{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T06:04:11Z","timestamp":1789711451193,"version":"4.0.1"},"reference-count":16,"publisher":"American Medical Association (AMA)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"<jats:sec id=\"ab-zoi250162-4\">\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>Focusing on the US southern land border only through a security lens minimizes the impact of security infrastructure and migrant health needs on local emergency medical services (EMS) clinicians.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi250162-5\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To explore the perceptions and experiences regarding the impact of migration on EMS clinicians in the communities of study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi250162-6\">\n                    <jats:title>Design, Setting, and Participants<\/jats:title>\n                    <jats:p>This qualitative study included in-depth interviews with fire department\u2013based EMS clinicians in 3 Arizona communities on the Mexico border from June 23 to 27, 2024. Interviews were conducted 1-on-1 while clinicians were on shift. Participants were recruited with the help of fire department leadership in each fire department.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi250162-7\">\n                    <jats:title>Main Outcomes and Measures<\/jats:title>\n                    <jats:p>This was an exploratory study designed to identify how EMS clinicians perceive the influence of migration in the study communities. Thematic analysis was conducted using inductive, latent coding.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi250162-8\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The 67 participants were predominately male (62 [93%]), which is reflective of the EMS profession in the border region. Years of experience as EMS clinicians were fairly evenly distributed: 5 years or less (14 [21%]), 6 to 10 years (18 [27%]), 11 to 20 years (18 [27%]), and 21 or more years (17 [25%]). EMS clinicians in these communities reported serving multiple populations, often responding to complex calls, and experiencing limited downtime and mass casualty\u2013like scenarios when there are high numbers of border crossings. Participants perceived that the local EMS system was strained, and occasionally overwhelmed, and that greater financial support from the federal government was necessary.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi250162-9\">\n                    <jats:title>Conclusions and Relevance<\/jats:title>\n                    <jats:p>The findings of this qualitative study of EMS clinicians suggest that migration has a complex, multidimensional influence on EMS clinicians in the border region. Deterrence-focused actions have not decreased the number of crossings but rather pushed migrants to cross in more dangerous ways, leading to more injuries and deaths. Our findings suggest that the strain placed on local EMS clinicians is unsustainable and may be exacerbated by increased deterrence-based policies. Instead, border-region EMS clinicians need increased federal funding to support their work.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2025.3111","type":"journal-article","created":{"date-parts":[[2025,4,4]],"date-time":"2025-04-04T17:46:23Z","timestamp":1743788783000},"page":"e253111","source":"Crossref","is-referenced-by-count":2,"title":["Border Region Emergency Medical Services in Migrant Emergency Care"],"prefix":"10.1001","volume":"8","author":[{"given":"Christine Crudo","family":"Blackburn","sequence":"first","affiliation":[{"name":"Department of Health Policy and Management, School of Public Health, Texas A&M University, College Station"},{"name":"USA Center for Rural Public Health Preparedness, School of Public Health, Texas A&M University, College Station"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mayra","family":"Rico","sequence":"additional","affiliation":[{"name":"USA Center for Rural Public Health Preparedness, School of Public Health, Texas A&M University, College Station"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren","family":"Knight","sequence":"additional","affiliation":[{"name":"School of Public Health, Texas A&M University, College Station"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brandy","family":"Sebesta","sequence":"additional","affiliation":[{"name":"USA Center for Rural Public Health Preparedness, School of Public Health, Texas A&M University, College Station"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirk","family":"Niekamp","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, School of Public Health, Texas A&M University, College Station"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2025,4,3]]},"reference":[{"issue":"1","key":"zoi250162r2","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1111\/aman.12967","article-title":"Called to \u201cAnkle Alley\u201d: tactical infrastructure, migrant injuries, and emergency medical services on the US-Mexico border.","volume":"120","author":"Jusionyte","year":"2018","journal-title":"Am Anthropol"},{"issue":"2","key":"zoi250162r3","doi-asserted-by":"publisher","first-page":"430","DOI":"10.1177\/019791839903300206","article-title":"Death at the border.","volume":"33","author":"Eschbach","year":"1999","journal-title":"Int Migr Rev"},{"key":"zoi250162r4","doi-asserted-by":"publisher","DOI":"10.1016\/j.lana.2024.100676","article-title":"A border health crisis at the United States-Mexico border: an urgent call to action.","volume":"31","author":"Tenorio","year":"2024","journal-title":"Lancet Reg Health Am"},{"issue":"4","key":"zoi250162r5","doi-asserted-by":"publisher","first-page":"431","DOI":"10.1017\/S1049023X17006434","article-title":"Border injuries: an analysis of prehospital demographics, mechanisms, and patterns of injuries encountered by USBP EMS agents in the El Paso (Texas USA) Sector.","volume":"32","author":"Baker","year":"2017","journal-title":"Prehosp Disaster Med"},{"issue":"2","key":"zoi250162r6","first-page":"76","article-title":"Obstetric emergencies at the United States-Mexico border crossings in El Paso, Texas.","volume":"37","author":"McDonald","year":"2015","journal-title":"Rev Panam Salud Publica"},{"issue":"4","key":"zoi250162r9","doi-asserted-by":"publisher","first-page":"591","DOI":"10.1177\/1049732316665344","article-title":"Code saturation versus meaning saturation: how many interviews are enough?","volume":"27","author":"Hennink","year":"2017","journal-title":"Qual Health Res"},{"issue":"5","key":"zoi250162r11","doi-asserted-by":"publisher","first-page":"2120","DOI":"10.1017\/dmp.2021.264","article-title":"Preparedness for mass casualty incidents: the effectiveness of current training model.","volume":"16","author":"Biswas","year":"2022","journal-title":"Disaster Med Public Health Prep"},{"issue":"3","key":"zoi250162r13","doi-asserted-by":"publisher","first-page":"378","DOI":"10.1080\/10903127.2019.1657212","article-title":"Deployment of alternative response units in a high-volume, urban EMS system.","volume":"24","author":"Mechem","year":"2020","journal-title":"Prehosp Emerg Care"},{"issue":"1","key":"zoi250162r14","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1002\/emp2.12014","article-title":"The association of job demands and resources with burnout among emergency medical services professionals.","volume":"1","author":"Crowe","year":"2020","journal-title":"J Am Coll Emerg Physicians Open"},{"issue":"5","key":"zoi250162r15","first-page":"1557","article-title":"Why border enforcement backfired.","volume":"121","author":"Massey","year":"2016","journal-title":"AJS"},{"key":"zoi250162r16","doi-asserted-by":"publisher","first-page":"661","DOI":"10.1111\/j.1728-4457.2001.00661.x","article-title":"Death at the border: efficacy and unintended consequences of US immigration control policy.","volume":"27","author":"Cornelius","year":"2001","journal-title":"Popul Dev Rev"},{"key":"zoi250162r7","volume-title":"Threshold: Emergency Responders on the US-Mexico Border","author":"Jusionyte","year":"2018"},{"key":"zoi250162r8","doi-asserted-by":"crossref","DOI":"10.1016\/0147-1767(85)90062-8","volume-title":"Naturalistic Inquiry","author":"Lincoln","year":"1985"},{"key":"zoi250162r10","volume-title":"Thematic Analysis: A Practical Guide","author":"Braun","year":"2021"},{"key":"zoi250162r1","unstructured":"US Customs and Border Protection. Southwest land border encounters. Modified August 16, 2024. Accessed September 26, 2024. https:\/\/www.cbp.gov\/newsroom\/stats\/southwest-land-border-encounters"},{"key":"zoi250162r12","unstructured":"US Customs and Border Protection. USBP implementation plan: enhanced medical support efforts. Accessed October 1, 2024. https:\/\/www.cbp.gov\/sites\/default\/files\/assets\/documents\/2020-Jul\/USBP-Medical-Directive-Implementation-Plan-CONOPS-only.pdf"}],"container-title":["JAMA Network Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/articlepdf\/2832135\/blackburn_2025_oi_250162_1742918027.51984.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,4]],"date-time":"2025-04-04T17:46:39Z","timestamp":1743788799000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2832135"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,3]]},"references-count":16,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,4,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamanetworkopen.2025.3111","relation":{},"ISSN":["2574-3805"],"issn-type":[{"value":"2574-3805","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,3]]}}}