Utilizing multidisciplinary mobile outreach clinics to provide comprehensive diabetic foot care to patients experiencing homelessness

Social determinants of health (SDoH) challenges can limit health care access and impose significant barriers to care, which have been amplified during the COVID-19 pandemic. We sought to evaluate the feasibility of implementing a multidisciplinary mobile outreach clinic for unhoused individuals with a focus on diabetic foot care and screening to overcome the SDoH-associated barriers to care. The multidisciplinary mobile clinic (MMC) model focused on a physician-driven volunteer initiative to recruit medical specialties in diabetic foot care from a large academic medical center. The MMC focused on providing diabetic foot ulcer care and screening because it is a complex medical problem that disproportionately impacts unhoused individuals and requires multidisciplinary care. Our group of academic-affiliated medical professionals partnered with existing community services to build relationships and trust with our target patient population. To determine whether MMCs are a feasible and sustainable model to improve health care access for communities impacted by limited SDoH resources, we measured the number of volunteers and medical services who participated in seven outreach clinic events over a 3-year period. SDoH-related factors impacting access to healthcare were evaluated using a Barriers to Access and Care Survey administered to MMC patient participants. From June 2020 to November 2023, a total of 241 patients were seen at seven multidisciplinary mobile clinics. All patients received health resources and donated items including new socks and shoes. Each clinic was fully staffed with over 50 volunteer medical providers. Additionally, we completed Barriers to Access and Care Surveys that showed personal resources and community stigma as being the largest barriers to care. By using the physical infrastructure established by partner organizations, the MMCs were able to integrate, at low cost, into existing community services to reach the target population. We report a feasible methodology for leveraging hospital-based resources to build MMCs in partnership with local community programs to provide multidisciplinary care to populations impacted by SDoH risks. This study reflects the valuable lessons we learned in optimizing MMC events for maximum community benefit.