Prevention on the Streets

This 39-foot, custom-built bus may look like an average motor home on the outside, but it is actually a healthcare unit on wheels. Equipped with a waiting room, three screening areas, and a restroom, this mobile center provides preventive health screenings and other services in six different locations around the city of Boston. With only five people on staff, the unit relies upon the assistance of countless volunteers, including medical residents and students, to serve the community.

The Family Van was founded in 1992 by Dr. Nancy Oriol, Dean of Students at Harvard Medical School. Dr. Oriol describes the van as the “knowledgeable neighbor.” Inspired, in part, by the Bridge Over Troubled Waters van, which has provided free medical services to run-away teens in Harvard Square since the 60’s, Dr. Oriol created The Family Van to address the specific healthcare needs of the urban community. The program started in a rented van, which operated only four mornings per week. Within two years the program was firmly rooted in the community and had gained the trust of people all across the city.

In order to maintain relationships in the community, the program operates on a regular schedule, Monday through Friday, 50 weeks per year. Individuals may come to the same areas of town at the same time each week and expect to see familiar faces. There is no appointment or insurance required and all services are offered anonymously. Every person who comes to The Family Van is considered a neighbor rather than a patient. This type of environment has allowed The Family Van to build trusting relationships in the community while providing a safe haven for people to discuss their health concerns. The large majority of its visitors are minorities, 30 percent of which consider English as a second language.

“Our goal is to be a bridge to healthcare,” explains Jennifer Bennet, Executive Director of The Family Van. “We like to meet people where they are.”

Bennet has been working with the program since 2005 and has seen the positive results of its presence in the community. As Executive Director, she works to ensure that every person who comes to The Family Van receives quality care that examines the physical, social and economic factors that can affect one’s health.

While The Family Van cannot diagnose or treat medical conditions, the program has been instrumental in the prevention and management of chronic illnesses such as diabetes and cardiovascular disease. To assess the risk factors for these conditions, The Family Van provides screenings such as blood glucose and hemoglobin A1c levels - which are determining factors in the diagnosis of diabetes, as well as blood pressure and cholesterol. Based on the results of such screening tests, The Family Van helps each individual to set up an appointment with a primary care physician who can diagnose and treat chronic illness. The program has been successful in identifying new cases of undiagnosed diabetes. Out of the past 31,000 visits, one-third were screened for diabetes. Forty percent of those screened for diabetes had abnormal levels of blood glucose. To assist the community in making lifestyle modifications, a registered dietician is on board to educate people in the community about how to prevent such conditions through diet and exercise. Staff and volunteers are also available to show those people with diabetes how to use their testing supplies.

The Family Van is just one of roughly 2,000 mobile healthcare programs across the United States. From California to Florida to Massachusetts, these programs provide preventive health services to those who do not have access to primary care. Programs such as The Family Van are funded through a patchwork of grants and charitable donations, which limits the services such programs can provide. It took nearly a year and a half to establish an A1c level screening program on The Family Van. Supporters of The Family Van and other similar programs stress the value that these healthcare units can impart to the community. “Mobile healthcare has the flexibility to be responsive to community needs,” says Bennet. In its 17 years of operation, the Family Van has consistently provided care to people across the city of Boston. Dr. Oriol attributes its success to the development of strong, trusting relationships with the community and the program’s ability to adapt to people’s needs. However, she understands that while The Family Van has reached numerous people and had tremendous success, there are still many who do not understand the importance of preventive healthcare. “We are here to help people understand why lifestyle changes make a difference,” Dr. Oriol concludes. To learn more about mobile healthcare programs like The Family Van in your area, visit www.mobilehealthclinicsnetwork.org.