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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. Transportation Assistance

Approach. Offer transportation options for families to reach healthcare facilities and access needed care

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Overview. Transportation barriers can limit healthcare access. This is particularly problematic for children with chronic medical conditions who require frequent medical visits or families with a lack of transportation options or an inability to take their children to appointments for personal or financial reasons. The availability of transportation options, such as healthcare-directed rideshare services, helps to overcome these transportation barriers and enables children and their families to reach healthcare facilities to seek needed preventive and acute care. There is growing evidence that transportation screening along with non-emergent medical transportation services for children and families lacking secure transportation is a low-cost and effective solution for reducing barriers to healthcare and improving clinic attendance rates.[1]

Evidence. Emerging Evidence. Strategies with this rating typically trend positive and have good potential to work...

Access the peer-reviewed evidence through the MCH Digital Library or related evidence source.

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.
  • Patient Experience of Care. This study improves individuals' perceptions, feelings, and satisfaction with the healthcare services they receive.
  • Utilization. This strategy improves the extent to which individuals and communities use available healthcare services.

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

Intervention Level. Individual/Family-Focused

Examples from the Field. There are currently no ESMs that use this strategy. Search similar intervention components in the ESM database.

Sample ESMs. Here are sample ESMs to use as models for your own measures using the RBA framework (see The Role of Title V in Adapting Strategies).

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

  • Number of healthcare organizations that offer transportation assistance to families. (Measures availability of transportation support) Number of transportation staff and community health workers trained to provide family-centered assistance. (Assesses workforce capacity building)

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

  • Percent of transportation services partnered with Title V that accommodate the scheduling needs and logistical preferences of families. (Measures family-centered service design) Percent of transportation assistance supported by Title V that is provided at no cost or with subsidies to families experiencing economic challenges. (Shows affordability and usability)

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

  • Number of cross-sector partnerships led by Title V established to expand transportation options for families that results in high levels of satisfaction. (Measures collaborative infrastructure) Number of innovative transportation solutions supported by Title V implemented to bring care closer to families and reduce travel burden. (Shows alternative approaches) Number of communities that demonstrate sustained reductions in child foregone care rates after implementing comprehensive transportation support. (Shows population health impact) Number of preventable child emergency department visits and hospitalizations averted through improved access to timely care via transportation assistance. (Measures health system impact)

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

  • Percent of cross-sector partnerships led by Title V established to expand transportation options for families that results in high levels of satisfaction. (Measures collaborative infrastructure) Percent of innovative transportation solutions supported by Title V implemented to bring care closer to families and reduce travel burden. (Shows alternative approaches) Percent of communities that demonstrate sustained reductions in child foregone care rates after implementing comprehensive transportation support. (Shows population health impact) Percent of preventable child emergency department visits and hospitalizations averted through improved access to timely care via transportation assistance. (Measures health system impact)

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] Vais, S., Thomson, L., Williams, A., & Sobota, A. (2020). Rethinking Rideshares: A Transportation Assistance Pilot for Pediatric Patients with Sickle Cell Disease. Journal of health care for the poor and underserved, 31(3), 1457–1470.

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.