An equity-focused approach to improving access to COVID-19 vaccination using mobile health clinics.

This article describes the implementation of an equity-focused strategy to increase the uptake of COVID-19 vaccination among communities of color and in traditionally underserved geographic areas using mobile health clinics (MHCs). The MHC Vaccination Program was implemented through a large integrated healthcare system in North Carolina using a grassroots development and engagement strategy along with a robust model for data-informed decision support to prioritize vulnerable communities. Several valuable lessons from this work can replicated for future outreach initiatives and community-based programming: •Health systems can no longer operate under the assumption that community members will come to them, particularly those experiencing compounding social and economic challenges. The MHC model had to be a proactive outreach to community members, rather than a responsive delivery mechanism. •Barriers to access included financial, legal, and logistical challenges, in addition to mistrust among historically underserved and marginalized communities. •A MHC model can be adaptable and responsive to data-informed decision-making approaches for targeted service delivery. •A MHC model is not a one-dimensional solution to access, but part of a broader strategy to create diverse points of entry into the healthcare system that fall within the rhythm of life of community members.

Participation in Clinical Trials Among Academic Dermatologists Affiliated With Veterans Affairs Hospitals: Survey Study.

Background: Clinical trials have led to the development of new and effective therapies for many dermatologic conditions. To our knowledge, there is no published study that has quantified and described the degree of involvement in clinical trials among academic dermatologists and their university affiliates. Objective: The purpose of this study was to characterize the involvement of academic dermatology departments in clinical trials research. Methods: An online survey was sent to 211 Veterans Affairs (VA)-employed dermatologists. It comprised 20 questions related to the number of clinical trials, support staff dedicated to clinical research, skin diseases studied, and the effect of the COVID-19 pandemic on conducting clinical research. Three rounds of survey invitations were sent over a 3-month period (March to May 2021). Data from all survey responses were reviewed for quantitative and descriptive analyses of the key outcome measures. Results: A total of 48 dermatologists completed the survey and provided their university affiliations and details of involvement in clinical trials research. Over half of participants (n=25, 58.1%) with a university affiliate reported that their affiliated dermatology department had a dedicated clinical trials unit. Basal cell carcinoma was the most frequently studied skin condition (n=9, 18.8%), followed by atopic dermatitis and psoriasis (n=4, 8.3% each); 66.7% of participants reported no current clinical trials participation. Of those conducting clinical trials, 87% (n=18) noted that COVID-19 was a barrier to conducting trials, with 52.2% (n=11) citing disrupted or decreased trials due to the pandemic. Conclusions: Although many dermatologists with university affiliations reported having a dedicated clinical trials unit at their institution, a majority of those surveyed reported not taking part in any active trials. Overall, the diseases investigated in academic clinical trials appear to follow national trends, though some of the top dermatological diseases are underrepresented in clinical trials research. A key limitation of our study was the low response rate (~23%) and that the survey responses from the sample of VA-based dermatologists may not be generalizable to all academic dermatology departments in the United States. The effect of the COVID-19 pandemic appeared to play a significant role in disrupting active trials.