Using mobile clinics to deliver care to difficult-to-reach populations: A COVID-19 practice we should keep

In the United States, mobile health clinics are an important method for delivering care to medically underserved populations. Mobile clinics have long been used in pediatric primary care, but there is little published to help pediatricians disseminate this practice more widely. During the COVID-19 pandemic, reduced in-person medical visits and subsequent declines in routine pediatric vaccination rates highlighted the importance of using a variety of care delivery models to reach patients. To improve vaccination coverage among young children in Boston during summer 2020, Mattapan Community Health Center and Codman Square Health Center deployed mobile clinics as an adjunct to their in-person preventive pediatric clinical services. In total, the health centers completed 17 mobile clinic sessions and served 50 unique patients, 77% of whom were African-American/Black and 75% of whom were under the age of two. A total of 146 vaccine injections were administered. A quality improvement survey of participating families demonstrated high levels of patient satisfaction and a high likelihood of using mobile services again in the future. The mobile clinic model was most valuable in reaching families who avoided in-person care due to COVID-19 transmission concerns or faced barriers to in-person care. The health centers fostered trust and demonstrated cultural competency during this novel initiative by leveraging established patient-provider relationships, using interpreters, and involving staff who reflected the diversity of the communities. Although there are challenges to implementing mobile health clinics, this initiative demonstrates the value of mobile clinics in delivering high quality pediatric preventive care to difficult-to-reach populations.