Getting this type of service up and running, however, can be challenging. The startup and operational costs are high, and the wide range of community needs can make it difficult to focus narrowly enough to make an impact. Without a clear program vision and a defined target population, efforts can quickly run out of funding.
Given the high-risk, high-reward potential, a careful study of best practice cases is warranted before venturing into this terrain. Based on our research, The Family Van, operated since 1992 by Harvard Medical School, is one of the pioneers to learn from.
Launched to provide free, culturally competent preventive care and health education to underserved neighborhoods in Boston, The Family Van has not only become an anchor in the communities it serves, it has also been able to achieve significant ROI. The keys to its success? Focusing on two core objectives: earning community trust and connecting patients to the full range of care.
Build long-term, trusting relationships with key community groups
With a mission of empowering their community and reducing health disparities, The Family Van presents itself to the community as a "knowledgeable neighbor." That knowledge is reflected in the staffing model used and services offered.
The van is operated by staff who can speak the most common languages in the community, and whose credentials reflect the most critical community needs. Specifically, van staff include a health educator, a dietician, and an HIV counselor who collectively speak five languages. Rotating specialists from partner organizations help meet additional community needs, such as sexual health education and maternal care.
Additionally, The Family Van trains its staff in cultural competency and relies on patients themselves to dictate the services offered by the clinic. Because patients play such a critical role in shaping strategy and offerings, they are more likely to feel respected and effectively served by The Family Van and return for follow-up care. In fact, one-third of The Family Van patients receive care two or more times a year, and one-third were referred by family or friends.
Serve as an access point to the full continuum of care
Because The Family Van was so successful in building strong community ties, it has served as a major access point for patients to the rest of the care continuum. In addition to preventive services such as education, pregnancy tests, and blood pressure and cholesterol screenings, 25% of patients are referred to the clinic's partners. These partners, such as community health centers and social services, address unmet clinical and social needs outside the scope of the clinic's operations (e.g., primary care, healthy food, legal services). By investing time and resources to build linkages between providers and at-risk patients, they were able to save $21 for every $1 invested into the program.
Mobile Health Clinics: Improving Access to Care for the Underserved
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