Community Care in Reach

A mobile outreach van in Boston uses data-driven hotspotting to bring on-demand addiction clinical care and harm reduction services directly to high-risk populations

The Kraft Center for Community Health at Massachusetts General Hospital sponsors a mobile outreach program, called Community Care in Reach, to reach at-risk populations in Boston neighborhoods with treatment and harm reduction services.

These services include:

  • providing medications for addiction treatment (e.g., buprenorphine)
  • clean syringes
  • naloxone
  • counseling on risk reduction
  • referrals to treatment
  • a wide range of preventive care and chronic disease management

Services are targeted using data on overdose deaths to find those neighborhoods most in need of outreach; four locations are now serviced weekly. 

The program has engaged stakeholders across the continuum of care as well as the police department and local business owners. There is a planned expansion of the program to include fentanyl testing, as well as coordination with other mobile outreach vans in Massachusetts to share best practices. It is supported in part by the GE Foundation, Ford Motor Company, the Hearst Foundation, Boston Health Care for the Homeless Program, and the Boston Public Health Commission. A toolkit based on Community Care in Reach for communities to replicate this model can be found here

The program has been evaluated and appears in the peer-reviewed literature

More information on the program can be found here

Made 9,098 contacts with people with OUD, distributing a total of 96,601 syringes and 2,956 naloxone kits and provided 854 buprenorphine prescriptions to 164 unique patients.

Continuum of Care
Treatment
Harm Reduction
Type of Evidence
Peer-reviewed
Report with evaluation
Response Approach
Early Intervention
Medications for Opioid Use Disorder
Outreach
Overdose prevention
Syringe service program / Needle exchange
Peer-reviewed Article

Evidence of Program Effectiveness

An initial process evaluation found that from January-October, 2018, staff made 3,457 contacts with injection drug users; had 248 patient encounters; distributed 36,510 syringes and collected 40,891; distributed 1,257 naloxone kits; and provided 131 prescriptions for buprenorphine. 

"As of December 31, 2019, the Community Care in Reach team made 9,098 contacts with people with OUD, distributing a total of 96,601 syringes and 2,956 naloxone kits. Clinicians had 1,336 clinical encounters with 328 unique patients and provided 854 buprenorphine prescriptions to 164 unique patients. Clinicians also provided 68 HIV tests and 42 hepatitis C tests and administered 324 vaccinations for influenza, pneumonia, TdAP, hepatitis A, hepatitis B, HPV, and meningitis...Results also demonstrate that buprenorphine treatment can succeed in a mobile setting, as 47 unique patients received prescriptions and all 28 undergoing follow-up toxicology screenings yielded one or more buprenorphine-positive result and 19 yielded at least 1 opioid-negative results." (Regis et al., 2020)