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

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.

2021 ◽  
Author(s):  
Wilson Mupfururirwa ◽  
Victoria Nembaware ◽  
Jack Morrice ◽  
Khuthala Mnika ◽  
Gaston Kuzamunu Mazandu ◽  
...  

BACKGROUND The impact of mobile phones and their applications in healthcare (mobile health) is well established for a range of diseases and cross-cutting complications, such as pain. While numerous mobile health (mHealth) pain interventions have been established, an evaluation of their prevalence, adequacy and distribution remains limited. OBJECTIVE This study aims at reviewing and comparing current pain management mHealth tools in high- versus low-income countries. METHODS A literature and application (app) store search was conducted in May 2021 using combinations of the following keywords: “pain management”, “pain”, “mobile health”, “telemedicine”, and “app”. Literature searches were conducted in PubMed, Scopus, Cochrane Review Library, and Google scholar. App store searches were conducted in Google Play and Apple App Store. Data characteristics descriptive analysis was performed using R software to summarize different datasets and compute p-values (P) for testing the significance of different hypotheses with the significance level set to 0.05. RESULTS The search identified 40 publications (literature search) and 230 mHealth applications (app store search), revealing a non uniform distribution of search categories (χ2= 133.7, P < 0.004) with a ratio approximating 1:6 (OR = 5.730, 95%CI:3.745-8.909, P < 0.004). About 86.7% of these 270 applications (apps) are from high-income countries, showing a statistically significant non uniform distribution of country categories: high- and low-income (χ2= 145.2, P < 0.004) approximating the theoretical distribution of a 7:1 ratio (OR = 6.476, 95%CI:4.180-10.222, P < 0.004). Moreover, there is no significant difference in the proportion of search categories between country categories ( χ2= 0.113, P = 0.737) and the difference in pain app prevalence in high- versus low-income countries is not statistically significant. Finally, we have observed that pain-tracking apps are significantly more prevalent in developed countries in comparison to low-income countries. CONCLUSIONS As expected, pain management app prevalence is higher in high-income countries. However, more research is required to readily comprehend the effectiveness of these apps.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S334-S334
Author(s):  
Stuti Dang ◽  
Kasra Sarhadi ◽  
Sonjia Kenya ◽  
Chuanhui Dong ◽  
Natalie Ferras ◽  
...  

Abstract Stroke is a leading cause of death and functional impairment that disproportionately impacts Hispanics. Several studies have supported the feasibility of mobile health interventions (mHealth) to provide health monitoring and patient education for improving chronic disease management, but none have focused on Latino stroke patients. The Hispanic Secondary Stroke Prevention Initiative is a randomized study of 200 stroke patients designed to evaluate the impact of a 12-month multi-modal Community Health Worker (CHW) and mHealth intervention on blood pressure control. Eligible participants were Latinos who experienced a mild-moderate stroke within the last five years. The CHW component included home visits, telephone calls, and daily text messages to obtain home blood pressure readings and provide patient navigation and health education. Feasibility was defined as the proportion of patients that responded to at least half the messages. Pre-post paired t-tests assessed improvements in question accuracy while correlation coefficients highlighted improvements in response rates. Among the 65 participants randomized to the intervention, the response rate was as follows: 37% - &gt;50% response, 21% - 25-50%, 19% - 10-25%, and 23% - &lt;10%, This finding suggests that mHealth interventions may be challenging in this population. However, the proportion of questions answered correctly increased from 63% to 84% in the intervention period’s last two months (p&lt;0.05). There was a positive correlation between increased response rates and response accuracy to patient education assessments (r=0.82, p&lt;0.05). These improvements in health knowledge suggest that a subset of patients may benefit from mHealth interventions, and the benefit correlates with use.


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

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S312-S312
Author(s):  
Paige Reason ◽  
Jerome A Leis ◽  
Claudia Cocco ◽  
Lynfa Stroud ◽  
Michelle Hladunewich ◽  
...  

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


PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0256908
Author(s):  
Phillip Levy ◽  
Erin McGlynn ◽  
Alex B. Hill ◽  
Liying Zhang ◽  
Steven J. Korzeniewski ◽  
...  

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.


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

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

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

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