Mass Gen. Brigham’s mobile health services have improved access to COVID-19 treatments for underserved populations
Two new articles from Mass General Brigham demonstrate the effectiveness of getting COVID-19 health care services to where people need them most. In early May 2021, a team from Mass Gen. Brigham began providing COVID vaccines to underserved populations living in the greater Boston area by dispatching mobile health units to 12 predominantly low-income and racial/ethnic minority communities across Massachusetts. Using community health vans, teams offered easily accessible vaccination without an appointment, regardless of insurance, immigration status or ability to pay. In an article published today in The American Journal of Public Health, The Mass General Brigham authors describe the success and challenges of the new program, which had higher vaccination rates among adolescents, non-white populations and people of Hispanic descent compared to vaccination rates in the state and in local communities.
“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 the Mass General Brigham and Kraft Center Community Care Van initiatives. . “Our goal was to bring COVID-19 health and immunization services into the community and meet people where they are. Data from the first few months of Mass General Brigham’s Community Care Vans, sometimes referred to as our “clinics on wheels,” show us that if you build it – and you build it well – they will come.”
In their AJPH article, Sarin Gupta and her colleagues describe what it took to build their program well and implement it effectively. Key elements of the program included:
- Engage and partner with community non-profit organizations, local health departments, and school board representatives;
- Staff the vans with trained, multilingual staff and engage an extensive network of volunteers;
- Identify the right places and the right times to reach the communities hardest hit by COVID-19.
The program also used a “double capital” model, engaging with a local transport company that was at risk of downsizing due to economic losses during the pandemic.
In a companion article recently published in Preventive medecine, the investigators analyzed the results of the first three months of the program. From May 20 to August 18, 2021, Community Health Vans conducted 130 sessions and administered 2,622 doses of COVID-19 vaccine. During the study, only 20% of people who received a vaccine at one of the mobile clinics identified as white. More than 56% listed their ethnicity as Hispanic (compared to the state’s vaccination rate of about 18%). Additionally, participants were more likely to be teenagers -; the average age of those vaccinated in the mobile clinics was 31 years. These early findings allowed the program to iterate and expand to more communities to maximize the program’s reach among communities serving people of color and those with high rates of health-related social needs.
The authors note that mobile health units could be used to help meet other community health needs beyond – and sometimes related to –; COVID-19[FEMALEVansarenowexpandingtheirofferingstoincludeamenuofservicestoprovidecareforpreventableandchronicdiseasesincludingscreeningforhighbloodpressure[FEMININELesfourgonnettesélargissentmaintenantleursoffrespourinclureunmenudeservicespouroffrirdessoinspourlesmaladiesévitablesetchroniquesycomprisledépistagedel’hypertensionartérielle
Already, we see participants coming to us who are interested in getting vaccinated, and also getting tested for high blood pressure while they are there -; and vice versa. Some participants ask us: ‘What are you going to provide next?’ It gives me hope. If we can provide care with cultural humility and ensure that everyone has access to it, we can begin to overcome barriers such as mistrust.”
Priya Sarin Gupta, MD, MPH, Medical Director of Mass General Brigham and Kraft Center Community Care Van Initiatives
Brigham and Women’s Hospital
Gupta, PS, et al. (2022) Mobile health services for COVID-19: counselling, testing and vaccination for medically underserved populations. American Journal of Public Health. doi.org/10.2105/AJPH.2022.307021.