{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T16:51:19Z","timestamp":1780332679543,"version":"3.54.1"},"posted":{"date-parts":[[2026,1,2]]},"group-title":"Health Systems and Quality Improvement","reference-count":46,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T00:00:00Z","timestamp":1767312000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.medrxiv.org\/about\/FAQ#license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2026,1,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>Mobile health clinics (MHCs) provide flexible, community-based care to underserved populations facing geographic and socioeconomic barriers. Maximizing coverage enables MHCs to reach more individuals, improve preventive and continuous care, and reduce health disparities. However, few strategies exist to guide placement and routing decisions. We present a framework to increase MHC utilization by optimizing service coverage.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Study Design<\/jats:title>\n                  <jats:p>This is a retrospective study.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We analyzed MHC deployments for Hepatitis C Virus (HCV) screening and treatment from a local health system in South Carolina. We used a location-allocation model to identify potential MHC placement sites that maximized the number of uninsured residents within a 5-minute drive or 10-minute walk. Demand was represented by block centroids weighted by the size of the uninsured population. We compared service area population, defined as the size of the target population within driving or walking distance, for model-proposed sites with coverage from previous MHC deployments. We fit negative binomial mixed effects models to evaluate the association between service area population and MHC utilization.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Optimized placements can nearly double population coverage, expanding access to uninsured residents within practical travel distances by 90% for driving and 135% for walking\u2014without requiring additional vehicles or resources. This approach also substantially reduces redundant service areas while shortening average travel times. Results show that small geographic shifts can yield significant improvements. In rural regions, greater geographic coverage is significantly associated with higher MHC utilization for HCV screening (drive p=.0037; walk p=.0095). We applied this framework with local health partners to guide real-world MHC deployment in South Carolina.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>This framework connects spatial analytics to service delivery, offering a replicable, operationally ready tool adaptable to various travel modes, site types, and disease contexts. It supports strategic placement in high-need locations by reducing travel time and service redundancy and ultimately improving health outcomes in medically underserved populations.<\/jats:p>\n                <\/jats:sec>","DOI":"10.64898\/2025.12.29.25342286","type":"posted-content","created":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T12:20:14Z","timestamp":1767356414000},"source":"Crossref","is-referenced-by-count":1,"title":["Optimizing Mobile Health Clinic Placement via Geospatial Modeling"],"prefix":"10.64898","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0609-0233","authenticated-orcid":false,"given":"Shakhawat H.","family":"Tanim","sequence":"first","affiliation":[{"name":"Postdoctoral Fellow, Center for Public Health Modeling and Response, Department of Public Health Sciences, Clemson University, 503 Edwards Hall, Clemson, SC 29634, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"White","sequence":"additional","affiliation":[{"name":"Research Assistant Professor, Department of Parks, Recreation and Tourism Management, Clemson University, 170 Sirrine Hall, Clemson, SC 29634, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Witrick","sequence":"additional","affiliation":[{"name":"Assistant Professor, Department of Public Health Sciences, Clemson University, 503 Edwards Hall, Clemson, SC 29634, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5275-7273","authenticated-orcid":false,"given":"Lior","family":"Rennert","sequence":"additional","affiliation":[{"name":"Associate Dean for Health Sciences, Associate Professor of Biostatistics, Department of Public Health Sciences, Director, Center for Public Health Modeling and Response, Clemson University, 503 Edwards Hall, Clemson, SC 29634, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"54368","reference":[{"key":"2026010502500870000_2025.12.29.25342286v1.1","doi-asserted-by":"crossref","unstructured":"Leibowitz, A. et al. Using mobile clinics to deliver care to difficult-to-reach populations: a COVID-19 practice we should keep. Prev. Med. Rep. 24, 101551 (2021).","DOI":"10.1016\/j.pmedr.2021.101551"},{"key":"2026010502500870000_2025.12.29.25342286v1.2","first-page":"875","article-title":"Mobile healthcare services in rural areas: an application with periodic location routing problem","volume":"44","year":"2022","journal-title":"Spectr"},{"key":"2026010502500870000_2025.12.29.25342286v1.3","doi-asserted-by":"crossref","unstructured":"Malone, N. C. et al. Mobile health clinics in the United States. Int. J. Equity Health 19, 40 (2020).","DOI":"10.1186\/s12939-020-1135-7"},{"key":"2026010502500870000_2025.12.29.25342286v1.4","doi-asserted-by":"crossref","unstructured":"Oriol, N. E. et al. Calculating the return on investment of mobile healthcare. BMC Med. 7, 27 (2009).","DOI":"10.1186\/1741-7015-7-27"},{"key":"2026010502500870000_2025.12.29.25342286v1.5","doi-asserted-by":"crossref","unstructured":"McGowan, C. R. et al. Mobile clinics in humanitarian emergencies: a systematic review. Confl. Health 14, 4 (2020).","DOI":"10.1186\/s13031-020-0251-8"},{"key":"2026010502500870000_2025.12.29.25342286v1.6","doi-asserted-by":"crossref","unstructured":"Yu, S. W. Y. , Hill, C. , Ricks, M. L. , Bennet, J. & Oriol, N. E . The scope and impact of mobile health clinics in the United States: a literature review. Int. J. Equity Health 16, 178 (2017).","DOI":"10.1186\/s12939-017-0671-2"},{"key":"2026010502500870000_2025.12.29.25342286v1.7","doi-asserted-by":"crossref","unstructured":"Rennert, L. et al. Implementation of a mobile health clinic framework for Hepatitis C virus screening and treatment: a descriptive study. Lancet Reg. Health Am. 29, 100648 (2024).","DOI":"10.1016\/j.lana.2023.100648"},{"key":"2026010502500870000_2025.12.29.25342286v1.8","doi-asserted-by":"crossref","first-page":"406","DOI":"10.2105\/AJPH.2011.300472","article-title":"Knowledgeable neighbors: a mobile clinic model for disease prevention and screening in underserved communities","volume":"102","year":"2012","journal-title":"Am. J. Public Health"},{"key":"2026010502500870000_2025.12.29.25342286v1.9","doi-asserted-by":"crossref","first-page":"706","DOI":"10.1177\/0009922820908586","article-title":"Evaluating Partial Series Childhood Vaccination Services in a Mobile Clinic Setting","volume":"59","year":"2020","journal-title":"Clin. Pediatr. (Phila"},{"key":"2026010502500870000_2025.12.29.25342286v1.10","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1177\/1078390320916236","article-title":"Evaluating Emergency Department Utilization for Mobile Mental Health Patients: A Correlational Retrospective Analysis","volume":"27","year":"2021","journal-title":"J. Am. Psychiatr. Nurses Assoc"},{"key":"2026010502500870000_2025.12.29.25342286v1.11","doi-asserted-by":"crossref","unstructured":"Alcendor, D. J. et al. Meharry Medical College Mobile Vaccination Program: Implications for Increasing COVID-19 Vaccine Uptake among Minority Communities in Middle Tennessee. Vaccines 10, 211 (2022).","DOI":"10.3390\/vaccines10020211"},{"key":"2026010502500870000_2025.12.29.25342286v1.12","doi-asserted-by":"crossref","first-page":"94","DOI":"10.2471\/BLT.22.020222","article-title":"Mobile care in the pandemic","volume":"100","year":"2022","journal-title":"Bull. World Health Organ"},{"key":"2026010502500870000_2025.12.29.25342286v1.13","doi-asserted-by":"crossref","unstructured":"McShane, M. , Zechman, A. , McNally, R. & Stephens, M . Mobile Health Clinic: Lessons Learned Building Partnerships Across Health Systems. 11, (2023).","DOI":"10.37765\/ajac.2023.89342"},{"key":"2026010502500870000_2025.12.29.25342286v1.14","doi-asserted-by":"publisher","DOI":"10.1007\/s10900-013-9681-1"},{"key":"2026010502500870000_2025.12.29.25342286v1.15","doi-asserted-by":"publisher","DOI":"10.1016\/S0377-2217(99)00289-1"},{"key":"2026010502500870000_2025.12.29.25342286v1.16","doi-asserted-by":"crossref","unstructured":"Murad, A. , Faruque, F. , Naji, A. & Tiwari, A . Using the location-allocation P-median model for optimising locations for health care centres in the city of Jeddah City, Saudi Arabia. Geospatial Health 16, (2021).","DOI":"10.4081\/gh.2021.1002"},{"key":"2026010502500870000_2025.12.29.25342286v1.17","doi-asserted-by":"crossref","unstructured":"Tao, Z. , Cheng, Y. , Dai, T. & Rosenberg, M. W . Spatial optimization of residential care facility locations in Beijing, China: maximum equity in accessibility. Int. J. Health Geogr. 13, (2014).","DOI":"10.1186\/1476-072X-13-33"},{"key":"2026010502500870000_2025.12.29.25342286v1.18","doi-asserted-by":"crossref","first-page":"8755","DOI":"10.3390\/ijerph19148755","article-title":"Location-Allocation Model to Improve the Distribution of COVID-19 Vaccine Centers in Jeddah City, Saudi Arabia","volume":"19","year":"2022","journal-title":"Int. J. Environ. Res. Public. Health"},{"key":"2026010502500870000_2025.12.29.25342286v1.19","unstructured":"United States Census Bureau. American Community Survey (ACS). Census.gov https:\/\/www.census.gov\/programs-surveys\/acs.html (2022)."},{"key":"2026010502500870000_2025.12.29.25342286v1.20","unstructured":"Missouri Census Data Center. Geocorr 2022 - MCDC. https:\/\/mcdc.missouri.edu\/applications\/geocorr2022.html (2022)."},{"key":"2026010502500870000_2025.12.29.25342286v1.21","unstructured":"US Census Bureau. Urban and Rural. Census.gov https:\/\/www.census.gov\/programs-surveys\/geography\/guidance\/geo-areas\/urban-rural.html (2023)."},{"key":"2026010502500870000_2025.12.29.25342286v1.22","unstructured":"ESRI. ArcGIS StreetMap Premium. https:\/\/www.esri.com\/en-us\/arcgis\/products\/arcgis-streetmap-premium\/overview (2025)."},{"key":"2026010502500870000_2025.12.29.25342286v1.23","unstructured":"ESRI. ArcGIS Business Analyst. https:\/\/www.esri.com\/en-us\/arcgis\/products\/arcgis-business-analyst\/overview (2025)."},{"key":"2026010502500870000_2025.12.29.25342286v1.24","doi-asserted-by":"crossref","unstructured":"Paul, P. , Carlson, S. A. , Carroll, D. D. , Berrigan, D. & Fulton, J. E. Walking for Transportation and Leisure among U.S. Adults\u2014National Health Interview Survey 2010. J. Phys. Act. Health 12, (2015).","DOI":"10.1123\/jpah.2013-0519"},{"key":"2026010502500870000_2025.12.29.25342286v1.25","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1177\/17151635221115411","article-title":"Geographic distribution of Ontario pharmacists: A focus on rural and northern communities","volume":"155","year":"2022","journal-title":"Can. Pharm. J. CPJ"},{"key":"2026010502500870000_2025.12.29.25342286v1.26","doi-asserted-by":"crossref","first-page":"e354","DOI":"10.1016\/S2468-2667(24)00076-8","article-title":"Identification of factors associated with opioid-related and hepatitis C virus-related hospitalisations at the ZIP code area level in the USA: an ecological and modelling study","volume":"9","year":"2024","journal-title":"Lancet Public Health"},{"key":"2026010502500870000_2025.12.29.25342286v1.27","doi-asserted-by":"crossref","first-page":"757","DOI":"10.1080\/13658810601169857","article-title":"Coverage optimization in continuous space facility siting","volume":"21","year":"2007","journal-title":"Int. J. Geogr. Inf. Sci"},{"key":"2026010502500870000_2025.12.29.25342286v1.28","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1177\/0361198119846095","article-title":"Pedestrian Network Analysis using a Network Consisting of Formal Pedestrian Facilities: Sidewalks and Crosswalks","volume":"2673","year":"2019","journal-title":"Transp. Res. Rec"},{"key":"2026010502500870000_2025.12.29.25342286v1.29","doi-asserted-by":"crossref","unstructured":"Guagliardo, M. F . Spatial accessibility of primary care: concepts, methods and challenges. Int. J. Health Geogr. 3, 3 (2004).","DOI":"10.1186\/1476-072X-3-3"},{"key":"2026010502500870000_2025.12.29.25342286v1.30","doi-asserted-by":"publisher","DOI":"10.1007\/s10900-013-9681-1"},{"key":"2026010502500870000_2025.12.29.25342286v1.31","doi-asserted-by":"crossref","unstructured":"Khakh, A. K. , Fast, V. & Shahid, R . Spatial Accessibility to Primary Healthcare Services by Multimodal Means of Travel: Synthesis and Case Study in the City of Calgary. Int. J. Environ. Res. Public. Health 16, 170 (2019).","DOI":"10.3390\/ijerph16020170"},{"key":"2026010502500870000_2025.12.29.25342286v1.32","doi-asserted-by":"crossref","unstructured":"Howard, K. A. et al. Factors associated with utilization of mobile health clinic hepatitis C virus services among medically underserved communities in South Carolina. BMC Glob. Public Health 2, 84 (2024).","DOI":"10.1186\/s44263-024-00114-w"},{"key":"2026010502500870000_2025.12.29.25342286v1.33","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1353\/hpu.2010.0831","article-title":"Broadening Perspectives on Mobile Medical Outreach to Homeless People","volume":"14","year":"2003","journal-title":"J. Health Care Poor Underserved"},{"key":"2026010502500870000_2025.12.29.25342286v1.34","doi-asserted-by":"crossref","unstructured":"Swamy, P. et al. Driving to Reduce Socioeconomic Barriers to Latent Tuberculosis Infection Care: A Mobile Pediatric Treatment Program. J. Public Health Manag. Pract. 28, E670 (2022).","DOI":"10.1097\/PHH.0000000000001482"},{"key":"2026010502500870000_2025.12.29.25342286v1.35","doi-asserted-by":"crossref","first-page":"1103","DOI":"10.1353\/hpu.2019.0076","article-title":"It\u2019s All About Trust and Respect: Cultural Competence and Cultural Humility in Mobile Health Clinic Services for Underserved Minority Populations","volume":"30","year":"2019","journal-title":"J. Health Care Poor Underserved"},{"key":"2026010502500870000_2025.12.29.25342286v1.36","doi-asserted-by":"crossref","unstructured":"Attipoe-Dorcoo, S. et al. Mobile health clinic model in the COVID-19 pandemic: lessons learned and opportunities for policy changes and innovation. Int. J. Equity Health 19, 73 (2020).","DOI":"10.1186\/s12939-020-01175-7"},{"key":"2026010502500870000_2025.12.29.25342286v1.37","doi-asserted-by":"crossref","unstructured":"Sheerazi, S. , Awad, S. A. & von Schreeb, J . Use of mobile health units in natural disasters: a scoping review. BMC Health Serv. Res. 25, 368 (2025).","DOI":"10.1186\/s12913-024-12067-9"},{"key":"2026010502500870000_2025.12.29.25342286v1.38","doi-asserted-by":"crossref","first-page":"640","DOI":"10.1007\/s10729-021-09565-1","article-title":"Optimization-driven framework to understand health care network costs and resource allocation","volume":"24","year":"2021","journal-title":"Health Care Manag. Sci"},{"key":"2026010502500870000_2025.12.29.25342286v1.39","doi-asserted-by":"crossref","first-page":"931","DOI":"10.1001\/jama.2021.0801","article-title":"Rapid Implementation of a Vaccination Superstation","volume":"325","year":"2021","journal-title":"JAMA"},{"key":"2026010502500870000_2025.12.29.25342286v1.40","first-page":"701","article-title":"Pivoting From Influenza to COVID-19 Vaccinations: How a Minnesota Vaccination Program Reduced Barriers for Refugee, Immigrant, and Migrant Communities Accessing Vaccines During the COVID-19 Pandemic","volume":"30","year":"2024","journal-title":"J. Public Health Manag. Pract. JPHMP"},{"key":"2026010502500870000_2025.12.29.25342286v1.41","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1089\/hs.2019.0146","article-title":"Current State of Mass Vaccination Preparedness and Operational Challenges in the United States, 2018-2019","volume":"18","year":"2020","journal-title":"Health Secur"},{"key":"2026010502500870000_2025.12.29.25342286v1.42","doi-asserted-by":"crossref","unstructured":"Durrance-Bagale, A. et al. Community engagement in health systems interventions and research in conflict-affected countries: a scoping review of approaches. Glob. Health Action 15, 2074131 (2022).","DOI":"10.1080\/16549716.2022.2074131"},{"key":"2026010502500870000_2025.12.29.25342286v1.43","doi-asserted-by":"publisher","DOI":"10.1007\/s10900-013-9798-2"},{"key":"2026010502500870000_2025.12.29.25342286v1.44","doi-asserted-by":"crossref","unstructured":"Dedmon, D. D. et al. Engaging with the Community Before Deploying a Rural Mobile Health Unit. J. Nurse Pract. 20, 105167 (2024).","DOI":"10.1016\/j.nurpra.2024.105167"},{"key":"2026010502500870000_2025.12.29.25342286v1.45","doi-asserted-by":"crossref","unstructured":"Allotey, P. , Tan, D. T. , Kirby, T. & Tan, L. H . Community Engagement in Support of Moving Toward Universal Health Coverage. Health Syst. Reform https:\/\/www.tandfonline.com\/doi\/abs\/10.1080\/23288604.2018.1541497 (2019).","DOI":"10.1080\/23288604.2018.1541497"},{"key":"2026010502500870000_2025.12.29.25342286v1.46","doi-asserted-by":"crossref","first-page":"1994","DOI":"10.1016\/j.vaccine.2023.02.045","article-title":"Trusted messengers and trusted messages: The role for community-based organizations in promoting COVID-19 and routine immunizations","volume":"41","year":"2023","journal-title":"Vaccine"}],"container-title":[],"original-title":[],"link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.64898\/2025.12.29.25342286","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T10:50:19Z","timestamp":1767610219000},"score":1,"resource":{"primary":{"URL":"http:\/\/medrxiv.org\/lookup\/doi\/10.64898\/2025.12.29.25342286"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,2]]},"references-count":46,"URL":"https:\/\/doi.org\/10.64898\/2025.12.29.25342286","relation":{},"subject":[],"published":{"date-parts":[[2026,1,2]]},"subtype":"preprint"}}