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 health care 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 health care-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 health care and improving clinic attendance rates.[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.
- 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. 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).
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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 families utilizing transportation services to access healthcare for their children. (Captures service utilization.)
- Number of transportation staff and community health workers trained to provide culturally competent and family-centered assistance. (Assesses workforce capacity building.)
- Number of children who receive timely preventive, acute, and chronic care visits as a result of transportation support. (Measures impact on foregone care prevention.)
- Number of families who report reduced stress and burden related to accessing healthcare after receiving transportation assistance. (Captures impact on family well-being.)
- Number of children with chronic conditions who maintain better health through regular attendance at management and treatment visits enabled by transportation services. (Indicates care quality impact.)
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Quadrant 2:
Measuring Quality of Effort ("How well did we do it?")
- Percent of transportation services that accommodate the scheduling needs and logistical preferences of families. (Measures family-centered service design.)
- Percent of transportation assistance that is provided at no cost or with subsidies to low-income families. (Captures affordability and accessibility.)
- Percent of transportation staff who receive training on child passenger safety and emergency response. (Assesses commitment to safety and quality.)
- Percent of children who attend all recommended well-child visits and immunizations on schedule due to the availability of transportation support. (Captures care continuity impact.)
- Percent of parents who report high satisfaction and reliability of the transportation services used to access their children's healthcare. (Measures user experience impact.)
- Percent of children from transportation-disadvantaged families who achieve health outcomes on par with their more advantaged peers. (Assesses equity impact.)
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Quadrant 3:
Measuring Quantity of Effect ("Is anyone better off?")
- Number of cross-sector partnerships (e.g., with ride-sharing companies, public transit agencies) established to expand transportation options for families. (Measures collaborative infrastructure.)
- Number of innovative transportation solutions (e.g., mobile clinics, telehealth) implemented to bring care closer to families and reduce travel burden. (Captures alternative approaches.)
- Number of policies and funding mechanisms secured to sustain transportation assistance programs for healthcare access. (Assesses long-term viability.)
- Number of communities that demonstrate sustained reductions in child foregone care rates after implementing comprehensive transportation support. (Captures 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.)
- Number of families that gain economic stability and employment opportunities as a result of reduced transportation barriers to child healthcare. (Indicates family economic impact.)
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Quadrant 4:
Measuring Quality of Effect ("How are they better off?")
- Percent of transportation assistance resources allocated to families and communities with the greatest barriers to healthcare access. (Measures equity focus.)
- Percent of transportation services that are linguistically and culturally appropriate for the diverse populations served. (Captures cultural responsiveness.)
- Percent of families from underserved communities who are aware of and able to easily access transportation assistance for their children's healthcare needs. (Assesses equitable outreach and accessibility.)
- Percent reduction in geographic and socioeconomic disparities in child foregone care rates achieved through targeted transportation interventions. (Demonstrates equity impact.)
- Percent decrease in the excess burden of preventable child morbidity and mortality in communities with transportation barriers to care. (Captures progress toward health equity.)
- Percent of parents from historically marginalized groups who report feeling empowered and respected in accessing transportation support for their children's care. (Measures experiences of equity.)
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Note. When looking at your ESMs, SPMs, or other strategies:
- Move from measuring quantity to quality.
- Move from measuring effort to effect.
- Quadrant 1 strategies should be used sparingly, when no other data exists.
- 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.
