Rennert Lior, Gezer Fatih, Jayawardena Iromi, Howard Kerry A, Bennett Kevin J, Litwin Alain H, Sease Kerry K
Department of Public Health Sciences, Clemson University, Clemson, SC, USA.
Center for Public Health Modeling and Response, Clemson University, Clemson, SC, USA.
Public Health Pract (Oxf). 2024 Sep 27;8:100550. doi: 10.1016/j.puhip.2024.100550. eCollection 2024 Dec.
Mobile health clinics (MHCs) effectively provide healthcare to underserved communities. However, their application during health emergencies is understudied. We described the implementation of an MHC program delivering vaccinations during the COVID-19 pandemic, examined the program's reach to medically underserved communities, and investigated characteristics of vaccination uptake in order to inform the utility of MHCs during health emergencies.
The study observed COVID-19 MHC vaccination rates and factors associated with uptake between February 20th, 2021, and February 17th, 2022.
Prisma Health deployed six MHCs to underserved communities. We described the characteristics of individuals who utilized the MHCs and evaluated census tract-level community factors associated with use of the MHCs through generalized linear mixed effects models.
The MHCs conducted 260 visits at 149 unique sites in South Carolina, providing 12,102 vaccine doses to 8545 individuals: 2890 received a partial dose, 4355 received a primary series, and 1300 received a booster dose. Among individuals utilizing the MHC, the median age was 42 years (IQR: 22-58), 44.0 % were Black, 49.2 % were male, and 44.2 % were uninsured. Black, Hispanic, and uninsured individuals were significantly more likely to utilize MHC services for COVID-19 vaccination. During periods when vaccines were limited, MHC utilization was significantly greater in communities facing access barriers to healthcare.
The high COVID-19 vaccination uptake at MHCs demonstrated that the MHC framework is an effective and acceptable intervention among medically underserved populations during health emergencies, especially when resources are scarce. The identified factors associated with vaccination uptake demonstrated that the MHCs had the greatest impact in higher-risk communities and can be used to inform allocation of such field-level interventions in future health emergencies.
移动健康诊所（MHCs）有效地为服务不足的社区提供医疗保健服务。然而，其在卫生紧急情况期间的应用研究不足。我们描述了在新冠疫情期间实施的一项提供疫苗接种服务的MHC项目，考察该项目对医疗服务不足社区的覆盖范围，并调查疫苗接种率的特征，以便为卫生紧急情况期间MHCs的效用提供参考。
该研究观察了2021年2月20日至2022年2月17日期间新冠MHC疫苗接种率及与接种相关的因素。
Prisma Health在服务不足的社区部署了六个MHC。我们描述了使用MHC的个体特征，并通过广义线性混合效应模型评估了与MHC使用相关的普查区层面的社区因素。
MHC在南卡罗来纳州的149个不同地点进行了260次访问，为8545人提供了12102剂疫苗：2890人接种了部分剂量，4355人接种了初始系列疫苗，1300人接种了加强针。在使用MHC的个体中，年龄中位数为42岁（四分位间距：22 - 58岁），44.0%为黑人，49.2%为男性，44.2%未参保。黑人、西班牙裔和未参保个体更有可能利用MHC服务进行新冠疫苗接种。在疫苗供应有限的时期，面临医疗保健获取障碍的社区对MHC的利用率显著更高。
MHC的新冠疫苗高接种率表明，在卫生紧急情况期间，尤其是资源稀缺时，MHC框架在医疗服务不足人群中是一种有效且可接受 的干预措施。确定的与疫苗接种率相关的因素表明，MHC在高风险社区产生的影响最大，可用于为未来卫生紧急情况中此类现场层面干预措施的分配提供参考。
