Access To Services Research Articles

A socio-ecological model of the management of leprosy reactions in Indonesia and India using the experiences of affected individuals, family members and healthcare providers

BackgroundLeprosy reactions (LR) are immune-mediated complications of leprosy that may be associated with severe and irreversible nerve damage. Non-medical aspects, such as financing, service provision, and healthcare resources in the management of LR are generally overlooked as studies tend to concentrate on clinical features and treatment. Barriers to accessing care and services are a major cause of suboptimal care for people with leprosy. This study aims to explore the barriers to and facilitators of high-quality care and management of LR in two leprosy-endemic countries with different health care models – Indonesia and India – and identify areas for improvement.MethodsA socio-ecological model was adopted. Data were obtained from 66 interviews with individuals who experienced LR and were seeking care at the two study sites. In addition, immediate family members of individuals with LR and healthcare workers attending to people with leprosy participated in seven focus group discussions (FGDs).ResultsThis study highlights the significant impact of public health insurance regulations and uptake at the macrosystem level on the provision of healthcare services, clinical decision-making, care expenditure, and the psychological well-being of individuals with LR in Indonesia and India. Lack of specialized health professionals and communication challenges were identified in both study populations. Indonesian participants encounter additional challenges due to a fragmented information system and drug shortages. This study identifies key facilitators in providing high-quality care for LR-affected individuals, including financial assistance, availability of corticosteroid alternatives, timely provision of care, and counselling. It found that the high coverage of public health insurance cards in the Indonesian model has increased access to care among individuals affected by LR, despite the challenges. Conversely, the Indian model of care offers treatment subsidies. The advantage of the Indonesian model is its ability to provide wider access to high-quality care, whereas the Indian model focuses on those in most need. This study emphasizes the importance of addressing these challenges through improved communication strategies, education aimed at the affected individuals, and accessible medical care. Furthermore, variations in care-seeking behaviour and self-care practices were observed in both sites, underscoring the need for culturally sensitive and comprehensive approaches to the management of LR.ConclusionThe study findings demonstrate that the factors identified at the four systemic levels are interrelated and have an impact on the access, acceptability, and management of LR services. Despite its accessibility and wider coverage of public health insurance, the integrated service model in Indonesia faces challenges associated with complex regulations and the availability of medication. India’s care model offers intensive, specialised care but has difficulties in ensuring sufficient health personnel, resources, and public health insurance coverage. These findings highlight the need to address these challenges to ensure timely, effective, and comprehensive care for individuals with LR.

Improvement in the effective cataract surgical coverage in Malaysia: evidence of impact from a mobile cataract outreach program

BackgroundEffective Cataract Surgical Coverage (eCSC) is one of the Universal Health Coverage (UHC) indicators recommended by the World Health Organization (WHO). It is calculated from a population survey and measures access and quality of eye care services in the community. We conducted simultaneous population-based eye surveys in two regions in Malaysia in 2023 to estimate eCSC and compare the results with the survey in 2014 following the implementation of a mobile cataract program.MethodsThe surveys were simultaneously done in Eastern and Sarawak administrative regions using the Rapid Assessment of Avoidable Blindness (RAAB) technique. It involved a multistage cluster sampling method, each cluster comprising 50 residents aged 50 years and older. Presenting visual acuity (PVA) was checked, and subjects with cataracts were identified. The corrected VA (Pinhole) of those who had undergone cataract surgery was measured. eCSC was calculated at all levels of cataract surgical thresholds according to the protocol. The findings were compared with the previous survey.ResultsA total of 10,184 subjects were enumerated, with 9,709 examined and 475 non-respondents. Females had a significantly lower Cataract Surgical Coverage (CSC) than males for cataract surgical threshold of < 3/60 for both regions in National Eye Survey (NES) II in 2014, [Eastern female 82.0%, 95% Confidence Interval (CI) (72.5, 91.5) vs. male 97.8%, 95% CI (92.8, 100.0), Sarawak female 76.9%, 95% CI (66.4, 87.3) vs. male 96.4%, 95% CI (91.6, 100.0)]. However, there was no significant gender difference in eCSC. Comparing NES II (2014) and NES III (2023) at various levels of cataract surgical threshold, eCSC improved within the range of 13.8-19.2% and 18.6-23.8% for Eastern and Sarawak, respectively.ConclusionThe improvement in eCSC could likely be attributed to both quality outcome enhancement and increased coverage, possibly due to the impact of the mobile cataract services in both regions. However, a coordinated approach is necessary to further strengthen and expand the coverage of the program to enable the country to achieve the 30% increase in eCSC as targeted by WHO.

Mental Health Awareness and Access to Services in Postpartum Women

ABSTRACT Background: Mental health disorders are prevalent among postpartum women, impacting both maternal and infant well-being. Despite the recognized importance of mental health support during the postpartum period, access to services remains limited for many. Materials and Methods: A cross-sectional survey was conducted with 200 postpartum women within six months postpartum at two major healthcare centers. Participants completed a questionnaire assessing their awareness of mental health issues, access to services, and perceived barriers. Data analysis included descriptive statistics and regression models to determine factors associated with awareness and access levels. Results: Of the 200 participants, 72% reported awareness of postpartum mental health issues, yet only 40% accessed available mental health services. Primary barriers included lack of information (45%), stigma (30%), and financial constraints (25%). Women with higher educational levels showed a significantly greater likelihood of accessing services (P &lt; 0.05), and those with family support were more likely to report positive mental health outcomes. Conclusion: While awareness of postpartum mental health is relatively high, access to services remains a significant challenge, hindered by stigma, lack of information, and financial barriers. Targeted interventions to improve information dissemination and reduce stigma could enhance service accessibility and mental health outcomes for postpartum women.

Empowering access: unveiling an overall composite spatial accessibility index to healthcare services in Southeastern Iran

BackgroundAccess to healthcare is critical for population health; however, geographic barriers persist especially in rural and deprived regions. This study aims to develop an overall composite potential spatial accessibility index to healthcare facilities and services in Sistan and Baluchestan Province in southeast Iran.MethodsThis study employed the enhanced two-step floating catchment area (E2SFCA) method to create an overall composite spatial accessibility index for healthcare facilities and services in Sistan and Baluchestan Province, southeast Iran. Spatial accessibility for general practitioners, nursing, dentistry, midwifery, pharmacy, medical laboratory, nutrition, public health, radiology, psychology, environmental health, rural health workers, inpatient hospital beds, and five medical specialty services were calculated. Spatial accessibility scores were normalized from 0 to 1 (no access = 0, low = 0.01 to 0.33, moderate = 0.331 to 0.66, high = 0.661 to 1) and aggregated into overall indices of primary, secondary, and overall healthcare accessibility for each district. Inequality was assessed using the Lorenz curve and Gini coefficient analysis.ResultsLow geographic accessibility was found across Sistan and Baluchestan Province, especially in rural areas. Almost 75% of the population had low/no access to overall primary care services within a 30-minute drive time. For secondary care, nearly 45% had low/no access to hospital inpatient beds within a 30-minute drive time, and around 40% had low/no access to specialists within a 60-minute drive time. Just 11.6% of the population had high overall healthcare access. The calculated Gini coefficient of 0.517 for the overall spatial accessibility index to healthcare services in Sistan and Baluchestan Province highlights a highly unequal distribution of healthcare services.ConclusionsThis study demonstrates a useful replicable methodology that combines individual service accessibility metrics into an overall spatial healthcare access index. Furthermore, this study provides evidence of major shortfalls in healthcare access across Sistan and Baluchestan Province. Targeted strategies are required to increase the availability and capacity of services in underserved communities. Improving geographic access is key for progressing towards universal coverage and better population health.

Environmental Economic Benefits in Public Service Malls: A Perspective on Resource Efficiency and Improving Community Welfare in Indonesia

The Public Service Mall (MPP) is an innovation in government services that aims to increase the efficiency, effectiveness, and accessibility of public services. From an environmental economic perspective, MPP contributes to optimizing the use of resources and encouraging the growth of community welfare. This research discusses the environmental economic benefits generated by MPPs in Indonesia, focusing on resource efficiency and its impact on community welfare. Through the integration of various services in one location, MPP reduces people's travel needs, thereby saving time, cost, and energy consumption. In addition, the existence of MPPs can encourage carbon footprint reduction through operational efficiency and optimization of public infrastructure. On the other hand, MPP improves the accessibility of basic services, which has an impact on reducing social disparities and improving the quality of life. The conclusion of this study shows that the development of MPP not only supports the bureaucratic reform agenda, but also has a positive impact on the environmental economy through more efficient resource management and sustainable improvement of community welfare.

Services availability and readiness assessment of adolescent sexual and reproductive health in primary healthcare facilities: evidence from selected districts in Ghana

BackgroundGlobally, adolescent health remains a public health priority given that adolescents often face unique vulnerabilities to health issues like mental disorders, substance abuse, and sexual health risks. In developing countries like Ghana, primary healthcare facilities (PHCs) are often the first point of contact for addressing these issues. However, there is a lack of literature examining the capacity of PHCs to address adolescent sexual and reproductive health (ASRH) issues. This study aims to fill this gap in the literature by assessing the availability and readiness of ASRH services within Ghana’s PHCs.MethodsThe study utilized a multi-stage sampling approach to select 67 PHCs across four districts in the Greater Accra region, reflecting Ghana's broad demographic diversity. We employed the WHO's Services Availability and Readiness Assessment (SARA) tool to measure the availability and readiness of ASRH services. This framework focused on key domains including service availability and readiness, assessing aspects such as HIV testing, family planning, and availability of contraceptives and necessary staff training. Data analysis was conducted using Stata version 17.0, analysing frequencies and percentages to capture the extent of service provision across the selected facilities.ResultsThe study highlighted significant disparities in the availability and readiness of essential ASRH services (HIV services, family planning, contraceptive pills, IUCD provisions, and male condoms) across selected districts and facility types. In Shai Osudoku, 65% of facilities offered a full range of selected ASRH services, the highest among the districts, whereas Ningo Prampram had the lowest at just 16%. In terms of facility types, 57% of CHPS facilities, 59% of health centres, and 44% of clinics provided all the selected ASRH services. Urban areas reported a 51% provision rate of these services, slightly less than the 54% observed in rural areas. Additionally, readiness disparities were evident: only 21% of urban facilities had adequate service guidelines compared to 29% in rural areas, and a higher percentage of rural facilities (46%) had trained staff, compared to 23% in urban areas.ConclusionThis study examined the availability and readiness of ASRH services in PHCs across the Greater Accra region, revealing significant disparities by location and facility type. Particularly, rural and public facilities demonstrated a higher availability of ASRH services compared to urban and private facilities. These findings suggest an uneven distribution of resources and highlight a potential urban underutilization of public health services. Moreover, the study identified a critical lack of service guidelines and trained staff across many facilities, emphasizing the need for enhanced training and resource allocation to improve service readiness. Targeted interventions are necessary to elevate the quality and accessibility of ASRH services, ensuring equitable health care delivery across all regions. Future research should expand to other regions to validate these findings and inform nationwide health strategies.

Physical Health Views Among Individuals Experiencing Mental Illness: A Mixed-Methods Study of Self-Reported Health and Contributing Factors.

Severe mental illness is linked to poor physical health and shorter life expectancy, yet research on how individuals experiencing mental illness view and on improve their physical health is limited. This study investigates the perceptions of individuals experiencing mental illness regarding their physical health, utilising a mixed-methods approach. Phase I involved quantitative and qualitative data from an online Qualtrics survey, which included the 12-item Short Form (SF-12) survey to measure participants' quality of life and assess self-reported physical and mental health. Key findings from Phase I revealed significant relationships between lower Physical Component Summary (PCS) scores and factors such as the frequency of GP visits. Additionally, exercise preferences were found to significantly impact Mental Component Summary (MCS) scores, with individuals who preferred a mix of exercise settings reporting higher MCS scores compared to those who exercised alone or with a training partner. Phase II explored these findings further through semi-structured interviews, where participants discussed themes including physical health perceptions, the role of medication and the importance of the general practitioner relationship. Thematic analysis revealed five main barriers to improving physical health: accessibility and availability of services, motivation, staff attitudes, medication side effects and the experience of diagnostic overshadowing. Participants reported viewing physical and mental health as interconnected and expressed a desire for more collaborative care. The results suggest that strengthening the relationship with GPs and increasing awareness of medication side effects may improve physical health outcomes for individuals experiencing mental illness. Mental health nurses can play a pivotal role in enhancing physical health outcomes by monitoring, supporting health-improving strategies and facilitating access to primary care services.

Does inter-city commuting lead to increasing disparity of public service accessibility within Chinese metropolitan areas? A case study of Guangzhou

Does inter-city commuting lead to increasing disparity of public service accessibility within Chinese metropolitan areas? A case study of Guangzhou

Geographic accessibility to hospital childbirths in Brazil (2010-2011 and 2018-2019): a cross-sectional study.

Delays in obstetric care are associated with adverse maternal outcomes, while long-distance travel for delivery is associated with high neonatal mortality and increased maternal morbidity. Distance and travel time are key components of geographic accessibility to health services and important risk indicators for maternal and neonatal care. This study evaluated whether the Brazilian Unified Health System (SUS) has been geographically accessible in providing hospital childbirth services, over time. Geographic accessibility to hospital deliveries in Brazil was mapped over two biennia (2010-2011 and 2018-2019), spanning a 10-year period, using national aggregated data from SUS Hospital Admissions Authorizations. Travel flows, distances, and times between women's municipalities of residence and hospitals were estimated. A total of 6,930,944 hospital deliveries were analyzed. Overall, 25.4% (n=1,759,306) of pregnant women traveled outside their municipalities to give birth in SUS hospitals, increasing from 23.6% (n=843,501) in 2010-2011 to 27.3% (n=915,805) in 2018-2019. Distance and travel time rose by 31.1% (54.0km-70.8km) and 33.6% (63.1-84.3min), respectively. Women experiencing maternal and/or neonatal death traveled longer distances and times. Regional disparities were evident: the Northeast had the highest proportion of women traveling (35.6%; n=817,499), and the North had the lowest (16.0%; n=138,295). Women in the North faced the longest travel distances (97.5-133.4km) and times (1,012-1,850min), while those in the Southeast and South experienced the shortest distances (37.2-55.9km and 41.2-54.8km, respectively) and times (38-52min and 41-52min). The results highlight regional disparities in maternal health service access within the SUS, which may affect maternal and neonatal outcomes. Targeted public health measures are needed to improve the availability of service, particularly in the North and Northeast regions, where access issues are most severe. Fundação Oswaldo Cruz; CNPq; FAPERJ.

Perspectives of Pharmacists Towards Patient-Centred Mental Health Pharmacy Services: A Focus Group Study

Introduction: The rising prevalence of mental illness is a growing concern. Integrating pharmacists into mental health care teams could help address this challenge by improving service quality and accessibility for patients. This study investigates pharmacists' opinions regarding treatment care in the Kuantan and Pekan areas and their attitudes toward patient-centred mental health pharmacy services. Methods: A qualitative study was conducted with 63 pharmacists around Kuantan and Pekan, Pahang, utilising a focus group discussion (FGD) style. The pharmacists were selected through purposive sampling from 2 general hospitals, 2 district health offices, and 1 teaching hospital. All locations are primary healthcare in Malaysia. The focus group topic guide was created using the relevant literature research. The entire interviews were audio-recorded and then transcribed verbatim. Thematic analysis was performed inductively to analyse the data. Results: This study involved 14 focus group sessions with all 63 pharmacists participating. Every interview was in person at the designated sites. From the interviews, 6 key themes were identified. 1. Role of pharmacists in mental health care. 2. Pharmacists-patients’ interactions. 3. Interprofessional collaborations with other healthcare workers. 4. Challenges and barriers. 5. Training needs for pharmacists and lastly 6. Improvement on the role of pharmacists and future practice. Conclusion: This research explores Malaysian pharmacists' perspectives on mental health treatments. It highlights pharmacists' potential contributions to mental health care, the challenges they face when assisting patients with mental health conditions, and the current limitations of mental health services in Malaysia's primary healthcare settings, hospitals, and Klinik Kesihatan.

Birth/Death Registration Integration with Services

The “Birth/Death Registration Integration with Ser- vices” Android application is designed to modernize and streamline the process of registering and managing birth and death certificates. This system features three distinct user roles: Admins, Users, and Workers. Admins oversee request management, assign tasks, and upload finalized certificates. Users can register, submit requests for certificates, and track their application statuses, while Workers are responsible for verifying requests and updating their progress in real-time. By digitizing these processes, the system reduces administrative burden, enhances transparency, and improves service accessibility. The project employs a secure, centralized architecture to address inefficiencies in traditional methods, ensuring robust and reliable service delivery

Understanding how older people with mild frailty engage with behaviour change to support their independence: a qualitative study

ObjectivesTo explore barriers and facilitators to behaviour change in older people with mild frailty.DesignQualitative study.SettingCommunity-dwelling older people living with mild frailty.Participants64 older people with mild frailty, workers delivering the service...

How Does Immigration, in Relation to Gender Differences in Canada, Influence the Accessibility of Mental Health Services for Youth?

How Does Immigration, in Relation to Gender Differences in Canada, Influence the Accessibility of Mental Health Services for Youth?

Effectiveness of the implementation of the birth planning and complication prevention (P4K) program for pregnant women in supporting the optimization of the labor process in the Working Area of Poasia Health Center, Kendari City

Overview: Improving maternal health is crucial for achieving the Sustainable Development Goals (SDGs), specifically reducing the Maternal Mortality Ratio (MMR) to 70 per 100,000 live births by 2030. Indonesia faces significant challenges in maternal health, particularly in Southeast Sulawesi. This study aims to analyze the impact of Birth Planning and Complication Prevention (P4K) on labor outcomes in the Poasia Health Center's working area in Kendari City. It focuses on the relationship between P4K preparation and the smoothness of labor among pregnant women in this region. Body of Knowledge: Maternal health is directly linked to lower maternal mortality and reduced complications during childbirth. Programs like P4K help pregnant women prepare for safe deliveries by educating them on recognizing danger signs and managing potential complications. Previous research has shown that birth planning and early detection of complications lower labor risks. These findings emphasize the importance of education, accessible health services, and psychological support to improve maternal health outcomes. Methods: The study used a cross-sectional design with a total sample of 69 pregnant women from the Poasia Health Center's working area. Data were collected through questionnaires and observations, with statistical analysis using the Chi-square test to assess the relationship between P4K preparation and smooth labor. Total sampling was employed to ensure all eligible participants were included. Results: Results revealed a significant link between P4K preparation and smoother labor. Of the 69 women surveyed, 85.7% who prepared for P4K had smooth deliveries, while 50% of those who did not prepare experienced complications. The statistical analysis indicated a p-value of 0.041, confirming the positive impact of P4K. Recommendation: The study recommends enhancing education and accessibility of P4K services, particularly for women facing transportation or economic challenges. Additionally, improving psychological support and educating families on pregnancy danger signs can further reduce complications and improve maternal health in the Poasia Health Center area.

2672 Exploring stakeholders’ experiences implementing a navigation program for people living with dementia and their carers

Abstract Introduction Navigating dementia care is challenging, but patient navigation (PN) offers valuable support for this population. The ‘Navigating Dementia NB/Naviguer la démence NB’ program piloted a PN program in New Brunswick, Canada, targeting people living with dementia (PLWD) and their carers. The program aimed to assist participants in navigating health and social care systems, matching their needs with available services. Methods Navigating Dementia NB was co-developed by researchers, patient partners, and clinicians. This pilot program embedded six PNs in primary care clinics/centres across the province between July 2022 and July 2023. Using a mixed methods approach, participant surveys and interviews were used to explore program benefits and recommendations for improvement. Focus groups were used to explore facilitators and barriers to program development and implementation. Results There were 150 participants (PLWD and carer dyads) enrolled in the PN program who provided informed consent. Interviews were conducted with 36 PLWD and their carers. Focus groups were conducted with nine members of the research team and five patient navigators. Program benefits included: emotional support from navigators, provision of relevant information, and facilitating connections to appropriate services. Recommendations for improvement included: the need for PLWD and their carers to have access earlier in the patient journey and the need to reassess provincial policies related to home care support. Facilitators for implementing a PN program included: providing appropriate staff training and leveraging established connections within the health and social systems. Barriers included a compressed timeline and existing systemic issues to service access. Conclusions The findings suggest that embedding PN for PLWD in community based primary care can be done. The program was beneficial for PWLD and their caregivers/care partners. Future plans involve partnering with government to support the implementation and evaluation of a province-wide scale-up of the PN program for this population.

Evaluation of the Accessibility to Urban Mobility Services with High Spatial Resolution—Case Study: Valencia (Spain)

This paper aims to evaluate the accessibility to urban mobility services with high spatial resolution. The methodology identifies the percentage of the population living within walking distance of the different public transport and shared mobility systems. The motivation for this study stems from the importance of understanding and improving sustainable urban mobility, as well as the need to evaluate the effectiveness of transportation infrastructure. The study involved creating buffers from each station following the road network according to urban design to identify areas within a 5-min walk, then calculating the affected population by age range within these zones to ensure equity. This method determined the percentage of the population with access to available mobility services: bike renting, urban bus, intercity bus, metro, taxi, tram and train. The application of the methodology to the Valencia case study underscores the overall strong accessibility of mobility services. The main results indicate access to mobility services for 99.98% of the total population of the city. The accessibility percentages for specific mobility services vary, with urban bus and bike renting showing high accessibility, while train and tram services exhibit lower accessibility rates. Additionally, the study extends its assessment to the peri-urban area, revealing a global access percentage of 46.33%. In conclusion, this study allows us to identify areas with lower accessibility and help to improve the sustainability of urban mobility. These findings can aid urban planners and policymakers by providing valuable insights into the city’s mobility network’s strengths and areas for improvement.

Neonatal Emergency Transport Organisation and Activities in Italy—The Nationwide 2023 Survey by the Neonatal Transport Study Group of the Italian Society of Neonatology

Background: The regionalisation of perinatal care emphasises the importance of transferring high-risk pregnancies “in utero” to minimise risks; yet, neonatal inter-facility transport remains necessary. Neonatal Emergency Transport Services (NETSs) play a crucial role in reducing transportation risks, especially for very preterm infants. Italy’s healthcare system, which is decentralised in nature, leads to variations in NETS organisation and resources across the country, resulting in disparities in access and quality of care. Methods: A questionnaire regarding neonatal transfer practices and NETS activity was sent to the 55 NETSs operating in twenty Italian regions. Demographic data were obtained from the Italian National Statistical Institute (ISTAT). Results: Survey Overview. A 2022 national survey by the Italian Society of Neonatology aimed to assess the status of NETS in Italy, achieving a 100% response rate from the 55 NETS. The 2022 data highlighted the transport of 6494 neonatal, of which 92% were primary transports (transferred to higher-level care) and 553 were back-transports (returning stabilised neonates to lower-level care). Subgroup analysis identified 544 transports of neonates born at 30–34 weeks of gestation and 305 transports of neonates born at under 30 weeks of gestation. This was shown to have regional variability. NETS coverage: 18 regions have full NETS coverage. Sicily offers partial coverage. Sardinia, despite an approved plan, lacks an operational NETS. Operational models: all NETS provide a 24/7 service; 50 NETSs rely on an on-call basis using NICU staff for transport. Only five NETS have dedicated teams exclusively for neonatal transport. This decentralisation results in heterogeneity in service availability, access, and quality. Conclusions: This study highlights that although differences still exist, the NETS in Italy is adequately structured and effective. The presence of NETS operating with limited transport volumes puts a strain on maintaining skilled staff and cost-effective operations. Regional disparities: inequities in NETS access (e.g., in Sicily and Sardinia regions) underline the need to improve regional collaboration. While Italy has made progress in organising NETS, regional discrepancies persist in access and service quality, reflecting the decentralised nature of its healthcare system.

P-1273. Connecting Underserved Communities With Saliva-Based PCR Testing for Respiratory Infection: Insights From A Mobile Lab-In-A-Van Pilot

Abstract Background Partnering with community leaders, we sought to address ongoing diagnostic testing needs in underserved neighborhoods and evaluate whether a saliva-based mobile testing program could help overcome barriers to testing for uninsured and low-income individuals. This is critical as many lack a primary care provider, cannot access reliable health information, or have limited financial resources.Figure 3.Layout of the mobile lab-in-a-van.(a) Mobile testing van top view; (b) interior work bench side view. Source: Flambeau RapidX (Delve) Methods Free SARS-CoV-2 testing was offered at popup events using the SalivaDirect extraction-free RT-qPCR protocol on a CLIA licensed van operated by Yale Pathology Labs under FDA Emergency Use Authorization; diagnostic results were available in as little as two hours. Testing locations were identified and advertised in partnership with the community. Patient perspectives on approachability, convenience, and usefulness of mobile testing were recorded via REDcap.Figure 7.Test site event coordination.(a) Screenshot of online scheduling platform; (b) screenshot of select fields from mobile testing event tracker. Results Between October 2023 and April 2024, 70 community events were hosted and 533 SARS-CoV-2 PCR tests administered. Across participants of all ages (0-91y, mean=42y), 79% (410/517) agreed it was easy to access the van and get a COVID test and 79% (411/517) agreed they were comfortable using the van. Of those tested, 59% (169/288) reported an annual household income of &amp;lt; $25,000; 92% (265/288) reported an income of &amp;lt; $50,000. In addition, 31% (160/517) were uninsured. Of those insured, 62% (142/228) identified “Public (Medicare, Medicaid, Tricare)” as their primary healthcare plan. Overall, 44% (128/290) reported getting the healthcare they need was a challenge, with 46% (134/289) reporting transportation challenges.Figure 5.Participant demographics (RP2 R0604 data though April 10, 2024) / Figure 9. Participant responses to select REDCap survey questions (RP2 R0604 data though April 10, 2024)Figure 5. (a) Self-identified race; (b) age distribution; (c) annual household income.Figure 9. (a) Ease of van access; (b) Comfort using the van; (c) Reason for choosing location. Conclusion This pilot demonstrated the positive impact a mobile testing program can have in addressing community needs. Analysis of participant demographics and identified barriers to service access underscores the program's effectiveness in addressing previously unmet testing requirements and enhancing healthcare accessibility within the target community. Moreover, feedback gathered from participants of all age groups via surveys reveals a strong consensus regarding the convenience and comfort of saliva-based testing at mobile events. This underscores the viability of mobile initiatives as a feasible approach to fulfilling future testing demands, particularly within underserved populations. Disclosures Anne L. Wyllie, PhD, SalivaDirect: Board Member|SalivaDirect: Honoraria

P-1327. Enhancing Sexual Health Access for Hispanic and Latino Men in the Southern U.S through a Bilingual Peer-Navigation Campaign

Abstract Background Hispanic and Latino Gay and Bisexual Men (HLGBM) are disproportionately impacted by HIV and face structural barriers in accessing sexual health services. To address these barriers, we developed an online sexual health outreach campaign linked to bilingual peer-navigation services in metro Atlanta.Figure 1illustrates examples from our sexual health campaign, featuring our trained bilingual navigator. The campaign emphasized the availability of free or low-cost sexual health services, aiming to increase awareness and accessibility among the community. Methods In partnership with local organizations, health departments, and Latino-focused advertising agencies, we developed an online outreach campaign in Spanish to increase awareness of sexual health services among HLGBM. This campaign also connected individuals with a trained bilingual Latino peer navigator for service access (Figure 1). The campaign was piloted from May 22 to August 21, 2023 (Pilot Phase), it was later adopted by a local health department starting September 1, 2023. We systematically recorded data including the number of individuals contacting the peer navigator, city locations, weekly contacts, referral types, and self-reported outcomes until February 29, 2024 (Post-implementation Phase).Figure 2lists the cities of individuals who have contacted the navigator. Cities with two or fewer individuals are grouped under "Other." "Out of State" includes contacts primarily from Tennessee, Alabama, North Carolina, and South Carolina. In the figure, red circles represent the locations from which contacts were made. The size of each circle is proportional to the number of contacts originating from that area. Results A total of 259 individuals responded to the campaign by contacting the navigator – 70 during the pilot phase and 189 during the post-implementation phase. The campaign reached individuals from several locations with high Hispanic/Latino populations in the Atlanta area (Figure 2). HIV/STI testing and HIV Pre-Exposure Prophylaxis (PrEP) were the most requested services. Participants initially requesting testing HIV/STI only were also provided with PrEP education and referrals. Importantly, a total of 28 participants requested linkage or re-engagement to HIV care (Table 1). During the pilot, 57% of all enrolled participants were successfully linked to services, while 85% did so post-implementation, reaching a higher linkage proportion (Table 1). On average 6 (range 1-19) individuals contacted the navigator per week (Figure 3).Table 1categorizes the types of services requested by individuals through the navigator. Services are grouped by demand frequency. Referral outcomes as reported by the client or the referral agency. “Completed” refers to cases where the patient received the intended service or referral. “Lost to Follow Up” indicates cases where the patient did not continue communication with the navigator, and “Pending” refers to ongoing referrals that have not yet concluded. *Only 50/70 patients in the pilot phase were followed for completion of services. Conclusion Our campaign and navigation program successfully reached HLGBM and linked them to local sexual health services. The pilot’s success led to the adoption of the campaign and navigation system by a local health department, with early data suggesting continued community engagement and service linkage, affirming the impact of culturally tailored public health interventions.Figure 3Displays the weekly contacts to the navigator during the pilot and post implementation phase. The arrow indicates when the navigator program was adopted by the Fulton County Board of Health. Data reflects sustained levels of interaction between individuals and the navigator throughout both phases, indicating robust engagement over time. Disclosures All Authors: No reported disclosures

Service Accessibility and Wellbeing in Amman’s Neighborhoods: A Comparative Study of Abdoun Al-Janoubi and Al-Zahra

Amman, the capital of Jordan, has undergone significant urbanization over the past seventy years, evolving from a small village into the nation’s largest city. This rapid growth has led to unpredictable population increases, creating socioeconomic disparities and affecting residents’ access to services and overall wellbeing. This study investigates the impact of service accessibility on wellbeing in two neighborhoods of Amman: Abdoun Al-Janoubi and Al-Zahra. Data were gathered from 492 household heads through structured interviews and systematic sampling. The study analyzed accessibility factors such as safety, convenience, comfort, and esthetics, and their influence on residents’ wellbeing, defined by positive emotions, social relationships, and overall life meaning. The results indicate a robust correlation between service accessibility and resident wellbeing, with Abdoun Al-Janoubi demonstrating superior accessibility and higher wellbeing compared to Al-Zahra. Key insights are illustrated, with data supporting the idea that enhanced urban service access improves quality of life. Safety and esthetics are critical factors, while comfort is less significant. Abdoun Al-Janoubi’s favorable attributes lead to higher wellbeing scores. Recommendations for urban planners include improving Al-Zahra’s infrastructure, enhancing esthetics, and optimizing public transport. Community organizations should promote social engagement, while local governments need to adjust zoning laws and upgrade public amenities.