Context Community paramedicine programs (i.e., non-emergency preventive care by emergency medical services personnel under the direction of a physician) offer a novel approach to improve the wellbeing of families with a heightened risk of adverse childhood experiences (ACEs). Community paramedics provide acute medical care and long-term support services that address the underlying causes of ACEs.

Program To participate, women must have characteristics that increase the likelihood of maternal or infant morbidity and mortality. Throughout pregnancy and the 16 weeks following birth, community paramedics make regular in-home visits to provide clinical care directed by the physician.

Community paramedics also provide services to meet the complex needs of mothers and infants. Nearly all mothers receive transportation assistance, abusive head trauma prevention education, home safety inspections, and guidance on coping, among others. Community paramedics often provide referrals to partner services, such as mental health and substance abuse services or doula services, and some unconventional services, such as connecting women with free or low-cost infant supplies. (e.g., diapers, formula) or assistance finding employment.

Evaluation As a new program, we first conducted a process evaluation. We interviewed community stakeholders and mothers, which we analyzed using content analysis.

Both groups are happy with the current program and believe it meets a significant need in the community. Several mothers discussed specific ways the program reduced violence in the home.

Learning Objectives To explain how developers considered the community needs and matched program components to these needs.

To define and summarize several challenges and strengths of the program.