Established Evidence Results

Intervention Components (click on component to see a list of all articles that use that intervention): Mobile Programs,

Intervention Description: The intervention involved designing and implementing flexible mass vaccination campaigns in the refugee camps, with the support of cultural mediators and volunteers from the community. The campaigns aimed to address the insufficient vaccination coverage for diseases such as MMR, pneumococcal disease, hepatitis B, poliomyelitis, diphtheria-tetanus-pertussis, and Haemophilus influenzae type b.

Intervention Results: he study found that vaccination coverage was high for the first dose of the MMR vaccine, but far from optimal for the second dose and for other diseases. The study also found that the availability of cultural mediators was a challenge, and that constant monitoring of vaccination coverage was difficult due to the constantly changing population in the camps.

Conclusion: The study highlights the importance of flexible mass vaccination campaigns in refugee settings, and the need for adequate cultural mediation support to address language and cultural barriers. The study also emphasizes the challenges of monitoring vaccination coverage in such settings.

Study Design: The study used a door-to-door household survey to collect data on vaccination coverage and needs of refugee children in the camps. Mass vaccination campaigns were then designed and implemented based on the survey results.

Setting: The study was conducted in refugee camps in Greece.

Population of Focus: The target audience was children aged 0-14 years living in the refugee camps.

Sample Size: The study included 3,786 children recorded as living in the camps in April 2018.

Age Range: The age range of the target audience was 0-14 years.

Intervention Components (click on component to see a list of all articles that use that intervention): Mobile Programs, Community Events,

Intervention Description: Interprofessional, student-run vaccine outreach program (VOP) that provided free vaccination events in nontraditional community locations

Intervention Results: The VOP reached hundreds of residents who were more vulnerable to influenza infection, including patients who were under- or uninsured, lacked stable housing, and/or were unemployed. Among VOP patients, 377 (21.8%) received their first ever vaccine and 483 (27.9%) obtained the influenza vaccine rarely or every few years which indicates the VOP reached many vaccine-naïve and vaccine-inconsistent individuals. With the addition of a nurse practitioner student to VOP leadership, the 2018–2019 VOP reached the most homeless or temporarily-housed (228, 32.3%), unemployed (313, 18.5%), and disabled (60, 8.5%) patients.

Conclusion: Healthcare students serve as an eager, underutilized resource who can be leveraged to disseminate vaccines to individuals with limited access to care.

Study Design: Retrospective analysis of demographic data collected through an optional survey

Setting: Davidson County, Tennessee, USA

Population of Focus: Marginalized populations, including the uninsured, unemployed, and unhoused individuals

Sample Size: 1,803 patients who received an influenza vaccine between 2015 and 2019

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): School-Based Mobile Clinic, Mobile Programs,

Intervention Description: This mixed methods study examined a mobile meal program implemented in a community with large economic disparities. Parents and caregivers who attended the mobile meal program with a child at one of three sites completed surveys that screened for risk of food insecurity and examined access and utilization of community food resources. Interviews with a representative subsample of English- and Spanish-speaking participants elicited an in-depth understanding of food insecurity in the community and perspectives on the mobile meal program.

Intervention Results: Surveys (n = 284) were completed in English (78%) and Spanish (22%). Participants identified primarily as Asian (32%), Latino/Hispanic (29%), and White (27%), with 26% screening positive for risk of food insecurity within the past 12 months. Qualitative interviews (n = 36) revealed widespread support for meals served in public settings as they were perceived to be welcoming, fostered social interactions, and helped the community at large. Participants described the high cost of living as a key motivation for participating and cited immigration fears as a barrier to accessing public resources.

Conclusion: Findings from this study suggest the importance of innovative community-based approaches to serving hard-to-reach children during the summer.

Study Design: Mixed methods design

Setting: Community-based

Population of Focus: Parents and caregivers

Sample Size: 284

Age Range: n/a

Intervention Components (click on component to see a list of all articles that use that intervention): Family-Based Interventions, Mobile Programs,

Intervention Description: Within a community-based participatory action research (CPBAR) framework, the JHCAIH and partners designed and administered household surveys at baseline and 3 months after MoGro's launch. A randomly selected 20% of households participated at each timepoint.

Intervention Results: About 75% of respondents indicated that MoGro had changed the foods they purchased, and 68% reported that MoGro had changed how their families ate. After MoGro's launch, food availability increased significantly and food insecurity decreased.

Conclusion: The evaluation documented MoGro's impact in the community; high self-reported positive changes, significant increases in food availability, and decreases in food insecurity.

Study Design: Community-based participatory action research (CPBAR) framework

Setting: Community-based

Population of Focus: Families

Sample Size: Unknown

Age Range: n/a

Intervention Components (click on component to see a list of all articles that use that intervention): Mobile Programs, Quality Improvement/Practice-Wide Intervention, Care Coordination,

Intervention Description: Children in two communities of a large city in the Midwestern United States have higher rates of asthma than other areas of the city. The communities have barriers to accessing care, including high rates of unemployment and being uninsured and undocumented. A mobile van provides no-cost asthma care to children at schools in these communities, but use of these services has decreased more than 50% over the past 5 years. School nurses have the potential to improve asthma outcomes by collaborating with health-care providers. The purpose of the program was to increase the number of appointments scheduled and attended on the asthma van at both schools. For this program, we (a) implemented an unaccompanied minor consent, (b) enhanced care coordination, and (c) improved a respiratory health survey tool.

Intervention Results: Results showed an increased number of appointments scheduled and attended on the asthma van.

Conclusion: The program was successful even though community-specific barriers existed.

Study Design: Pre-post intervention study

Setting: Two communities in a large city in the Midwestern United States

Population of Focus: Children in two communities in a large city in the Midwestern United States who have higher rates of asthma compared to other areas in the city

Sample Size: 718 students for Community A School and 267 students for Community B School

Age Range: Children aged 6-11 years old

Intervention Components (click on component to see a list of all articles that use that intervention): Mobile Programs, Prenatal Care Access,

Intervention Description: The intervention in the study was the SmartMoms Canada mHealth app, which was developed for both Android and IOS devices . The app was designed to promote healthy lifestyle behaviors such as physical activity, healthy diet, managing anxiety, and practicing adequate sleep hygiene among pregnant and postpartum women . The app was provided to the participants, who were given a minimum of one week to become familiar with the technological accessories, including a Fitbit Charge 2 fitness tracker and a BodyTrace scale . During the focus groups, the participants were asked to provide feedback on their experiences using the app, including its strengths and weaknesses, and suggestions for future improvements

Intervention Results: The study found that pregnant and postpartum women positively viewed the SmartMoms Canada app with respect to its ability to provide pregnancy guidance, pregnancy-specific exercises, and advice on sleep . The participants also expressed a desire for more feedback in the form of notifications, further interactivity to input their own goals, and short workout routines based on time availability and stage of pregnancy . Additionally, the women highlighted the importance of organizing the app based on their personal health preferences and emphasized the inclusion of overall maternal health, including exercise, nutrition, and mindfulness . Furthermore, the study revealed that the participants were critical of certain aspects of the app, such as its design and aesthetic, and expressed a need for more emphasis on physical activity and less focus on weight tracking . The women also shared their experiences with other mHealth services and expressed their technological proficiency and knowledge of pregnancy-specific mHealth services . Overall, the results indicated that the SmartMoms Canada app was well-received by the participants, who provided valuable feedback for its improvement and future development , .

Conclusion: The conclusion of the study highlighted the potential of the SmartMoms Canada app as a promising solution to address the gaps in healthcare provider communication related to weight during pregnancy, along with support on physical activity, diet, and sleep . The authors emphasized the importance of incorporating qualitative feedback to improve the app, including the integration and synchronization of Wi-Fi™ enabled accessories and the provision of greater feedback on weight gain . The study also underscored the significance of embedding evidence-based tools in daily healthcare routines and encouraging healthcare providers to integrate such tools in their practice . Furthermore, the authors suggested that the future of mHealth tools and their role in prenatal care will depend on the successful embedding of these evidence-based tools in daily health care routines and encouraging healthcare providers to integrate such tools in their practice . They also indicated that the findings from this study and future studies will contribute to offering home pregnancy care, patient empowerment, and revolutionizing prenatal care practices, ultimately contributing to improved maternal-fetal health outcomes .

Study Design: The study utilized a qualitative research design, specifically employing focus groups and thematic analysis to gather and analyze data . Two focus groups involving a total of 13 participants, consisting of both currently pregnant and recently postpartum women, were organized for the study . The focus groups were transcribed verbatim, and thematic analysis was undertaken using manual coding and NVivo software . Additionally, Likert-scale surveys were used to collect and analyze responses from the participants .

Setting: The study was conducted in Ottawa, Canada, which is the capital city of Canada . The focus groups and evaluations took place at the University of Ottawa, indicating that the research was carried out in an academic setting. This setting is significant as it reflects the potential for the SmartMoms Canada mHealth app to be integrated into the Canadian healthcare system and academic research environment.

Population of Focus: The target audience of the study on the SmartMoms Canada mHealth app is pregnant and postpartum women in Canada . The study aimed to evaluate the receptiveness, functionality, and future prospects of the app among this population. The participants in the study were women who were pregnant or had given birth to a baby within six months of the first scheduled focus group . The study aimed to assess the utility of the SmartMoms Canada mHealth app in improving weight outcomes during pregnancy and promoting healthful lifestyle behaviors such as physical activity, healthy diet, managing anxiety, and practicing adequate sleep hygiene

Sample Size: The study involved a total of 13 participants in two focus groups, with 11 pregnant women and 7 postpartum women initially expressing interest and eligibility to participate . Of these, 17 women attended the first appointment and were given the SmartMoms Canada app along with the necessary accessories. However, 4 women were lost to follow-up, leaving a total of 13 participants who took part in one of the two focus groups

Age Range: The average age of the participants in the study was 31.5 years, with a standard deviation of 3.28 years . This indicates that the participants were generally in their early thirties. However, the specific age range of the participants was not explicitly provided in the information available from the study.

Intervention Components (click on component to see a list of all articles that use that intervention): Mobile Programs, Concurrent Infant/Mother Checkups

Intervention Description: Implementation of a mobile postpartum clinic, known as the Dyadic Care Mobile Units program, at Boston Medical Center

Intervention Results: 1. Increased Attendance Rates: The mobile clinic achieved a high appointment attendance rate of 97%, which contrasts with the 60% attendance rate for postpartum parents coming into the traditional healthcare institution. 2. 2. Improved Access to Care: The mobile clinic program addressed structural determinants of health by overcoming barriers of transportation access and clinic wait times, thereby increasing safety and ease for new families to access care. 3. Improved Patient Outcomes: The high-touch postpartum care provided by the mobile clinic team was associated with improved patient outcomes, particularly related to hypertensive disorders of pregnancy and depression. Multiple patients were readmitted directly to the postpartum unit from the van in acute hypertensive crises.

Conclusion: The mobile clinic succeeded in increasing attendance rates, improving access to care, and addressing unmet material needs for participating patients.

Study Design: Descriptive program evaluation

Setting: Obstetrics and Gynecology Department’s Midwifery Service and the Pediatric Department at Boston Medical Center (BMC), a tertiary care hospital in Boston

Population of Focus: Postpartum patientnewborn dyads; health professionals

Sample Size: 347 postpartum patients; 364 newsborns

Age Range: <20--35+ (maternal age range)

Intervention Components (click on component to see a list of all articles that use that intervention): Care Coordination, Mobile Programs,

Intervention Description: The intervention involved the implementation of mobile complex care plans (MCCPs) for children with medical complexity (CMC) enrolled in a complex care program. The MCCPs were individualized, updated quarterly, integrated within the electronic health record (EHR), and made accessible to parents through an online patient portal (OPP) on their mobile devices.

Intervention Results: The results of the study "Mobile Complex Care Plans to Enhance Parental Engagement for Children With Medical Complexity" are as follows: 1. Feasibility: a) In the one-year study period from September 1, 2016, to August 31, 2017, 94% of eligible patients (n = 47) received 162 mobile complex care plans (MCCPs). b) Seventy-four percent of parents (n = 35) reviewed MCCPs online, indicating a high level of engagement with the care plans. c)Forty-six percent of parents who reviewed MCCPs (n = 16) sent a follow-up message, and the care team responded within a median time of 7.2 hours, demonstrating timely communication between the care team and parents. 2. Parental Engagement and Experience: a) In qualitative interviews, parents identified MCCPs as an important reference and communication tool that improved their understanding of their child's overall medical situation. b) The MCCPs were perceived as facilitating parental engagement and delivering timely communication with the care team, as reported by the parents. 3. Care Coordination: The study demonstrated that integration of MCCPs into care coordination for children with medical complexity (CMC) was feasible and facilitated parental engagement. Overall, the study findings indicated that mobile complex care plans (MCCPs) for CMC in a complex care program were feasible, facilitated parental engagement, and delivered timely communication. The MCCPs were perceived as important reference and communication tools by parents, contributing to improved understanding of their child's medical situation and enhancing care coordination.

Conclusion: As the CMC population grows and their care coordination needs further intensify, care plans will play an increasingly vital role to prevent key information from “falling through the cracks.” As care plans are more widely implemented, complex care programs will need an efficient approach that engages parents. By fully leveraging the EHR and OPP, our novel MCCPs offer the potential for care plans to fulfill their promise of being a patient-centered, dynamic, and comprehensive blueprint for CMC, their parents, and their care team.

Study Design: The study utilized a mixed methods design. It combined quantitative and qualitative approaches to evaluate the feasibility and impact of mobile complex care plans (MCCPs) for children with medical complexity (CMC) enrolled in a complex care program. The quantitative aspect of the study involved assessing the prevalence of home Internet and computer/mobile device access among parents of CMC enrolled in the Complex Care Service (CCS) program. Additionally, the study quantified the utilization of MCCPs by eligible patients and the level of parental engagement with the MCCPs. The qualitative component of the study involved conducting interviews with parents to gain insights into their experiences with MCCPs and to understand the impact of MCCPs on parental engagement, parent experience, and care coordination. The qualitative interviews provided additional depth and context to complement the quantitative data analysis, allowing for a comprehensive understanding of the intervention's effects on the target population.

Setting: The setting for the study described in this article was a complex care program for children with medical complexity (CMC) in Durham, North Carolina.

Population of Focus: The target audience for the study includes healthcare professionals and researchers involved in the care of children with medical complexity (CMC), particularly those working in complex care programs or similar settings. Additionally, the study findings may be of interest to professionals involved in care coordination, pediatric healthcare technology, and patient engagement. Furthermore, the study's focus on mobile health innovations and their impact on parental engagement and care coordination suggests that professionals in the fields of mobile health, digital health, and health informatics may also find the research relevant.

Sample Size: The sample size for the study was 50 participants. All participants were children with medical complexity (CMC) enrolled in the Complex Care Service (CCS) program in Durham, NC. The study used structured criteria to identify high-need, high-cost patients to receive mobile complex care plans (MCCPs) as part of the intervention. Of the 50 participants, 47 were eligible to receive MCCPs, and 94% of those eligible received MCCPs during the one-year study period. The study also included qualitative interviews with parents of eligible participants to gather insights into their experience with MCCPs.

Age Range: 0.4 to 18.5 years

Intervention Components (click on component to see a list of all articles that use that intervention): Access, Community Health Workers (CHWs), Mobile Programs

Intervention Description: The authors created extending Maternal Care After Pregnancy (eMCAP), a community-based program, to address health care disparities and enhance access to care for the 12 months after birth. The team also evaluated the ability of Z codes (ICD-10 codes for social determinants of health) to identify patients with health-related social needs. The program is a multidisciplinary effort of nurses, nurse home visitors, physicians, advanced practice providers (APRNs [advanced practice registered nurses]), community health workers (CHWs), social services, behavioral health teams, and pharmacists working within a specially designed electronic health registry linked to existing electronic medical records and an obstetric quality database.

Intervention Results: The eMCAP program demonstrated improvement in attendance and quality of postpartum care for women living in underserved areas with chronic hypertenion (CHTN) and diabetes mellitus (DM). Compared to matched controls who were provided standard referrals, follow-up postpartum attendance for eMCAP women with CHTN was significantly better at 2 weeks and 1, 3, 6, 9, and 12 months (all p < 0.001). Similarly, eMCAP women with DM had significantly better follow-up at 2 weeks (p = 0.04), 1 month (p = 0.002), and 3 months (p = 0.049), resulting in HbA1c values for DM being significantly lower (p < 0.05) throughout the postpartum period.

Conclusion: The postpartum period represents a critical opportunity to understand and improve short- and long-term health with various platforms suggested to combat this crisis, but the roles of access to care, community-based support, and electronic health management systems remain unknown. We offer our experiences from eMCAP as an opportunity for further study in other health care settings. The findings of improved health care outcomes are key measures important to improving maternal morbidity and mortality across the United States.

Study Design: Observational study

Setting: Parkland health system in Dallas

Population of Focus: Predominantly Black and Hispanic women

Sample Size: 1,479 enrolled women

Age Range: Reproductive age

Intervention Components (click on component to see a list of all articles that use that intervention): Mobile Programs,

Intervention Description: The intervention involved providing free influenza vaccinations in nontraditional settings for uninsured and underinsured immigrant and racial/ethnic minority groups through the MINI project

Intervention Results: The results of the study included demographic information such as sex, age group, race/ethnicity, first-time vaccinated for influenza, and health insurance status of the participants

Conclusion: The conclusion emphasized the importance of committing to a long-term relationship with the community and working through problems when they arise to ensure the success of community-based initiatives like MINI

Study Design: The study utilized a survey as a census of all persons who received an influenza vaccination at a MINI-organized clinic during the 2017-2018 influenza season

Setting: The setting for the study is the Minnesota Immunization Networking Initiative (MINI), a community-based collaborative that provides free influenza vaccinations in nontraditional settings for uninsured and underinsured immigrant and racial/ethnic minority groups

Population of Focus: The target audience includes uninsured and underinsured immigrant and racial/ethnic minority groups in Minneapolis–St Paul, Minnesota, who are in need of influenza vaccinations

Sample Size: The survey included a total of 5910 persons who received influenza vaccination at a MINI-organized clinic during the 2017-2018 influenza season

Age Range: The age range of the participants varied from children aged <9 who could be assisted by a parent or guardian to adults over 75 years old

Intervention Components (click on component to see a list of all articles that use that intervention): Mobile Programs, Concurrent Infant/Mother Checkups

Intervention Description: A mobile medical center was emergently repurposed to provide postpartum/postnatal care for women and neonates (caregiver-infant dyads) during the early COVID-19 pandemic.

Intervention Results: Two-thirds of women who were evaluated on the mobile medical center (MMC) attended an in-person or telehealth postpartum visit, and 16.7% had a documented missed postpartum visit. All women evaluated on the MMC had blood pressure evaluated. Over two-thirds (69.7%) had at least one postpartum blood pressure reading > 120/80 mmHg, and 19.6% had readings elevated enough to require contact with the obstetric provider for further guidance. Follow-up visits with either an outpatient or obstetric provider regarding blood pressure then occurred in 15.2% of mothers, and four (6.1%) required emergent treatment and/or readmission to the hospital for postpartum hypertension detected on the MMC. Nearly all caregivers reported they were very satisfied and very likely to recommend the MMC to friends (98.5% and 94.1%, respectively)

Conclusion: In this assessment of caregivers who accessed the MMC-a rapidly-developed COVID-19 pandemic response-insights from caregivers, predominantly people of color, provided considerations for future postpartum/postnatal service delivery. Perceptions that the MMC addressed health-related social needs and barriers to traditional office-based visits and the identification of maternal hypertension requiring urgent intervention suggest that innovative models for postpartum mother-infant care may have long-lasting benefits.

Study Design: Mixed methods observational study

Setting: Mobile medical center in New Haven, Connecticut

Population of Focus: Caregiver-infant dyads

Sample Size: 139 caregiver-infant dyads contacted

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): Mobile Programs, Nurse/Nurse Practitioner,

Intervention Description: A brief parent-based sexual health intervention delivered by student nurses, which included a manual, booster calls, and coordination with a local pediatric mobile vaccination clinic to offer free vaccinations

Intervention Results: The intervention group had significantly higher rates of HPV vaccination and lower rates of sexual activity initiation compared to the control group at 6-month follow-up

Conclusion: Student nurses can be effective facilitators of prevention interventions for adolescent sexual health, and investing in their training and utilization can serve hard-to-reach communities

Study Design: Randomized controlled trial

Setting: Schools and after-school programs

Population of Focus: Parents and youth

Sample Size: 530 adolescent-parent dyads

Age Range: Not specified, but the study involved youth in middle school

Intervention Components (click on component to see a list of all articles that use that intervention): INTER_HOSPITAL_SYSTEMS, Mobile Programs

Intervention Description: Thematic analysis of interview data collected during a 2-day site visit and multivariate regression analysis of electronic records of patients (children andadolescents) that received care from 2000 through 2015, representing 84,279 unique patients.

Intervention Results: Mobile dental care programs can increased both preventive and restorative dental care for individuals who otherwise would not easily access oral health care services. The interview data revealed that program growth relied on relationships with school leaders, expanded scope of practice for dental assistants and dental therapists, and high Medicaid reimbursement.

Conclusion: Mobile dental care programs can increase both preventive and restorative dental care for individuals who otherwise would not easily access oral health care services; mobile dental programs could be an option in many other communities and schools.

Setting: Community

Population of Focus: Children and adolescents ages 4 to 15