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

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 S...

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Autores principales: Levy, Phillip, McGlynn, Erin, Hill, Alex B., Zhang, Liying, Korzeniewski, Steven J., Foster, Bethany, Criswell, Jasmine, O’Brien, Caitlin, Dawood, Katee, Baird, Lauren, Shanley, Charles J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8631611/
https://www.ncbi.nlm.nih.gov/pubmed/34847164
http://dx.doi.org/10.1371/journal.pone.0256908
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author Levy, Phillip
McGlynn, Erin
Hill, Alex B.
Zhang, Liying
Korzeniewski, Steven J.
Foster, Bethany
Criswell, Jasmine
O’Brien, Caitlin
Dawood, Katee
Baird, Lauren
Shanley, Charles J.
author_facet Levy, Phillip
McGlynn, Erin
Hill, Alex B.
Zhang, Liying
Korzeniewski, Steven J.
Foster, Bethany
Criswell, Jasmine
O’Brien, Caitlin
Dawood, Katee
Baird, Lauren
Shanley, Charles J.
author_sort Levy, Phillip
collection PubMed
description 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.
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spelling pubmed-86316112021-12-01 From pandemic response to portable population health: A formative evaluation of the Detroit mobile health unit program Levy, Phillip McGlynn, Erin Hill, Alex B. Zhang, Liying Korzeniewski, Steven J. Foster, Bethany Criswell, Jasmine O’Brien, Caitlin Dawood, Katee Baird, Lauren Shanley, Charles J. PLoS One Research Article 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. Public Library of Science 2021-11-30 /pmc/articles/PMC8631611/ /pubmed/34847164 http://dx.doi.org/10.1371/journal.pone.0256908 Text en © 2021 Levy et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Levy, Phillip
McGlynn, Erin
Hill, Alex B.
Zhang, Liying
Korzeniewski, Steven J.
Foster, Bethany
Criswell, Jasmine
O’Brien, Caitlin
Dawood, Katee
Baird, Lauren
Shanley, Charles J.
From pandemic response to portable population health: A formative evaluation of the Detroit mobile health unit program
title From pandemic response to portable population health: A formative evaluation of the Detroit mobile health unit program
title_full From pandemic response to portable population health: A formative evaluation of the Detroit mobile health unit program
title_fullStr From pandemic response to portable population health: A formative evaluation of the Detroit mobile health unit program
title_full_unstemmed From pandemic response to portable population health: A formative evaluation of the Detroit mobile health unit program
title_short From pandemic response to portable population health: A formative evaluation of the Detroit mobile health unit program
title_sort from pandemic response to portable population health: a formative evaluation of the detroit mobile health unit program
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8631611/
https://www.ncbi.nlm.nih.gov/pubmed/34847164
http://dx.doi.org/10.1371/journal.pone.0256908
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