Attitudes of EMS Stakeholders in Barbados: A Convergent Parallel Mixed-Methods Study

Objective: To examine the attitudes of accident and emergency (A&E) doctors, prehospital EMS providers, and A&E nurses based on the tripartite model of attitudes theory. How do the attitudes of EMS stakeholders in Barbados align with the attributes of the EMS Agenda for the Future?

Design and Methods: A convergent parallel mixed-methods design was used. Beliefs, affect, and behavior measures were used as dependent and independent variables. Stakeholders were examined collectively and separately. Sampling was purposeful (n=105). Semi-structured interviews and a four-part survey were used to answer eight research questions. Inferential statistical methods were applied using SPSS. NVivo was used to code qualitative information collected.

Results: A confidence interval of 0.95 was used to report findings. A significant regression model based on beliefs and behaviors was identified for prehospital EMS providers (F[1,63]=9.278, p=0.003), with an R2 of .130. A significant regression model based on affect and beliefs was identified for A&E doctors (F[1,27]=5.896, p=0.022), with an R2 of 0.179; prehospital EMS providers (F[1, 62]=10.931, p=0.002), with an R2 of 0.150; and A&E nurses (F[1, 9]=7.318, p=0.024), with an R2 of 0.448. Eight themes emerged from the research.

Conclusions: EMS legislation, regulation, and medical direction are important in the English-speaking Caribbean, as they address a strategic priority of the Caribbean community. A 2050 EMS Agenda for the Caribbean is suggested to strengthen prehospital EMS and serve as a future model for out-of-hospital care in the region.