Van Drives Nursing, Research

UNC School of Nursing faculty Marianne Cockroft, far left, and Wanda Wazenegger, far right, join nursing students Katie Steinheber and Mairo Bori to provide clinical care to Wake County residents.

UNC School of Nursing faculty Marianne Cockroft, far left, and Wanda Wazenegger, far right, join nursing students Katie Steinheber and Mairo Bori to provide clinical care to Wake County residents.

By Morag MacLachlan, Communications Director, UNC’s Institute for Global Health & Infectious Diseases (IGHID) and Kelly Kirby, Communications Director, UNC School of Nursing

A white nondescript van is making the rounds in central North Carolina bringing clinical care, experiential education and reliable research results along for the ride.

Healy is the mobile health van owned by the Division of Infectious Diseases within the UNC School of Medicine. Initially purchased in 2010 to meet study volunteers in the community, the van is now rented to other departments and schools at UNC. The School of Nursing sets off in the van each Tuesday to see chronically ill, low-income patients in Wake County.

“For us, it’s been fantastic,” says Becky Sidden, executive director of Western Wake Crisis Ministry in Apex. “We were able to provide our clients with food and financial assistance, but we were unable to provide health screenings until this partnership.”

Western Wake Crisis Ministry serves 703 households or 2,310 individuals in Wake County. A survey conducted in December 2015 revealed that chronic illnesses, like diabetes, depression and seizures, were one of the top reasons residents sought financial assistance through Western Wake Crisis Ministry.

This nurse-led, nurse-run clinic provides a free health assessment as well as educational materials to help patients manage their own health needs. With regular checkups and better disease management, chronically ill patients can improve their long-term health outlook and avoid costly emergency room visits and ambulance services.

“We provide blood pressure and blood sugar screenings as well as education on chronic disease self-management,” says Mairo Bori, BSN, RN, who is earning her master’s degree in nursing. “It’s been a wonderful opportunity for clients to learn about their health. I have really enjoyed giving back to the community.”

Nursing students also gain exposure to community nursing and have learned that many clients relish the opportunity to ask health questions without the pressure that their provider needs to rush off to the next appointment.

“This is my first experience with community nursing and it has given me insight into the needs of the community we are serving,” says Katie Steinheber, RN, who is studying to become a nurse practitioner. “The educational aspect is huge because we are teaching the clients about self-management. And we have time to listen to them because we are not facing the normal health provider time constraints patients often face in a doctor’s office.”

The van allows the Division of Infectious Diseases to reach study volunteers in the community, improving the validity of research results.

The van allows the Division of Infectious Diseases to reach study volunteers in the community, improving the validity of research results.

Reliable Research Results
The Division of Infectious Diseases originally purchased the van in 2010 to make it easier for research participants to stay on study. Having timely data also maintains the validity of research results.

“Every research center needs this van. Our data scores would be so much lower without it,” says Becky Straub, RN, MPH, a clinical research nurse in the Division of Infectious Diseases. “People need to get to work or their car breaks down, which would prevent them from being able to come into Chapel Hill for a study visit. But we can take the van and go to them. We get the data, and they can get right back to living their lives.”

The non-descript nature of the van and the blinds on its windows mean Straub and other research staff can meet a study volunteer out in the community without compromising confidentiality. This was especially helpful during a study that measured liver enzyme levels, says Erin Hoffman, clinical research coordinator in the Division of Infectious Diseases.

“We had a healthy study volunteer whose levels were high, so we had to do a weekly blood draw,” Hoffman says. “It would have been impossible to ask this person to drive to Chapel Hill each week. We were able to drive to her and do a quick blood draw on the van without attracting any unwanted attention. This was not only more convenient for her, but it was also cost-effective for us because we didn’t have to book a space in the hospital to draw her blood each week.”

The majority of studies done by the Division focus on treating people living with HIV. Hoffman and fellow clinical research coordinator Miriam Chicurel-Bayard, RN, will often travel the 60 miles southeast of Chapel Hill to Dunn, NC, to connect with study volunteers at CommWellHealth. Data collected on the van has had a global impact. The van was used for the domestic arm of the groundbreaking START Trial, which showed that immediately starting people diagnosed with HIV on antiretroviral therapy improved both their short- and long-term health, and made them less infectious than delaying beginning anti-HIV medications until their T-cell count dropped. The START trial results prompted the World Health Organization to change its treatment guidelines in September 2015.

“The main point of research is to collect good data,” says Chicurel-Bayard. “This van allows us to do just that and it gives our generous study volunteers options. People appreciate options, and we are happy to offer them that flexibility and understanding because after all, they are volunteering.”

For more information about Healy, the mobile health van, visit www.researchvan.com.