Service Learning in Health Care for Underserved Communities: University of Iowa Mobile Clinic, 2019

Abstract

The University of Iowa Mobile Clinic (UIMC) is an interdisciplinary student-run free medical clinic founded in 2002. UIMC provides free health screenings, education, and basic services to underserved populations in Iowa: immigrants, refugees, migrant farmworkers, individuals experiencing homelessness, low-income individuals, and people who live in rural communities. Forty-four percent of patients surveyed use UIMC as their only source of care. Ninety-seven percent of patients surveyed rate care as excellent or good. UIMC is a crucial safety net health care resource in Iowa to improve health equity. (Am J Public Health. Published online ahead of print July 16, 2020: e1–e4. doi:10.2105/AJPH.2020.305755)

Understanding Student-Run Health Initiatives in the Context of Community-Based Services: A Concept Analysis and Proposed Definitions

“…While many services were part of ongoing initiatives, such as clinics and regular mobile outreach programs, 6 , 29 , 35 , 51 , 52 , 71 , 72 , 74 , 75 some were episodic as with annual influenza vaccinations and health fairs. 54 , 56 , 57 , 64 , 76 , 77 Delivery of healthcare services ranged from primary care, which is generally first point of contact in relation to a health concern, 19 , 20 , 53 , 78 to ongoing follow-up of chronic conditions like diabetes and cardiovascular disease 35 , 48 , 79 , 80 and specialty services, such as prenatal care, musculoskeletal clinic, psychiatry, gynecologic care, and surgery. 20 , 28 , 58 , 61 , 81 A few individual health care student-run initiatives provided a range of primary care, specialty services, and diagnostics that sometimes also provided a consistent, comprehensive, and ongoing source of care for clients.…”

“…These health initiatives spanned a range of populations and health conditions, most commonly in the provision of care to persons who were uninsured, underserved, and/or considered to be at-risk. 6 , 18 , 29 , 35 , 45 , 51 , 61 , 64 , 68 , 71 , 72 , 76 , 85 , 88 , 91 Persons uninsured for healthcare services was 1 prominent population for student-run services, particularly through SRFCs, in much of the literature originating in the United States. 20 , 22 , 41 , 42 , 45 , 72 , 78 , 83 , 91 - 93 Uninsured status was closely associated with low socioeconomic standing, including poverty and the “working poor,” or not meeting criteria for Medicaid as in the case for many immigrants and refugees.…”

“…Many literature sources where volunteerism was described were in reference to students who volunteered without any expectation of credit toward their education program and usually were connected to a desire for experiences outside the normal curricula of their program. 22 , 29 , 35 , 61 , 62 , 68 , 81 , 82 , 85 However, there were situations where students were identified as volunteers and there was either a connection to program credit or fulfillment of some other obligation, such as service-learning hours or interprofessional care experience. 51 , 71 , 72 , 74 , 90 , 96 , 97 Volunteerism also extended to practitioners, particularly where there was a requirement for professional oversight in services being delivered or need for alternative service, such as interpretation and laboratory skills.…”

Breast and Cervical Cancer Screening Rates in Student-Run Free Clinics: A Systematic Review

“…Quality of chronic disease management in SRFCs has been assessed, with evidence suggesting comparable care to other care settings. 5,[7][8][9][10][11][12][13][14][15] However, the efficacy of SFRCs at meeting national averages in women's cancer screenings has shown mixed results. One study found greater rates of mammography among their patients compared to national averages.…”

“…For many of these patients, SRFCs may be their only source of care. 5,6 As of 2014, SRFCs collectively provided over 37,000 annual patient visits. Quality of chronic disease management in SRFCs has been assessed, with evidence suggesting comparable care to other care settings.…”