scholarly journals From pandemic response to portable population health: A formative evaluation of the Detroit mobile health unit program

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0256908
Author(s):  
Phillip Levy ◽  
Erin McGlynn ◽  
Alex B. Hill ◽  
Liying Zhang ◽  
Steven J. Korzeniewski ◽  
...  
Keyword(s):  
Social Services ◽  
Mobile Health ◽  
Social Vulnerability ◽  
Formative Evaluation ◽  
Preventive Health Services ◽  
Health Unit ◽  
Social Vulnerability Index ◽  
Vulnerable Communities ◽  
Deployment Strategy ◽  
Mobile Health Unit

This article describes our experience developing a novel mobile health unit (MHU) program in the Detroit, Michigan, metropolitan area. Our main objectives were to improve healthcare accessibility, quality and equity in our community during the novel coronavirus pandemic. While initially focused on SARS-CoV-2 testing, our program quickly evolved to include preventive health services. The MHU program began as a location-based SARS-CoV-2 testing strategy coordinated with local and state public health agencies. Community needs motivated further program expansion to include additional preventive healthcare and social services. MHU deployment was targeted to disease “hotspots” based on publicly available SARS-CoV-2 testing data and community-level information about social vulnerability. This formative evaluation explores whether our MHU deployment strategy enabled us to reach patients from communities with heightened social vulnerability as intended. From 3/20/20-3/24/21, the Detroit MHU program reached a total of 32,523 people. The proportion of patients who resided in communities with top quartile Centers for Disease Control and Prevention Social Vulnerability Index rankings increased from 25% during location-based “drive-through” SARS-CoV-2 testing (3/20/20-4/13/20) to 27% after pivoting to a mobile platform (4/13/20-to-8/31/20; p = 0.01). The adoption of a data-driven deployment strategy resulted in further improvement; 41% of the patients who sought MHU services from 9/1/20-to-3/24/21 lived in vulnerable communities (Cochrane Armitage test for trend, p<0.001). Since 10/1/21, 1,837 people received social service referrals and, as of 3/15/21, 4,603 were administered at least one dose of COVID-19 vaccine. Our MHU program demonstrates the capacity to provide needed healthcare and social services to difficult-to-reach populations from areas with heightened social vulnerability. This model can be expanded to meet emerging pandemic needs, but it is also uniquely capable of improving health equity by addressing longstanding gaps in primary care and social services in vulnerable communities.

scholarly journals An Assessment of Social and Physical Vulnerability to Hydroclimate Extremes in Appalachia

2021 ◽  
Author(s):  
Leah R. Handwerger ◽  
Jennifer R. Runkle ◽  
Ronald Leeper ◽  
Elizabeth Shay ◽  
Kara Dempsey ◽  
...  
Keyword(s):  
Social Vulnerability ◽  
Scientific Community ◽  
Vulnerability Index ◽  
Precipitation Variability ◽  
Mitigation Strategies ◽  
Climate Projections ◽  
Social Vulnerability Index ◽  
Physical Vulnerability ◽  
Vulnerable Communities ◽  
Vulnerability Indicators

Abstract Appalachia is a cultural region in the southern and central Appalachian Mountains that lags behind the nation in several social vulnerability indicators. Climate projections over this region indicate that precipitation variability will increase in both severity and frequency in future decades, suggesting that the occurrence of natural hazards related to hydroclimate extremes will also increase. The objective of this study was to investigate the spatiotemporal patterns of drought and precipitation and determine how trends overlap with vulnerable communities across Appalachia. The study utilized trend analysis through Mann-Kendall calculations and a Social Vulnerability Index, resulting in a bivariate map that displays areas most susceptible to adverse effects from hydroclimate extremes. Results show the southwestern portion of the region as most vulnerable to increased precipitation, and the central-southeast most vulnerable to an increase in drought-precipitation variability. This study is among the first to utilize the boundaries defined by the Appalachian Regional Commission from a climatological perspective, allowing findings to reach audiences outside the scientific community and bring more effective mitigation strategies that span from the local to federal levels.

Factors to Consider When Buying a Mobile Health Unit

1999 ◽  
Vol 29 (2) ◽  
pp. 34-41 ◽  
Author(s):  
Deborah Moulavi ◽  
Angeline Bushy ◽  
Janice Peterson ◽  
Elizabeth Stullenbarger
Keyword(s):  
Mobile Health ◽  
Health Unit ◽  
Mobile Health Unit

scholarly journals 423. Implementation of a Hierarchy of Controls in a Mobile Health Unit to Safely Care for Inpatients with COVID-19 during Healthcare System Surge

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S312-S312
Author(s):  
Paige Reason ◽  
Jerome A Leis ◽  
Claudia Cocco ◽  
Lynfa Stroud ◽  
Michelle Hladunewich ◽  
...  
Keyword(s):  
Mobile Health ◽  
Healthcare Workers ◽  
Patient Characteristics ◽  
Vaccination Rate ◽  
Health Unit ◽  
Term Care ◽  
Mandatory Education ◽  
Pandemic Planning ◽  
Alpha Variant ◽  
Mobile Health Unit

Abstract Background In April 2021, Sunnybrook Health Sciences Centre opened a Mobile Health Unit (MHU, i.e. medical tents) under the direction of the Ontario Ministry of Health and Long Term Care in response to a surge in hospitalized patients with COVID-19 during wave three of the pandemic. Providing care to patients in non-conventional spaces is not new, however, experience in safely caring for COVID-19 patients in these settings is lacking. Our aim is to describe the implementation of our MHU and associated outcomes of these COVID-19 patients. Methods A multidisciplinary clinical and operations team was created to plan, execute and operate a safe environment for COVID-19 patients and healthcare workers within the MHU. Patient selection was restricted to patients with COVID-19 who were clinically recovering from severe COVID-19 pneumonia. Ventilation was optimized with air flow directed away from patient areas, velocity reduced to below 0.25 meters per second, and air exchanges of 24-28 per hour. All healthcare workers working in the MHU were offered COVID-19 vaccine and required to complete mandatory education if they declined (vaccination rate of 87% was achieved among dedicated staff). Universal masking and eye protection was used throughout the MHU with designated areas for donning and doffing personal protective equipment. Results In total, 32 patients with COVID-19 were managed in the MHU between 26 April and 21 May, 2021. Table 1 provides the summary of patient characteristics. All patients had a median of one-day of transmission-based precautions remaining in their course and were infected with Alpha variant with exception of one patient with the Gamma variant. Among those patients with genotyping available, all were infected with SARS-CoV-2 carrying the N501Y mutation. Four of the 32 patients required transfer to the main hospital for medical indication while the others were discharged home or to rehabilitation. None of the healthcare workers who worked within the MHU developed COVID-19 infection. Conclusion We safely cared for patients recovering from COVID-19 infection in an MHU to support system healthcare capacity. Our experience, including the specific hierarchy of controls implemented, may be helpful for future pandemic planning. Disclosures All Authors: No reported disclosures

Neighborhood Psychiatry in a Mobile Health Unit

1971 ◽  
Vol 22 (8) ◽  
pp. 233-236
Author(s):  
Henry N. Massie
Keyword(s):  
Mobile Health ◽  
Health Unit ◽  
Mobile Health Unit

Rural Mobile Health Unit: Outcomes

1998 ◽  
Vol 15 (1) ◽  
pp. 3-11 ◽  
Author(s):  
Betty B. Alexy ◽  
Christine Elnitsky
Keyword(s):  
Mobile Health ◽  
Health Unit ◽  
Mobile Health Unit

THINKING ABOUT A MOBILE HEALTH UNIT TO DELIVER SERVICES? THINGS TO CONSIDER BEFORE BUYING

2000 ◽  
Vol 8 (1) ◽  
pp. 6-16 ◽  
Author(s):  
Deborah Muolavie ◽  
Angeline Busby ◽  
Janice Peterson ◽  
Elizabeth Stullenbarger
Keyword(s):  
Mobile Health ◽  
Health Unit ◽  
Mobile Health Unit

scholarly journals A University-Community Problem Based Mobile Health Unit Solution: Indirect and Direct Measures of the Impact of Rural Health in the Central Valley

2017 ◽  
Vol 3 (1) ◽  
pp. 68 ◽  
Author(s):  
Cyndi Guerra ◽  
Cheryl Hickey ◽  
Elizabeth Villalobos
Keyword(s):  
Rural Health ◽  
Mobile Health ◽  
Low Income ◽  
Central Valley ◽  
Health Unit ◽  
Access To Health Services ◽  
Mobile Clinic ◽  
Mobile Health Unit ◽  
The Impact ◽  
University Community

The development of a medical home is an integral component in decreasing health disparities among disenfranchised communities. Mobile health clinics contribute to increasing access to health services, promoting health education, and improving care coordination especially among low income rural patients. This problem based solution, case study describes the experience of a University-community based partnership in the development of a mobile clinic model within ambulatory Community Medical Health. In 2014, a university based, nursing program initiated, mobile health unit was created to offer basic medical care to rural health areas in the Central Valley. The following case describes how this was accomplished, what outcomes were tracked and what lessons were gleamed as a means of improving the process for future endeavors or as a model to others looking to develop a similar project. Over the past two years the mobile health unit has shown the increased need for medical services as evident by an increase of patient visits in these areas. In addition, implementation results and considerations are discussed including key process indicators, limitations and future model directions.

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