Mass General Brigham Mobile Health Services Improved Access to COVID-19 Services for Underserved Populations

Two new papers from Mass General Brigham demonstrate the effectiveness of delivering COVID-19 healthcare services where people need them most. In early May 2021, a team from Mass General Brigham began providing COVID vaccinations to an underserved population living in the greater Boston area by sending mobile health units to 12 predominantly low-income and racial/ethnic minority communities in Massachusetts. Using public health vans, the teams offered readily available vaccination on a walk-in basis without regard to insurance, immigration status or ability to pay. In an article published today in American Journal of Public Health, Mass General Brigham authors describe the success and challenges of the new program, which has higher vaccination rates among adolescents, non-white populations and Hispanics compared to state and local community vaccination rates.

“To date, our program has provided nearly 20,000 doses of vaccination against COVID-19,” said corresponding author Priya Sarin Gupta, MD, MPH, medical director of Mass General Brigham and Kraft Center’s Community Care Initiatives. “Our goal was to bring the health and vaccination services against COVID-19 to the community and meet people where they are. Data from the first few months of Brigham General’s public care vans, sometimes called our “clinics on wheels,” show us that if you build it -; and you build it well -; they will come.”

In their AJPH paper, Sarin Gupta and colleagues outline what it takes to build their program well and implement it effectively. Key elements of the program include:

  • Engaging and partnering with community nonprofits, local health departments, and school board representatives;
  • Providing vans with trained, multilingual staff and engaging a large network of volunteers;
  • Identifying the right places and times to reach communities that have been hardest hit by COVID-19.

The program also used a “dual equity” model, engaging with a local transportation company that was at risk of downsizing due to economic losses during the pandemic.

In a companion article recently published in Preventive medicine, the researchers analyzed the results of the first three months of the program. From May 20 to August 18, 2021, public health vans conducted 130 sessions and administered 2,622 doses of the COVID-19 vaccine. During the study, only 20 percent of people who received a vaccine from one of the mobile clinics self-identified as white. More than 56 percent listed their ethnicity as Hispanic (compared to the state’s vaccination rate of about 18 percent). In addition, participants were more likely to be adolescents -; the average age of those vaccinated in the mobile clinics is 31 years. These early findings allowed the program to be replicated and expanded to more communities to maximize the program’s reach to communities serving people of color and those with high levels of social health-related needs.

The authors note that mobile health units can be used to support other community health needs beyond – and sometimes intertwined with -; COVID-19. The vans are now expanding their offerings to include a menu of services to offer care for preventable and chronic diseases, including offering high blood pressure screenings.

We are already seeing participants come to us who are interested in being vaccinated and also screened for high blood pressure while they are there -; and vice versa. Some participants ask us, “What will you provide next?” That gives me hope. If we can provide care with cultural humility and ensure that everyone has access, we can begin to overcome barriers such as mistrust.”

Priya Sarin Gupta, MD, MPH, Medical Director of Brigham and Kraft Center for Mass Care Community Care Initiatives

source:

Brigham and Women’s Hospital

Journal reference:

Gupta, PS et al. (2022) Mobile health services for COVID-19: counseling, testing and vaccination for medically underserved populations. American Journal of Public Health. doi.org/10.2105/AJPH.2022.307021.

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