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Levy P, McGlynn E, Hill AB, Zhang L, Korzeniewski SJ, Foster B, Criswell J, O’Brien C, Dawood K, Baird L, Shanley CJ. From pandemic response to portable population health: A formative evaluation of the Detroit mobile health unit program. PLoS One 2021; 16:e0256908. [PMID: 34847164 PMCID: PMC8631611 DOI: 10.1371/journal.pone.0256908] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Accepted: 07/20/2021] [Indexed: 11/20/2022] Open
Abstract
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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Affiliation(s)
- Phillip Levy
- Department of Emergency Medicine, Wayne State University School of Medicine, Detroit, Michigan, United States of America
| | - Erin McGlynn
- Department of Emergency Medicine, Wayne State University School of Medicine, Detroit, Michigan, United States of America
| | - Alex B. Hill
- Department of Emergency Medicine, Wayne State University School of Medicine, Detroit, Michigan, United States of America
| | - Liying Zhang
- Department of Family Medicine and Public Health Sciences, Wayne State University School of Medicine, Detroit, Michigan, United States of America
| | - Steven J. Korzeniewski
- Department of Family Medicine and Public Health Sciences, Wayne State University School of Medicine, Detroit, Michigan, United States of America
| | - Bethany Foster
- Department of Emergency Medicine, Wayne State University School of Medicine, Detroit, Michigan, United States of America
| | - Jasmine Criswell
- Wayne Health, Wayne State University, Detroit, Michigan, United States of America
| | - Caitlin O’Brien
- Wayne Health, Wayne State University, Detroit, Michigan, United States of America
| | - Katee Dawood
- Wayne Health, Wayne State University, Detroit, Michigan, United States of America
| | - Lauren Baird
- Wayne Health, Wayne State University, Detroit, Michigan, United States of America
| | - Charles J. Shanley
- Department of Surgery, Wayne State University School of Medicine, Detroit, Michigan, United States of America
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