evaluation study with leaders of volunteer agencies. We picked out the information relevant to services that disabled people access, as a way to provide a snapshot of the issues experienced during the various lockdowns, as well as participants’ concerns for the future of volunteering in the UK.

Potential Application for First Responder Organisations of Desensitisation and Reprocessing Treatment for Individuals with Post-Traumatic Stress Disorder

This literature review discusses the impact and nature of traumatic experiences of first responders, focusing on their ability to cope with the cognitive and behavioural symptoms associated with post-traumatic stress disorder (PTSD). First responders are defined as police, fire, ambulance, military, public health service workers, and state, local, and volunteer agencies, who protect and safeguard communities. First responders disproportionately suffer from PTSD; symptoms often lead to inability to continue their duties. Individuals and organisations should consider how individuals recover from PTSD. This paper reviews literature on PTSD interventions and recommends Eye Movement Desensitisation Reprocessing (EMDR) Therapy for treatment of PTSD in first responders. The literature review explored effective treatment options for overcoming PTSD and found an embedded culture in first responder organisations of cognitive avoidance, which results in reduced help seeking behaviours. Poor help-seeking behaviours correlate with high levels of PTSD and psychological distress, low levels of mental health literacy, and career issues. This paper discusses how EMDR is a potential and effective therapy to reduce symptoms of PTSD in first responders. Evidence reviewed in this paper suggests EMDR should be used as a treatment option for first responders to help reformulate negative thoughts/beliefs associated with exposure to traumatic events.

Examining barriers, motivators and injury related to physical training in wildland firefighters

Fitness is critical in keeping wildland firefighters (WLFFs) healthy and safe from injury. Unfortunately, little is known about the physical training (PT) programs of WLFFs. The purpose of this study was to understand motivators, barriers and injuries related to PT. We used a descriptive research design. Information about PT practices was collected through interviews with key informants and was analysed qualitatively. Additionally, a questionnaire was developed, reviewed by experts, pilot tested and distributed electronically to WLFFs. A total of 16 interviews were conducted with key informants from multiple state, federal and volunteer agencies. Two overarching concepts, firefighter culture and environment, emerged from interviews as major influences on PT. The most frequently identified barrier to PT was work-related projects taking precedence over PT. Multiple motivating factors were identified, including having supervisors that participate in PT and wanting to be seen as a strong crewmember. Nearly half the injuries reported by WLFF resulted from PT and ~40% were viewed as preventable injuries. This project provides an understanding of the current PT practices of WLFFs. More importantly, results from this study identify, from the perspective of the firefighters themselves, the major motivators and barriers to engaging in PT.

Disability policies in Japan and Sweden: A comparative perspective

The aim of this article was to compare disability policies in Japan and Sweden. Social protection in the two countries has taken different directions. Policy orientation in Japan is ‘productivist’, paternalistic, family-oriented, and firmly involves medical expertise in assessing eligibility to disability services. In practice, social services in Japan is the result of negotiations between social service staff at the local level, volunteer agencies and private contributors. In Sweden, social services, were established as social rights, financed by public money, and distributed by public sector agencies or out-sourced to private providers. Such support, assessed by social workers, were intended to facilitate daily life and achieve “good living conditions”. While Japan's disability services are characterized by the medical model and improving physical accessibility, practices in Sweden are based on a social relational model perspective of disability services combined with increasing ‘deservingness ethics’.

Somali Refugee Resettlement and Residential Patterns in Nashville, Tennessee

This research aims to cast scholarly light on the burgeoning Somali community in Nashville, Tennessee, by examining the residential patterns of Somali refugees. Using a mixed-methods approach that includes in-depth interviews, focus groups, and volunteer agencies, this study reveals that Somali refugees face particular barriers that directly influence the residential processes of Nashville’s Somali refugee community. Some of these barriers are rooted in the Somali community’s interpretation of Islam forbidding the provision or acceptance of loans with interest (ribā) from banks and other lenders, leading many Somalis to feel they are unable to participate in common Western banking practices. These types of barriers can limit both homeownership and entrepreneurial endeavors. Such complex cultural factors shaping Somali refugee resettlement challenge the deterministic model of spatial assimilation theory and underscore the need for more nuanced, group-specific research to understand the residential patterns and spatial outcomes of new refugee and immigrant communities in metropolitan areas in the U.S. South. The findings from this study are of value to local policymakers and community-based organizations interested in crafting legislation and establishing services that help Somali refugees better adapt to their host society.

Older-person volunteering in rural and regional Australia: Recruitment, retention, and health benefits

ABSTRACTAustralian volunteer agencies are experiencing a shortage of volunteers along with an ageing workforce population. An examination was made of the current volunteer population at a regional Australian center (St. Vincent de Paul) in relation to recruitment and retention. A 30-question multiple-choice questionnaire examined the factors that affect volunteers’ capacity to engage in work with the agency. The questions were subdivided into the following categories: volunteer demographics; views regarding volunteer work in Australia; volunteer health and wellbeing; and the transport needs of the volunteers. The data were analyzed with a focus on assessing views on volunteer work in Australia. An examination was then made of the impact of chronic health conditions, and areas were identified that may enhance support for volunteers. Although chronic health conditions were not of major concern in this study, further studies are needed to clarify the physical, psychological, and social benefits of volunteering in the regional Australian context.

Sudden unexpected death in epilepsy: Identifying risk and preventing mortality.

Premature death among individuals with epilepsy is higher than in the general population, and sudden unexpected death is the most common cause of this mortality. A new multisite collaborative research consortium, the Center for sudden unexpected death in epilepsy (SUDEP) Research (CSR), has received major funding from the National Institutes of Health (NIH) to examine the possible biologic mechanisms underlying this potentially preventable comorbidity and develop predictive biomarkers for interventions that could lower SUDEP incidence. This inaugural report describes the structure of the CSR, its priorities for human and experimental research, and the strategic collaborations and advanced tools under development to reduce this catastrophic outcome of epilepsy. The CSR Partners Program will work closely with committed volunteer agencies, industry, and academic institutions to accelerate and communicate these advances to the professional and lay community.

Digital detectives and virtual volunteers: Integrating emergent online communities into disaster response operations

The demonstration of altruistic behaviours by disaster survivors, and even those observing emergencies from afar, is well documented. Over the past few decades, government-sponsored crisis planning has evolved to include affiliated volunteer agencies, with a general acknowledgment of the need to plan for unaffiliated or spontaneous volunteers. Just as the understanding of the need for volunteers has grown, so too have the ways in which volunteers are able to donate their time and skills. The popularity of social media networks and online communities provide new ways for the public to get involved in disaster response. Public service agencies should be proactive in investigating these emerging platforms and understanding their impacts during crises. Established methods of integrating on-scene volunteers into post-disaster response operations can be used as templates for creating virtual volunteer programmes.

The Moral Neoliberal: Welfare and Citizenship in Italy (review)

Reviewed by: The Moral Neoliberal: Welfare and Citizenship in Italy Michael Blim Andrea Muehlebach, The Moral Neoliberal: Welfare and Citizenship in Italy. Chicago: University of Chicago Press, 2012. 228 pp. Without Gramsci, neither contemporary Italy nor Andrea Muehlebach’s book about it could be imagined. For this writer, and for Muehlebach, this is precisely the problem, for Italians of many political stripes seeking social change invoke as their interlocutors Machiavelli and the Catholic Church in their (r)evolutionary visions of a new Italian society. Between their imagination of hegemonic conquest and the act, however, lies the sclerotic Italian society of the past quarter century, transforming each bold idea into pusillanimous power projections onto a political and social landscape still unaccepting of its Cold War and un-rejecting of its Fascist pasts. Muehlebach argues that Italians today, or more specifically Milanese Italians under the fetishizing guise of volunteer work, are becoming increasingly responsible for helping disadvantaged individuals and groups neglected or delegated to their care by the state. In doing so, they are transforming themselves into persons for whom citizenship no longer consists of positive rights for themselves or the people they help, but becomes a new kind of subjection in which supplanting state effort itself is a form of validation and virtue. Both persons from Catholic and leftists sectors (specifically the leftist union confederation) participate wholeheartedly in this exercise, the possible unintended by-product of which is an affect-laden belief in the need for a society with broadly distributed social compassion. This new disposition derives from the workings of neoliberalism in the Italian context, the author argues, hence the title “the moral neoliberal.” The theoretical relationship posited between neoliberalism and a new social personality seems to me a bit forced and at odds with the actual history of neoliberal programs and the rise of the Italian welfare state. The latter, such as it is, developed as a highly path-dependent zigzag of programs [End Page 1279] and policies traveling through a post-World War II Italian society buffeted by the imperatives of feeding itself and making a collective living in the face of its much stronger European neighbors; by massive worker resistance in Italy’s industrial core and worker complacency everywhere else; and by the maneuvers of the American hegemon to govern a polity split between Church and lay parties, all of whom wanted to create a distributive state in their quest for political legitimacy. Classically “late-developing,” historically forced to protect itself from economic and political marginalization within the northern-dominated European community, possessed of North-South economic differences inside its borders without parallel in Western Europe, Italy can even claim the dubious distinction of being among the first, and certainly the first of any major Western economy, to suffer in 1974 an IMF structural adjustment program. Even so, while the country was caught in the clutches of international as well as its own bankers, the Italian Parliament in 1978 created a universal, national health service, an achievement which, like its British counterpart or the United States’ Social Security Act, remains the crown jewel of an otherwise jerry-rigged welfare state. I would argue that Italy offers very particular “particulars” to its interpreters that destabilize the kind of sure-fired, direct relationship posited by Muehlebach between a neoliberalist epoch and the new form of comportment she argues is emerging in Italy today. The book is oddly pitched. If it is to serve as an essay on neoliberal temperament as conditioned by the formation of a new socially helping, though responsibalized self, then its scope should have included putting the Italian findings among others now reported around the neoliberalized world. Instead, after cursory mention of the new role of affect in what are taken to be neoliberalized societies, the book might best work under the title “The Northern Italian Way of Welfare,” in which the evidence the author adduces from interaction with volunteers, volunteer trainers, and volunteer agencies would establish her case indeed. The Catholic Church in Italy, an outsized entity if there ever was one, jealously protects its seignorial rights as the country’s chief charity arm, securing directly from the Italian state the right to be the...

In Reply

We appreciate your interest in our study of trauma patients transported directly to a trauma center by ground versus helicopter ambulance1 and the opportunity to address your comments. There are some important differences to point out between our study and the trial described. First, the target population of our study was not confined to head-injured patients, but rather included all reported injured patients except those with burns, or who, based on available data, appeared to be in traumatic arrest at the scene of injury. Second, as described in our article, the air crews in Oklahoma consist almost exclusively of a nurse and paramedic. The inclusion of a physician on a helicopter ambulance would be very uncommon in our state, as would direct consultation with physician specialists throughout a transport. Also, ground EMS services in geographic locations outside Oklahoma’s metropolitan areas, where the trauma centers are located, are often basic level and many are volunteer agencies. In areas lacking ground advanced life support prehospital care, there could be ethical if not legal concerns if the transport of severely injured patients were left to randomization to available ground resources or to an advanced medical helicopter. These factors formed the basis of our statement that it was unlikely a broad randomized controlled trial comparing ground and helicopter transport would be undertaken, at least in states with large rural populations such as Oklahoma. Our article discusses that while we did have some data regarding advanced airway management, we lacked details of when the procedure was actually performed. The prehospital procedure data we did have showed that helicopter crews more often used advanced procedures, especially advanced airway procedures. Because we lacked complete data regarding procedures and timing of procedures, a post hoc analysis was performed of patients grouped by weighted revised trauma score (RTS) values based on initial scene vital signs. The idea behind the post hoc analysis was that if helicopter crews more often use advanced procedures, then identifying a group of patients more likely to benefit from these procedures would make the association of helicopter EMS and reduced mortality seen for the overall group stand out within this subgroup. There were very few deaths in patients with RTS values above 7 (75% of the patients), and the hazard ratio for mortality associated with helicopter EMS transport, although similar to the overall hazard ratio, was no longer statistically significant. Conversely, for patients with the worst vital signs (RTS < 3), the mode of transport did not affect mortality risk. It was for the group with RTS values between 3 and 7 that the association of HEMS and reduced risk of mortality was most evident; a group of patients likely to be similar to those selected for inclusion in your trial. As for confusing prehospital care and mode of transport, the article explicitly discusses the fact that mode of transport is not a treatment and points out, as have others,2 that any differences in mortality related to mode of transport must be related to either differences in care or faster transport to definitive care. From previous work regarding time and distance,3 it seems that differences in care are the more likely explanation. We look forward to the results of your trial and the possibility that its results can be extended to our trauma system.

Volunteering for Museums: The Variation in Motives across Volunteer Age Groups

Abstract The value of volunteering is well documented, and though there is a readily available recruitment pool for volunteers, many come from an aging population that is also relatively affluent and has many more opportunities and demands for their free time in retirement. This paper examines the motives of older volunteers in a state museum in Australia with the aim of differentiating motivations within subsets of volunteering groups. The study undertook a census of 450 volunteers at the museum, using the Voluntary Functions Inventory (VFI). The findings reveal various levels of motivation within the older age groups. Such findings can assist volunteer agencies in enhancing the quality of their volunteers’ experience.

Helping Haiti in the Wake of Disaster: Law Students as First Responders

On January 12, 2010, a devastating and catastrophic 7.0 magnitude earthquake struck Haiti. A week after the earthquake, and only a day after the United States designated Temporary Protected Status (TPS) for eligible Haitians living in the U.S., University of Miami law students, faculty and other volunteers became legal “first responders,” assisting those in need. As Miamians, we all recognized that the tragic events of January 12 had affected not only those Haitians in Port au Prince, but the entire Haitian country and diaspora. Haitians here in the United States were anxious to help financially but many lacked work authorization. In a country where remittances were already equal to 30% of the pre-earthquake gross domestic product, a program that would deliver employment authorization documents to previously undocumented Haitians held tremendous promise as a means of infusing cash where it was most needed - directly to family and loved ones back in Haiti. Our law school clinic does a significant amount of immigration status adjustment work and has experience applying for fee waivers from United States Citizenship and Immigration Services (USCIS). This is the story of how we put an immediate-need and longer-term TPS service effort together, the lessons we learned in doing so, and what we believe to be a sustainable clinical pedagogy and law school service model built around disaster assistance and recovery. We begin by examining how lawyers and law students have traditionally made valuable contributions to disaster response by using their legal training. All too often, those efforts have been hampered by the ad hoc nature in which they have been constructed post-disaster, and by the limitations inherent in the relatively small number of lawyers available to offer significant amounts of time to the overwhelming number of disaster-affected individuals. Recognizing this, many volunteer agencies and legal services providers have sought to improve the response time, quality, and quantity of post-disaster legal assistance by preparing materials and training volunteer lawyers in advance. Our proposal incorporates and builds on these improvements by arguing that law students and law clinics are a veritable “army” of untapped potential legal resources that could be configured to provide quick legal responses to emergencies and disasters, targeted to enforce disaster victims’ basic needs. We encourage the legal community that is already working on emergency and disaster preparedness, relief and recovery to include law school clinics and students in their present efforts; and we encourage law school clinical instructors and pro bono programs to give serious consideration to incorporating legal first response into their pedagogical and service programs.

CBRN preparedness in a small community: How the Isle of Man has integrated responding and support services

The Isle of Man was not included in the rollout of the UK Government’s New Dimension programme to equip the civilian emergency services for dealing with large-scale terrorist-led incidents. Threat analysis for the island deemed this scenario to be a low-risk, low-frequency event, but one that would have a high impact upon the community, infrastructure and stability of this well regulated and highly successful international financial centre. A practical, pragmatic and integrated approach by the responding emergency services, government departments and volunteer agencies has resulted in the establishment of a credible response capability for chemical, biological, radiological and nuclear incidents. This paper details how the initial risk analysis was carried out, and describes the updating of the emergency management plan and the development of the interoperability of the emergency services, including the link between preplanning and operational command. Ongoing training and improvements in disaster management are also discussed.

Development, situation and perspective of self-help support in Germany

Self-help groups and self-help associations are an important part of the social security system. In Germany, self-help contact points, senior citizen centers, volunteer agencies, citizen centers and multi-generation houses combine citizen participation with innovative professional services. Unfortunately, there is no guarantee of continuous financial support for these important, locally administered institutions. There are about 280 self-help contact points and more than 400 federal self-help associations that support and promote self-help in Germany. Healthy communities, healthy workplaces and healthy people need a decentralized system of self-help programs operated at local and regional levels, in districts and towns. Thereby, professional support systems that operate self-help programs and promote citizen participation in the self-help programs must be managed in a similar regional format. New forms of cooperation from the regional and local governments, private companies, and citizen engagement already exist. Additionally, regional projects of integrated maintenance systems with the regional health maintenance institutions have been established. Currently, the central challenges of the self-help programs are quality development, inclusion of people with social disadvantages and of people with migrational background. The essential prerequisites for this work are continuous financial support and a politically supported infrastructure, which is in fact an important health investment.

Families Of Rural Volunteer Firefighters

The protection of Australian rural communities from fire and other emergencies is provided mostly by volunteers. However, many fire agencies are facing concerns over falling volunteer numbers and are increasingly looking at factors potentially impacting on volunteering. Evidence suggests that family issues play a role in many volunteer resignations and could be contributing to declining volunteer numbers. Despite this, there is little research available on the families of rural volunteer firefighters and agencies have little evidence to inform strategies for supporting the families of their volunteers. In a preliminary effort to address this lack of knowledge, this review summarises the small amount of research available on rural families in general, and then volunteer firefighter families in particular. It then introduces a potentially useful model of Work–Family Conflict, which suggests that time- and strain-based pressures may be important sources of difficulty for spouses and partners balancing volunteer firefighter and family roles. This review concludes by summarising directions for future research that are important, if volunteer-based rural fire agencies are to develop policies to better support the families of their volunteers

For Whom Does the Bell Toll? The Conservation of Heritage in Disasters

Emergency management has come a long way in the last 20 years, and certainly since the Newcastle earthquake of1989 and the Nyngan flood of April 1990. Planning now includes dissemination of information, provision for warning and evacuation, ensuring speedy mobilisation of personnel, provision of equipment and post disaster activities; it also involves definition of roles and coordination of the efforts of agencies, such as the emergency services, police, ambulance, fire services, volunteer agencies and defence service personnel, should they be needed. In recent years, the potential for terrorist attacks has been added to the list of long-recognised disasters, and the creeping impact of climate change has begun to exacerbate many weather-related disasters. While in many disasters there is potential for damage and destruction of heritage assets, most post-disaster action is at present aimed at rescue and return to normality. Despite its advances, disaster planning still does not include mechanisms for assessing and conserving vulnerable heritage assets. Consequently, their preservation becomes the lowest priority of disaster-related activities. A response plan is therefore required that is integrated into emergency services’ plans and manuals to safeguard heritage assets. The plan must recognise that the necessary decision-making requires the expertise of heritage professionals and cannot be left to emergency personnel that lack the required knowledge. The plan should be championed in each state and territory by its heritage agency, and when disaster occurs, managed by it in a cooperative manner within the emergency service framework. A register should also be prepared of skilled heritage personnel who can be called on in an emergency; it should be kept up-to-date and categorised according to capabilities. It is the heritage community’s responsibility to pursue the introduction of such reforms.

Politics, Programs, and Protests: Catholic Relief Services in Vietnam, 1954-1975

It is now thirty years since Americans finally departed from Saigon in 1975.That this longest in U.S.history still electrifies the political climate was abundantly evident in the last presidential election. John Kerry opened his campaign with a dramatic rendering of his heroic feats as a swift-boat commander in Vietnam to which members of his crew gave testimony. Anti-Kerry political ads followed, sponsored by the putative Swift-Boat Veterans for Truth, who sought to portray him as utterly unworthy of his wartime honors. Another pro-Republican group depicted Kerry as a national anti-war activist who debased the coinage of traditional patriotism, and thereby disqualified himself from leading the nation in the in Iraq as well as in the struggle against terrorism. Anti-Bush ads then challenged the integrity of the President's record as a reserve Air Force pilot during the Vietnam War. Within the preceding context, it is clear that any contemporary historian engaged in writing about Vietnam must be aware that the very process itself entails a political act. The there has affected the deep stories of all those who were, and are, either defenders or opponents of America's involvement in that military action. There is also the inevitable distortion of memory and of bias among those who viewed the from such varying perspectives as that of the church, of the larger society, as well as of the academy. Yawning generation gaps were current during the war and still affect our perspectives today. Any historian examining so divisive a conflict must struggle to achieve the necessary scholarly detachment, even when he or she has access to what seem to be voluminous records. In writing about Catholic Relief Services I have the luxury of rich documentation that reveals both sides in a that polarized the nation. Nevertheless, there is always a danger of interpretive prejudices unwittingly creeping into any narrative of conflict. Introduction: The Context In 1943, during Franklin D. Roosevelt's post-World War II planning to incorporate religious voluntary agencies into relief and recovery efforts, Catholic War Relief Services-NCWC was established by the Catholic bishops' National Catholic Welfare Conference. After 1955 it was renamed Catholic Relief Services-NCWC. As a participant in the National War Fund, CRS was allotted 2.4 million dollars for immediate projects to respond to the needs of Polish refugees in Mexico, Palestine, and other Catholic refugees and prisoners of war. Of course, CRS could not use the funds for ecclesiastical purposes or any kind of religious activity, but all funds were to go for health and general-welfare projects. CRS was almost entirely dependent upon U.S. aid; it also received the funds collected in every diocese on Laetare Sunday that originated in a 1941 collection for overseas aid. Over the years Church World Service (which included the major Protestant denominations and the Orthodox Church) and the United Jewish Appeal collected funds on that same weekend, marking it a special time for reflection on the needs of the human family. Eileen Egan, author of a history of CRS, captured the significance of the appeals by the principal faiths: By their efficacy in mobilizing their communities to make sacrifices for suffering in far corners of the globe, the faith-related volunteer agencies earned the respect of the U.S. government, of foreign governments . . . and of intergovernmental agencies. ... In the post-war decades, over threefourths of all voluntary aid from the American people was donated by the three great faith-related agencies.1 Of course, this voluntary aid could be used for religious activities. In postwar Europe CRS had the advantage of funneling its U.S. aid for the social welfare and medical needs of people through the Church's extensive networks of institutions, i.e., hospitals, orphanages, and other charities. It was the only agency overseas recognized by many countries, making it the largest relief service. …

I NFLUENZA I MMUNIZATIONS P ROVIDED BY EMS A GENCIES : T HE MEDICVAX P ROJECT

Objective. Emergency medical services (EMS) agencies may be an underutilized resource for provision of preventive health services. This study sought to demonstrate the feasibility for EMS agencies to provide influenza immunizations. Methods. This prospective, observational cohort study was conducted with urban, suburban, and rural EMS agencies that volunteered to participate. EMS managers and paramedics attended an orientation program, and then developed and implemented recruitment strategies. Adult volunteer subjects who met Centers for Disease Control and Prevention criteria for influenza vaccination were enrolled. Paramedics obtained informed consent, determined subject eligibility, administered the vaccine, and observed each subject for 10 minutes. Paramedics, EMS managers, and subjects completed surveys; EMS managers reported costs and resource utilization. Data were analyzed descriptively. Results. Ninety paramedics from 15 EMS agencies in three counties participated. Subjects were recruited by print and broadcast media and enrolled at 73 events held at retail establishments, community events, EMS stations, churches, senior citizen complexes, and private residences. Of the 2,075 adults immunized, 1,014 (49%) did not receive influenza vaccination in the previous year. Seven hundred five (34%) reported that they probably would not have been vaccinated elsewhere. Fixed cost for each immunization was $3.42. The EMS managers estimated their variable costs to range from zero dollars (volunteer agencies with all donated expenses) to $15.31 per immunization. No adverse events were reported. Subjects, paramedics, and EMS managers indicated a high level of satisfaction with the project. Conclusion. The MEDICVAX Project demonstrated the feasibility of EMS agencies to safely provide influenza immunizations. The project reached some adults who likely would not have been immunized.