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A Systematic Review of Interventions to Minimize Transportation Barriers Among People with Chronic Diseases.
Starbird, Laura E; DiMaina, Caitlin; Sun, Chun-An; Han, Hae-Ra.
Afiliación
  • Starbird LE; Center for Health Policy, Columbia University School of Nursing, 560 W. 168th Street, New York, NY, 10032, USA. les2163@cumc.columbia.edu.
  • DiMaina C; Johns Hopkins University School of Nursing, Baltimore, MD, USA.
  • Sun CA; Johns Hopkins University School of Nursing, Baltimore, MD, USA.
  • Han HR; Center for Cardiovascular and Chronic Care, Johns Hopkins University School of Nursing, Baltimore, MD, USA.
J Community Health ; 44(2): 400-411, 2019 04.
Article en En | MEDLINE | ID: mdl-30206755
Transportation is an important social determinant of health. Transportation barriers disproportionately affect the most vulnerable groups of society who carry the highest burden of chronic diseases; therefore, it is critical to identify interventions that improve access to transportation. We synthesized evidence concerning the types and impact of interventions that address transportation to chronic care management. A systematic literature search of peer-reviewed studies that include an intervention with a transportation component was performed using three electronic databases-PubMed, EMBASE, and CINAHL-along with a hand-search. We screened 478 unique titles and abstracts. Two reviewers independently evaluated 41 full-text articles and 10 studies met eligibility criteria for inclusion. The transportation interventions included one or more of the following: providing bus passes (n = 5), taxi/transport vouchers or reimbursement (n = 3), arranging or connecting participants to transportation (n = 2), and a free shuttle service (n = 1). Transportation support was offered within multi-component interventions including counseling, care coordination, education, financial incentives, motivational interviewing, and navigation assistance. Community health/outreach workers (n = 3), nurses (n = 3), and research or clinic staff (n = 3) were the most common interventionists. Studies reported improvements in cancer screening rates, chronic disease management, hospital utilization, linkage and follow up to care, and maternal empathy. Overall, transportation is a well-documented barrier to engaging in chronic care among vulnerable populations. We found evidence suggesting transportation services offered in combination with other tailored services improves patient health outcomes; however, future research is warranted to examine the separate impact of transportation interventions that are tested within multi-component studies.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Transportes / Enfermedad Crónica / Atención a la Salud / Accesibilidad a los Servicios de Salud Tipo de estudio: Prognostic_studies / Systematic_reviews Aspecto: Determinantes_sociais_saude / Implementation_research Límite: Humans Idioma: En Revista: J Community Health Año: 2019 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Países Bajos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Transportes / Enfermedad Crónica / Atención a la Salud / Accesibilidad a los Servicios de Salud Tipo de estudio: Prognostic_studies / Systematic_reviews Aspecto: Determinantes_sociais_saude / Implementation_research Límite: Humans Idioma: En Revista: J Community Health Año: 2019 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Países Bajos