{"doi":"10.1111/jch.14800","title":"Origins of a novel mobile health unit program to prevent cardiovascular disease in vulnerable communities","abstract":"Cardiovascular disease (CVD) is a leading cause of morbidity and mortality in the United States1 with hypertension being the primary contributor.2 This is particularly apparent among marginalized populations such as metropolitan Detroit, Michigan, USA, where for decades our team has conducted population health research that focuses on preventive care and chronic disease management. Circumstances changed, however, during the COVID-19 pandemic, which prompted a major overhaul of our approach. Here, we describe our experiences transitioning from a stationary operation to a mobile health unit (MHU) program that provides dynamic, individualized healthcare and referral resources among socially vulnerable communities. Our twofold aim is to describe the implementation of our program and explain the rationale for investigating new systems of community-based care for CVD risk reduction under a health equity framework. Prior to 2020, our team conducted CVD research by recruiting participants primarily via screening efforts in urban emergency departments (EDs). However, the emergence of COVID quite dramatically halted recruitment and related research activities. As such, the ever-changing pandemic required innovative and adaptable strategies to continue serving these communities. While we initially began conducting drive-through COVID-19 testing in fixed locations, we quickly learned that social vulnerability, particularly transportation challenges and low socioeconomic status, proved to be a steep barrier to adequate care, thus increasing chronic disease risk (especially hypertension) in this population.3 To help alleviate these barriers, we partnered with the Ford Motor Company (Dearborn, MI, USA) to develop a fleet of vehicle-based health platforms, now known as MHUs. These MHUs enabled us to bring testing services directly to local communities across the Detroit area while also targeting specific areas of greatest need and social vulnerability. Detroit communities suffer from the highest rates of hypertension in the state of Michigan (https://www.cdc.gov/places) as well as from extreme social vulnerability. Together, both conditions contributed to an excessively high rates of COVID-related morbidity and mortality during the initial wave of the pandemic.4 To address this serious problem, our MHUs began screening for high blood pressure (BP) shortly after implementing mobile COVID-testing. Our rationale was that in contrast to traditional healthcare models, MHUs are uniquely capable of accessing difficult-to-reach populations in areas with heightened social vulnerability that have high CVD rates. Mobile platforms fill crucial gaps in the existing healthcare system by bringing care directly to people where they work, worship, live, and play to promote cardiovascular health equity. On average, our fleet of MHUs are deployed to six different sites per day with each one staffed by a registered nurse, site lead, patient service representative, and research assistant. In the first year, 3039 people were screened for hypertension; 63% had abnormal BP (≥120/80 mmHg), and about half (32%) met criteria for stage-2 hypertension.5 The MHUs currently offer an expanded suite of services that include multiple screenings to promote cardiovascular, metabolic, and renal health including BP measurement, onsite blood testing for diabetes, renal function, and hyperlipidemia, as well as immunizations, testing for HIV and hepatitis C, and (perhaps most importantly) linkages to primary care providers (PCPs) if needed. Given our mission to increase access to preventive care in socially vulnerable populations, we further implemented a data-driven strategy to optimize the targeting of geographic deployment. We began using Wayne State University's (Detroit, MI, USA) PHOENIX (Population Health Outcomes Information Exchange) Prevalence Profiler (phoenix-data.wayne.edu)6 to identify and reach “hotspots” with high social vulnerability and increased chronic disease bur","journal":"Journal of Clinical Hypertension","year":2024,"id":444350,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":7,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.953,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1259891,"name":"Nora Akcasu","orcid":null,"position":1,"is_corresponding":false},{"id":19389,"name":"Bethany J. Foster","orcid":"0000-0002-2753-442X","position":2,"is_corresponding":false},{"id":1073549,"name":"Ijeoma Nnodim Opara","orcid":"0000-0002-7231-9796","position":3,"is_corresponding":false},{"id":1255516,"name":"Samantha Bauer","orcid":"0000-0002-2529-2930","position":4,"is_corresponding":false},{"id":536720,"name":"Steven J. Korzeniewski","orcid":"0000-0002-8895-6052","position":5,"is_corresponding":false},{"id":267329,"name":"Robert D. Brook","orcid":"0000-0002-8521-7262","position":6,"is_corresponding":false},{"id":331877,"name":"Phillip D. Levy","orcid":"0000-0001-7306-5620","position":7,"is_corresponding":false},{"id":432010,"name":"Michael J. Twiner","orcid":"0000-0001-9267-267X","position":0,"is_corresponding":true}],"reference_count":12,"raw_metadata":null,"created_at":"2026-07-19T02:01:33.526738Z","pmid":"38501742","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}