Developing a Public Health Quality Tool for Mobile Health Clinics to Assess and Improve Care
Highlights
- It illustrates how to translate broad public health quality aims into practical, measurable strategies.
- It offers a model for applying quality assessment and quality improvement processes in the practice of public health.
- It fills a major gap, with a straightforward, evidence-based quality improvement tool for public health programs to meaningfully participate in quality assessment.
- The PHQ Tool highlights the value mobile clinics add to strengthening the broader public health and healthcare systems.
- Measuring quality in public health enables more targeted, effective population level improvements, giving practitioners clear, actionable strategies to enhance equity and impact.
- Aggregated quality data strengthens advocacy and informs funding and policy decisions, elevating mobile clinics as essential contributors to population health.
Abstract
1. Introduction
2. Methods
2.1. Public Health Quality Tool Development
2.1.1. Early Foundations: The Family Van and Mobile Health Map
2.1.2. National Partnerships and Public Health Quality Aims
2.1.3. Collaborative Design with Diverse Clinics
2.1.4. Online Tool Construction and Release
2.2. Pilot Testing and Iterative Refinement
2.2.1. Early Pilots and Feedback
2.2.2. Sector Engagement and Dissemination
3. Results
3.1. Application and Quality Priorities
- 96% rated usability as high;
- ≥70% found questions relevant to their practice;
- 83% planned to strengthen work in at least one quality aim.
- Proactive aim: Increase capacity for real-time needs analysis and client feedback systems.
- Efficient aim: Expand cost tracking and develop simple ROI calculations for funders.
- Equitable aim: Improve service location convenience and offer trusted formats for health education in multiple languages.
3.2. Uptake and Clinic Characteristics
- Organizations with federal (40%), philanthropic (65%), public (56%), and private (67%) funding (many reporting multiple sources).
- Urban, suburban, and rural catchment areas, including post-disaster deployments after hurricanes and during the COVID-19 pandemic.
4. Discussion
- Accessible quality improvement encourages sustained self-evaluation across diverse organizations.
- Equity integration ensures that assessment frameworks reflect community realities.
- Data combined with narrative context strengthens advocacy with funders and health systems.
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Abbreviations
| PHQTool | Public Health Quality Tool |
| MHCs | Mobile Health Clinics |
| MHMap | Mobile Health Map |
| QI | Quality Improvement |
| MHCA | Mobile Health Clinics Association |
| ROI | Return on Investment |
| HHS | Health and Human Services |
| HRSA | Health Resources and Services Administration |
| FORHP | Federal Office of Rural Health |
| FQHC | Federally Qualified Health Center |
Appendix A
| Public Health Quality Tool Metrics | Definition | Metrics |
|---|---|---|
| Equitable | Does your program advance health equity? An equitable program works towards health equity by addressing health disparities—the gaps in quality of health or health care due ot the social determinants of health (like race or ethnicity, education level, or socioeconomic status). |
|
| Health Promoting | Is your program health promoting? A health promoting program adopts policies and strategies that advance safe practices by providers and the population and that increase the probability of positive health behavior and outcomes. |
|
| Proactive | Is your program proactive? Proactive programs adopt policies and sustainable practices in a timely manner, while mobilizing rapidly to address new and emerging threats and vulnerabilities. |
|
| Transparent | How transparent is your program? Transparency ensures openness in the delivery and practices, with particular emphasis on valid, reliable, accessible, timely, and meaningful data that are readily available to stakeholders, including the public. |
|
| Effective & Efficient | How effective and efficient is your program? Effective and efficient programs use evidence, science, and best practices to achieve optimal results in areas of greatest need. Understands costs and benefits of public health interventions, to facilitate the optimal use of resources to achieve desired outcomes. |
|
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| Public Health Aim | Example Strategies |
|---|---|
| Equitable | Affordable services for uninsured/underinsured clients; Materials at <6th-grade literacy; 2+ languages offered; Staff who reflect community diversity |
| Health Promoting | Health education/counseling; Evidence-based clinical interventions (e.g., vaccines); Addressing contextual and social determinants |
| Proactive | Analyzing community health data; Regular client surveys; Adaptive service models for emerging needs; Staff emergency training |
| Transparent | Public reporting of program/process/outcome data; Accessible governance and finance information |
| Effective | Prioritizing evidence-based interventions; Assessing changes in knowledge/behavior/health outcomes post-intervention |
| Efficient | Tracking costs/ROI per person served, streamlining operations without sacrificing access or quality |
| Year | Milestone |
|---|---|
| 1992 | The Family Van launches in Boston |
| 2007 | The Family Van, Mobile Healthcare Association (MHA), Harvard School of Public Health and health economist Paul Cote Jr., MBA begin Return on Investment (ROI) pilot |
| 2009 | The Family Van, MHA, The Boston Children’s Hospital Department of Information Technology and Harvard Medical School (HMS) Department of Bioinformatics launch Mobile Health Map.org (MHM) and the online ROI calculator |
| 2011 | MHM team presents ROI calculator to Health Resources Service Administration (HRSA) and Federal Office of Rural Health Policy (FORHP) in Washington, DC Honoré et al. [10] publishes public health quality aims |
| 2012 | Health and Human Services (HHS) and Office of Minority Health (OMH) sponsor a convening inviting over 100 Representatives of Agencies and Offices including Peggy A. Honoré, Director of Public Health Systems, Finance, and Quality Program, Office of Healthcare Quality/Office of the Assistant Secretary for Health, Department of Health and Human Services |
| 2012 | Honore invited and fund MHMap to convert the Public Health Quality Aims (PHQA) to concrete Metrics and create an online tool for PHQ |
| 2012–2013 | Collaborative working group with five flagship clinics create quality assessment tool |
| 2014 | Public Health Quality Tool (PHQTool) launches online, free for any Mobile clinic registered on MHMap, first public presentation American Public Health Association (APHA) annual meeting New Orleans |
| 2015 | Version 2 released after user feedback |
| 2016–2019 | National dissemination of PHQTool with invited presentations at APHA annual meetings, Institute for Health Improvement (IHI) forum, National Quality Partners, MHA Annual Conferences, HRSA, FOPHP, Agency for Healthcare Research and Quality (AHRQ), Weitzman Institute, and an interview on National Public Radio |
| 2020 | The Leon Lowenstein Family Foundation funds MHMap, and helps scale MHCs during COVID Response, MHMap and Quality tool rebuilt |
| 2023–2025 | 82+ clinics nationwide complete quality tool; mobile clinics nationwide use MHMap tools for advocacy |
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Share and Cite
Oriol, N.E.; Lin, J.; Bennet, J.; DeLorenzo, D.; Fallon, M.K.; Gracy, D.; Hill, C.; Vasquez, M.; Vavasis, A.; Williams, M.; et al. Developing a Public Health Quality Tool for Mobile Health Clinics to Assess and Improve Care. Int. J. Environ. Res. Public Health 2026, 23, 141. https://doi.org/10.3390/ijerph23020141
Oriol NE, Lin J, Bennet J, DeLorenzo D, Fallon MK, Gracy D, Hill C, Vasquez M, Vavasis A, Williams M, et al. Developing a Public Health Quality Tool for Mobile Health Clinics to Assess and Improve Care. International Journal of Environmental Research and Public Health. 2026; 23(2):141. https://doi.org/10.3390/ijerph23020141
Chicago/Turabian StyleOriol, Nancy E., Josephina Lin, Jennifer Bennet, Darien DeLorenzo, Mary Kathryn Fallon, Delaney Gracy, Caterina Hill, Madge Vasquez, Anthony Vavasis, Mollie Williams, and et al. 2026. "Developing a Public Health Quality Tool for Mobile Health Clinics to Assess and Improve Care" International Journal of Environmental Research and Public Health 23, no. 2: 141. https://doi.org/10.3390/ijerph23020141
APA StyleOriol, N. E., Lin, J., Bennet, J., DeLorenzo, D., Fallon, M. K., Gracy, D., Hill, C., Vasquez, M., Vavasis, A., Williams, M., & Honoré, P. (2026). Developing a Public Health Quality Tool for Mobile Health Clinics to Assess and Improve Care. International Journal of Environmental Research and Public Health, 23(2), 141. https://doi.org/10.3390/ijerph23020141

