{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T05:14:30Z","timestamp":1783660470260,"version":"3.55.0"},"reference-count":38,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:00:00Z","timestamp":1782777600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Truist Bank","award":["n\/a"],"award-info":[{"award-number":["n\/a"]}]},{"name":"Tepper Foundation","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Healthcare disparities are widespread across the U.S. Mobile health programming is designed to dismantle systemic healthcare barriers for medically underserved communities. The purpose of this study was to assess the effectiveness of two southeastern U.S. mobile primary care programs. Guided by the Social Determinants of Health framework, this descriptive study examines the programs\u2019 patient populations to determine reach and patient medical data to ascertain patients\u2019 connection to the medical system and long-term primary care. Data were collected via electronic health record (EHR) and analyzed in Power BI and R. Basic descriptive, crosstab and chi-square statistics were conducted to assess the patient population and explore patient healthcare engagement prior to and following their initial mobile primary care visit. The results indicate that mobile primary care programs are utilized by systemically underserved groups, with both program A and B\u2019s patient population identifying primarily as Latin\/Hispanic (69.6% and 41.3% respectively), uninsured (99.1% and 59.8%), and Spanish-speaking (64.4% and 42.3%). Additionally, each program demonstrates an ability to engage patients in long-term primary care utilization via repeat utilizers (65.5% and 25.9%). McNemar\u2019s chi-square results show that participation in either of the mobile primary care programs has a statistically significant, non-random measurable effect on patient primary care enrollment. Differences in program structure and findings are explored, and recommendations for future practice, research, and policy are discussed.<\/jats:p>","DOI":"10.3390\/ijerph23070861","type":"journal-article","created":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T03:06:34Z","timestamp":1782875194000},"page":"861","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["No Roadblocks: How Mobile Primary Care Navigates Barriers to Health Access"],"prefix":"10.3390","volume":"23","author":[{"given":"Kayleigh E.","family":"Zinter","sequence":"first","affiliation":[{"name":"Center for Clinical and Community Impact, Advocate Health, 1000 Blythe Boulevard, Charlotte, NC 28203, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan","family":"Burns","sequence":"additional","affiliation":[{"name":"Center for Clinical and Community Impact, Advocate Health, 1000 Blythe Boulevard, Charlotte, NC 28203, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellen","family":"Pinnette","sequence":"additional","affiliation":[{"name":"Center for Clinical and Community Impact, Advocate Health, 1000 Blythe Boulevard, Charlotte, NC 28203, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trent B.","family":"Legare","sequence":"additional","affiliation":[{"name":"Center for Clinical and Community Impact, Advocate Health, 1000 Blythe Boulevard, Charlotte, NC 28203, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheena C.","family":"McNeill","sequence":"additional","affiliation":[{"name":"Center for Clinical and Community Impact, Advocate Health, 1000 Blythe Boulevard, Charlotte, NC 28203, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-3746-3394","authenticated-orcid":false,"given":"Alissa L.","family":"Sedelow","sequence":"additional","affiliation":[{"name":"Center for Clinical and Community Impact, Advocate Health, 1000 Blythe Boulevard, Charlotte, NC 28203, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremy","family":"Moseley","sequence":"additional","affiliation":[{"name":"Center for Clinical and Community Impact, Advocate Health, 1000 Blythe Boulevard, Charlotte, NC 28203, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Snow","sequence":"additional","affiliation":[{"name":"Center for Clinical and Community Impact, Advocate Health, 1000 Blythe Boulevard, Charlotte, NC 28203, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Latoya Mallard","family":"Alexander","sequence":"additional","affiliation":[{"name":"Center for Clinical and Community Impact, Advocate Health, 1000 Blythe Boulevard, Charlotte, NC 28203, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renee M.","family":"Stakeman","sequence":"additional","affiliation":[{"name":"Center for Clinical and Community Impact, Advocate Health, 1000 Blythe Boulevard, Charlotte, NC 28203, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashley B.","family":"Foster","sequence":"additional","affiliation":[{"name":"Center for Clinical and Community Impact, Advocate Health, 1000 Blythe Boulevard, Charlotte, NC 28203, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,30]]},"reference":[{"key":"ref_1","unstructured":"Blumenthal, D., Gumas, E., Shah, A., Fields, K., Doty, M.M., and Schneider, E.C. (2024). Mirror, Mirror 2024: A Portrait of the Failing U.S. Health System, The Commonwealth Fund. Available online: https:\/\/www.commonwealthfund.org\/publications\/fund-reports\/2024\/sep\/mirror-mirror-2024."},{"key":"ref_2","unstructured":"Peter, G., and Peterson Foundation (2025, December 01). (2025, October 7) How Does the U.S. Healthcare System Compare to Other Countries?. Available online: https:\/\/www.pgpf.org\/article\/how-does-the-us-healthcare-system-compare-to-other-countries\/."},{"key":"ref_3","unstructured":"Schneider, E.C., Shah, A., Doty, M.M., Tikkanen, R., Fields, K., and Williams, R.D. (2023). U.S. Health Care from a Global Perspective, 2022: Accelerating Spending, Worsening Outcomes, The Commonwealth Fund. Available online: https:\/\/www.commonwealthfund.org\/publications\/issue-briefs\/2023\/jan\/us-health-care-global-perspective-2022."},{"key":"ref_4","unstructured":"Agency for Healthcare Research and Quality (2025, December 04). 2023 National Healthcare Quality and Disparities Report, Available online: https:\/\/www.ahrq.gov\/research\/findings\/nhqrdr\/nhqdr23\/index.html."},{"key":"ref_5","unstructured":"Cohen, R.A., Terlizzi, E.P., and Martinez, M.E. (2025, December 02). Health Insurance Coverage: Early Release of Estimates from the National Health Interview Survey, January\u2013June 2024, Available online: https:\/\/www.cdc.gov\/nchs\/data\/nhis\/earlyrelease\/insur202412.pdf."},{"key":"ref_6","unstructured":"Schneider, E.C., Shah, A., Doty, M.M., and Tikkanen, R. (2022). Primary Care in High-Income Countries: How the United States Compares, The Commonwealth Fund. Available online: https:\/\/www.commonwealthfund.org\/publications\/issue-briefs\/2022\/mar\/primary-care-high-income-countries-how-united-states-compares."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1370\/afm.1903","article-title":"Perspectives in Primary Care: A Conceptual Framework and Path for Integrating Social Determinants of Health Into Primary Care Practice","volume":"14","author":"DeVoe","year":"2016","journal-title":"Ann. Fam. Med."},{"key":"ref_8","unstructured":"National Academies of Sciences, Engineering, and Medicine (NASEM) (2021). Implementing High-Quality Primary Care: Rebuilding the Foundation of Health Care, The National Academies Press."},{"key":"ref_9","unstructured":"Office of Disease Prevention and Health Promotion (2024, December 22). Access to Primary Care, Available online: https:\/\/odphp.health.gov\/healthypeople\/priority-areas\/social-determinants-health\/literature-summaries\/access-primary-care."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1111\/j.1468-0009.2005.00409.x","article-title":"Contribution of primary care to health systems and health","volume":"83","author":"Starfield","year":"2005","journal-title":"Milbank Q."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"506","DOI":"10.1001\/jamainternmed.2018.7624","article-title":"Association of primary care physician supply with population mortality in the United States, 2005\u20132015","volume":"179","author":"Basu","year":"2019","journal-title":"JAMA Intern. Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"716","DOI":"10.1111\/1468-0009.12638","article-title":"The role of primary care in improving population health","volume":"101","author":"Stange","year":"2023","journal-title":"Milbank Q."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"103301","DOI":"10.1016\/j.healthplace.2024.103301","article-title":"The unfairness of place: A cultural history of the UK\u2019s \u2018Postcode Lottery","volume":"90","author":"Redhead","year":"2024","journal-title":"Health Place"},{"key":"ref_14","first-page":"6","article-title":"Zip code health disparities: Mapping cardiovascular inequities at the neighborhood level","volume":"20","author":"Khan","year":"2024","journal-title":"Methodist DeBakey Cardiovasc. J."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1750","DOI":"10.1001\/jama.2016.4226","article-title":"The association between income and life expectancy in the United States, 2001\u20132014","volume":"315","author":"Chetty","year":"2016","journal-title":"JAMA"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1097\/AOG.0000000000004226","article-title":"The contrast of color: Why the black community continues to suffer health disparities","volume":"137","year":"2021","journal-title":"Obstet. Gynecol."},{"key":"ref_17","unstructured":"Rayabandla, S.M. (2020). A review of the characteristics of Super-Utilizers and evidence-based approaches to reduce healthcare utilization. Capstone Exp., 154. Available online: https:\/\/digitalcommons.unmc.edu\/coph_slce\/154?utm_source=digitalcommons.unmc.edu%2Fcoph_slce%2F154&utm_medium=PDF&utm_campaign=PDFCoverPages."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1312","DOI":"10.1377\/hlthaff.2014.1186","article-title":"For many patients who use large amounts of health care services, the need is intense yet temporary","volume":"34","author":"Johnson","year":"2015","journal-title":"Health Aff."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1186\/s12939-020-1135-7","article-title":"Mobile health clinics in the United States","volume":"19","author":"Malone","year":"2020","journal-title":"Int. J. Equity Health"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1186\/s12939-023-02004-3","article-title":"Factors associated with mobile medical clinic use: A retrospective cohort study","volume":"22","author":"Coaston","year":"2023","journal-title":"Int. J. Equity Health"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1186\/s12939-017-0671-2","article-title":"The scope and impact of mobile health clinics in the United States: A literature review","volume":"16","author":"Yu","year":"2017","journal-title":"Int. J. Equity Health"},{"key":"ref_22","first-page":"1594","article-title":"Knowledgeable neighbors: A mobile clinic model for disease prevention and screening in underserved communities","volume":"104","author":"Hill","year":"2012","journal-title":"Am. J. Public Health"},{"key":"ref_23","first-page":"261","article-title":"Mobile health clinics in the era of reform","volume":"20","author":"Hill","year":"2014","journal-title":"Am. J. Manag. Care"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"101551","DOI":"10.1016\/j.pmedr.2021.101551","article-title":"Using mobile clinics to deliver care to difficult-to-reach populations: A COVID-19 practice we should keep","volume":"24","author":"Leibowitz","year":"2021","journal-title":"Prev. Med. Rep."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"100550","DOI":"10.1016\/j.puhip.2024.100550","article-title":"Mobile health clinics for distribution of vaccinations to underserved communities during health emergencies: A COVID-19 case study","volume":"8","author":"Rennert","year":"2024","journal-title":"Public Health Pract."},{"key":"ref_26","first-page":"100648","article-title":"Implementation of a mobile health clinic framework for hepatitis C virus screening and treatment: A descriptive study","volume":"29","author":"Rennert","year":"2023","journal-title":"Lancet Reg. Health Am."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1377\/hlthaff.2011.1392","article-title":"Mobile clinic in Massachusetts associated with cost savings from lowering blood pressure and emergency department use","volume":"32","author":"Song","year":"2013","journal-title":"Health Aff."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1353\/cpr.2023.0013","article-title":"The integration of community voice in the implementation of a mobile health program","volume":"17","author":"Zimmer","year":"2023","journal-title":"Prog. Community Health Partnersh. Res. Educ. Action"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1353\/hpu.2024.a919825","article-title":"Implementing a teaching rural mobile health clinic: Challenges and adaptations","volume":"35","author":"Brant","year":"2024","journal-title":"J. Health Care Poor Underserved"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"38","DOI":"10.37765\/ajac.2023.89342","article-title":"Mobile health clinic: Lessons learned building partnerships across health systems","volume":"11","author":"McShane","year":"2023","journal-title":"Am. J. Accountable Care"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"2150132720980623","DOI":"10.1177\/2150132720980623","article-title":"Analysis of annual costs of mobile clinics in the Southern United States","volume":"11","author":"Delgado","year":"2020","journal-title":"J. Prim. Care Community Health"},{"key":"ref_32","unstructured":"Centers for Disease Control and Prevention (2025, December 05). CDC\/ATSDR Social Vulnerability Index (SVI), Available online: https:\/\/www.atsdr.cdc.gov\/placeandhealth\/svi\/index.html."},{"key":"ref_33","unstructured":"National Academies of Sciences, Engineering, and Medicine (2016). A Framework for Educating Health Professionals to Address the Social Determinants of Health, National Academies Press."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Momeni, A., Pincus, M., and Libien, J. (2017). Cross tabulation and categorical data analysis. Introduction to Statistical Methods in Pathology, Springer International Publishing.","DOI":"10.1007\/978-3-319-60543-2_5"},{"key":"ref_35","unstructured":"Looti, M. (2025, December 08). McNemar\u2019s Test in R: A Step-by-Step Guide for Paired Data Analysis. PSYCHOLOGICAL STATISTICS. Available online: https:\/\/statistics.arabpsychology.com\/perform-mcnemars-test-in-r\/."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Kaufman, R.A., Mallick, M., Thanex Louis, J., Williams, M., and Oriol, N. (2024). The role of street medicine and mobile clinics for persons experiencing homelessness: A scoping review. Int. J. Environ. Res. Public Health, 21.","DOI":"10.3390\/ijerph21060760"},{"key":"ref_37","first-page":"101173","article-title":"Trump\u2019s second presidency begins: Evaluating effects on the US health system","volume":"48","author":"Greer","year":"2025","journal-title":"Lancet Reg. Health Am."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"2188","DOI":"10.2337\/dc23-0960","article-title":"National prevalence of diabetes and barriers to care among U.S. farmworkers and association with migrant worker status","volume":"46","author":"Olson","year":"2023","journal-title":"Diabetes Care"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/23\/7\/861\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T04:33:25Z","timestamp":1783658005000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/23\/7\/861"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,30]]},"references-count":38,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026,7]]}},"alternative-id":["ijerph23070861"],"URL":"https:\/\/doi.org\/10.3390\/ijerph23070861","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,30]]}}}