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Strengthen the Evidence for Maternal and Child Health Programs

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Evidence Tools
MCHbest. Forgone Health Care.

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Strategy. Mobile Health Clinics

Approach. Implement mobile health clinics to reach children in remote or rural regions and ensure access to necessary health care services

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Overview. Mobile health clinics or mobile vans can reach children in remote regions reducing the likelihood of missed or delayed medical care enabling more children to receive necessary health care services. Many mobile clinics provide care for health conditions, such as asthma, to children in areas experiencing limited access to healthcare across the U.S. and could also utilize care coordination and/or school nurses to bring students to clinics from schools with consent to treat from parents or guardians. Positive outcomes as a result of mobile clinics and collaboration with school nurses include more school days attended, less work days missed for parents, decreased health care spending costs, and improved health outcomes.[1]

Evidence. Emerging Evidence. Strategies with this rating typically trend positive and have good potential to work. They often have a growing body of recent, but limited research that documents effects. However, further study is needed to confirm effects, determine which types of health behaviors and conditions these interventions address, and gauge effectiveness across different population groups. (Clarifying Note: The WWFH database calls this "mixed evidence").

Access the peer-reviewed evidence through the MCH Digital Library or related evidence source. (Read more about understanding evidence ratings).

Source. Peer-Reviewed Literature

Outcome Components. This strategy has shown to have impact on the following outcomes (Read more about these categories):

  • Access to/Receipt of Care. This strategy increases the ability for individuals to obtain healthcare services when needed, including preventive, diagnostic, and treatment services.
  • Utilization. This strategy improves the extent to which individuals and communities use available healthcare services.
  • Timeliness of Care. This strategy promotes delivery of healthcare services in a timely manner to optimize benefits and prevent complications.

Detailed Outcomes. For specific outcomes related to each study supporting this strategy, access the peer-reviewed evidence and read the Intervention Results for each study.

Intervention Type. Direct Care (Read more about intervention types and levels as defined by the Public Health Intervention Wheel).

Intervention Level. Community-Focused

Examples from the Field. There are currently no ESMs that use this strategy. As Title V agencies begin to incorporate this strategy into ESMs, examples will be available here. Until then, you can search for ESMs that have similar intervention components in the ESM database.

Sample ESMs. Here are sample ESMs to use as models for your own measures using the Results-Based Accountability framework (for suggestions on how to develop programs to support this strategy, see The Role of Title V in Adapting Strategies).

Quadrant 1:
Measuring Quantity of Effort ("What/how much did we do?")

PROCESS MEASURES:

  • Number of mobile health clinics deployed to remote or rural regions. (Measures service availability and reach)
  • Number of healthcare providers and staff trained to deliver culturally competent and trauma-informed care through mobile clinics. (Assesses workforce development)

OUTCOME MEASURES:

  • Number of children in remote or rural areas who receive essential health services through mobile clinics. (Measures access to preventive care)
  • Number of acute illnesses and injuries treated promptly by mobile health clinics, preventing complications and hospitalizations. (Indicates timely care impact)

Quadrant 2:
Measuring Quality of Effort ("How well did we do it?")

PROCESS MEASURES:

  • Percent of mobile clinic visits that include comprehensive health assessments and risk screenings for children. (Measures adherence to preventive care guidelines)
  • Percent of children and families who receive mobile clinic services in their preferred language and with culturally appropriate communication. (Evaluates linguistic and cultural competence)

OUTCOME MEASURES:

  • Percent of children in remote or rural regions who are up-to-date on all recommended preventive care services after accessing mobile clinics. (Measures preventive care impact)
  • Percent of children with positive developmental and health outcomes attributed to regular access to mobile clinic services. (Assesses health impact)

Quadrant 3:
Measuring Quantity of Effect ("Is anyone better off?")

PROCESS MEASURES:

  • Number of community partnerships established to support and sustain mobile health clinic initiatives. (Measures collaborative infrastructure)
  • Number of telehealth capabilities integrated into mobile clinics to enhance access to specialty care and care coordination. (Shows service innovation and expansion)

OUTCOME MEASURES:

  • Number of preventable child deaths and disabilities averted in remote or rural communities through timely intervention by mobile clinics. (Measures prevention of adverse outcomes)
  • Number of rural healthcare facilities that experience reduced strain on emergency services and inpatient capacity due to support from mobile clinics. (Indicates health system impact)

Quadrant 4:
Measuring Quality of Effect ("How are they better off?")

PROCESS MEASURES:

  • Percent of mobile clinic locations selected based on analysis of geographic disparities in child health care access and outcomes. (Measures data-driven equity focus)
  • Percent of mobile clinic advisory boards that include representation from underserved communities served. (Assesses community voice in governance)

OUTCOME MEASURES:

  • Percent reduction in geographic disparities in rates of foregone care and unmet health needs among children. (Shows spatial equity impact)
  • Percent decrease in health outcome disparities between children in remote or rural areas and those in more populated regions. (Demonstrates geographic health equity progress)

Note. When looking at your ESMs, SPMs, or other strategies:

  1. Move from measuring quantity to quality.
  2. Move from measuring effort to effect.
  3. Quadrant 1 strategies should be used sparingly, when no other data exists.
  4. The most effective measurement combines strategies in all levels, with most in Quadrants 2 and 4.

Learn More. Read how to create stronger ESMs and how to measure ESM impact more meaningfully through Results-Based Accountability.

References

[1] Green, L. A., & Ailey, S. H. (2021). Increasing Childhood Asthma Care Appointments on a Mobile Asthma Van. The Journal of school nursing : the official publication of the National Association of School Nurses, 37(3), 209–219.

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.