Perinatal Outcomes and Patient-Reported Satisfaction Associated with the Receipt of Prenatal Care via a Mobile Health Clinic: A Scoping Review

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Methods We included peer-reviewed, empirical studies from open databases, conducted in the United States, that examined perinatal outcomes and/or patient experiences related to mobile clinic-based prenatal care. Results Two papers were eligible. Both focused on urban settings and foreign-born and/or Spanish speaking populations covered by Medicaid or uninsured. Both studies reported earlier initiation of women receiving prenatal care on a mobile health clinic compared to clinic-based care. Neither study reported patient satisfaction with care. Conclusion Despite growing use of mobile health clinics for prenatal care in the U.S., few studies have evaluated perinatal outcomes or patient satisfaction. Further research is needed to assess the effectiveness and acceptability of prenatal care delivered through mobile health clinics. Figures Figure 1 Introduction Prenatal care is one of the most frequently used preventive healthcare services in the United States with nearly 12.5 million visits in 2019 (Santo & Kang, 2023 ). Early entry to prenatal care can improve perinatal outcomes by ensuring that pregnant women and people have access to important and timely screening, improving opportunities to identify and manage chronic diseases, and establishing and maintaining the patient-provider relationship (Kilpatrick et al., 2017 ). Despite evidence that early initiation of prenatal care can be beneficial, rates of timely entry to care have been decreasing. Between 2022 and 2023, receipt of first-trimester prenatal care decreased by 1% from 76.1% to 77.0%, respectively, while the rate of no prenatal care increased by 5% (Martin et al., 2024 ). One contributor to this decrease is a growing shortage of maternity care providers that is expected to worsen in the coming years. The closure of hospital obstetric units has exacerbated maternity care workforce shortages and has disproportionately impacted rural communities (Kozhimannil et al., 2025 ). By 2037, there is expected to be a shortage of 9,890 OBGYNs in the United States, representing a supply adequacy of 82% of need (HRSA, 2024 ). Additional factors that may contribute to late or non-receipt of prenatal care include structural and social factors such as lack of access to reliable transportation, affordability of care, and, among Hispanic and African American patients, lower satisfaction with patient-provider communication that may contribute to low or no attendance rates (Centers for Medicare and Medicaid Services, n.d.; Pérez-Stable & El-Toukhy, 2018 ). These factors contribute to racial, ethnic, and geographic disparities in prenatal care access, utilization, and perinatal outcomes (Howell et al., 2016 ; Lemas et al., 2023 ). In response to the growing need for equitable and accessible care, there has been an interest in the use of mobile health clinics to deliver prenatal care. A mobile health clinic is defined as a fully equipped health clinic on wheels that meets underserved populations where they are (Edgerley et al., 2007 ). While mobile health clinics have generally demonstrated efficacy in increasing access to care and improving health outcomes in underserved populations, we are unaware of a synthesis of evidence regarding their use and effectiveness for facilitating access to prenatal care for women and birthing people (Jones et al., 2005 ; Mobile Health Map, n.d.; Yu et al., 2017 ). Thus, the objective of this scoping review was to synthesize the existing body of research to better understand: 1) perinatal outcomes, including self-reported satisfaction with care, associated with receipt of prenatal care on a mobile health clinic in the United States, and 2) gaps and opportunities for future research, policy, and/or practice. Methods This scoping review follows methodology recommended by the Joanna Briggs Institute and complies with guidelines from the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for scoping reviews (PRISMA-ScR) (Peters et al., 2021 ; Tricco et al., 2018 ). A review protocol was registered with Open Science Framework and proceeded as planned with some modifications to columns in the data extraction table (Center for Open Science, n.d.; Eggen et al., 2025 ). This manuscript is not based upon clinical study or patient data. Eligibility Criteria The selection of inclusion and exclusion criteria was guided by the Population, Concept, and Context (PCC) framework and is documented in Table 1 (Peters et al., 2022 ). All peer-reviewed, empirical studies published in English that took place in the United States and assessed perinatal outcomes, including patient-reported satisfaction with care, associated with the receipt of prenatal care on a mobile health clinic were considered. No time limits were imposed on the search as we sought to capture the complete body of knowledge that currently exists in the peer-reviewed literature. Table 1 Eligibility Criteria Inclusion Criteria Criteria Population Pregnant women and birthing people of all ages in the United States Concept Perinatal outcomes, including patient-reported satisfaction with care, associated with the receipt of prenatal care on a mobile health clinic. Context Empirical, peer-reviewed studies in the United States (quantitative, qualitative, or mixed-methods) investigating prenatal care receipt on a mobile unit. No time restrictions were applied. Exclusion Criteria Studies were excluded if they were: 1) Not empirical studies, 2) Not peer-reviewed, 3) Took place outside of the United States, and 4) Not published in English. Information Sources and Search Strategy The search strategy was developed by a health sciences librarian (AS) in collaboration with the lead author (ME). The search included the following search string adapted to fit each database: ((((mobile) OR (van)) AND ((clinic) OR (unit))) AND ((matern*) OR (obstetric) OR (pregna*) OR (prenatal) OR (perinatal) OR (postnatal) OR (antenatal))) NOT ((app) OR (application) OR (phone) OR (cellphone) OR (telemedicine) OR (telehealth)) . Search strings for each database are documented in Table 2 . A systematic search of PubMed, Embase, CINAHL, Health Source, Psychology and Behavioral Sciences Collection, APA PsycInfo, Social Sciences Abstracts, and Web of Science was conducted on December 9, 2024 by the clinical librarian. The database results were imported into Zotero for record keeping and then Covidence on the same day. Table 2 Search Strings Database Search String PubMed ((("Mobile Health Units"[Mesh]) OR (((mobile) OR (van)) AND ((clinic) OR (unit)))) AND ((matern*) OR (obstetric) OR (pregna*) OR (prenatal) OR (perinatal) OR (postnatal) OR (antenatal))) NOT ((app) OR (application) OR (phone) OR (cellphone) OR (telemedicine) OR (telehealth)) Embase (mobile:ti,ab,kw OR van:ti,ab,kw) AND (clinic:ti,ab,kw OR unit:ti,ab,kw) AND (matern*:ti,ab,kw OR obstetric:ti,ab,kw OR pregna*:ti,ab,kw OR prenatal:ti,ab,kw OR perinatal:ti,ab,kw OR postnatal:ti,ab,kw OR antenatal:ti,ab,kw) NOT (app:ti,ab,kw OR application:ti,ab,kw OR phone:ti,ab,kw OR cellphone:ti,ab,kw OR telemedicine:ti,ab,kw OR telehealth:ti,ab,kw) EBSCO (CINAHL, Health Source, Psychology and Behavioral Sciences Collection, PsycInfo, Social Sciences Abstracts) ((((mobile) OR (van)) AND ((clinic) OR (unit))) AND ((matern*) OR (obstetric) OR (pregna*) OR (prenatal) OR (perinatal) OR (postnatal) OR (antenatal))) NOT ((app) OR (application) OR (phone) OR (cellphone) OR (telemedicine) OR (telehealth)) Web of Science ((("Mobile Health Units"[Mesh]) OR (((mobile) OR (van)) AND ((clinic) OR (unit)))) AND ((matern*) OR (obstetric) OR (pregna*) OR (prenatal) OR (perinatal) OR (postnatal) OR (antenatal))) NOT ((app) OR (application) OR (phone) OR (cellphone) OR (telemedicine) OR (telehealth)) Data Selection, Extraction, and Synthesis Title and abstract screening was completed in December 2024 and January 2025. Three reviewers (YL, MU, AM) independently screened all title and abstracts for eligibility criteria using Covidence software (Veritas Health Innovation, 2025). Covidence is a web-based collaboration software platform that streamlines the production of systematic and other literature reviews. The study PI (ME) addressed any disagreements among the reviewers. Four independent reviewers (YL, MU, AM, and ME) read all papers included in the full-text review. Disagreements were addressed through discussion and consensus. References were hand-searched during the full-text review stage to identify eligible papers that may have been missed during databases searches. Following full-text review in Covidence, all eligible papers were exported to a Zotero library for data extraction. All four reviewers extracted data from the included papers independently and a discussion process was used to complete the table. Due to the small number of eligible papers, we did not use the process of pilot data extraction as described in the protocol (Eggen et al., 2025 ). We did not conduct a quality assessment of papers as this is not a requirement for a scoping review (Peters et al., 2022 ). Data were extracted from included papers and reported in tabular format using the following categories: first author and year of publication, purpose, setting, sample, study design and data source(s), study period, outcome(s) measured, and key findings. This scoping review was not subject to review by an institutional review board. Results Study Inclusion A total of 5,223 articles were identified using the search strategy. After duplicates were removed (n = 927), 4,296 articles underwent title and abstract screening. Among these, fourteen articles met the eligibility criteria and were reviewed in full. Twelve articles were then excluded for not meeting eligibility criteria. Two papers were included in the final review. The search process and results, including reasons for exclusions at the full-text stage, are summarized in a PRISMA flow chart (Fig. 1 ). Characteristics of Included Studies Characteristics from the two articles included in the review are summarized in Table 3 . Both studies were published more than 15 years ago with study periods of January 2000 to July 2004 (Edgerley et al., 2007 ) and August 2007 to September 2008 (O’Connell et al., 2010 ). Both studies used a retrospective cohort design with a sample of women who initiated care on a mobile health clinic and a comparison group who initiated care in a local community clinic, matched on demographics. Both studies were descriptive and, while one study reported conducting a logistic regression to assess prenatal care utilization and birth outcomes, the results of the regression were not presented in the paper (O’Connell et al., 2010 ). Both studies focused on urban areas with one study setting in Redwood City and East Palo Alto, California (Edgerley et al., 2007 ) and the other in Miami-Dade County, Florida (O’Connell et al., 2010 ). In both studies, a majority of the sample were immigrants who were either uninsured or covered by Medicaid. One study included primarily Spanish-speaking women (Edgerley et al., 2007 ), and the other study consisted mostly (95%) of foreign-born women (O’Connell et al., 2010 ). In one study, the sample consisted of women who used California’s Medicaid Program, MediCal, to pay for delivery and prenatal care (Edgerley et al., 2007 ). In the other study, only a small percentage of the study population had Medicaid coverage at delivery (13.2%) and most of the women in the sample used self-payment at delivery (O’Connell et al., 2010 ). A key difference in the studies is that the mobile health clinic in the California study was used as a point of care initiation only (Edgerley et al., 2007 ). Women who began their prenatal care on the mobile unit would then transfer to a community clinic to receive the remainder of their prenatal care. In the Miami-Dade County study, women could both begin and continue with prenatal care visits on the mobile clinic (O’Connell et al., 2010 ). Table 3 Characteristics of Included Studies First Author, Year of Publication Purpose Setting Sample Study Design and Data Source(s) Study Period Outcome(s) Measured Key Findings (Edgerley et al., 2007 ) To examine whether the use of a community mobile health van allows for earlier access to prenatal care and higher rates of adequate care, compared to care initiated in community clinics. Low-income neighborhoods in Redwood City and East Palo Alto, CA Mobile unit group : n = 108 women enrolled in MediCal who initiated prenatal care on the mobile unit; 81.5% spoke Spanish as primary language Comparison (Clinic) group : n = 127 women covered by MediCal who initiated prenatal care in a community clinic; 84.2% spoke Spanish as primary language. Both groups included only singleton births delivered at Lucile Packard Hospital Retrospective cohort study; birth records and a hospital database of infant medical records January 1, 2000-July 4, 2004 Onset of prenatal care, number of prenatal visits, adequacy of care using the Revised Graduated Index of Prenatal Care Utilization (R-GINDEX), gestational age at delivery, delivery method, NICU admission, birthweight. Mobile unit group initiated prenatal care three weeks earlier (10.2 ± 6.9 weeks) than clinic group (13.2 ± 6.9 weeks); van and clinic patients equally likely to receive adequate prenatal care; no significant differences in other outcomes. (O’Connell et al., 2010 ) To assess differences in prenatal care utilization and birth outcomes among women who used a mobile van as a source of prenatal care compared to women who received in-clinic care. Miami-Dade County, FL Mobile unit group : n = 182 mothers who accessed prenatal care at least one time on the van and delivered an infant during the study period; 94.5% foreign-born. Comparison (Clinic) group : n = 182 mothers who delivered an infant during the study period and resided in the zip codes in which the mobile unit mothers resided; 96.2% foreign-born. Retrospective cohort study; medical records and Vital Statistics August 2007-September 2008 Trimester of prenatal care initiation, adequacy of care using the Kessner and Kotelchuck Indices), birthweight, gestational age, congenital anomalies, abnormal conditions of the newborn. Mobile unit group more likely to have first-trimester prenatal care (81%) compared to clinic group (63.2%) (p = 0.0006); mobile group had a higher rate of adequate prenatal care (88.5%) compared to clinic group (73.1%) Preterm births were lower in the mobile unit group (5.0% vs. 10.4%, p = 0.0492); mean weeks of gestation for mobile unit was 39.2 +- 1.3 and clinic group was 38.6 +- 2.3 (p = 0.01). No other statistically significant differences between the mobile unit and clinic groups were observed. Perinatal Outcomes In assessing the impact of the use of mobile health clinics on perinatal outcomes, Edgerley and colleagues ( 2007 ) measured prenatal care timing and adequacy, gestational age at onset of care and delivery, birthweight, delivery method, and percentage admission to the neonatal intensive care unit (NICU). O’Connell and colleagues ( 2010 ) assessed prenatal care utilization (timing and adequacy) and birth outcomes, including preterm birth, birthweight, gestational age at delivery, congenital anomalies and abnormal conditions (O’Connell et al., 2010 ). The findings of each study as it relates to perinatal outcomes is detailed below. Prenatal Care Timing and Adequacy In both studies, a higher percentage of women who initiated care on a mobile health clinic (mobile group) did so earlier than those who initiated care in a clinic setting (comparison group). In the study of mostly foreign-born women in Miami-Dade County, 81% of mothers in the mobile group started prenatal care in the first trimester compared to 63.2% in the comparison group (p = 0.0006). Using the Kessner Index, the study identified a significant difference in the receipt of adequate prenatal care between the mobile group (88.5%) versus the comparison group (73.1%) (p = 0.0003) Similarly, using the Kotelchuck Index as a measurement tool, the study authors found that more mothers in the mobile group (77.5%) had adequate prenatal care compared to mothers in the comparison group (61.5%) (p < 0.0001). Among mothers in the mobile group, the median number of prenatal care visits was five with 33.0% of mothers visiting the mobile clinic for care fewer than three times and 8.2% visiting more than ten times (O’Connell et al., 2010 ). Edgerley and colleagues ( 2007 ) measured prenatal care adequacy using the Revised Graduated Index of Prenatal Care Utilization (R-GINDEX). The authors found that prenatal care adequacy (adequate plus or adequate) was higher among the mobile group (44.4%) versus the comparison group (34.6%) though the difference was not statistically significant (p = 0.13). Mothers in the mobile group began care three weeks earlier than women in the comparison group (p = 0.001) (Edgerley et al., 2007 ). Delivery Method One study reported delivery method and found no differences when comparing mobile health clinic users (vaginal: 85.2%, cesarean: 14.8%) and women in the comparison group (vaginal: 85.0%, cesarean: 15.0%) (p = 0.98) (Edgerley et al., 2007 ). Gestational Age at Delivery O’Connell and colleagues ( 2010 ) found that women in the mobile group had a higher mean number of weeks gestation at delivery (39.2 weeks ± 1.3) relative to the comparison group (38.6 weeks ± 2.3) (p = 0.01). Edgerley and colleagues reported no differences when comparing the mobile group (39.5 ± 1.5 weeks) to the comparison group (39.2 ± 1.9 weeks) (p = 0.20) (Edgerley et al., 2007 ). Preterm Birth O’Connell and colleagues ( 2010 ) reported a statistically significant difference in the rate of preterm birth in the mobile group (5.0%) relative to the comparison group (10.4%) (p = 0.0492), after adjusting for potential confounders. Results of the logistic regression were not available in the paper and the authors did not identify the confounders that were considered in the model. Congenital Anomalies and Abnormal Conditions No infants born to mothers in the mobile health clinic group had a congenital anomaly compared to seven infants (0.55%) in the comparison group (p = 0.3166). The authors reported no statistically significant differences in abnormal conditions when comparing the mobile health clinic group (5.0%) to the comparison group (3.9%) (p = 0.6901) (O’Connell et al., 2010 ). NICU Admissions One study reported a lower rate of NICU admissions among infants born to mothers in the mobile group (8.3%) relative to the comparison group (14.2%) (p = 0.16) (Edgerley et al., 2007 ). Birthweight No differences in infant birthweight were identified in the study of primarily Spanish speaking patients covered by Medicaid in California (Edgerley et al., 2007 ). O’Connell and colleagues ( 2010 ) reported a lower percentage of low birthweight infants among the mobile group (4.4%) relative to the comparison group (8.8%) (p = 0.0911). Self-reported satisfaction with care Neither study included an assessment of self-reported satisfaction with prenatal care. Gaps and Opportunities for Future Research, Policy and/or Practice Recommended opportunities for future research included the use of larger and more diverse samples to increase statistical power and increase external validity of the results (Edgerley et al., 2007 ). Both studies used data collected from infant birth certificates and medical records, which may have limited the ability to control for confounding factors and to use a study design that takes into account self-selection bias (Edgerley et al., 2007 ; O’Connell et al., 2010 ). Primary data collection using questionnaires or interviews was recommended as a means for gathering more detailed information regarding maternal factors and outcomes (O’Connell et al., 2010 ). Discussion This scoping review synthesized the peer-reviewed literature regarding perinatal outcomes and patient-reported satisfaction with prenatal care among women who initiated and/or received care on a mobile health clinic in the United States. A key finding of this scoping review was a gap in the literature regarding the effectiveness and acceptability of receiving prenatal care on a mobile health clinic. The absence of recent research underscores the need to reassess and update the relevance and utility of mobile clinics in the current maternal health landscape, especially in light of ongoing maternity care workforce shortages and persistent disparities in access to prenatal care. Importantly, neither study included a measure of patient-reported satisfaction with care, an important aspect of quality of care. Despite the limited number of studies, the findings of this review offer some insight into the potential benefits of mobile health clinics for increasing access to prenatal care and improving perinatal outcomes. Additionally, the findings point to opportunities for future work in this area. The two studies in this review focused primarily on immigrants in urban areas who were uninsured or covered by Medicaid. Women from immigrant communities face structural barriers to accessing timely and adequate prenatal care, including challenges with transportation to and from healthcare visits, language barriers, lack of trust towards prenatal care providers in their communities, and systematic exclusion from Medicaid coverage (Camargo et al., 2023 ; Janevic et al., 2022 ). Similarly, rural-residing women with Medicaid coverage experience systemic barriers to care such as lack of providers in their community willing to accept Medicaid, transportation, and childcare challenges. These challenges contribute to higher rates of delayed or no prenatal care compared to women who have private insurance (Armstrong-Mensah et al., 2021 ; Bellerose et al., 2022 ). Given the increasing closures of hospital obstetric units in primarily rural states and shrinking maternity care workforce, there is a need to evaluate the effectiveness and acceptability of mobile health clinics in delivering prenatal care in rural communities (U.S. Government Accountability Office, 2022 ). The growing number of mobile health clinics in rural communities across the country provides ample opportunity to evaluate both the effectiveness of mobile health clinics in delivering prenatal care and patient satisfaction with care (Mobile Health Map, n.d.). While the studies in this review provide suggestive findings that mobile health clinics may increase prenatal care utilization and adequacy among marginalized women, the retrospective and descriptive research designs inherently introduce bias. While both studies matched women in the mobile health clinic and comparison groups on maternal factors, there is uncertainty regarding unobserved sociodemographic variables that were not available in birth records or electronic medical records. The use of larger sample sizes, more robust research designs, and richer data sources can facilitate a better understanding of the impact of mobile health clinics on prenatal care access and outcomes across diverse populations and communities. The use of randomized controlled trials can mitigate the selection bias that was a limitation of the study designs in this review. Additionally, qualitative studies that explore the mechanisms by which mobile health clinics alleviate social drivers of health to increase access to prenatal care can provide insights for the development of effective policy and practice levers. Future studies should integrate a measure of patient satisfaction to better understand the acceptability of this mode of care delivery among women. Overall, the findings of this review suggest that mobile health clinics may be a useful strategy in increasing early and adequate prenatal care access among marginalized populations in United States. However, there is a dearth of research exploring the impact of mobile prenatal care on perinatal outcome and no research regarding patient satisfaction, cultural relevance, or economic feasibility of this mode of care delivery model in a contemporary context. Limitations This review has several limitations. First, it included two studies, both of which focused on small homogeneous samples in urban areas, were published more than ten years ago, and employed retrospective research designs. These limitations reduce the generalizability of findings to other communities and populations. Our decision to exclude grey literature may have limited the inclusion of more recent evidence regarding the effectiveness of mobile health clinics in delivering prenatal care and improving outcomes. The lack of peer-reviewed publications highlights the need for additional research in this area. Conclusions This scoping review provides some evidence of the impact that mobile health clinics have on increasing access to prenatal care and improving perinatal outcomes. Our findings highlight the need for additional research to guide policy and practice decisions to improve access to prenatal care and provide evidence to inform resource allocation to diverse modes of care delivery. Future studies that examine the cost-effectiveness of prenatal mobile health clinics can further inform policy development to support this innovation. Declarations Funding Funding for this scoping review was provided by the Kentucky Cabinet for Health and Family Services through a State University Partnership titled “Bridging Healthcare Disparities.” The funder had no role in the review’s design, analysis, or reporting. Ethics approval and consent to participate Not applicable as this study is not a clinical trial. Consent for publication Not applicable. Conflict of Interest/ Competing interests The authors have no competing interests to declare that are relevant to the content of this article. Acknowledgments. Not applicable Authors and Affiliations Melissa Eggen PhD, MPH University of Louisville School of Public Health and Information Sciences Department of Health Management and Systems Sciences 485 E Gray St, Louisville, KY 40202 [email protected] Yiru Lou, MPH University of Louisville School of Public Health and Information Sciences Department of Health Promotion and Behavioral Sciences 485 E Gray St, Louisville, KY 40202 [email protected] Anika Mehta, MSc, MTech University of Louisville School of Public Health and Information Sciences Department of Health Management and Systems Sciences 485 E Gray St, Louisville, KY 40202 [email protected] Ansley Stuart, MSIS University of Louisville – University Libraries Kornhauser Health Sciences Library 540 S. Preston St., Louisville, KY 40202 [email protected] Melody Ucho University of Louisville School of Public Health and Information Sciences Department of Health Management and Systems Sciences 485 E Gray St, Louisville, KY 40202 [email protected] Sara A. Choate, PhD University of Louisville School of Public Health and Information Sciences Department of Health Promotion and Behavioral Sciences 485 E Gray St, Louisville, KY 40202 [email protected] Ethics approval and consent to participate Not applicable as this study is not a clinical trial. Consent for publication Not applicable. Conflict of Interest/ Competing interests The authors have no competing interests to declare that are relevant to the content of this article. References Armstrong-Mensah E, Dada D, Bowers A, Muhammad A, Nnoli C. Geographic, Health Care Access, Racial Discrimination, and Socioeconomic Determinants of Maternal Mortality in Georgia, United States. 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Ann Intern Med. 2018;169(7):467–73. https://doi.org/10.7326/M18-0850 . U.S. Government Accountability Office. (2022). Maternal Health: Availability of Hospital-Based Obstetric Care in Rural Areas . https://www.gao.gov/products/gao-23-105515 Veritas H, Innovation HI. Covidence Systematic Review Software [Computer software]. Veritas Health Innovation. www.covidence.org; 2025. Yu SWY, Hill C, Ricks ML, Bennet J, Oriol NE. The scope and impact of mobile health clinics in the United States: A literature review. Int J Equity Health. 2017;16(1):178. https://doi.org/10.1186/s12939-017-0671-2 . Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7686229","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Systematic Review","associatedPublications":[],"authors":[{"id":538398726,"identity":"4b17615e-57b2-4308-a6c0-6b6214be480c","order_by":0,"name":"Melissa 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1","display":"","copyAsset":false,"role":"figure","size":488143,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003ePRISMA Flow Chart for Study Selection\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"floatimage1.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-7686229/v1/1d29369728b391946086c4b0.jpeg"},{"id":96917258,"identity":"0d739266-5c0e-421c-aff2-b31b1b9c2db2","added_by":"auto","created_at":"2025-11-27 14:09:27","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1311279,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7686229/v1/2d8fbf2c-650c-408d-ac99-7531b37367cb.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Perinatal Outcomes and Patient-Reported Satisfaction Associated with the Receipt of Prenatal Care via a Mobile Health Clinic: A Scoping Review","fulltext":[{"header":"Introduction","content":"\u003cp\u003ePrenatal care is one of the most frequently used preventive healthcare services in the United States with nearly 12.5\u0026nbsp;million visits in 2019 (Santo \u0026amp; Kang, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). Early entry to prenatal care can improve perinatal outcomes by ensuring that pregnant women and people have access to important and timely screening, improving opportunities to identify and manage chronic diseases, and establishing and maintaining the patient-provider relationship (Kilpatrick et al., \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e2017\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eDespite evidence that early initiation of prenatal care can be beneficial, rates of timely entry to care have been decreasing. Between 2022 and 2023, receipt of first-trimester prenatal care decreased by 1% from 76.1% to 77.0%, respectively, while the rate of no prenatal care increased by 5% (Martin et al., \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). One contributor to this decrease is a growing shortage of maternity care providers that is expected to worsen in the coming years. The closure of hospital obstetric units has exacerbated maternity care workforce shortages and has disproportionately impacted rural communities (Kozhimannil et al., \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e2025\u003c/span\u003e). By 2037, there is expected to be a shortage of 9,890 OBGYNs in the United States, representing a supply adequacy of 82% of need (HRSA, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2024\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eAdditional factors that may contribute to late or non-receipt of prenatal care include structural and social factors such as lack of access to reliable transportation, affordability of care, and, among Hispanic and African American patients, lower satisfaction with patient-provider communication that may contribute to low or no attendance rates (Centers for Medicare and Medicaid Services, n.d.; P\u0026eacute;rez-Stable \u0026amp; El-Toukhy, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e2018\u003c/span\u003e). These factors contribute to racial, ethnic, and geographic disparities in prenatal care access, utilization, and perinatal outcomes (Howell et al., \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2016\u003c/span\u003e; Lemas et al., \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e2023\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eIn response to the growing need for equitable and accessible care, there has been an interest in the use of mobile health clinics to deliver prenatal care. A mobile health clinic is defined as a fully equipped health clinic on wheels that meets underserved populations where they are (Edgerley et al., \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2007\u003c/span\u003e). While mobile health clinics have generally demonstrated efficacy in increasing access to care and improving health outcomes in underserved populations, we are unaware of a synthesis of evidence regarding their use and effectiveness for facilitating access to prenatal care for women and birthing people (Jones et al., \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e2005\u003c/span\u003e; Mobile Health Map, n.d.; Yu et al., \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e2017\u003c/span\u003e). Thus, the objective of this scoping review was to synthesize the existing body of research to better understand: 1) perinatal outcomes, including self-reported satisfaction with care, associated with receipt of prenatal care on a mobile health clinic in the United States, and 2) gaps and opportunities for future research, policy, and/or practice.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003eThis scoping review follows methodology recommended by the Joanna Briggs Institute and complies with guidelines from the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for scoping reviews (PRISMA-ScR) (Peters et al., \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e2021\u003c/span\u003e; Tricco et al., \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e2018\u003c/span\u003e). A review protocol was registered with Open Science Framework and proceeded as planned with some modifications to columns in the data extraction table (Center for Open Science, n.d.; Eggen et al., \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2025\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eThis manuscript is not based upon clinical study or patient data.\u003c/p\u003e\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003eEligibility Criteria\u003c/h2\u003e\u003cp\u003eThe selection of inclusion and exclusion criteria was guided by the Population, Concept, and Context (PCC) framework and is documented in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e (Peters et al., \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). All peer-reviewed, empirical studies published in English that took place in the United States and assessed perinatal outcomes, including patient-reported satisfaction with care, associated with the receipt of prenatal care on a mobile health clinic were considered. No time limits were imposed on the search as we sought to capture the complete body of knowledge that currently exists in the peer-reviewed literature.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eEligibility Criteria\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"2\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eInclusion Criteria\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCriteria\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePopulation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePregnant women and birthing people of all ages in the United States\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eConcept\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePerinatal outcomes, including patient-reported satisfaction with care, associated with the receipt of prenatal care on a mobile health clinic.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eContext\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eEmpirical, peer-reviewed studies in the United States (quantitative, qualitative, or mixed-methods) investigating prenatal care receipt on a mobile unit. No time restrictions were applied.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eExclusion Criteria\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eStudies were excluded if they were: 1) Not empirical studies, 2) Not peer-reviewed, 3) Took place outside of the United States, and 4) Not published in English.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003eInformation Sources and Search Strategy\u003c/h3\u003e\n\u003cp\u003eThe search strategy was developed by a health sciences librarian (AS) in collaboration with the lead author (ME). The search included the following search string adapted to fit each database: \u003cem\u003e((((mobile) OR (van)) AND ((clinic) OR (unit))) AND ((matern*) OR (obstetric) OR (pregna*) OR (prenatal) OR (perinatal) OR (postnatal) OR (antenatal))) NOT ((app) OR (application) OR (phone) OR (cellphone) OR (telemedicine) OR (telehealth))\u003c/em\u003e. Search strings for each database are documented in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e. A systematic search of PubMed, Embase, CINAHL, Health Source, Psychology and Behavioral Sciences Collection, APA PsycInfo, Social Sciences Abstracts, and Web of Science was conducted on December 9, 2024 by the clinical librarian. The database results were imported into Zotero for record keeping and then Covidence on the same day.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eSearch Strings\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"2\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDatabase\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSearch String\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePubMed\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cem\u003e(((\"Mobile Health Units\"[Mesh]) OR (((mobile) OR (van)) AND ((clinic) OR (unit)))) AND ((matern*) OR (obstetric) OR (pregna*) OR (prenatal) OR (perinatal) OR (postnatal) OR (antenatal))) NOT ((app) OR (application) OR (phone) OR (cellphone) OR (telemedicine) OR (telehealth))\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEmbase\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cem\u003e(mobile:ti,ab,kw OR van:ti,ab,kw) AND (clinic:ti,ab,kw OR unit:ti,ab,kw) AND (matern*:ti,ab,kw OR obstetric:ti,ab,kw OR pregna*:ti,ab,kw OR prenatal:ti,ab,kw OR perinatal:ti,ab,kw OR postnatal:ti,ab,kw OR antenatal:ti,ab,kw) NOT (app:ti,ab,kw OR application:ti,ab,kw OR phone:ti,ab,kw OR cellphone:ti,ab,kw OR telemedicine:ti,ab,kw OR telehealth:ti,ab,kw)\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEBSCO (CINAHL, Health Source, Psychology and Behavioral Sciences Collection, PsycInfo, Social Sciences Abstracts)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cem\u003e((((mobile) OR (van)) AND ((clinic) OR (unit))) AND ((matern*) OR (obstetric) OR (pregna*) OR (prenatal) OR (perinatal) OR (postnatal) OR (antenatal))) NOT ((app) OR (application) OR (phone) OR (cellphone) OR (telemedicine) OR (telehealth))\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eWeb of Science\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cem\u003e(((\"Mobile Health Units\"[Mesh]) OR (((mobile) OR (van)) AND ((clinic) OR (unit)))) AND ((matern*) OR (obstetric) OR (pregna*) OR (prenatal) OR (perinatal) OR (postnatal) OR (antenatal))) NOT ((app) OR (application) OR (phone) OR (cellphone) OR (telemedicine) OR (telehealth))\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\n\u003ch3\u003eData Selection, Extraction, and Synthesis\u003c/h3\u003e\n\u003cp\u003eTitle and abstract screening was completed in December 2024 and January 2025. Three reviewers (YL, MU, AM) independently screened all title and abstracts for eligibility criteria using Covidence software (Veritas Health Innovation, 2025). Covidence is a web-based collaboration software platform that streamlines the production of systematic and other literature reviews. The study PI (ME) addressed any disagreements among the reviewers. Four independent reviewers (YL, MU, AM, and ME) read all papers included in the full-text review. Disagreements were addressed through discussion and consensus. References were hand-searched during the full-text review stage to identify eligible papers that may have been missed during databases searches. Following full-text review in Covidence, all eligible papers were exported to a Zotero library for data extraction. All four reviewers extracted data from the included papers independently and a discussion process was used to complete the table. Due to the small number of eligible papers, we did not use the process of pilot data extraction as described in the protocol (Eggen et al., \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2025\u003c/span\u003e). We did not conduct a quality assessment of papers as this is not a requirement for a scoping review (Peters et al., \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e2022\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eData were extracted from included papers and reported in tabular format using the following categories: first author and year of publication, purpose, setting, sample, study design and data source(s), study period, outcome(s) measured, and key findings. This scoping review was not subject to review by an institutional review board.\u003c/p\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec7\" class=\"Section2\"\u003e\u003ch2\u003eStudy Inclusion\u003c/h2\u003e\u003cp\u003e\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003eA total of 5,223 articles were identified using the search strategy. After duplicates were removed (n\u0026thinsp;=\u0026thinsp;927), 4,296 articles underwent title and abstract screening. Among these, fourteen articles met the eligibility criteria and were reviewed in full. Twelve articles were then excluded for not meeting eligibility criteria. Two papers were included in the final review. The search process and results, including reasons for exclusions at the full-text stage, are summarized in a PRISMA flow chart (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\u003ch2\u003eCharacteristics of Included Studies\u003c/h2\u003e\u003cp\u003e\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003eCharacteristics from the two articles included in the review are summarized in Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e. Both studies were published more than 15 years ago with study periods of January 2000 to July 2004 (Edgerley et al., \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2007\u003c/span\u003e) and August 2007 to September 2008 (O\u0026rsquo;Connell et al., \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2010\u003c/span\u003e). Both studies used a retrospective cohort design with a sample of women who initiated care on a mobile health clinic and a comparison group who initiated care in a local community clinic, matched on demographics. Both studies were descriptive and, while one study reported conducting a logistic regression to assess prenatal care utilization and birth outcomes, the results of the regression were not presented in the paper (O\u0026rsquo;Connell et al., \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2010\u003c/span\u003e). Both studies focused on urban areas with one study setting in Redwood City and East Palo Alto, California (Edgerley et al., \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2007\u003c/span\u003e) and the other in Miami-Dade County, Florida (O\u0026rsquo;Connell et al., \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2010\u003c/span\u003e). In both studies, a majority of the sample were immigrants who were either uninsured or covered by Medicaid. One study included primarily Spanish-speaking women (Edgerley et al., \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2007\u003c/span\u003e), and the other study consisted mostly (95%) of foreign-born women (O\u0026rsquo;Connell et al., \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2010\u003c/span\u003e). In one study, the sample consisted of women who used California\u0026rsquo;s Medicaid Program, MediCal, to pay for delivery and prenatal care (Edgerley et al., \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2007\u003c/span\u003e). In the other study, only a small percentage of the study population had Medicaid coverage at delivery (13.2%) and most of the women in the sample used self-payment at delivery (O\u0026rsquo;Connell et al., \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2010\u003c/span\u003e). A key difference in the studies is that the mobile health clinic in the California study was used as a point of care initiation only (Edgerley et al., \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2007\u003c/span\u003e). Women who began their prenatal care on the mobile unit would then transfer to a community clinic to receive the remainder of their prenatal care. In the Miami-Dade County study, women could both begin and continue with prenatal care visits on the mobile clinic (O\u0026rsquo;Connell et al., \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2010\u003c/span\u003e).\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eCharacteristics of Included Studies\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"8\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFirst Author, Year of Publication\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePurpose\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eSetting\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eSample\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eStudy Design and Data Source(s)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eStudy Period\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003eOutcome(s) Measured\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\"\u003e\u003cp\u003eKey Findings\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e(Edgerley et al., \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2007\u003c/span\u003e)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eTo examine whether the use of a community mobile health van allows for earlier access to prenatal care and higher rates of adequate care, compared to care initiated in community clinics.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eLow-income neighborhoods in Redwood City and East Palo Alto, CA\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003eMobile unit group\u003c/b\u003e: n\u0026thinsp;=\u0026thinsp;108 women enrolled in MediCal who initiated prenatal care on the mobile unit; 81.5% spoke Spanish as primary language\u003c/p\u003e\u003cp\u003e\u003cb\u003eComparison (Clinic) group\u003c/b\u003e: n\u0026thinsp;=\u0026thinsp;127 women covered by MediCal who initiated prenatal care in a community clinic; 84.2% spoke Spanish as primary language.\u003c/p\u003e\u003cp\u003eBoth groups included only singleton births delivered at Lucile Packard Hospital\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eRetrospective cohort study; birth records and a hospital database of infant medical records\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eJanuary 1, 2000-July 4, 2004\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eOnset of prenatal care, number of prenatal visits, adequacy of care using the Revised Graduated Index of Prenatal Care Utilization (R-GINDEX), gestational age at delivery, delivery method, NICU admission, birthweight.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eMobile unit group initiated prenatal care three weeks earlier (10.2\u0026thinsp;\u0026plusmn;\u0026thinsp;6.9 weeks) than clinic group (13.2\u0026thinsp;\u0026plusmn;\u0026thinsp;6.9 weeks); van and clinic patients equally likely to receive adequate prenatal care; no significant differences in other outcomes.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e(O\u0026rsquo;Connell et al., \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2010\u003c/span\u003e)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eTo assess differences in prenatal care utilization and birth outcomes among women who used a mobile van as a source of prenatal care compared to women who received in-clinic care.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eMiami-Dade County, FL\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003eMobile unit group\u003c/b\u003e: n\u0026thinsp;=\u0026thinsp;182 mothers who accessed prenatal care at least one time on the van and delivered an infant during the study period; 94.5% foreign-born.\u003c/p\u003e\u003cp\u003e\u003cb\u003eComparison (Clinic) group\u003c/b\u003e: n\u0026thinsp;=\u0026thinsp;182 mothers who delivered an infant during the study period and resided in the zip codes in which the mobile unit mothers resided; 96.2% foreign-born.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eRetrospective cohort study; medical records and Vital Statistics\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eAugust 2007-September 2008\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eTrimester of prenatal care initiation, adequacy of care using the Kessner and Kotelchuck Indices), birthweight, gestational age, congenital anomalies, abnormal conditions of the newborn.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eMobile unit group more likely to have first-trimester prenatal care (81%) compared to clinic group (63.2%) (p\u0026thinsp;=\u0026thinsp;0.0006); mobile group had a higher rate of adequate prenatal care (88.5%) compared to clinic group (73.1%)\u003c/p\u003e\u003cp\u003ePreterm births were lower in the mobile unit group (5.0% vs. 10.4%, p\u0026thinsp;=\u0026thinsp;0.0492); mean weeks of gestation for mobile unit was 39.2 +- 1.3 and clinic group was 38.6 +- 2.3 (p\u0026thinsp;=\u0026thinsp;0.01). No other statistically significant differences between the mobile unit and clinic groups were observed.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003ePerinatal Outcomes\u003c/h3\u003e\n\u003cp\u003eIn assessing the impact of the use of mobile health clinics on perinatal outcomes, Edgerley and colleagues (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2007\u003c/span\u003e) measured prenatal care timing and adequacy, gestational age at onset of care and delivery, birthweight, delivery method, and percentage admission to the neonatal intensive care unit (NICU). O\u0026rsquo;Connell and colleagues (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2010\u003c/span\u003e) assessed prenatal care utilization (timing and adequacy) and birth outcomes, including preterm birth, birthweight, gestational age at delivery, congenital anomalies and abnormal conditions (O\u0026rsquo;Connell et al., \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2010\u003c/span\u003e). The findings of each study as it relates to perinatal outcomes is detailed below.\u003c/p\u003e\n\u003ch3\u003ePrenatal Care Timing and Adequacy\u003c/h3\u003e\n\u003cp\u003eIn both studies, a higher percentage of women who initiated care on a mobile health clinic (mobile group) did so earlier than those who initiated care in a clinic setting (comparison group). In the study of mostly foreign-born women in Miami-Dade County, 81% of mothers in the mobile group started prenatal care in the first trimester compared to 63.2% in the comparison group (p\u0026thinsp;=\u0026thinsp;0.0006). Using the Kessner Index, the study identified a significant difference in the receipt of adequate prenatal care between the mobile group (88.5%) versus the comparison group (73.1%) (p\u0026thinsp;=\u0026thinsp;0.0003) Similarly, using the Kotelchuck Index as a measurement tool, the study authors found that more mothers in the mobile group (77.5%) had adequate prenatal care compared to mothers in the comparison group (61.5%) (p\u0026thinsp;\u0026lt;\u0026thinsp;0.0001). Among mothers in the mobile group, the median number of prenatal care visits was five with 33.0% of mothers visiting the mobile clinic for care fewer than three times and 8.2% visiting more than ten times (O\u0026rsquo;Connell et al., \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2010\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eEdgerley and colleagues (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2007\u003c/span\u003e) measured prenatal care adequacy using the Revised Graduated Index of Prenatal Care Utilization (R-GINDEX). The authors found that prenatal care adequacy (adequate plus or adequate) was higher among the mobile group (44.4%) versus the comparison group (34.6%) though the difference was not statistically significant (p\u0026thinsp;=\u0026thinsp;0.13). Mothers in the mobile group began care three weeks earlier than women in the comparison group (p\u0026thinsp;=\u0026thinsp;0.001) (Edgerley et al., \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2007\u003c/span\u003e).\u003c/p\u003e\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e\u003ch2\u003eDelivery Method\u003c/h2\u003e\u003cp\u003eOne study reported delivery method and found no differences when comparing mobile health clinic users (vaginal: 85.2%, cesarean: 14.8%) and women in the comparison group (vaginal: 85.0%, cesarean: 15.0%) (p\u0026thinsp;=\u0026thinsp;0.98) (Edgerley et al., \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2007\u003c/span\u003e).\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec12\" class=\"Section2\"\u003e\u003ch2\u003eGestational Age at Delivery\u003c/h2\u003e\u003cp\u003eO\u0026rsquo;Connell and colleagues (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2010\u003c/span\u003e) found that women in the mobile group had a higher mean number of weeks gestation at delivery (39.2 weeks\u0026thinsp;\u0026plusmn;\u0026thinsp;1.3) relative to the comparison group (38.6 weeks\u0026thinsp;\u0026plusmn;\u0026thinsp;2.3) (p\u0026thinsp;=\u0026thinsp;0.01). Edgerley and colleagues reported no differences when comparing the mobile group (39.5\u0026thinsp;\u0026plusmn;\u0026thinsp;1.5 weeks) to the comparison group (39.2\u0026thinsp;\u0026plusmn;\u0026thinsp;1.9 weeks) (p\u0026thinsp;=\u0026thinsp;0.20) (Edgerley et al., \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2007\u003c/span\u003e).\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec13\" class=\"Section2\"\u003e\u003ch2\u003ePreterm Birth\u003c/h2\u003e\u003cp\u003eO\u0026rsquo;Connell and colleagues (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2010\u003c/span\u003e) reported a statistically significant difference in the rate of preterm birth in the mobile group (5.0%) relative to the comparison group (10.4%) (p\u0026thinsp;=\u0026thinsp;0.0492), after adjusting for potential confounders. Results of the logistic regression were not available in the paper and the authors did not identify the confounders that were considered in the model.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec14\" class=\"Section2\"\u003e\u003ch2\u003eCongenital Anomalies and Abnormal Conditions\u003c/h2\u003e\u003cp\u003eNo infants born to mothers in the mobile health clinic group had a congenital anomaly compared to seven infants (0.55%) in the comparison group (p\u0026thinsp;=\u0026thinsp;0.3166). The authors reported no statistically significant differences in abnormal conditions when comparing the mobile health clinic group (5.0%) to the comparison group (3.9%) (p\u0026thinsp;=\u0026thinsp;0.6901) (O\u0026rsquo;Connell et al., \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2010\u003c/span\u003e).\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec15\" class=\"Section2\"\u003e\u003ch2\u003eNICU Admissions\u003c/h2\u003e\u003cp\u003eOne study reported a lower rate of NICU admissions among infants born to mothers in the mobile group (8.3%) relative to the comparison group (14.2%) (p\u0026thinsp;=\u0026thinsp;0.16) (Edgerley et al., \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2007\u003c/span\u003e).\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec16\" class=\"Section2\"\u003e\u003ch2\u003eBirthweight\u003c/h2\u003e\u003cp\u003eNo differences in infant birthweight were identified in the study of primarily Spanish speaking patients covered by Medicaid in California (Edgerley et al., \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2007\u003c/span\u003e). O\u0026rsquo;Connell and colleagues (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2010\u003c/span\u003e) reported a lower percentage of low birthweight infants among the mobile group (4.4%) relative to the comparison group (8.8%) (p\u0026thinsp;=\u0026thinsp;0.0911).\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec17\" class=\"Section2\"\u003e\u003ch2\u003eSelf-reported satisfaction with care\u003c/h2\u003e\u003cp\u003eNeither study included an assessment of self-reported satisfaction with prenatal care.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec18\" class=\"Section2\"\u003e\u003ch2\u003eGaps and Opportunities for Future Research, Policy and/or Practice\u003c/h2\u003e\u003cp\u003eRecommended opportunities for future research included the use of larger and more diverse samples to increase statistical power and increase external validity of the results (Edgerley et al., \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2007\u003c/span\u003e). Both studies used data collected from infant birth certificates and medical records, which may have limited the ability to control for confounding factors and to use a study design that takes into account self-selection bias (Edgerley et al., \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2007\u003c/span\u003e; O\u0026rsquo;Connell et al., \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2010\u003c/span\u003e). Primary data collection using questionnaires or interviews was recommended as a means for gathering more detailed information regarding maternal factors and outcomes (O\u0026rsquo;Connell et al., \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2010\u003c/span\u003e).\u003c/p\u003e\u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis scoping review synthesized the peer-reviewed literature regarding perinatal outcomes and patient-reported satisfaction with prenatal care among women who initiated and/or received care on a mobile health clinic in the United States. A key finding of this scoping review was a gap in the literature regarding the effectiveness and acceptability of receiving prenatal care on a mobile health clinic. The absence of recent research underscores the need to reassess and update the relevance and utility of mobile clinics in the current maternal health landscape, especially in light of ongoing maternity care workforce shortages and persistent disparities in access to prenatal care. Importantly, neither study included a measure of patient-reported satisfaction with care, an important aspect of quality of care. Despite the limited number of studies, the findings of this review offer some insight into the potential benefits of mobile health clinics for increasing access to prenatal care and improving perinatal outcomes. Additionally, the findings point to opportunities for future work in this area.\u003c/p\u003e\u003cp\u003eThe two studies in this review focused primarily on immigrants in urban areas who were uninsured or covered by Medicaid. Women from immigrant communities face structural barriers to accessing timely and adequate prenatal care, including challenges with transportation to and from healthcare visits, language barriers, lack of trust towards prenatal care providers in their communities, and systematic exclusion from Medicaid coverage (Camargo et al., \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2023\u003c/span\u003e; Janevic et al., \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). Similarly, rural-residing women with Medicaid coverage experience systemic barriers to care such as lack of providers in their community willing to accept Medicaid, transportation, and childcare challenges. These challenges contribute to higher rates of delayed or no prenatal care compared to women who have private insurance (Armstrong-Mensah et al., \u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2021\u003c/span\u003e; Bellerose et al., \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). Given the increasing closures of hospital obstetric units in primarily rural states and shrinking maternity care workforce, there is a need to evaluate the effectiveness and acceptability of mobile health clinics in delivering prenatal care in rural communities (U.S. Government Accountability Office, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). The growing number of mobile health clinics in rural communities across the country provides ample opportunity to evaluate both the effectiveness of mobile health clinics in delivering prenatal care and patient satisfaction with care (Mobile Health Map, n.d.).\u003c/p\u003e\u003cp\u003eWhile the studies in this review provide suggestive findings that mobile health clinics may increase prenatal care utilization and adequacy among marginalized women, the retrospective and descriptive research designs inherently introduce bias. While both studies matched women in the mobile health clinic and comparison groups on maternal factors, there is uncertainty regarding unobserved sociodemographic variables that were not available in birth records or electronic medical records. The use of larger sample sizes, more robust research designs, and richer data sources can facilitate a better understanding of the impact of mobile health clinics on prenatal care access and outcomes across diverse populations and communities. The use of randomized controlled trials can mitigate the selection bias that was a limitation of the study designs in this review. Additionally, qualitative studies that explore the mechanisms by which mobile health clinics alleviate social drivers of health to increase access to prenatal care can provide insights for the development of effective policy and practice levers. Future studies should integrate a measure of patient satisfaction to better understand the acceptability of this mode of care delivery among women.\u003c/p\u003e\u003cp\u003eOverall, the findings of this review suggest that mobile health clinics may be a useful strategy in increasing early and adequate prenatal care access among marginalized populations in United States. However, there is a dearth of research exploring the impact of mobile prenatal care on perinatal outcome and no research regarding patient satisfaction, cultural relevance, or economic feasibility of this mode of care delivery model in a contemporary context.\u003c/p\u003e"},{"header":"Limitations","content":"\u003cp\u003eThis review has several limitations. First, it included two studies, both of which focused on small homogeneous samples in urban areas, were published more than ten years ago, and employed retrospective research designs. These limitations reduce the generalizability of findings to other communities and populations. Our decision to exclude grey literature may have limited the inclusion of more recent evidence regarding the effectiveness of mobile health clinics in delivering prenatal care and improving outcomes. The lack of peer-reviewed publications highlights the need for additional research in this area.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eThis scoping review provides some evidence of the impact that mobile health clinics have on increasing access to prenatal care and improving perinatal outcomes. Our findings highlight the need for additional research to guide policy and practice decisions to improve access to prenatal care and provide evidence to inform resource allocation to diverse modes of care delivery. Future studies that examine the cost-effectiveness of prenatal mobile health clinics can further inform policy development to support this innovation.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFunding for this scoping review was provided by the Kentucky Cabinet for Health and Family Services through a State University Partnership titled \u0026ldquo;Bridging Healthcare Disparities.\u0026rdquo; The funder had no role in the review\u0026rsquo;s design, analysis, or reporting.\u003c/p\u003e\n\u003cp\u003eEthics approval and consent to participate\u003c/p\u003e\n\u003cp\u003eNot applicable as this study is not a clinical trial.\u003c/p\u003e\n\u003cp\u003eConsent for publication\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003eConflict of Interest/ Competing interests\u003c/p\u003e\n\u003cp\u003eThe authors have no competing interests to declare that are relevant to the content of this article.\u003cstrong\u003e\u003cbr\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors and Affiliations\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eMelissa Eggen PhD, MPH\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eUniversity of Louisville School of Public Health and Information Sciences\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eDepartment of Health Management and Systems Sciences\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e485 E Gray St, Louisville, KY 40202\u0026nbsp;\u003c/p\u003e\n\u003cp\[email protected]\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eYiru Lou, MPH\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eUniversity of Louisville School of Public Health and Information Sciences\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eDepartment of Health Promotion and Behavioral Sciences\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e485 E Gray St, Louisville, KY 40202\u0026nbsp;\u003c/p\u003e\n\u003cp\[email protected]\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAnika Mehta, MSc, MTech\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eUniversity of Louisville School of Public Health and Information Sciences\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eDepartment of Health Management and Systems Sciences\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e485 E Gray St, Louisville, KY 40202\u0026nbsp;\u003c/p\u003e\n\u003cp\[email protected]\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAnsley Stuart, MSIS \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eUniversity of Louisville \u0026ndash; University Libraries\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eKornhauser Health Sciences Library\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e540 S. Preston St., Louisville, KY 40202\u0026nbsp;\u003c/p\u003e\n\u003cp\[email protected]\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eMelody Ucho\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eUniversity of Louisville School of Public Health and Information Sciences\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eDepartment of Health Management and Systems Sciences\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e485 E Gray St, Louisville, KY 40202\u0026nbsp;\u003c/p\u003e\n\u003cp\[email protected]\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eSara A. Choate, PhD\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eUniversity of Louisville School of Public Health and Information Sciences\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eDepartment of Health Promotion and Behavioral Sciences\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e485 E Gray St, Louisville, KY 40202\u0026nbsp;\u003c/p\u003e\n\u003cp\[email protected]\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eEthics approval and consent to participate\u003c/p\u003e\n\u003cp\u003eNot applicable as this study is not a clinical trial.\u003c/p\u003e\n\u003cp\u003eConsent for publication\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003eConflict of Interest/ Competing interests\u003c/p\u003e\n\u003cp\u003eThe authors have no competing interests to declare that are relevant to the content of this article.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eArmstrong-Mensah E, Dada D, Bowers A, Muhammad A, Nnoli C. 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Int J Equity Health. 2017;16(1):178. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1186/s12939-017-0671-2\u003c/span\u003e\u003cspan address=\"10.1186/s12939-017-0671-2\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"","lastPublishedDoi":"10.21203/rs.3.rs-7686229/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7686229/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eIntroduction\u003c/h2\u003e\u003cp\u003eThis paper aimed to synthesize existing evidence regarding perinatal outcomes and patient-reported satisfaction associated with receiving prenatal care on a mobile health clinic in communities with limited access to care.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003eWe included peer-reviewed, empirical studies from open databases, conducted in the United States, that examined perinatal outcomes and/or patient experiences related to mobile clinic-based prenatal care.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eTwo papers were eligible. Both focused on urban settings and foreign-born and/or Spanish speaking populations covered by Medicaid or uninsured. Both studies reported earlier initiation of women receiving prenatal care on a mobile health clinic compared to clinic-based care. Neither study reported patient satisfaction with care.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e\u003cp\u003eDespite growing use of mobile health clinics for prenatal care in the U.S., few studies have evaluated perinatal outcomes or patient satisfaction. Further research is needed to assess the effectiveness and acceptability of prenatal care delivered through mobile health clinics.\u003c/p\u003e","manuscriptTitle":"Perinatal Outcomes and Patient-Reported Satisfaction Associated with the Receipt of Prenatal Care via a Mobile Health Clinic: A Scoping Review","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-11-03 10:28:01","doi":"10.21203/rs.3.rs-7686229/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"32fde3e9-bb46-4318-9d9c-afe2ff9e39bc","owner":[],"postedDate":"November 3rd, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-11-26T09:24:18+00:00","versionOfRecord":[],"versionCreatedAt":"2025-11-03 10:28:01","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7686229","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7686229","identity":"rs-7686229","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}