Knowledgeable Neighbors: a mobile clinic model for disease prevention and screening in underserved communities

Abstract

The Family Van mobile health clinic uses a "Knowledgeable Neighbor" model to deliver cost-effective screening and prevention activities in underserved neighborhoods in Boston, MA. We have described the Knowledgeable Neighbor model and used operational data collected from 2006 to 2009 to evaluate the service. The Family Van successfully reached mainly minority low-income men and women. Of the clients screened, 60% had previously undetected elevated blood pressure, 14% had previously undetected elevated blood glucose, and 38% had previously undetected elevated total cholesterol. This represents an important model for reaching underserved communities to deliver proven cost-effective prevention activities, both to help control health care costs and to reduce health disparities.

FIGURE 1—

The Family Van parked at one of its regular sites in Boston, MA.

FIGURE 2—

Rainelle Walker-White, Manager of Direct Service, Family Van, with Santos, a Family Van client.

FIGURE 3—

Results from screening for previously undetected elevated blood pressure, total serum cholesterol, and blood glucose levels in first-time Family Van clients: Boston, MA, 2006–2009. Note. Screening included only first-time clients who did not already have the diagnosis of the condition and who opted for screening. Thresholds were as per national guidelines (blood pressure—high: diastolic ≥ 90 mm Hg or systolic ≥ 140 mm Hg; borderline high: diastolic = 80–89 mm Hg or systolic = 120–139 mm Hg; blood glucose—high: fasting ≥ 126 mg/dL, nonfasting ≥ 200 mg/dL; borderline high: fasting = 110–126mg/dL; nonfasting = 140–200 mg/dL; total serum cholesterol—high ≥ 240 mg/dL; borderline high = 200–239 mg/dL).