Established Evidence Results

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

Intervention Description: It was a retrospective cohort study that aimed to investigate the association between travel time and prenatal care attendance among women who received prenatal care and delivered at North Carolina Women’s Hospital between July 1, 2014, and June 30, 2016. The study utilized electronic medical record (EMR) data from the Carolina Data Warehouse for Health (CDW-H) and the UNC Hospital Perinatal Database (PNDB) to identify a subset of women from the Care4Moms study with singleton pregnancies who received prenatal care from UNC OB/GYN physicians in the NC Women’s Hospital Clinic and were at least 18 years of age. The study used multinomial logistic regression models to estimate the association between travel time and appointment attendance, adjusted for sociodemographic covariates

Intervention Results: The study found that for every 10 minutes of additional travel time, women were 1.05 times as likely to arrive late and 1.03 times as likely to cancel appointments than arrive on time. However, travel time did not significantly affect a patient’s likelihood of not showing for appointments. Additionally, the study identified disparities in appointment attendance based on sociodemographic factors. Non-Hispanic black patients were 71% more likely to arrive late and 51% more likely to not show for appointments than non-Hispanic white patients. Publicly insured women were 28% more likely to arrive late to appointments and 82% more likely to not show for appointments than privately insured women

Conclusion: The study concluded that changes to transportation availability alone may only modestly affect outcomes compared with strategically improving access for sociodemographically marginalized women. The findings suggested that marginalized socioeconomic groups may have a higher risk of poor attendance, widening existing health disparities. The study recommended that providers consider re-evaluating punitive late-arrival policies and informed strategies to better address the needs of patients with longer travel times, particularly those belonging to marginalized sociodemographic groups

Study Design: The study design was a retrospective cohort study of women who received prenatal care and delivered at North Carolina Women’s Hospital between July 1, 2014, and June 30, 2016. The study utilized electronic medical record (EMR) data from the Carolina Data Warehouse for Health (CDW-H) and the UNC Hospital Perinatal Database (PNDB) to identify a subset of women from the Care4Moms study with singleton pregnancies who received prenatal care from UNC OB/GYN physicians in the NC Women’s Hospital Clinic and were at least 18 years of age. The study used multinomial logistic regression models to estimate the association between travel time and appointment attendance, adjusted for sociodemographic covariates

Setting: The setting of the study is based on a U.S.-based population of pregnant women older than 18 years. The research aims to provide insights into the impact of travel time on appointment attendance outcomes within this demographic

Population of Focus: e target audience for this study includes healthcare professionals, policymakers, and researchers involved in maternal and child health, particularly those interested in understanding the impact of travel time on prenatal care attendance and its implications for marginalized socio-demographic groups. Additionally, public health officials and organizations focused on improving access to prenatal care for underserved populations would also find this research relevant and valuable

Sample Size: The study included a sample size of 2,808 women who received prenatal care and delivered at North Carolina Women’s Hospital between July 1, 2014, and June 30, 2016. This sample size encompassed a total of 24,021 appointments, providing a robust dataset for analyzing the association between travel time and prenatal care attendance

Age Range: The study included women who were at least 18 years of age. The age range was categorized into five levels: 18–24, 25–28, 29–32, 33–35, and 36 years and older. This age restriction was implemented to mitigate potential differences in this population’s access to transit, as North Carolina law restricts access to a regular driver’s license to those older than 18 years

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Patient Reminder/Invitation, Home Visits, Transportation Assistance

Intervention Description: To assess the impact of a tiered patient immunization navigator intervention (immunization tracking, reminder/recall, and outreach) on improving immunization and preventive care visit rates in urban adolescents.

Intervention Results: Significant increase in preventive care visit rates in the intervention group vs control group (p<.01)

Conclusion: A tiered tracking, reminder/recall, and outreach intervention improved immunization and preventive care visit rates in urban adolescents.

Study Design: RCT

Setting: 8 urban primary care practices in Rochester, New York

Population of Focus: Adolescents ages 11-15 enrolled in one of the practices

Data Source: Medical record review

Sample Size: Total (N=7546) Intervention (n=3707) Control (n=3,839)

Age Range: Not specified

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

Intervention Description: Transportation barriers can limit health care access. This is particularly problematic for patients with chronic medical conditions such as sickle cell disease (SCD) who require frequent medical visits. This study assesses the efficacy of health care-directed rideshare services for overcoming these barriers at an urban pediatric specialty clinic. A pilot study was conducted at Boston Medical Center's Pediatric Hematology Clinic from January to April 2019. Patients whose caregivers reported transportation difficulties were offered rides. Primary outcomes were no-show rates and cost. Secondary outcomes included timeliness and patient experience.

Intervention Results: Implementation of rideshare services led to an 8.5% decrease in the no-show rate among patients with SCD. The intervention cost $2,175 over three months and generated $40,262 in charges. No adverse experiences were reported.

Conclusion: In an urban, underserved pediatric hematology clinic, the use of rideshare services is a feasible and relatively low-cost strategy for improving health care access.

Study Design: Program evaluation

Setting: Pediatric Hematology Clinic at Boston Medical Center (BMC), which is the largest safety-net hospital in New England

Population of Focus: Pediatric patients with sickle cell disease under 21 years of age who faced transportation challenges and were receiving care at the Pediatric Hematology Clinic at Boston Medical Center

Sample Size: 86 participants

Age Range: Pediatric patients under 21 years of age (Average Age=12.98; Std Dev: 5.81)