Big Wheels Keep on Big Wheels Keep on Turnin’:Turnin’: Expanding Mobile Expanding Mobile

Services throughout Services throughout Downstate IllinoisDownstate Illinois

Julie A. Pryde, MSW, LSWJulie A. Pryde, MSW, LSWDirector, Division Infectious Disease Director, Division Infectious Disease

Prevention & ManagementPrevention & Management

Champaign-Urbana Public Health DistrictChampaign-Urbana Public Health District

Our CommunityOur Community Population of over 180,000 Diversity: 77% White; 11.2 % Black; 6.5% Asian;

and 2.9% Hispanic. Home of the University of Illinois (world-renowned

Natl. Center for Supercomputing Applications). Excellent medical facility: (Level I Trauma Center,

Level III Perinatal Center, teaching hospital) A vibrant business community An assortment of cultural resources and facilities Nationally and internationally recognized city and

county park systems More than 100 churches/religious facilities

reflecting a variety of religious beliefs

Our Community through Public Health’s Our Community through Public Health’s eyes:eyes:

16.1% of the population living in poverty. 16.1% of the population living in poverty. 2 emergency homeless shelters for men, none for women 2 emergency homeless shelters for men, none for women Limited mental health services for low-income personsLimited mental health services for low-income persons Paucity of substance abuse treatment resources: no pay-Paucity of substance abuse treatment resources: no pay-

methadone treatment facility in all of downstate IL (yet)methadone treatment facility in all of downstate IL (yet) Champaign is a high incidence county for Gonorrhea and Champaign is a high incidence county for Gonorrhea and

Chlamydia. Chlamydia. Syphilis outbreak in 2002-03 and again in 2005-06. Syphilis outbreak in 2002-03 and again in 2005-06. Third highest HIV/AIDS rate in the State of Illinois. Third highest HIV/AIDS rate in the State of Illinois. Only one, small, federally-funded community health center Only one, small, federally-funded community health center

(seriously overburdened)(seriously overburdened) No Title III Clinic for persons with HIVNo Title III Clinic for persons with HIV

The Problem facing the The Problem facing the Health Department:Health Department:

Needed to increase outreach services to Needed to increase outreach services to targeted populations (MSM, IDU, HRH)targeted populations (MSM, IDU, HRH)

Public Health offered only limited hours Public Health offered only limited hours (M-F: 8-4 with an hour for lunch). (M-F: 8-4 with an hour for lunch). STD clinic hours only total 5 hours a weekSTD clinic hours only total 5 hours a week Needed an outreach site where we could Needed an outreach site where we could

provide exams for STDsprovide exams for STDs Needed a way for clients to receive Needed a way for clients to receive

HIV/STD/TB/Hepatitis services which was HIV/STD/TB/Hepatitis services which was confidential (avoid stigma) confidential (avoid stigma)

The Problem facing the The Problem facing the Mobile Program:Mobile Program:

The mobile unit was used almost The mobile unit was used almost exclusively in rural areasexclusively in rural areas

The mobile unit provided very The mobile unit provided very limited serviceslimited services

The services offered were very The services offered were very underutilizedunderutilized

Carle had an undeserved Carle had an undeserved reputation in community as being reputation in community as being unconcerned about needs of poorunconcerned about needs of poor

The Solution for both:The Solution for both:

A collaboration between the A collaboration between the health department and the health department and the existing mobile program at existing mobile program at the hospitalthe hospital

The solution:The solution:Wellness on WheelsWellness on Wheels

How does WOW work?How does WOW work? PH conducted key informant PH conducted key informant

interviews to help us pick locationsinterviews to help us pick locations The Mobile provides a nurse driver The Mobile provides a nurse driver

($20 hr.) who provides services ($20 hr.) who provides services PH pays mileage of $2 a mile PH pays mileage of $2 a mile

(cheap as we are in town)(cheap as we are in town) PH sends a nurse and or a PH sends a nurse and or a

counselor (flex schedule)counselor (flex schedule)

What we provide (FREE What we provide (FREE services):services): Blood pressure screeningBlood pressure screening Blood sugar screeningBlood sugar screening Cholesterol checksCholesterol checks Anonymous HIV testingAnonymous HIV testing STD screeningSTD screening ImmunizationsImmunizations Risk reduction counselingRisk reduction counseling Health educationHealth education Facilitated referrals to community resourcesFacilitated referrals to community resources Risk reduction suppliesRisk reduction supplies Linkage to syringe exchangeLinkage to syringe exchange TB testingTB testing Acute care Acute care

““Mobile” allows us Mobile” allows us maximum flexibilitymaximum flexibility

We choose locations based on:We choose locations based on: STD mapSTD map Participant inputParticipant input Shifting populationShifting population Need (outbreaks)Need (outbreaks) Community input (special events)Community input (special events)

WOW Special Event WOW Special Event LocationsLocations

Special Events:Special Events:

Special Events:Special Events:

The Results:The Results:

WOW Clients August 2002-2003

(n=615)

Minority84%

Non-Min16%

Specifically…Specifically…WOW Clients by Sex & Race

August 2002-August 2003 (n=615)

Blk M45%

BLK F26%

WM9%

WF7%

HM5%

HF5%

Other1%AF

1%AM1%

Another problem Another problem emerges!emerges!

We noticed high STD rates among We noticed high STD rates among youthyouth

There were barriers to youth using our There were barriers to youth using our clinics: hours of operation & stigma.clinics: hours of operation & stigma.

Youth had less access to transportationYouth had less access to transportation

What to do?!?!?!?!What to do?!?!?!?!

Collaborate with another Collaborate with another Mobile ProgramMobile Program

TEEN WELLNESS on WHEELS!

Teen Wellness on WheelsTeen Wellness on Wheels Started in 2002Started in 2002 Operates outside of local High Schools when Operates outside of local High Schools when

school is in sessionschool is in session Operates outside of local pool and water park Operates outside of local pool and water park

during summer monthsduring summer months Collaborates with Planned Parenthood’s Teen Collaborates with Planned Parenthood’s Teen

Peer Educators to provide information on birth Peer Educators to provide information on birth controlcontrol

Reached nearly 500 youth during the first year of Reached nearly 500 youth during the first year of operationoperation

Requests from other schools to bring the Mobile Requests from other schools to bring the Mobile to eventsto events

How does Public Health How does Public Health Benefit from these Benefit from these collaborations?collaborations?

Increased trust with target populationsIncreased trust with target populations Increased case findingIncreased case finding Increased attendance in STD clinicIncreased attendance in STD clinic Much free publicityMuch free publicity Benefits of being associated with CarleBenefits of being associated with Carle Increased collaboration and Increased collaboration and

cooperation from sites (public housing, cooperation from sites (public housing, soup kitchen, homeless shelters, and soup kitchen, homeless shelters, and others)others)

How Do Mobile Unit Owners How Do Mobile Unit Owners Benefit from these Benefit from these collaborations?collaborations? Giving back to the community (not-for-profit Giving back to the community (not-for-profit

Foundation)Foundation) Good public relations (much publicity)Good public relations (much publicity) WOW has sparked interest within Carle & WOW has sparked interest within Carle &

Christie about the Mobile Health ProgramChristie about the Mobile Health Program Have since created a linkage with Have since created a linkage with

overburdened community health center overburdened community health center (provide 2 extra exam rooms 4 days wk) (provide 2 extra exam rooms 4 days wk)

Increased cooperation with other community Increased cooperation with other community agencies (Planned Parenthood, American agencies (Planned Parenthood, American Lung Assoc., UI Community Health, and Lung Assoc., UI Community Health, and others)others)

2004: Yet another 2004: Yet another problem emerges!problem emerges!

Lack of flexibility with shared mobile units.Lack of flexibility with shared mobile units. Inability to use mobiles during late night Inability to use mobiles during late night

and early morning hoursand early morning hours Inability to change the schedule without a Inability to change the schedule without a

great deal of advance noticegreat deal of advance notice The Mobiles were too large for some The Mobiles were too large for some

locationslocations

SOLUTION?!?!SOLUTION?!?!

WOWee!!!WOWee!!!

2 Room Mobile Counseling & Testing Unit

WOWee:WOWee: Works weekends & eveningsWorks weekends & evenings Parks outside of Labor Ready from 5:30-Parks outside of Labor Ready from 5:30-

8:30 AM8:30 AM Parks outside of gay bars from 11PM-2AMParks outside of gay bars from 11PM-2AM Allows us to attend special eventsAllows us to attend special events Parks in Public HousingParks in Public Housing Allows maximum flexibility to target Allows maximum flexibility to target

specific areas (GIS/Chlamydia Project)specific areas (GIS/Chlamydia Project)

Graphics Matter!Graphics Matter!

How can we expand even How can we expand even further?further?

IL Children’s Health Care IL Children’s Health Care Foundation grantsFoundation grants

Collaborated with the IDPH Office Collaborated with the IDPH Office of Minority Health to expand WOW of Minority Health to expand WOW throughout IL (received federal throughout IL (received federal grant)grant)

Illinois Governor Rod Blagojevich Illinois Governor Rod Blagojevich made WOW a part of BASUAH made WOW a part of BASUAH statewide initiativestatewide initiative

What can you do to keep What can you do to keep the Big Wheels Turnin’?the Big Wheels Turnin’?

Collaborate with local health departments and Collaborate with local health departments and CBOsCBOs

Use your mobile & their expertise of the target Use your mobile & their expertise of the target populations to expand services (you use it during populations to expand services (you use it during the day, they use it at night)the day, they use it at night)

Partner with Health Departments & CBOs to Partner with Health Departments & CBOs to apply for funding opportunities that you may not apply for funding opportunities that you may not qualify for on your ownqualify for on your own

Consider selling or donating your used mobile to Consider selling or donating your used mobile to a health department or CBO. They have the a health department or CBO. They have the advantage of your experience & can call with advantage of your experience & can call with questions or advisequestions or advise

Join the Downstate IL Join the Downstate IL Mobile Health AllianceMobile Health Alliance

Modeled after the Chicago Mobile Modeled after the Chicago Mobile Health AllianceHealth Alliance

Will provide opportunities for:Will provide opportunities for: NetworkingNetworking Resource sharingResource sharing Technical assistanceTechnical assistance Group projectsGroup projects Future conferences and trainingsFuture conferences and trainings

THANK YOU!THANK YOU!Julie A. PrydeJulie A. Pryde

jjpryde@cuphd.orgpryde@cuphd.org

217-239-7827217-239-7827

Keep those Big Wheels Keep those Big Wheels Turnin’!!!Turnin’!!!