Lessons learned from a sustained mobile prenatal care delivery program: results from a mixed-methods evaluation to understand appointment attendance and patient satisfaction

Persistent racial and socioeconomic disparities in prenatal care attendance in the United States are driven by structural barriers, including transportation challenges, inflexible scheduling, and limited access to culturally responsive services. Mobile health clinics (MHCs) may mitigate these barriers by delivering care directly within underserved communities; however, evidence evaluating their effectiveness relative to fixed-site clinics (FSCs) remains limited. We conducted a mixed-methods evaluation of OhioHealth’s Wellness on Wheels Women’s Health (WOW-WH) mobile prenatal care program in Central Ohio, comparing appointment adherence and patient and provider experiences with two FSCs. Quantitative electronic medical record data were used to assess no-show rates for prenatal visits from July 2022 through June 2023. Differences in attendance across sites were analyzed using chi-square tests. Qualitative data were collected through seven focus groups with patients and providers and analyzed using the Practical, Robust Implementation and Sustainability Model (PRISM) to identify implementation-related facilitators and barriers influencing appointment adherence. The WOW-WH MHC demonstrated significantly lower prenatal care no-show rates (5.71%) compared with both FSCs (8.05% and 12.23%; χ² test, p < 0.001). Qualitative findings highlighted strong provider–patient relationships, proximity of services, and access to wraparound supports as key facilitators of appointment adherence. Identified barriers included fragmented scheduling processes and limited availability of interpreter services. This evaluation demonstrates that mobile prenatal care delivery is associated with improved appointment adherence compared with traditional fixed-site models. Integration of social services and continuity of provider teams fostered trust and engagement among patients. MHCs represent a scalable and sustainable strategy for advancing prenatal care access and promoting health equity. Targeted investments in mobile infrastructure, centralized scheduling, and language access services may further enhance the effectiveness of MHC-based prenatal care models.