Improving Community Health Through Innovation.

Evaluation

Rationale

Demonstrating reach and impact of the mobile health program is not only critical for internal decision-making in order to maximize effectiveness, but also for potential funders and other stakeholders. Mobile health programs should endeavor to design evaluations where.

• Data are maximally useful—Data collected can demonstrate the impact and/or effectiveness of the program.

• The burden of data collection in the mobile setting is minimized—As much of the harm reduction and clinical services taking place will not be conducive to inserting research assistants into the staffing model, much of the onus of data collection will likely fall on the frontline staff. Evaluation design should ensure that any data collecting requirements are reasonable and as minimally disruptive to service provision as possible. When data collection efforts and access or quality to service provision are at odds, the team should always prioritize service provision and re-evaluate data collecting options

Potential data points to collect

• Contacts during outreach

• Needles collected/distributed

• Naloxone kits distributed

• Clinical encounters

• Unique patients

• Buprenorphine/naltrexone prescriptions

• Total filled prescriptions

• Unique buprenorphine/naltrexone patients

• Toxicology results with buprenorphine/

naltrexone present

 

Data sources

• Toxicology results without illicit opioids present

• Returning patients

• Referrals made (where and % successful)

• Patients treated for HIV, HCV (if applicable)

• Patients successfully completing HCV treatment

(if applicable)

• Clinical tests: HIV, HBV, HCV, STI

• Positive clinical tests: HIV, HBV, HCV, STI

• PrEP/PEP use

Other potential evaluation projects

• Quasi experimental trial—Compare outcomes in neighborhoods/areas where the mobile health unit currently serves to similar areas where no similar mobile programming currently exists. Do overdose rates change/differ? Other trends?

• Cost effectiveness analysis—Analyze the mobile health program’s economic impact on the local health care system; determine whether or not harm reduction services, wound care and treatment are preventing costly interactions with healthcare services (e.g., emergency department visits for skin infections, etc.).

• Randomized control trial—Does the presence of a mobile health unit in a region increase access and health of a community compared to similar areas with no van present? Also may compare the same area duringclinical days vs. non-clinical days.