Preventative health, diversity, and inclusion: a qualitative study of client experience aboard a mobile health clinic in Boston, Massachusetts

Bouchelle, Zoe; Rawlins, Yasmin; Hill, Caterina; Bennet, Jennifer; Pérez, Leonor; Oriol, Nancy E.

doi:10.1186/s12939-017-0688-6

Cited by 10 publications

(7 citation statements)

References 27 publications

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“…They frame patient experiences as welcoming vs unwelcoming, noting that the latter’s stigmatising ethic, like in our findings of patient experiences in the mainstream health system, leads to system aversion. Our findings also parallel those of Bouchelle et al ’s20 exploration of the experiences of medically vulnerable people accessing a mobile health van in Boston. Bouchelle et al found that in addition to accessible communication styles, a diverse and knowledgeable workforce, and conveniently located services, a culture of respect and dignity aboard the outreach clinic was central in facilitating access to service.…”

Section: Discussionsupporting

confidence: 88%

“…They further contribute to the small body of qualitative evidence for the effectiveness of mobile health clinics that serve people who are deprived of housing 3. While recent qualitative work1 19 20 explored why people use a mobile health clinic (accessing basic necessities, convenience, friendly atmosphere), our findings probe what it is about the model that works. Our findings describe the nuances of quality care and help to elucidate the what and the how behind the quantitative evidence of the effectiveness of mobile health clinics.…”

Section: Discussionmentioning

confidence: 76%

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‘It’s so simple’ Lessons from the margins: a qualitative study of patient experiences of a mobile health clinic in Hamilton, Ontario, Canada

Nussey

Lamarche²,

O’Shea³

2023

BMJ Open

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ObjectiveOur study explored the experiences of clients of HAMSMaRT (Hamilton Social Medicine Response Team), a mobile health service, in the context of their experiences of the overall healthcare system.DesignWe conducted a qualitative study with reflexive thematic analysis.SettingHAMSMaRT is a mobile health service in Hamilton, Ontario Canada providing primary care, internal and addiction medicine and infectious diseases services.ParticipantsEligible participants were clients of HAMSMaRT who could understand English to do the interview and at least 16 years of age. Fourteen clients of HAMSMaRT were interviewed.ResultsOur findings represented five themes. When the themes of people deserve care, from the margins to the centre, and improved and different access to the system are enacted, the model of care works, represented by the theme it works!. The way in which participants compared their experiences of HAMSMaRT to the mainstream healthcare system insinuated how simple it is, represented by the theme it’s so simple.ConclusionsOur findings offer guidance to the broader healthcare system for walking from the rhetoric to practice of person-centred care.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 76%

‘It’s so simple’ Lessons from the margins: a qualitative study of patient experiences of a mobile health clinic in Hamilton, Ontario, Canada

Nussey

Lamarche²,

O’Shea³

2023

BMJ Open

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“…The people and organizations that operate mobile clinics are often motivated by a commitment to underserved communities and use the mobile clinic as a vehicle to deliver care in ways that differ from traditional medical settings. For example, Bouchelle and colleagues reported that The Family Van, a mobile clinic in Boston, creates a culture of respect and inclusivity [16]. In many instances, mobile clinics serve as a bridge between communities and the health care system.…”

Section: Discussionmentioning

confidence: 99%

Mobile health clinics in the United States

Malone

Williams

Fawzi

et al. 2020

Int J Equity Health

Self Cite

100

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Background Mobile health clinics serve an important role in the health care system, providing care to some of the most vulnerable populations. Mobile Health Map is the only comprehensive database of mobile clinics in the United States. Members of this collaborative research network and learning community supply information about their location, services, target populations, and costs. They also have access to tools to measure, improve, and communicate their impact. Methods We analyzed data from 811 clinics that participated in Mobile Health Map between 2007 and 2017 to describe the demographics of the clients these clinics serve, the services they provide, and mobile clinics’ affiliated institutions and funding sources. Results Mobile clinics provide a median number of 3491 visits annually. More than half of their clients are women (55%) and racial/ethnic minorities (59%). Of the 146 clinics that reported insurance data, 41% of clients were uninsured while 44% had some form of public insurance. The most common service models were primary care (41%) and prevention (47%). With regards to organizational affiliations, they vary from independent (33%) to university affiliated (24%), while some (29%) are part of a hospital or health care system. Most mobile clinics receive some financial support from philanthropy (52%), while slightly less than half (45%) receive federal funds. Conclusion Mobile health care delivery is an innovative model of health services delivery that provides a wide variety of services to vulnerable populations. The clinics vary in service mix, patient demographics, and relationships with the fixed health system. Although access to care has increased in recent years through the Affordable Care Act, barriers continue to persist, particularly among populations living in resource-limited areas. Mobile clinics can improve access by serving as a vital link between the community and clinical facilities. Additional work is needed to advance availability of this important resource.

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“…The concept of a statewide CDCP grew from conversations with community partners frustrated with the toll of a tainted drug supply. They yielded 3 observations: (1) emerging evidence from Canada suggested that CDCPs might be synergistic with other harm-reduction programming; (2) Massachusetts's state-supported interventions for overdose response included naloxone distribution, 18 postoverdose outreach, 19 and mobile health units, 20 all of which provided opportunities for patient-centered, low-threshold, harm-reduction programming and possible drug checking initiatives; and (3) research led by Dr Green and colleagues 16,21 indicated that technologies are available for CDCPs.…”

Section: Conceptualizing the Programmentioning

confidence: 99%

Implementation and Uptake of the Massachusetts Drug Supply Data Stream: A Statewide Public Health-Public Safety Partnership Drug Checking Program

Green

Olson

Jarczyk

et al. 2022

Journal of Public Health Management and Practice

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Context:The illicit drug supply is rapidly evolving. Equally important to gathering drug supply data for monitoring is timely sharing of information with people who use drugs, the providers who care for them, law enforcement partners, and public health stakeholders so that efforts to avoid harmful substances, take preventive actions, and better target interventions can occur. Program: The Massachusetts Drug Supply Data Stream (MADDS) is the country's first statewide community drug checking program. Founded on public health-public safety partnerships, MADDS collects remnant drug packaging and paraphernalia with residue from people who use drugs and noncriminal samples from partnering police departments. MADDS tests samples using simultaneous immunoassay fentanyl test strips, Fourier-transform infrared spectrometry (FTIR), and off-site laboratory testing by gas chromatography-mass spectrometry (GC/MS). Results are accessible to community programs and municipalities, while trend analyses inform public health for cross-site alerts and informational bulletins. Implementation: MADDS was launched statewide in 2020 and rapidly expanded to a multisite program. Program staff approached communities and met with municipal police and community partners to secure written agreements to host drug checking. Community partners designed sample collection consistent with their pandemic era workflows. Consultations with stakeholders gathered feedback on design and deliverables. Evaluation: The program tests sample donations on-site from community agencies and police departments, incorporates review by a medical toxicologist for health and safety concerns, crafts stakeholder-specific communications, and disseminates English, Spanish, and Portuguese language materials. For 2020, a total of 427 samples were tested, of which 47.1% were positive for fentanyl. By early 2021, MADDS detected shifts in cocaine purity, alerted communities of a new toxic fentanyl analogue and a synthetic cannabinoid contaminant, and confirmed the increase of xylazine (a veterinary sedative) in Massachusetts. Discussion: Community drug checking programs can be collaboratively designed with public health and public safety to generate critical health and safety information for people who use drugs and the communities where they live.

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Preventative health, diversity, and inclusion: a qualitative study of client experience aboard a mobile health clinic in Boston, Massachusetts

Cited by 10 publications

References 27 publications

‘It’s so simple’ Lessons from the margins: a qualitative study of patient experiences of a mobile health clinic in Hamilton, Ontario, Canada

‘It’s so simple’ Lessons from the margins: a qualitative study of patient experiences of a mobile health clinic in Hamilton, Ontario, Canada

Mobile health clinics in the United States

Implementation and Uptake of the Massachusetts Drug Supply Data Stream: A Statewide Public Health-Public Safety Partnership Drug Checking Program

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