In 2010, we, a team of highly experienced clinicians and researchers at McMaster University Department of Family Medicine, began to recognize the surge of 911 calls from subsidized housing buildings in Hamilton, Ontario. These escalated call volumes were confirmed by our partners---Paramedic Services, Public Health and City Housing.

Low-income, older adults living in subsidized housing are a vulnerable population¹ and report poorer health. This population has a higher risk of developing multiple chronic conditions^2-6, falling⁷, poorer mental health⁸ and experiencing poverty and social isolation^9,10.  In our current CP@clinic sites, out of 3,390 older adult participants in subsidized housing, 82.8% have at least one cardiometabolic disease, 66.7% have hypertension, 30.7% have diabetes, 63.6% have pain or discomfort, 52.0% have mobility problems, 34.2% have difficulty in performing usual activities, and 19.0% have difficulty with doing self-care. These older adults often encounter barriers to accessing primary care¹¹. Their lower health literacy makes health education challenging and increases the likelihood of seeking costly acute hospital care¹². Having groups of low-income individuals living in close proximity provides the opportunity to efficiently deliver health-related programs and resources in a location accessible to a large number of people.

To address the high needs of this vulnerable, hard to reach population and the high 911 call rate--- the CP@clinic program was created.

The CP@clinic program was first tested through a pilot study and then again in a large, multi-community pragmatic randomized controlled trial, both rendering very positive results. To date, about one third of Ontario Paramedic Services are implementing CP@clinic. In 2019, Dr. Gina Agarwal and the McMaster Community Paramedicine Research Team were awarded Health Care Policy Contribution Program (HCPCP) funding by Health Canada to expand this innovative program with paramedic services across Canada! The skill set and expertise of the research team will be utilized in the in planning, implementing and evaluating CP@clinic.

The McMaster Community Paramedicine Research team continues to focus on improving health systems for vulnerable populations and contributing evidence to drive health system change in Ontario.