International Journal of Environmental Research and Public Health

Research

9 pages, 236 KB

Open AccessArticle

Description of a Pharmacist-Led Mobile Health Clinic to Fill Primary Care Coverage in a Medically Underserved Rural Area

by Emily Eddy, Stuart Beatty, David Nau, Karen L. Kier, Michelle Musser and Michael Rush

Int. J. Environ. Res. Public Health 2026, 23(5), 645; https://doi.org/10.3390/ijerph23050645 - 12 May 2026

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Abstract

Objective: Describe a mobile health clinic program led by pharmacists to provide services in a primary care shortage area. Methods: ONU HealthWise is a comprehensive pharmacy service offered by Ohio Northern University Raabe College of Pharmacy with a mobile clinic initiated in 2015. [...] Read more.

Objective: Describe a mobile health clinic program led by pharmacists to provide services in a primary care shortage area. Methods: ONU HealthWise is a comprehensive pharmacy service offered by Ohio Northern University Raabe College of Pharmacy with a mobile clinic initiated in 2015. ONU HealthWise is located in an HRSA-designated medically underserved and primary care shortage area and the mobile health clinic visits 11–18 locations monthly plus additional sites for screening or vaccinations. Medical residents from a health-system attend some locations and collaborative practice agreements allow pharmacists to initiate and adjust medications. Student pharmacists rotate through the mobile clinic to gain experiential training toward their Doctor of Pharmacy. The mobile clinic is an integral part of the learning and precepting for ONU HealthWise PGY-1 residents. Results: Over a 12-month period (July 2024–June 2025), the mobile clinic held 148 clinics across 7 rural counties in northwest Ohio. A total of 1265 screenings were conducted at 713 patient encounters (604 unique patients). Of the screenings, 38.1% of blood glucose, 21.6% of cholesterol, and 60.1% of blood pressures were abnormal. All abnormal tests resulted in either a medication adjustment, scheduled follow-up at future mobile clinic, or referral to a provider. Student pharmacists spent more than 3670 h on the mobile health clinic in experiential education. Conclusion: Pharmacists can be an integral healthcare provider by increasing access to primary care services through a mobile health clinic in a medically underserved area. The service provides learners with vital patient experiences. Full article

(This article belongs to the Special Issue Advances and Trends in Mobile Healthcare)

14 pages, 747 KB

Open AccessArticle

Bridging Gaps in Care: Evaluation of a Mobile Health Model Addressing Social Determinants and Harm Reduction in Eastern Puerto Rico

by Elisa Pujals, Glorimar Caraballo-Correa, Kathia Ocasio Maldonado, Yelanesse Pastrana Gonzalez, Rafael A. Torruella and Luis Román Badenas

Int. J. Environ. Res. Public Health 2026, 23(4), 529; https://doi.org/10.3390/ijerph23040529 - 18 Apr 2026

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Abstract

The harms associated with substance use continue to disproportionately affect marginalized populations. This study presents a retrospective program evaluation of a mobile health unit that delivers integrated clinical and harm reduction services to marginalized populations in Eastern Puerto Rico. Methods: A secondary data [...] Read more.

The harms associated with substance use continue to disproportionately affect marginalized populations. This study presents a retrospective program evaluation of a mobile health unit that delivers integrated clinical and harm reduction services to marginalized populations in Eastern Puerto Rico. Methods: A secondary data analysis was conducted using administrative data from a mobile health unit, capturing client encounters, service utilization (e.g., mental health support, health screenings, safe injection counseling, and case management), visit frequency, and demographic characteristics. This study is framed as an implementation-focused program evaluation. Descriptive and exploratory analyses were conducted to assess service delivery, program reach, utilization patterns, and selected program outcomes over a 1.5-year period. Results: Between January 2022 and October 2023, the mobile health unit served 279 participants across eight municipalities. Participants exhibited higher rates of intravenous drug use, mental health disorders, homelessness, and incarceration history compared with previously published estimates for the general Puerto Rican population, although these comparisons are indirect. The program delivered multidisciplinary services and facilitated referrals addressing key social determinants of health, including housing, nutritional assistance, identification services, in-patient treatment, and medication-assisted treatment. Model-based estimates using the Mobile Health Map Impact Tracker tool suggest that, in 2023, mobile health screenings may be associated with a return on investment of approximately 6:1, 259 avoided emergency department visits, 29 life-years saved, and approximately USD 2.4 million in healthcare cost savings. Conclusions: This evaluation demonstrates the feasibility of a mobile health model integrating harm reduction and clinical services to reach highly marginalized populations and facilitate connections to health and social services. Findings reflect program implementation, service reach, and engagement rather than causal effectiveness. Mobile health approaches may represent a feasible and potentially beneficial strategy for expanding access to care, although further research incorporating patient-level outcomes is needed to assess effectiveness. Full article

(This article belongs to the Special Issue Advances and Trends in Mobile Healthcare)

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11 pages, 1135 KB

Open AccessArticle

Increased Density of Mobile Health Unit Encounters Among Primary Care Health Professional Shortage Areas

by Phillip D. Levy, Michael J. Twiner, Bethany Foster, Mallory Lund, Naitik Nilesh-Shah, Paul J. Kurian, Brian Reed, Anna Steinberg-Abreu, James L. Young II, Robert D. Brook and Steven J. Korzeniewski

Int. J. Environ. Res. Public Health 2026, 23(4), 457; https://doi.org/10.3390/ijerph23040457 - 3 Apr 2026

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Abstract

Mobile health units (MHUs) can reach populations facing barriers to traditional primary care, but information about factors associated with their utilization is limited. The objective of this ecological study was to evaluate whether MHU encounter density is increased in census tracts designated as [...] Read more.

Mobile health units (MHUs) can reach populations facing barriers to traditional primary care, but information about factors associated with their utilization is limited. The objective of this ecological study was to evaluate whether MHU encounter density is increased in census tracts designated as Primary Care Health Professional Shortage Areas (HPSAs) and explore whether associations varied by socioeconomic vulnerability. We analyzed Wayne State University/Wayne Health MHU encounters with adult patients from July 2021 to September 2025. Negative binomial regression models with a log link and log(population) offset tested the a priori hypothesis that encounter density was increased in designated versus undesignated HPSA census tracts. Sensitivity analyses assessed variation by social vulnerability index score quartiles established by the US Centers for Disease Control and Prevention. One quarter of the five-county metropolitan Detroit, Michigan, catchment area census tracts were designated healthcare shortage areas. Overall, 13,852 encounters with 10,924 unique patients occurred across 924 of 1305 census tracts. Encounter rate per adult population was significantly increased by severalfold comparing designated versus undesignated shortage areas, with stronger associations at lower socioeconomic vulnerability index score quartiles (interaction p = 0.0006). These findings support continued efforts to scale and evaluate MHUs to address projected healthcare shortages, particularly in socioeconomically vulnerable areas. Full article

(This article belongs to the Special Issue Advances and Trends in Mobile Healthcare)

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18 pages, 723 KB

Open AccessArticle

Examining the Association Between Frequency of Mobile Clinic Visits and Diabetes and Hypertension Control

by Angela Coaston, Caroline Stephens, Soo-Jeong Lee, Sandra J. Weiss, Julene Johnson and Thomas Hoffmann

Int. J. Environ. Res. Public Health 2026, 23(3), 303; https://doi.org/10.3390/ijerph23030303 - 28 Feb 2026

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Abstract

Objective: To examine the association between frequency of mobile clinic visits and diabetes or hypertension control among patients who received regular mobile clinic care, controlling for patient sociodemographic characteristics and comorbidities. Design: Retrospective cohort study using patient chart review. Sample: Patients who regularly [...] Read more.

Objective: To examine the association between frequency of mobile clinic visits and diabetes or hypertension control among patients who received regular mobile clinic care, controlling for patient sociodemographic characteristics and comorbidities. Design: Retrospective cohort study using patient chart review. Sample: Patients who regularly visited mobile medical clinics in Southern California (N = 218) between 1 January 2018 and 31 December 2019. Measurements: The dependent variables were hemoglobin A1c and blood pressure control. The independent variable was number of visits per year. Longitudinal associations were examined using a linear mixed model or generalized linear mixed model. Results: Among regular mobile clinic patients with diabetes (n = 86), there was no significant association between number of visits and hemoglobin A1c control (hemoglobin A1c < 6.5). Among regular mobile clinic patients with hypertension (n = 129), the odds of hypertension control (blood pressure < 140/90 mmHg) over time significantly increased as the frequency of clinic visits increased (adjusted OR = 5.27, 95% CI 1.63–16.99). Conclusions: The study findings suggest that regular mobile clinic use by adults with hypertension improves blood pressure control over time. However, the frequency of mobile clinic visits had no effect on diabetes control overtime. Patients with diabetes need additional interventions to achieve hemoglobin A1c control. Full article

(This article belongs to the Special Issue Advances and Trends in Mobile Healthcare)

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11 pages, 539 KB

Open AccessArticle

Improving Rural Healthcare in Mobile Clinics: Real-Time, Live Data Entry into the Electronic Medical Record Using a Satellite Internet Connection

by Daniel Jackson Smith, Elizabeth Mizelle, Nina Ali, Valery Cepeda, Tonya Pearson, Kayla Crumbley, Dayana Pimentel, Simón Herrera Suarez, Kenneth Mueller, Quyen Phan, Erin P. Ferranti and Lori A. Modly

Int. J. Environ. Res. Public Health 2025, 22(6), 842; https://doi.org/10.3390/ijerph22060842 - 28 May 2025

Cited by 3 | Viewed by 4739

Abstract

The Farmworker Family Health Program (FWFHP) annually supports 600 farmworkers in connectivity-challenged rural areas. Traditional paper-based data collection poses validity concerns, prompting a pilot of direct data entry using tablets and satellite internet to enhance efficiency. The purpose of this article is to [...] Read more.

The Farmworker Family Health Program (FWFHP) annually supports 600 farmworkers in connectivity-challenged rural areas. Traditional paper-based data collection poses validity concerns, prompting a pilot of direct data entry using tablets and satellite internet to enhance efficiency. The purpose of this article is to describe, using the TIDier checklist, a real-time, live data-entry EMR intervention made possible by satellite internet. Utilizing a customized REDCap database, direct data entry occurred through tablets and satellite internet. Patients received a unique medical record number (MRN) at the mobile health clinic, with an interprofessional team providing care. Medication data, captured in REDCap before the mobile pharmacy visit, exhibited minimal defects at 6.9% of 319 prescriptions. To enhance data collection efficiency, strategies such as limiting free text variables and pre-selecting options were employed. Adequate infrastructure, including tablets with keyboards and barcode scanners, ensured seamless data capture. Wi-Fi extenders improved connectivity in open areas, while backup paper forms were crucial during connectivity disruptions. These practices contributed to enhanced data accuracy. Real-time data entry in connectivity-limited settings is viable. Replacing paper-based methods streamlines healthcare provision, allowing timely collection of occupational and environmental health metrics. The initiative stands as a scalable model for healthcare accessibility, addressing unique challenges in vulnerable communities. Full article

(This article belongs to the Special Issue Advances and Trends in Mobile Healthcare)

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Review

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21 pages, 630 KB

Open AccessReview

What Do We Know About Rural Mobile Health Clinics? A Scoping Review

by Katherine Simmonds, Madison Evans, Nancy Nguyen, Niharika Putta and Alexis Thom

Int. J. Environ. Res. Public Health 2026, 23(5), 558; https://doi.org/10.3390/ijerph23050558 - 25 Apr 2026

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Abstract

Rural communities face significant healthcare access barriers that contribute to persistent health disparities. Mobile health clinics (MHCs) have emerged as a promising strategy for expanding healthcare access, yet their effectiveness in rural settings remains understudied. The aim of this review was to examine [...] Read more.

Rural communities face significant healthcare access barriers that contribute to persistent health disparities. Mobile health clinics (MHCs) have emerged as a promising strategy for expanding healthcare access, yet their effectiveness in rural settings remains understudied. The aim of this review was to examine the literature to determine what is known about access, health outcomes, and the cost-effectiveness of rural MHCs, specifically with regard to their impact on patient access and outcomes, return on investment (ROI)/financial, and program sustainability. We conducted a comprehensive search of peer-reviewed and grey literature sources. Systematic screening yielded 34 documents for full analysis. Thematic analysis was conducted across three domains: patient access, patient outcomes, and ROI/sustainability. All 34 documents provided data on patient access, with common themes including expanded service utilization, multi-service integration, overcoming geographic and transportation barriers, and improved healthcare affordability. Thirty-two documents addressed patient outcomes, reporting improvements in preventive care delivery, chronic disease management, and high patient satisfaction. Twenty-eight documents included ROI/sustainability information, with evidence suggesting cost-effectiveness particularly through emergency department visit avoidance and multi-service integration. Across the literature reviewed, the quality of evidence varied considerably, yet we concluded mobile health clinics demonstrate promise for expanding healthcare access and improving outcomes in rural populations. Key success factors include multi-service integration, diverse funding partnerships, technological integration, and strong community engagement. More rigorous research with longitudinal clinical outcome measures and robust economic analyses is needed. Full article

(This article belongs to the Special Issue Advances and Trends in Mobile Healthcare)

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21 pages, 1004 KB

Open AccessReview

Mobile Eye Units in the United States and Canada: A Narrative Review of Structures, Services and Challenges

by Valeria Villabona-Martinez, Anna A. Zdunek, Jessica Y. Jiang, Paula A. Sepulveda-Beltran, Zeila A. Hobson and Evan L. Waxman

Int. J. Environ. Res. Public Health 2026, 23(1), 7; https://doi.org/10.3390/ijerph23010007 - 19 Dec 2025

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Abstract

Background and Objectives: Mobile Eye Units (MEUs) have emerged as practical innovations to overcome geographic, financial, and systemic obstacles to eye care. Although numerous programs operate across the United States and Canada, a narrative review describing their structure, implementation and services, remain limited. [...] Read more.

Background and Objectives: Mobile Eye Units (MEUs) have emerged as practical innovations to overcome geographic, financial, and systemic obstacles to eye care. Although numerous programs operate across the United States and Canada, a narrative review describing their structure, implementation and services, remain limited. This narrative review examines various MEUs models in the United States and Canada, using real-world examples to highlight each model’s structure, services, populations served, and key benefits and limitations. Methods: We performed a narrative review of peer-reviewed and gray literature published from 1990 to August 2025, identifying mobile eye units in the United States and Canada. Programs were grouped into four operational models based on services, equipment, and implementation characteristics. Ophthalmology residency program websites in the United States were also reviewed to assess academic involvement in mobile outreach. Results: We identified four operational MEU models: Fully Equipped Mobile Units (FEMUs), Semi-Mobile Outreach Units (SMOUs), School-Based Vision Mobile Units (SBVMUs), and Hybrid Teleophthalmology Units (HTOUs). FEMUs provide comprehensive on-site diagnostic capabilities but require substantial financial and logistical resources. SMOUs are lower-cost and flexible but offer more limited diagnostics. SBVMUs facilitate early detection in children and reduce school-based access barriers but depend on school coordination. HTOUs expand specialist interpretation through remote imaging, although their success relies on reliable digital infrastructure. Across all models, follow-up and continuity of care remain major implementation challenges. Approximately 21% of U.S. ophthalmology residency programs publicly report involvement in mobile outreach. Conclusions: MEUs play a critical role in reducing geographic and structural barriers to eye care for underserved populations across United States and Canada. However, limited outcome reporting, particularly regarding follow-up rates and continuity of care, hinders broader assessment of their effectiveness. Strengthening the integration of MEUs with patient navigators, integrated electronic health record, insurance support and support of local health networks is essential for improving long-term sustainability and impact. Full article

(This article belongs to the Special Issue Advances and Trends in Mobile Healthcare)

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17 pages, 323 KB

Open AccessReview

Complexity and Barriers to Vision Care: A Narrative Review Informed by a Mobile Eye Program

by Valeria Villabona-Martinez, Anne Schulman, Bharadwaj Chirravuri, Kerollos Kamel, Paula A. Sepulveda-Beltran, Zeila Hobson and Evan L. Waxman

Int. J. Environ. Res. Public Health 2025, 22(12), 1880; https://doi.org/10.3390/ijerph22121880 - 18 Dec 2025

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Abstract

Purpose: To describe structural and systemic barriers to ophthalmic care experienced by underserved patients, particularly those facing language obstacles, immigration-related constraints, limited insurance coverage, financial hardship, and navigation challenges in an urban setting, and to examine these barriers through a complexity-informed lens. [...] Read more.

Purpose: To describe structural and systemic barriers to ophthalmic care experienced by underserved patients, particularly those facing language obstacles, immigration-related constraints, limited insurance coverage, financial hardship, and navigation challenges in an urban setting, and to examine these barriers through a complexity-informed lens. Methods: We conducted a narrative literature review focused on healthcare disparities, patient navigation, complexity in care delivery, and time-sensitive prioritization frameworks in ophthalmology. Findings were integrated with case vignettes drawn from Eyes on Wheels (EOW), a mobile eye care initiative that provides no-cost examinations at Federally Qualified Health Centers (FQHCs) and free clinics. Cases were identified through routine clinical documentation and used to illustrate how structural barriers described in the literature manifest in real-world care pathways. Results: Three recurring system-level issues were identified across EOW encounters: (A) misclassification of medically necessary, time-sensitive ophthalmic care as “non-urgent”; (B) patient disengagement driven by cumulative structural and logistical barriers; and (C) failures that arise when the healthcare system, functioning as a complex adaptive system (CAS), is unable to adapt to patients’ and systems’ changing circumstances. A review of the literature confirmed that these patterns reflect widely documented challenges faced by underserved urban populations. Three EOW case vignettes, selected from seven patients identified in 2024, are presented as illustrative examples of these systemic patterns. Conclusions: Addressing inequities in eye care requires an approach that recognizes how many parts of the healthcare system interact and affect a patient’s ability to receive timely treatment. Vision loss is often the preventable result of systems that are rigid, fragmented, or unable to adapt to a patient’s circumstances. Improving outcomes will require flexible care models, such as mobile clinics, paired with strong institutional support, patient-centered navigation, and consistent assessment of social needs and barriers to care. Sustained progress will depend on collaboration across organizations, adaptable leadership, and policies that respond to the real-world situations in which patients live. Full article

(This article belongs to the Special Issue Advances and Trends in Mobile Healthcare)

Other

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15 pages, 282 KB

Open AccessBrief Report

Partners, Pride, and Prevention: Scaling Mpox Vaccination Access Across Minnesota

by Ingrid M. E. Johansen, Darcey K. McCampbell and Luke M. Leners

Int. J. Environ. Res. Public Health 2026, 23(5), 593; https://doi.org/10.3390/ijerph23050593 - 30 Apr 2026

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Abstract

Mpox is a rare but potentially serious vaccine-preventable disease. The 2022 United States outbreak disproportionately impacted gay, bisexual, and other men who have sex with men, people living with HIV, and people of transgender experience. Early vaccination efforts revealed substantial racial and geographic [...] Read more.

Mpox is a rare but potentially serious vaccine-preventable disease. The 2022 United States outbreak disproportionately impacted gay, bisexual, and other men who have sex with men, people living with HIV, and people of transgender experience. Early vaccination efforts revealed substantial racial and geographic inequities, with lower uptake among Black and Hispanic cisgender men, transgender women, and residents of rural areas. To address these challenges, Fairview’s Minnesota Immunization Networking Initiative (MINI), a 20-year-old mobile health collaborative, partnered with state and local public health agencies and community-based organizations to expand mpox vaccine access. With support from governmental outbreak response funding and stockpiled vaccine, mobile clinics were deployed in trusted community settings, including Pride events and recurring community sites. Targeted outreach, education, and coordination with local providers supported stigma reduction and second-dose series completion. Program data were collected from October 2022 through December 2024. MINI hosted 125 community-based mpox vaccination events, administered 2259 doses to individuals from 220 cities across the United States, including 195 cities in the Midwest. Pride events were key entry points for first-dose vaccination, particularly in rural areas; urban non-Pride clinics played a complementary role in facilitating second-dose completion. Program-level vaccination-to-case ratios were highest among populations experiencing disproportionate mpox burden, including Black, Hispanic, and American Indian/Alaska Native male participants, suggesting alignment of preventive resources with community need. MINI’s mobile, partnership-driven approach demonstrates the value of pairing large-scale community events with recurring clinics to address barriers to both vaccine access and series completion. These findings underscore the importance of flexible, community-centered infrastructure in advancing health equity and strengthening outbreak preparedness. Full article

(This article belongs to the Special Issue Advances and Trends in Mobile Healthcare)

17 pages, 853 KB

Open AccessSystematic Review

Mobile Cancer Screening Programs: A Systematic Review of Implementation Challenges and Population Access

by Safa ElKefi, Roberta Scheinmann, Alicia K. Matthews and Erica Phillips

Int. J. Environ. Res. Public Health 2026, 23(4), 465; https://doi.org/10.3390/ijerph23040465 - 4 Apr 2026

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Abstract

Objective: This review aimed to synthesize evidence on the design characteristics, implementation considerations, and operational challenges of mobile cancer screening units. Methods: A PRISMA-guided review was conducted. Data extracted included screening type, target population, program characteristics, mobile unit features, and reported implementation barriers. [...] Read more.

Objective: This review aimed to synthesize evidence on the design characteristics, implementation considerations, and operational challenges of mobile cancer screening units. Methods: A PRISMA-guided review was conducted. Data extracted included screening type, target population, program characteristics, mobile unit features, and reported implementation barriers. Study quality was assessed using the Mixed Methods Appraisal Tool (MMAT). Results: Sixty-four articles published across 13 countries met the inclusion criteria. Most interventions focused on breast cancer screening (n = 37), followed by lung (n = 11), cervical (n = 6), colorectal, skin, prostate, and multi-cancer screening programs. MSUs were most frequently deployed in urban areas (21 urban/18 rural/17 both). Several comparative studies (fixed programs vs. MSUs) reported higher screening uptake in mobile programs, although findings varied substantially by setting, population, and study design. However, adherence and clinical outcomes varied, often reflecting baseline socioeconomic differences in the populations served. Common implementation barriers included follow-up coordination challenges, program costs, equipment and space limitations, and gaps in referral and reimbursement systems. Conclusions: These findings highlight the potential of mobile screening units as public health strategies to expand access to cancer screening while underscoring the need for stronger implementation frameworks and long-term evaluation of program outcomes. Full article

(This article belongs to the Special Issue Advances and Trends in Mobile Healthcare)

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8 pages, 878 KB

Open AccessBrief Report

Cesarean Section Rates and Mobile Health’s Role in Equitable Access to Prenatal Care

by Nicole Person-Rennell, Patrick Rivers, James Hollister, Alicia Dinsmore, Nicole Bratsch, Judith Ortiz, Kristen Rundell and Karen Lutrick

Int. J. Environ. Res. Public Health 2026, 23(3), 288; https://doi.org/10.3390/ijerph23030288 - 26 Feb 2026

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Abstract

Cesarean section (CS) rates have risen globally, and while an often lifesaving and necessary intervention, CS deliveries increase future maternal/neonatal risks and are costly to both patients and healthcare systems. The U.S. Department of Health and Human Services has set a national low-risk [...] Read more.

Cesarean section (CS) rates have risen globally, and while an often lifesaving and necessary intervention, CS deliveries increase future maternal/neonatal risks and are costly to both patients and healthcare systems. The U.S. Department of Health and Human Services has set a national low-risk pregnancy CS (NTSV) target of 23.9% under the Healthy People 2030 initiative. This analysis compares NTSV rates of uninsured patients receiving prenatal care from a mobile clinic to the national target and also compares overall mobile health CS rates with national and state CS rates. Through reviewing 5 years of electronic medical records, we calculated an NTSV CS rate of 25.0% among our University of Arizona Mobile Health Program prenatal patients, an uninsured and medically vulnerable patient group. This rate is similar to both the most recent Arizona state average of 23.4% and the national target of 23.9%. The MHP total CS rate is 26% over our study period, which is less than the most recent National and Arizona rates of 32.3% and 29.0%. These findings suggest that access to free prenatal care through a mobile health delivery model may contribute to favorable obstetric outcomes among uninsured individuals and have implications for addressing maternal and neonatal health inequities among those who face multiple barriers to receiving adequate prenatal care. Full article

(This article belongs to the Special Issue Advances and Trends in Mobile Healthcare)

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11 pages, 361 KB

Open AccessBrief Report

The Strategic Advantage of FQHCs in Implementing Mobile Health Units: Lessons Learned from a Pilot Initiative

by Lauren Bifulco, Anna Rogers, Cecilia Hackerson, Marwan S. Haddad, April Joy Damian and Kathleen Harding

Int. J. Environ. Res. Public Health 2026, 23(2), 158; https://doi.org/10.3390/ijerph23020158 - 27 Jan 2026

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Abstract

High-need populations face substantive barriers to accessing primary care, leading to disproportionately poor health outcomes. This descriptive, observational study details the implementation of a Federally Qualified Health Center (FQHC) program designed to improve engagement in care and enabling services by leveraging mobile health [...] Read more.

High-need populations face substantive barriers to accessing primary care, leading to disproportionately poor health outcomes. This descriptive, observational study details the implementation of a Federally Qualified Health Center (FQHC) program designed to improve engagement in care and enabling services by leveraging mobile health units (MHUs) to provide comprehensive, low-barrier primary care services to residents who were previously unable or unwilling to engage with the traditional healthcare system. The program sought to overcome common access challenges such as lack of transportation, lack of insurance, and mistrust of healthcare institutions. We describe the operational framework of this program, examine the types of care delivered, and offer recommendations from the perspective of a large multi-site FQHC experienced in reengaging people back to the healthcare system but new to providing mobile health care. We describe our program’s focus on prioritizing patient engagement and access and its consideration of operational and technical infrastructure. Based on our FQHC’s experience, we provide recommendations on how to address patients’ health and social needs. FQHCs have the potential to implement MHUs, drawing on their existing infrastructure and community relationships. Our MHU program is well-aligned with our FQHC’s commitment and priority to deliver essential care and foster continuity within hard-to-reach communities, strengthening the local healthcare safety net and improving healthcare for high-need populations. Full article

(This article belongs to the Special Issue Advances and Trends in Mobile Healthcare)

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12 pages, 257 KB

Open AccessBrief Report

Developing a Public Health Quality Tool for Mobile Health Clinics to Assess and Improve Care

by Nancy E. Oriol, Josephina Lin, Jennifer Bennet, Darien DeLorenzo, Mary Kathryn Fallon, Delaney Gracy, Caterina Hill, Madge Vasquez, Anthony Vavasis, Mollie Williams and Peggy Honoré

Int. J. Environ. Res. Public Health 2026, 23(2), 141; https://doi.org/10.3390/ijerph23020141 - 23 Jan 2026

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This report describes the development and deployment of the Public Health Quality Tool (PHQTool), an online resource designed to help mobile health clinics (MHCs) assess and improve the quality of their public health services. MHCs provide essential clinical and public health services to [...] Read more.

This report describes the development and deployment of the Public Health Quality Tool (PHQTool), an online resource designed to help mobile health clinics (MHCs) assess and improve the quality of their public health services. MHCs provide essential clinical and public health services to underserved populations but have historically lacked tools to assess and improve the quality of their work. To address this gap, the PHQTool was developed as an online, evidence-based, self-assessment resource for MHCs, hosted on the Mobile Health Map (MHMap) platform. This report documents the collaborative development process of the PHQTool and presents preliminary evaluation findings related to usability and relevance among mobile health clinics. Drawing from national public health frameworks and Honore et al.’s established public health quality aims, the PHQTool focuses on six aims most relevant to mobile care: Equitable, Health Promoting, Proactive, Transparent, Effective, and Efficient. Selection of the six quality aims was guided by explicit criteria developed through pilot testing and stakeholder feedback. The six aims were those that could be directly implemented through mobile clinic practices and were feasible to assess within diverse mobile clinic contexts. The remaining three aims (“population-centered,” “risk-reducing,” and “vigilant”) were determined to be less directly actionable at the program level or required system-wide or data infrastructure beyond the scope of individual mobile clinics. Development included expert consultation, pilot testing, and iterative refinement informed by user feedback. The tool allows clinics to evaluate practices, identify improvement goals, and track progress over time. Since implementation, 82 MHCs representing diverse organizational types have used the PHQTool, reporting high usability and identifying common improvement areas such as outreach, efficiency, and equity-driven service delivery. Across pilot and post-pilot implementation phases, a majority of respondents agreed or strongly agreed that the tool was user-friendly, relevant to their work, and appropriately scoped for mobile clinic practice. Usability and acceptance were assessed using descriptive statistics, including percentage agreement across Likert-scale items as well as qualitative feedback collected during structured debriefs. Reported findings reflect self-reported perceptions of feasibility, clarity, and relevance rather than inferential statistical comparisons. The PHQTool facilitates systematic quality assessment within the mobile clinic sector and supports consistent documentation of public health efforts. By providing a standardized, accessible framework for evaluation, it contributes to broader efforts to strengthen evidence-based quality improvement and promote accountability in MHCs. Full article

(This article belongs to the Special Issue Advances and Trends in Mobile Healthcare)

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