Programs of Research
Community Paramedicine at Clinic (CP@clinic) Program
The CP@clinic Program was developed to help keep low-income older adults healthy at home and reduce avoidable 911 calls. Community paramedics (CPs) take on a novel non-urgent care role and visit with older adults in common rooms of social housing, addressing their unmet health needs. The CPs use evidence-based assessments to evaluate older adults’ health risks. Algorithms within the CP@clinic Program Database guide paramedics in setting health goals with program participants and providing tailored health education and referrals to primary care and community resources.
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Community Paramedicine at Home (CP@home) & My Care Plan App (MyCP App)
Community Paramedicine at home (CP@home) was research intervention delivered by community paramedics in the homes of frequent Emergency Medical Services (EMS) callers with multimorbidity. Its goal was to deliver health risk assessments and referrals to appropriate health and community services with the intention of preventing health emergencies or redirecting access to more appropriate health care services.
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Health Care Provider at Clinic (HCP@clinic)
The standard CP@clinic model has been adapted for implementation by health care workers. This has the potential to have a great impact on chronic disease prevention and monitoring in older adults nationally.
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Social Housing Cohort: Chronic disease, social isolation, lifestyles, COVID-19, and Long Term Care transitions from Social Housing
This project generates knowledge and investigates patterns in health, chronic disease, COVID-19 status and healthcare use, and movement into Long Term Care of residents of social housing, a vulnerable population, growing in numbers. The impact of this work is a raised awareness of the burden of disease in social housing residents’ so that ultimately health can be improved through interventions and policy. Within this work collaborations have been made with Dr Michelle Wyndham-West (OCAD), Dr Jim Dunn (Health and Ageing, McMaster University), Canada Mortgage Housing Corporation, the Canadian Housing Evidence Collaborative, Ontario Non-profit Housing Association and multiple Local Municipal Housing Authorities.
Global justice through global health research leadership
LMICs Research:Those living in poverty in both rural and urban areas in LMICs are a focus of projects that Dr Agarwal has either led or collaborated on. The CHAP-Philippines, Diabetes Risk Assessment Tools in LMIC, and cancer prevention research program in Thailand, all described in section A, aim to give health care access to those who are impoverished and marginalized. These research projects also help the LMICs to adapt appropriate technologies to strengthen their healthcare system.
Global Health Research Leadership: As a trailblazer, Dr. Agarwal is a designated leader and a member of many global alliance research groups (Diabetes, Hypertension, Multimorbidity) that consolidate knowledge and develop the research agenda to address the explosion of chronic diseases in LMICs and vulnerable populations in HICs.
Legal Health Clinic study
This pioneering project sought to connect vulnerable populations to Legal Aid through the primary care doctors office - a trusted setting for vulnerable populations. This medical-legal partnership was very successful and the Legal Health Clinic has been sustained in Hamilton, and has fostered the development of other such clinics in Ontario.
Cardiovascular Health Awareness Program (CHAP) in Social Housing
This program was an adaptation of the CHAP program that was evaluated through a community-cluster RCT in small to mid-sized communities across Ontario. CHAP was a cardiometabolic health assessment and health promotion program delivered by volunteers in the community setting. This research program evaluated (Cluster RCT) CHAP in social housing buildings in Quebec and Ontario. This study was funded by CIHR.
Community Health Assessment Program in the Philippines (CHAP-P)
This program was an adaptation of the CHAP program that was evaluated through a community-cluster RCT in small to mid-sized communities across Ontario. CHAP was a cardiometabolic health assessment and health promotion program delivered by volunteers in the community setting. This research program evaluated (Cluster RCT) CHAP in social housing buildings in Quebec and Ontario. This study was funded by CIHR.
Diabetes Risk Tool work
Dr. Agarwal has collaborated with researchers in the Philippines (Ateneo de Zamboanga), Indonesia (Siyah Kuala University), Nepal, and Iran to develop or adapt Diabetes risk assessment tools for the local setting. These tools are used to assess the risk of individuals for developing diabetes and referring them to the appropriate healthcare provider and community resource for early identification, management, health promotion and disease prevention. These collaborations allow for shared learning and technology transfer between the different participating countries.
Enhanced Community Health Education and Communication (eCHEC): Thailand Cancer Prevention Research
This is a collaborative research project led by Dr. Gina Agarwal (McMaster University, Canada) and Dr. Pattapong Kessomboon (Khon Khaen University, Thailand). The aim of the research is to evaluate the Enhanced Community Health Education and Communication (eCHEC) intervention in decreasing risk factors for developing Cholangiocarcinoma among community residents in the province of Khon Khaen, Thailand.
UK-Canada Emergency calls Data analysis and GEospatial mapping (EDGE) Consortium
This is a collaborative project between Community and Health Research Unit (CaHRU), University of Lincoln, UK (with Dr Niro Siriwardena, Dr Frank Tanzer and Dr Mark Gussy), East Midlands and Yorkshire Ambulance Services and McMaster University initiated by Dr. Agarwal. The aim of the consortium is to analyze and compare Emergency call data in the UK and Canada, review patterns of Ambulatory Care Sensitive Conditions, mainly chronic diseases, among vulnerable (low income/resourced) populations, identify factors (healthcare access, community resources, etc.), and develop/propose solutions to improve the health of populations through appropriate primary healthcare use.
Race, Racialization and Health
Race has been recognized as a determinant of health. The extent to which it impacts individuals is not fully appreciated in Canada, with few studies. Dr Agarwal has led collaboration with others at McMaster (Dr Kapiriri from Health and Ageing in the Faculty of Social Sciences, and Dr Juliet Daniels from the Department of Biology). She has attracted seed funding from the McMaster Institute for Health Equity to build a program of enquiry along this line. Together they plan to invite other McMaster faculty and to explore the impact of racialization on the health of Canadians
Healthy aging of adults receiving support in the community and their caregivers
Race has been recognized as a determinant of health. The extent to which it impacts individuals is not fully appreciated in Canada, with few studies. Dr Agarwal has led collaboration with others at McMaster (Dr Kapiriri from Health and Ageing in the Faculty of Social Sciences, and Dr Juliet Daniels from the Department of Biology). She has attracted seed funding from the McMaster Institute for Health Equity to build a program of enquiry along this line. Together they plan to invite other McMaster faculty and to explore the impact of racialization on the health of Canadians