# Developing a Public Health Quality Tool for Mobile Health Clinics to Assess and Improve Care

## TL;DR

This paper introduces a new tool to help mobile health clinics assess and improve the quality of their public health services, focusing on equity and efficiency.

## Contribution

The paper presents the development of the PHQTool, a novel, evidence-based quality assessment tool tailored for mobile health clinics.

## Key findings

- 82 mobile health clinics used the PHQTool and reported high usability and identified areas for improvement like outreach and equity.
- A majority of users agreed the tool was user-friendly and relevant to their work.
- The PHQTool supports systematic quality assessment and promotes accountability in mobile health clinics.

## Abstract

Public health relevance—How does this work relate to a public health issue?
It illustrates how to translate broad public health quality aims into practical, measurable strategies.It offers a model for applying quality assessment and quality improvement processes in the practice of public health.

It illustrates how to translate broad public health quality aims into practical, measurable strategies.

It offers a model for applying quality assessment and quality improvement processes in the practice of public health.

Public health significance—Why is this work of significance to public health?
It fills a major gap, with a straightforward, evidence-based quality improvement tool for public health programs to meaningfully participate in quality assessment.The PHQ Tool highlights the value mobile clinics add to strengthening the broader public health and healthcare systems.

It fills a major gap, with a straightforward, evidence-based quality improvement tool for public health programs to meaningfully participate in quality assessment.

The PHQ Tool highlights the value mobile clinics add to strengthening the broader public health and healthcare systems.

Public health implications—What are the key implications or messages for practitioners, policy makers and/or researchers in public health?
Measuring quality in public health enables more targeted, effective population level improvements, giving practitioners clear, actionable strategies to enhance equity and impact.Aggregated quality data strengthens advocacy and informs funding and policy decisions, elevating mobile clinics as essential contributors to population health.

Measuring quality in public health enables more targeted, effective population level improvements, giving practitioners clear, actionable strategies to enhance equity and impact.

Aggregated quality data strengthens advocacy and informs funding and policy decisions, elevating mobile clinics as essential contributors to population health.

This report describes the development and deployment of the Public Health Quality Tool (PHQTool), an online resource designed to help mobile health clinics (MHCs) assess and improve the quality of their public health services. MHCs provide essential clinical and public health services to underserved populations but have historically lacked tools to assess and improve the quality of their work. To address this gap, the PHQTool was developed as an online, evidence-based, self-assessment resource for MHCs, hosted on the Mobile Health Map (MHMap) platform. This report documents the collaborative development process of the PHQTool and presents preliminary evaluation findings related to usability and relevance among mobile health clinics. Drawing from national public health frameworks and Honore et al.’s established public health quality aims, the PHQTool focuses on six aims most relevant to mobile care: Equitable, Health Promoting, Proactive, Transparent, Effective, and Efficient. Selection of the six quality aims was guided by explicit criteria developed through pilot testing and stakeholder feedback. The six aims were those that could be directly implemented through mobile clinic practices and were feasible to assess within diverse mobile clinic contexts. The remaining three aims (“population-centered,” “risk-reducing,” and “vigilant”) were determined to be less directly actionable at the program level or required system-wide or data infrastructure beyond the scope of individual mobile clinics. Development included expert consultation, pilot testing, and iterative refinement informed by user feedback. The tool allows clinics to evaluate practices, identify improvement goals, and track progress over time. Since implementation, 82 MHCs representing diverse organizational types have used the PHQTool, reporting high usability and identifying common improvement areas such as outreach, efficiency, and equity-driven service delivery. Across pilot and post-pilot implementation phases, a majority of respondents agreed or strongly agreed that the tool was user-friendly, relevant to their work, and appropriately scoped for mobile clinic practice. Usability and acceptance were assessed using descriptive statistics, including percentage agreement across Likert-scale items as well as qualitative feedback collected during structured debriefs. Reported findings reflect self-reported perceptions of feasibility, clarity, and relevance rather than inferential statistical comparisons. The PHQTool facilitates systematic quality assessment within the mobile clinic sector and supports consistent documentation of public health efforts. By providing a standardized, accessible framework for evaluation, it contributes to broader efforts to strengthen evidence-based quality improvement and promote accountability in MHCs.