Use of a community mobile health van to increase early access to prenatal care.
OBJECTIVE
To examine whether the use of a community mobile health van (the Lucile Packard Childrens Hospital Women's Health Van) in an underserved population allows for earlier access to prenatal care and increased rate of adequate prenatal care, as compared to prenatal care initiated in community clinics.


METHODS
We studied 108 patients who initiated prenatal care on the van and delivered their babies at our University Hospital from September 1999 to July 2004. One hundred and twenty-seven patients who initiated prenatal care in sites other than the Women's Health Van, had the same city of residence and source of payment as the study group, and also delivered their babies at our hospital during the same time period, were selected as the comparison group. Gestational age at which prenatal care was initiated and the adequacy of prenatal care - as defined by Revised Graduated Index of Prenatal Care Utilization (RGINDEX) - were compared between cases and comparisons.


RESULTS
Underserved women utilizing the van services for prenatal care initiated care three weeks earlier than women using other services (10.2 +/- 6.9 weeks vs. 13.2 +/- 6.9 weeks, P = 0.001). In addition, the data showed that van patients and non-van patients were equally likely to receive adequate prenatal care as defined by R-GINDEX (P = 0.125).


CONCLUSIONS
Women who initiated prenatal care on the Women's Health Van achieved earlier access to prenatal care when compared to women initiating care at other community health clinics.
Edgerley
Laura P
LP
Stanford University School of Medicine, Stanford, CA 94305, USA.
El-Sayed
Yasser Y
YY
Druzin
Maurice L
ML
Kiernan
Michaela
M
Daniels
Kay I
KI
D000328:Adult; D002140:California; D015331:Cohort Studies; D003151:Community Health Centers / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility; D006785:Hospitals, University; D006801:Humans; D008427:Maternal Health Services / Q000706:statistics & numerical data / Q000600:supply & distribution*; D008507:Medically Underserved Area; D008952:Mobile Health Units / Q000706:statistics & numerical data*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011295:Prenatal Care / Q000458:organization & administration / Q000706:statistics & numerical data*; D015397:Program Evaluation; D012189:Retrospective Studies; D013997:Time Factors