文章基本信息

标题：Knowledgeable Neighbors:A Mobile Clinic Model for Disease Prevention and Screening in Underserved Communities
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作者：Caterina Hill ; David Zurakowski ; Jennifer Bennet 等
期刊名称：American journal of public health
印刷版ISSN：0090-0036
出版年度：2012
卷号：102
期号：3
页码：406-410
DOI：10.2105/AJPH.2011.300472
语种：English
出版社：American Public Health Association
摘要：The Family Van mobile health clinic uses a “Knowledgeable Neighbor” model to deliver cost-effective screening and prevention activities in underserved neighborhoods in Boston, MA. We have described the Knowledgeable Neighbor model and used operational data collected from 2006 to 2009 to evaluate the service. The Family Van successfully reached mainly minority low-income men and women. Of the clients screened, 60% had previously undetected elevated blood pressure, 14% had previously undetected elevated blood glucose, and 38% had previously undetected elevated total cholesterol. This represents an important model for reaching underserved communities to deliver proven cost-effective prevention activities, both to help control health care costs and to reduce health disparities. KEY FINDINGS ▪The Family Van mobile health clinic succeeded in reaching mainly minority low-income clients by using a community-based “Knowledgeable Neighbor” model. ▪Of the clients screened, 60% had previously undetected elevated blood pressure, 14% had previously undetected elevated blood glucose, and 38% had previously undetected elevated total cholesterol. ▪Male clients were almost as common as female clients. Men were more likely to be uninsured and had higher rates of previously undiagnosed elevated blood pressure and blood glucose. ▪Most clients had health insurance, suggesting that this service addresses barriers to health care beyond lack of insurance. ▪Mobile health clinics are a promising tool to deliver proven cost-effective chronic disease prevention interventions in underserved areas and to meet the dual imperatives of controlling health care costs and reducing health disparities. New solutions are needed to deliver cost-effective preventive interventions for chronic conditions in low-income minority communities across the United States, both to reduce health disparities and to control the nation's rising health care costs. 1–4 The National Commission on Prevention Priorities has identified the top 25 cost-effective preventive interventions, including hypertension, diabetes, and hypercholesterolemia screening. 5 However, as highlighted in the National Healthcare Disparities Report, low-income minority communities have poor access to these services. 2 They experience poorer client-provider communication and lower client trust and health literacy. 1,2,6 In addition, financial and logistical barriers include lack of insurance, out-of-pocket medical expenses, distance to services, appointment scarcity, and the complexities of navigating the system with public or no insurance. 1,2,6–8 Created to overcome barriers to health care, mobile health clinics have operated in the United States for many years, and an estimated 2000 currently operate. 9,10 Despite the mobile health clinic sector's size, it has low visibility within the health care system perhaps because of its positioning in the nonprofit sector and its relative lack of rigorous formal evaluation. The aims of this study were to describe the model used by one mobile health clinic and to evaluate the rates of previously undetected elevated blood pressure, blood glucose, and total serum cholesterol levels yielded from screening. This study used anonymous information collected for operational purposes.