Evaluation of the Mobile Health Clinic Event to Address School Enrollment Barriers in Vulnerable Populations

ABSTRACTBackground: In North Carolina, children must have a completed Health Assessment Transmittal Form and up-to-date immunizations within 30 days of school entry. Children from uninsured and medically underserved families may face barriers to completing these requirements, increasing risk for delayed enrollment or temporary exclusion. Mobile Health Clinics (MHCs) offer a community-based strategy to address these barriers; however, multisector school-entry events require coordinated workflow and system integration to function efficiently.Purpose: This program evaluation aimed to evaluate the implementation, reach, workflow functioning, and participant experience of the 2025 Wake County, North Carolina school health assessment event led by the UNC School of Nursing Mobile Health Clinic (UNC-SON-MHC) in collaboration with public health and community partners, and to inform strategies to improve future MHC-led school entry events.Methods: Guided by the CDC Program Evaluation Framework, this mixed-methods evaluation analyzed Pediatric Intake Forms (N = 74), structured observational field notes, time-tracking data, and post-event surveys completed by families (N = 40) and staff/volunteers (N = 25). Evaluation domains included demographic reach, insurance and primary care access, service outputs, workflow efficiency, vaccine coordination, and stakeholder feedback.Results: Seventy-four children completed school-entry health assessments, 76 completed hearing screenings, and 27 received 55 vaccine doses. Participating children represented diverse racial and ethnic backgrounds; 67.6% were uninsured. Among surveyed families (N = 40), 72.5% reported their child did not have a regular primary care provider. Family satisfaction was high, with 100% reporting their questions were answered and 95% indicating they would recommend the event. Key workflow challenges included role ambiguity, documentation inefficiencies, and limited real-time immunization record access at registration, highlighting opportunities to improve role clarity, streamline documentation, and strengthen vaccine coordination at entry.Conclusion: The event was feasible and successful in reaching children facing significant access barriers. Findings support mobile, community-based school-entry events as a viable strategy to promote equitable access and school readiness. Future events may benefit from clearer onboarding, centralized vaccine determination at registration, defined documentation roles, and pre-event workflow walkthroughs to improve coordination while maintaining accessibility and positive participant experience.