“Bringing the treatment to where they are.” Mobile health vans have exploded since the pandemic.
The Community Care Van is one of three operated by Mass General Brigham. Originally launched during the pandemic to offer COVID-19 testing in hard-hit neighborhoods like Chelsea, Everett and Revere, the vans have recently expanded their services to address other health disparities.
The MGH vans are part of a growing movement of mobile clinics in Greater Boston that have attracted increased funding as the pandemic has exposed existing barriers to health care and created new ones.
Mollie Williams, executive director of Mobile Health Map, a database of mobile clinics in the United States, said she has seen tremendous growth in mobile healthcare over the past two years.
“We’ve seen so many new clinics pop up during the pandemic…pivoting their services and their approach in a new way,” said Williams, who is also a lecturer in global health and social medicine at Harvard Medical School. .
Several organizations have launched mobile clinics during the pandemic to increase access to vaccines and address vaccine hesitancy, especially in underserved communities. Bringing health care directly to patients not only eliminates transportation and time barriers, but helps patients trust their providers, according to Williams, who is also executive director of The Family Van, which is operated by Harvard. Medical School.
“Our customers tell us, ‘because you come to our neighborhood, we know you really care about us,'” she said. “It demonstrates a commitment to the community.”
For Manuel Barahona, walking down the street to visit the van is a much more convenient option than crossing town to Boston Medical Center, where he usually goes for medical treatment. Barahona, who lives within walking distance of the van location in Chelsea, first visited the site out of curiosity after seeing crowds gathering and returned for various health services, including his flu shot last Friday.
Not only is the van geographically accessible in Barahona, but also linguistically accessible. Spanish-speaking, he can be taken care of by the team whose members speak Spanish and Portuguese.
Cesar Guerra Castillo, who oversees the operations of one of the vans, said he chose sites close to established community organizations, such as La Colaborativa in Chelsea or STEPRox Recovery Support Center, a Roxbury-based organization offering support to the alcohol and/or drug addiction, for the convenience of patients and also to establish trust.
Since adding the new service a few months ago, the vans have performed 1,256 blood pressure tests on a diverse population of patients, nearly half of whom identify as Hispanic and nearly a fifth as Black, according to Dr. Priya Sarin Gupta, the program doctor. director and primary care physician at Massachusetts General Hospital and Harvard Medical School. More than a third of the patients had arterial hypertension.
“Not everyone realizes the importance of knowing what your blood pressure is. [or testing for cardiovascular diseases] because they are silent conditions until they become problematic,” said Sarin Gupta. “It gives us the opportunity to provide health education on what is almost as important as the clinical care we provide.”
On board each van is a team of community health workers and a nurse practitioner, regularly joined by doctors and an addiction treatment coach, available to answer general medical questions or refer patients to the right resources. Patients may also present with non-medical concerns, including food insecurity and housing issues, to be connected with organizations that can help.
“I think it’s easier and less intimidating to get all your information from one person than to have to Google and try to figure out what you’re eligible for,” said Karla Chamorro Garcia, one of the community health workers in the van.
Geographic barriers can prevent many people from getting help because they may live too far from healthcare providers, said Heidi DiRoberto, regional executive director of Spectrum Health Systems, Inc. A provider at Addiction and mental health treatment nonprofit in Worcester, it launched its own mobile treatment service last month, which is the first in the state to offer all three drugs for drug use disorders. opioids: methadone, suboxone and vivitrol.
The new program, sponsored by the Massachusetts Bureau of Substance Addiction Services, aims to make treatment more accessible to patients struggling with addiction, many of whom must come in for treatment daily.
“With opioid use disorders, especially methadone, daily self-care is critical,” DiRoberto said. “But some of these people are homeless or face other inequities that don’t allow them to come to the program every day…so we bring the treatment to where they are.”
Part of tackling holistic substance use disorders is offering mental health services, which in a post-COVID world can be difficult to access due to high demand. To help fill that gap, the Whittier Street Health Center in Roxbury, which has run its Mobile Health Van program since 2018, announced last week that it would expand its services to include mental health screenings in its four vans.
“It helps to quickly identify people with addictions or mental health issues and then help them and their families access resources,” said Frederica Williams, president and CEO of Whittier Street Health. Center. “By screening people early before it becomes a major problem or screening people when they are ready to commit, we are able to connect them to care.”
The privacy of a van can also help people feel more comfortable sharing their mental health issues, which can lead to a lot of stigma, she said.
These programs are part of a long history of mobile care in Greater Boston.
The Harvard Medical School Family Van has operated in the city for three decades. Originally launched to combat the high rates of infant and maternal mortality in Boston’s black populations, it now primarily offers support for patients with chronic conditions four days a week.
“There are a lot of doctors in Boston. What we need is to connect those who need health care to people who can provide it and community health workers are really well placed to do that because they come from the community and understand the barriers,” said Williams.
Zeina Mohammed can be contacted at [email protected] Follow her on Twitter @_ZeinaMohammed.