Mobile Health Clinic Research Articles

The Integration of Community Voice in the Implementation of a Mobile Health Program.

Health care access is vital to advancing health equity. The purpose of this paper was to use a community-based participatory research approach to engage underserved communities in the development of a new mobile health clinic (MHC) program and to discuss the lessons learned from the conversations. Community conversations helped identify barriers to access to health care, community strengths, and health concerns. They also helped the MHC leaders develop programming. The community-based participatory research approach guided five community conversations conducted (N = 51 participants) from 2018 to 2019. Participants provided input on their personal experiences with a) existing facilitators and barriers to health, b) priority health issues and needs, and c) recommendations for MHC program development. Barriers to health care access were identified, as were many community strengths. Recommendations directly informed MHC program development and implementation, including availability of services at no cost, mammogram referrals, mental health screening, eye exams, and nutrition counseling. This project highlights the importance of collaboration between academic partners and communities to inform health care programs and the implementation of a MHC based on community voice and input.

Mobile Health Clinic: Lessons Learned Building Partnerships Across Health Systems

Mobile Health Clinic: Lessons Learned Building Partnerships Across Health Systems

Commentary: The perspectives of homeless people using the services of a mobile health clinic in relation to their health needs: a qualitative study on community-based outreach nursing.

Commentary: The perspectives of homeless people using the services of a mobile health clinic in relation to their health needs: a qualitative study on community-based outreach nursing.

The perspectives of homeless people using the services of a mobile health clinic in relation to their health needs: a qualitative study on community-based outreach nursing.

Significant social and health issues are associated with homelessness. Negative experiences with the healthcare system are also frequent and cause people experiencing homelessness to avoid health services. The purpose of this study was to (1) explore participants' health needs concerning outreach nursing services and (2) describe the perceptions and preferences of people who access this form of community-based intervention. We conducted a critical ethnography with semi-structured interviews of 12 people experiencing homelessness who receive the services of a nurse-led mobile clinic, and 60 hours of observation during the provision of these services. Our results describe the perspectives of people experiencing homelessness in three main categories: (1) worrisome health and social needs, (2) non-use of healthcare and (3) what connects us to health services. Timely access to healthcare is an important issue for people experiencing homelessness. Nurse-led clinics meet needs that go far beyond health issues.

‘It’s so simple’ Lessons from the margins: a qualitative study of patient experiences of a mobile health clinic in Hamilton, Ontario, Canada

ObjectiveOur study explored the experiences of clients of HAMSMaRT (Hamilton Social Medicine Response Team), a mobile health service, in the context of their experiences of the overall healthcare system.DesignWe conducted...

Challenges and opportunities for medical referrals at a mobile community health clinic serving sexual and gender minorities in rural South Carolina: a qualitative approach

BackgroundSexual and gender minorities (SGM) in the Southern United States face challenges in accessing sexual and gender affirming health care. Alternative care models, like inclusive mobile clinics, help mitigate barriers to care for SGM. There is limited data in the literature on the experience of medical referral processes for SGM individuals accessing services from mobile health clinics.Aims and objectivesThe purpose of this study is to describe the medical referral experiences of SGM clients and their providers at a mobile health clinic in the Southern United States.MethodsWe recruited English-speaking individuals who provided care or received care from the mobile health clinic in South Carolina between June 2019 and August 2020. Participants completed a brief demographic survey and a virtual in-depth, semi-structured individual interview. Data analysis was conducted using an iterative process to generate codes, categories, and themes. Data collection and analysis were terminated once thematic saturation was achieved.ResultsThe findings from this study indicated that the mobile health clinic had an inconsistent referral process that was largely dependent on providers’ knowledge. Furthermore, clients and providers expressed individual barriers to the referral process, such as financial barriers, and opportunities to improve the referral process, such as an opt-in follow-up from the mobile clinic and increased mobile clinic resources.ConclusionThe findings in this study underscore the importance of having mobile clinics create a structured referral process that all medical providers are familiar with, and the value of hiring patient navigators that can support and refer clients to care that goes beyond the mobile health clinic setting.

Edition 62 – Mental Health Driving Change: Addressing America's Mental Health Crisis through the Power of Mobile Clinics in Underserved Communities

Our nation confronts an escalating mental health crisis and we find ourselves at a critical crossroads of this crisis, which if not addressed could gain epidemic proportions. This paper proposes an innovative, timely and potentially game-changing strategy advocating for the use of Mobile Mental Health Clinics (MMHCs) to address mental health challenges in underserved communities. By augmenting the well-established benefits of mobile health clinics with the imperative of mental health, we propose a proactive and cost-effective model that brings mental health services directly to the patient’s doorstep. The paper details how we could employ cutting-edge technology, streamline patient intake, treatment, and monitoring and provide an efficient approach that’s adaptable to the rapidly evolving healthcare landscape. It also offers a detailed and comprehensive operating model for a MMHC, encompassing staffing, service provision, community engagement, and potential collaborations while addressing the challenges and solutions associated with implementing such a model.

A qualitative assessment of provider satisfaction and experiences with a COVID-19 community mobile health clinic outreach model in underserved Baltimore neighborhoods.

Although previous studies have assessed provider perceptions about telehealth, no prior studies have qualitatively assessed the experiences and satisfaction of health-care providers with a community mobile health clinic model within underserved urban settings. This study draws on the views expressed by community health workers (n = 4), registered nurses (n = 2), Grace Medical Center outreach specialists (n = 2), and physician assistants staffing LifeBridge Health's virtual hospital (n = 3) to understand their satisfaction and experiences with a COVID-19 community mobile health clinic in underserved Baltimore neighborhoods. Thematic analysis of the interviews was used to extract themes and subthemes of our health-care providers' experiences with the community mobile health clinic model. These individuals shared their experiences addressing social determinants of health, the perceived impact of community mobile health clinic, satisfaction with and limitations of the pilot project, as well as future implications for the community mobile health clinic model. Finally, ideas for how the model can fit into the existing healthcare delivery framework are suggested. The context surrounding the COVID-19 pandemic has provided a unique opportunity to critically address healthcare frameworks and models. The LifeBridge community mobile health clinic served as an initiative to truly bridge together community outreach and health access. Among the many themes, health-care providers on the team applauded the model for its potential to bring preventative health care to the patient with the goal of improving patient health outcomes.

Vision Bus Aotearoa: a platform for strengthening eye health teaching, research and community partnership

ABSTRACT Clinical Relevance Vision Bus Aotearoa is a fully equipped mobile eye health clinic designed to provide a novel platform for undergraduate optometry clinical training, community eye health research and deliver services to underserved communities. Background Aotearoa New Zealand has inequitable access to eye health care. Vision Bus Aotearoa aims to work in partnership with communities to provide comprehensive mobile primary eye health care services while training optometry students, and integrating community eye health research. Methods A description is provided of the governance model which has been involved throughout the project. Results The process of vehicle manufacture, clinical set-up, funding models and service delivery are described. The aims of the project are detailed in terms of optometry teaching, clinical services in partnership with communities, and research integration and implementation. Conclusion Vision Bus Aotearoa represents a valuable opportunity to deliver mobile eye health care to historically underserved communities, enhance undergraduate optometry teaching and to provide a unique platform for community eye health research.

Solar Energy Implementation for Health-Care Facilities in Developing and Underdeveloped Countries: Overview, Opportunities, and Challenges

Developing and underdeveloped countries face innumerable problems related to the accessibility and quality of energy that put the lives of patients, health-care infrastructures, and health workers at risk. Current approaches, such as grid power, unsustainable energy sources such as diesel or gas, and mobile health clinics, have proven insufficient to address this issue. In response, access to reliable health care and electricity has undergone multiple transformations in the last decade, especially in remote and rural areas. Good health and clean energy are two of the 17 United Nations Sustainable Development Goals, originally designed to be a “shared blueprint for peace and prosperity for people and the planet, now and into the future.” Unfortunately, little is known about the interaction between health-care access and energy access in developing and underdeveloped countries, mainly in remote or rural areas. For this reason, this study conducts a review of the literature, including current approaches, challenges, and opportunities for the implementation of solar energy in health centers. As a result, several challenges and opportunities in three impact areas are presented: (1) operational, (2) environmental, and (3) economic. This study delivers detailed information that allows the implementation of solar energy in the health-care sector (in a more effective manner) by sharing best practices.

Nothing about us without us: Community-based participatory research to improve HIV care for mobile patients in Kenya and Uganda

BackgroundPopulation mobility is prevalent and complex in sub-Saharan Africa, and can disrupt HIV care and fuel onward transmission. While differentiated care models show promise for meeting the needs of mobile populations by addressing care cascade gaps, the voices of mobile populations need to be included when designing care delivery models. We assessed the unmet needs of mobile populations and engaged mobile stakeholders in the design and implementation of service delivery to improve care outcomes for mobile people living with HIV (PLHIV). MethodsCBPR was conducted in 12 rural communities in Kenya and Uganda participating in a mobility study within the Sustainable East Africa Research in Community Health (SEARCH) test-and-treat trial (NCT# 01864603) from 2016 to 2019. Annual gender-balanced meetings with between 17 and 33 mobile community stakeholders per meeting were conducted in local languages to gather information on mobility and its influence on HIV-related outcomes. Discussions were audio-recorded, transcribed and translated into English. Findings were shared at subsequent meetings to engage mobile stakeholders in interpretation. At year three, intervention ideas to address mobile populations’ needs were elicited. After refinement, these intervention options were presented to the same communities for prioritization the following year, using a participatory ranking approach. ResultsTransit hubs, trading centers, and beach sites were identified as desirable service locations. Communities prioritized mobile health ‘cards’ with electronic medical records and peer-delivered home-based services. Mobile health clinics, longer antiretroviral refills, and 24/7 (after service) were less desirable options. Care challenges included: lack of transfer letters to other clinics; inability to adhere to scheduled appointments, medication regimens, and monitoring of treatment outcomes while mobile amongst others. ConclusionsIterative discussions with mobile community stakeholders elicited communities’ health priorities and identified challenges to achieving HIV care cascade outcomes. Understanding the mobility patterns and unique needs of mobile populations through responsive community engagement is critical.

93 Mapping Mobile Health Clinics in Canada: Delivering Equitable Primary Care to Children and Vulnerable Populations

Abstract Background Low-income and racially diverse populations often have multiple barriers in accessing healthcare and are at increased risk of poor health outcomes. COVID-19 exacerbated these health inequities: decreased in-person appointments, difficult access to virtual care and deprioritization of elective clinical activity led to delays in well-child visits and vaccination. This public health emergency highlighted a need to develop alternative models to enable access to primary care for vulnerable children. While mobile clinics are well-established in the United States, little is known about them in Canada. Objectives This study aims to characterize Canadian mobile clinics providing primary care health services to vulnerable populations, including children, and seeks to inform the implementation of a pediatric mobile clinic under development. Design/Methods This environmental scan screened scientific databases and the grey literature using a combination of terms designating mobile health clinics and Canadian locations. Relevant Canadian primary care mobile clinic initiatives were subsequently included. We defined primary care mobile clinics as movable health care units providing primary healthcare services delivered by general medical practitioners (pediatricians and family physicians). Examples of excluded initiatives were mobile clinics focused on education/literacy, dental care, vision care, endocrinology, cancer screening, safe injection sites, vaccination, physical rehabilitation and urgent care. Descriptive statistics and qualitative analysis were performed. Results 29 clinics were identified, of which 26 are still active. Most clinics were located in Ontario (n=11), followed by British Columbia (n=8), Alberta (n=5), Quebec (n=2) and the Maritimes (n=2). The first mobile clinic in Canada was launched in 1996, with an increasing number of new clinics in 2021. While all clinics served vulnerable populations, some targeted specific groups, such as children, people experiencing homelessness, immigrants, LGBTQ+ individuals and Indigenous peoples. We identified three pediatric mobile clinics, two of which targeted teenagers. Onboard the clinics, physicians often worked with nurses, outreach workers and social workers. These professionals provided primary care services, as well as healthcare navigation, sexual education, mental health care, harm reduction supplies, vaccination and emergency care. All mobile clinics partnered with their local government, charities or businesses to fund their initiative. Conclusion Mobile health clinics are a growing model of primary care in Canada. They are the result of a multidisciplinary collaboration between healthcare providers, social workers and outreach workers. To this date, Canadian pediatric mobile clinics remain a handful and represent an interesting avenue to address health inequities in children, during the pandemic and beyond.

Smart Rural Village’s Healthcare and Energy Indicators—Twin Enablers to Smart Rural Life

Poverty in rural areas remains rife and high despite the rapid societal developments and technological advancements the world is riding on, brought about by the advent of the Fourth Industrial Revolution. Most communities and individuals in many rural areas of the world often face near zero to limited access to basic services such as access to energy and healthcare. The study’s objective is to develop linkages between smart rural health indicators and smart rural energy indicators. This is achieved by using a six-stage method developed over a two year period. The method uses sustainable development goals as a point of departure; however, in this study, the focus is on healthcare and energy access. The following indicators has been derived: the number of patients in a village monitored remotely, the number of persons having access to a mobile health clinic powered by a renewable energy source, the number of network routers powered by renewable energy to enable drone usage in a village, and the accessibility of a patient’s database by the village surgeon remotely due to reliable and accessible servers powered by a mixture of sustainable and renewable energy. The paper concludes that a sustainable, renewable energy mix acts as the enabling link that renders healthcare services in rural villages accessible to all.

A Digitally Capable Mobile Health Clinic to Improve Rural Health Care in America: A Pilot Quality Improvement Study

ObjectiveTo address the problem of limited health care access for patients in rural southern Minnesota, a digitally capable mobile health clinic (MHC) quality improvement initiative was launched in a rural community-based health system. MethodsThis project was designed and implemented according to our institutional strategic plan, guiding principles for virtual community care, and existing approved standards of care. A quality improvement development and pilot implementation framework was rapidly developed using Agile methodology. ResultsThe resulting technology and equipment selection, overall clinic design, vehicle vendor selection, clinical schedule and workflows, staffing model, equipment and technology selection, and testing were achieved in 12 months. The pilot site communities were chosen on the basis of size, interest, and lack of existing access. Four underserved rural communities now have access to telehealth consultations, laboratory testing, and in-person primary care examinations. By April 30, 2022, the MHC had provided 1498 patient appointments while maintaining our standards of care. Newly established broadband internet access for these communities and their residents was a valuable secondary outcome. ConclusionBy designing and implementing an MHC quality improvement intervention that provides both in-person and advanced telehealth options for patients in rural communities, our institution rapidly provided a potential solution for the rural health care crisis. The MHC not only replaces traditional brick-and-mortar facilities but also expands service offerings and access to technology for rural communities and the people who live and work in them.

Forging Community Partnerships to Examine Pesticide Exposure and Risk Perceptions among Latinx Farmworkers

Background: Research with structurally marginalized populations has a history of being extractive and providing a benefit primarily to the researchers rather than the participants. To address these concerns, there is an increasing emphasis in the field of environmental epidemiology to conduct community-based work and return exposure results to study participants. The aim of this work is to forge partnerships with trusted community organizations to support and help facilitate a mixed-methods investigation of pesticide exposure and risk perceptions among Latinx farmworkers, a population that faces many barriers to health protection. We further aim to create multi-media science communication products to effectively translate individual- and group-level study findings and to increase engagement and empowerment among participants. Methods: We focused six months of the one-year study period prior to data collection on community engagement and gaining trust, first with community partners and then study participants. We used various strategies, including social media engagement, holding teleconference and in-person meetings, and snowball sampling to establish and build upon existing partnerships. Focusing our study on the benefit to participants and research communication plan was key in obtaining buy-in from community partners. Results: We partnered with County Health Coalitions; migrant head start programs; non-profit organizations; housing providers; social media groups; and mobile health clinics to recruit participants, establish trusting relationships, and develop strategies to maximize the benefits of participating in the study. Examples include developing tailored research communication products; providing food boxes with organic, culturally appropriate food items; and providing childcare during data collection events. Conclusion: Forging collaborations with diverse individuals and community groups is critical in establishing trust with structurally marginalized populations. Our work provides an example of how to develop these partnerships, center community priorities, and maximize the benefit of participation both for study participants and partner organizations. Key Words: pesticides, farmworker, community-engaged research

Well-being index of Indigenous people of Peninsular Malaysia: an application of the multidimensional poverty index (MPI)

The Indigenous people of Malaysia are a heterogeneous community scattered over more than 852 villages in Peninsular Malaysia. This community has been identified as socioeconomically and culturally poor and marginalized in Peninsular Malaysia. Therefore, the study aims to examine the well-being and create well-being indices of the Indigenous people. This study employed Alkire and Foster’s multidimensional poverty index (MPI) to create the well-being indices by using primary data. The finding revealed that Indigenous people are likely to remain poor due to insufficient access to basic education and lack of employment opportunities. The well-being index showed that females are more deprived than males and Indigenous people living in rural areas are better off compared to those living in urban and sub-urban areas. The study suggests that there is a need to combat low education levels and the government should introduce a community-based education system and mobile health clinics for Indigenous people.

What mental illness means in different cultures: Perceptions of mental health among refugees from various countries of origin

Introduction: Mental illness remains a significant issue in refugees worldwide. Internationally, there continues to be stigma surrounding mental health, mental illness, and mental health treatment. Cultural stigma is just one of many barriers to mental healthcare for refugees. Perceptions of mental health are culture-specific and continue to play a role in refugees.
 Purpose: The purpose of this review study is to make distinctions between the perceptions of mental health of refugees based on country of origin because knowing these cultural differences has the potential to improve refugee mental healthcare. This knowledge could contribute to treatment approaches and help break some of the barriers to mental healthcare for refugees.
 Methodology: An extensive literature review of relevant articles published between 2000-2021 was performed using the databases APA PsycInfo, Global Health, MEDLINE via Ovid, CINAHL Plus with Full Text, and Google Scholar. The following search terms, in addition to other related and relevant terms, were used: “mental health, refugees, mental health barriers, perceptions of mental illness, country of origin.”
 Results: There were both numerous similarities and differences between the perceptions of mental health among refugees from different cultures. There were similarities in terms of mental health stigma, with certain cultures thinking of mental health/illness as taboo, as shameful, or associating it with evil spirits. A few of the cultures studied had similar ideas about the causes of mental illness, believing it was due to traumatic events or possession by evil spirits. The refugee groups had some common treatment options, including informal conversation, religious-based ideas, and community-level solutions. Some differences between refugees from different cultures involved certain symptoms associated with mental health, including physical symptoms, and differing degrees of religiosity.
 Discussion: Based on studies reviewed about the perceptions of mental health of various refugee cultures, many recommendations are proposed to improve refugee mental healthcare. Suggestions include focusing on cultural competency and community-level solutions, in addition to implementing mobile health clinics and telehealth.
 Conclusions: This review discusses the perceptions of mental health, mental illness, and mental health treatment of refugees from numerous countries of origin. It is unique in its inclusion of different groups of refugees. Culture seems to play a significant role in the perceptions encountered. Keeping culture in mind, several recommendations are made to improve refugee mental healthcare, such as more integrative treatment methods and telehealth.

Mobile Health Clinics as a Healthcare Delivery Model to Address Community Disparities.

Mobile Health Clinics as a Healthcare Delivery Model to Address Community Disparities.

Usefulness of volunteer urgent mobile health clinics in improving cost-effective healthcare in the Al-Qassim Region, Saudi Arabia

Mobile clinics are generally customized vehicles equipped with important medical equipment and staff to provide primary health services for populations at risk, enforce disease prevention, and improve access to chronic health management, at reduced costs. The present study evaluated the usefulness and effectiveness of volunteer mobile clinics in providing healthcare in different medical specialties in rural area hospitals in Saudi Arabia. The study also estimated the cost of providing such healthcare facilities and stakeholder satisfaction through the use of a standardized questionnaire. A total of 1299 patients attended the 36 mobile clinics’ setup with 39 volunteer consultants in five hospitals namely Al- Nabahanyah, Abanat, Qibah, and Qusiba. The age of the patients ranged between 1 to 80 years. The average cost per patient was reduced to 150 SAR which is 25% lesser than that of the national average cost of consultation (200 SAR). Based on the survey results it was seen that the overall satisfaction of patient services offered by mobile is very high (87.4%) while it ranged between 80-95% in different hospitals. However, the response rate was very low and ranged between 16-31% while the average response rate was 21.8%.

Mobile clinics: Medical service strategy for disaster healthcare response operation

Purpose: Disrupted healthcare facilities due to disasters leave the affected communities without access to sufficient health care. This study proposed the use of mobile health clinics to address the issues faced by medical service providers during disaster response.Design/methodology/approach: A mobile health clinic a mobile facility that performs health care services from a stationary location. The model was developed as a healthcare response strategy, considering demand uncertainties due to the nature of the disaster. Therefore, this study objective is to simultaneously generate the mobile health clinic route and schedule and determine how each mobile health clinic covers patient demands within a pre-specified time horizon. The stochastic model is presented because the disaster's impact varies according to its scale.Findings: An investigation of the medical shelter effect in locations with high number of displaced people and the routing of mobile clinics for several shelter locations with a small number of people show that a hybrid strategy comprising a medical shelter and a mobile health clinic is the best option. Mobile health clinics can serve many locations within an appropriate walking distance. It can also route them to other locations when the time constraint allows. With a high number of people located in a shelter, building a medical shelter provides a better service.Originality/value: This study proposed mobile health clinics as a medical service strategy during disaster response to address the challenges faced by communities during a disaster response. The idea of mobile health clinics (MHC) is to improve communities’ access to healthcare services.