Two new articles from Mass General Brigham demonstrate the effectiveness of bringing COVID-19 health care services to where people need them most. In early May 2021, a team from Mass General Brigham began providing COVID vaccinations to underserved populations living in the greater Boston area by dispatching mobile health units to 12 low-income and predominantly racial/ethnic minority communities in Massachusetts. Using community health vans, teams provided easily accessible vaccination, regardless of insurance, immigration status or ability to pay. In an article published today in The American Journal of Public Health, The Mass General Brigham authors describe the success and challenges of the new program, which has seen higher vaccination rates among adolescents, non-white populations and people of Hispanic descent compared to state vaccination rates. and local communities.
“To date, our program has provided nearly 20,000 doses of COVID-19 vaccination,” said corresponding author Priya Sarin Gupta, MD, MPH, medical director of Mass General Brigham and Kraft Center Community Care Van Initiatives. “Our goal was to bring COVID-19 health and immunization services to the community and meet people where they are. Data from the first few months of use of Mass General Brigham’s community care vans, sometimes called “clinics on wheels,” shows us that if you build them — and if you build them well — they will come. »
In their AJPH Sarin Gupta and her colleagues describe what it took to develop their program and implement it effectively. The key elements of the program are:
- Engagement and partnership with community non-profit organizations, local health departments and school board representatives;
- The staffing of vans with trained and multilingual staff and the commitment of a vast network of volunteers;
- Identify the right places and times to reach communities that have been hardest hit by COVID-19.
The program also used a “double equity” model, engaging with a local transportation company that was at risk of downsizing due to economic losses suffered during the pandemic.
In a companion article recently published in Preventive medecinethe researchers analyzed the results of the first three months of the program. From May 20 to August 18, 2021, Community Health Vans held 130 sessions and administered 2,622 doses of COVID-19 vaccine. During the study, only 20% of people who received a vaccine at one of the mobile clinics identified as white. More than 56% said they were Hispanic (compared to the state’s vaccination rate of about 18%). In addition, participants were more often teenagers – the average age of those vaccinated in the mobile clinics was 31 years old. These early findings allowed the program to iterate and expand to other communities to maximize the program’s reach with communities of color and those with high rates of health-related social needs.
The authors note that mobile health units could be used to help meet other community health needs beyond – and sometimes intertwined with –; COVID-19. The vans are now expanding their offerings to include a menu of services to offer care for preventable and chronic conditions, including offering high blood pressure screening.
We’re already seeing attendees wanting to get vaccinated and getting screened for high blood pressure while they’re there, and vice versa. Some participants ask us: “What are you going to provide next? It gives me hope. If we can provide care with cultural humility and ensure that everyone has access to it, we can begin to overcome barriers such as mistrust. »
Priya Sarin Gupta, MD, MPH, medical director of the Mass General Brigham and Kraft Center Community Care Van Initiatives