Two new papers from Mass General Brigham demonstrate the effectiveness of delivering COVID-19 health services to where people need them most. In early May 2021, a team from Mass General Brigham began providing COVID immunizations to underserved populations living in the greater Boston area by deploying mobile health units to 12 mostly low-income and racial/ethnic minority communities in Massachusetts. Using community health vans, teams provided readily available vaccinations without regard to insurance, immigration status, or ability to pay. In an article published today in The American Journal of Public Health, Mass General Brigham’s authors describe the success and challenges of the new program, which had higher immunization rates among youth, nonwhite populations, and people of Hispanic descent compared to state and local community immunization rates.
“To date, our program has provided nearly 20,000 doses of COVID-19 vaccine,” 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 the COVID-19 health and immunization services to the community and meet people where they are. Data from the early months of Mass General Brigham’s community care vans, sometimes referred to as our ‘clinics on wheels,’ tells us that if you build it – and you build it well – they will come.”
In your AJPH Papers describe Sarin Gupta and colleagues what it took to build their program well and implement it effectively. Key elements of the program included:
- Engaging and partnering with community non-profit organizations, local health authorities and school board representatives;
- Staffing vans with trained, multilingual staff and engaging a large volunteer network;
- Identifying the right places and times to reach communities hardest hit by COVID-19.
The program also used a “double equity” model to work with a local transport company that was at risk of downsizing due to economic losses during the pandemic.
In a recently published accompanying paper in preventive medicine, investigators analyzed results from the first three months of the program. From May 20 to August 18, 2021, community health trucks conducted 130 sessions and administered 2,622 doses of COVID-19 vaccine. During the study, only 20 percent of people who received a vaccine from one of the mobile clinics identified themselves as white. More than 56 percent reported their ethnicity as Hispanic (compared to the state’s immunization rate of about 18 percent). In addition, the participants tended to be adolescents -; The average age of those vaccinated in the mobile clinics was 31 years. These early results allowed the program to be replicated and expanded to more communities to maximize the program’s outreach to 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 address other community health needs that extend beyond – and sometimes are intertwined with -; COVID-19. The vans are now expanding their offerings to include a range of services to treat preventable and chronic conditions, including high blood pressure screenings.
We are already seeing people coming to us interested in getting vaccinated and being screened for high blood pressure at the same time -; and vice versa. Some participants ask us: “What will you offer next?” It gives me hope If we provide care with cultural humility and ensure everyone has access, we can begin to break down barriers like distrust.”
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: Counseling, Testing and Vaccination for Medically Underserved Populations. American Journal of Public Health. doi.org/10.2105/AJPH.2022.307021.