Abstract / Summary
Objectives: The objectives of this study were to collect firsthand accounts from mobile healthcare unit (MHU) leaders on their MHU's COVID-19 response through key informant interviews and to identify lessons learned from COVID-19 adaptations and how they may be applied to improve preparedness and resiliency of mobile health units to disasters and emergencies in the future. Study design: Key informants who were leaders of regional coalitions of the Mobile Healthcare Association (MHA) were invited to participate in a qualitative study. Methods: Contact information for leaders of the 14 regional coalitions was obtained from the MHA. Leaders were invited via email to participate in a key informant interview. Interviews were recorded, with verbal consent, and transcribed using the Zoom videoconferencing transcription function (San Jose, CA). Transcripts were analyzed using Braun and Clarke's six step thematic analysis methodology through inductive coding of key phrases and terms to identify themes. Results: Ten key informant interviews were conducted over the course of an eleven month period (Response Rate = 71.4%). Four themes emerged during the analysis, (1) temporary stoppage of care during COVID-19, (2) adjustments to care when operations resumed, (3) complexity in the evolving needs of emergency preparedness, and (4) concerns around other disasters and emergencies. Conclusions: While nearly all MHUs operating at the beginning of the COVID-19 pandemic experienced interruptions in care and service provision, the time frame in which the clinics resumed operations varied based on parent organization policies. MHUs that were independently operated or affiliated with a hospital system experienced briefer disruptions and were able to more rapidly adapt their services to public health control measures, as did MHUs that were prioritized as a key factor in the parent organizations' community outreach strategy. Community engagement and collaboration with community organizations was highlighted as a key to continuing to reach the MHU's target population during the COVID-19 pandemic and future emergencies.