A Systematic Review of Interventions to Minimize Transportation Barriers Among People with Chronic Diseases

Laura E. Starbird, Caitlin DiMaina, Chun An Sun, Hae Ra Han

Research output: Contribution to journalReview articlepeer-review

Abstract

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.

Original languageEnglish (US)
Pages (from-to)400-411
Number of pages12
JournalJournal of Community Health
Volume44
Issue number2
DOIs
StatePublished - Apr 1 2019

Keywords

  • Chronic disease
  • Healthcare access
  • Systematic review
  • Transportation

ASJC Scopus subject areas

  • Health(social science)
  • Public Health, Environmental and Occupational Health

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