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Patient Navigators

Patient Navigators are healthcare professionals who assist individuals in navigating the compleaxit of the healthcare system.
They help patients access and coordinate medical services, overcome barriers to care, and improve health outcomes.
Patient Navigators can improve reproducibility and research accuracy by facilitating the identification of relevant protocols from literature, preprints, and patents, and enabling AI-powered comparisons to identify the best protocols and products.
This can enhance the research process and lead to more reliable results.

Most cited protocols related to «Patient Navigators»

1
Patient Navigation for Cancer Care
The working definition of patient navigation was provided by the NCI’s CRHCD in their request for applications. 13 In this definition, patient navigation refers to support and guidance offered to persons with abnormal cancer screening or a new cancer diagnosis in accessing the cancer care system, overcoming barriers, and facilitating timely, quality care provided in a culturally sensitive manner. Patient navigation is intended to target those who are most at risk for delays in care, including racial and ethnic minorities and those from low income populations. Furthermore, patient navigation targets specific time points in the cancer care continuum; we operationally define patient navigation as starting at the time of an abnormal screening result and ending at the determination that the screening test was a false positive or, for those individuals with a new cancer diagnosis, continuing through the completion of cancer treatment. The goal of patient navigation is to facilitate timely access to quality cancer care that meets cultural needs and standards of care for all patients.
Examples of navigation services include: arranging various forms of financial support, arranging for transportation to and childcare during scheduled appointments, identifying and scheduling appointments with culturally sensitive caregivers, coordinating care among providers, arranging for interpreter services, ensuring coordination of services among medical personnel, ensuring that medical records are available at each scheduled appointment, and providing other services to overcome access barriers encountered during the cancer care process including linkage to community resources. Navigators work to address health literacy and to train patients to advocate for themselves in the health care system. They are also trained to provide emotional support to patients during this stressful period. Navigators may also identify systems issues that serve as barriers to many patients, and work towards reduce the complexity to the patient of the multidisciplinary approach to care.
The concept of patient navigation is based upon the care management or case management model, which has four components.14 The first is case identification, which is a systematic approach to the identification of those individuals with abnormal cancer screening in need of follow-up care or incident cancers. The second is identifying individual barriers to receiving care. Navigators contact patients and elicit information about the barriers to completion of recommended care. The third is developing an individualized plan to address the barriers that are identified. The fourth is tracking, which is a systematic method of following each case through resolution of the problem. In the case of cancer navigation, this is to resolution of a diagnostic evaluation when a benign condition is diagnosed or follow-up to completion of primary therapy when a cancer or pre-malignant condition is diagnosed.
The navigator will focus on assisting patients and coordinating care of the patients among providers, community, and the patients and their families. Given that patient navigators are working primarily with racial/ethnic minority and low-income patients, cultural competence is a key feature. Cultural and linguistic competence is a set of congruent behaviors, attitudes, and policies that enable effective work in cross-cultural situations.15
PNRP sites vary in the prior training, skill sets, and educational background of navigators and include lay community peers, health educators and advocates, medical assistants, social workers, and nurses. The study has set a minimum requirement of a high school diploma or General Education Diploma. In an effort to achieve a core set of knowledge, skills, and competencies across navigators, a standardized training has been developed. The curriculum focuses on basic information about cancer and its diagnosis and treatment, professionalism, understanding barriers to care, communication skills, cultural competency, ethical conduct of human subjects research, and developing a local network of resources to support patients.16
Freund K.M., Battaglia T.A., Calhoun E., Dudley D.J., Fiscella K., Paskett E., Raich P.C, & Roetzheim R.G. (2008). The NCI Patient Navigation Research Program Methods, Protocol and Measures. Cancer, 113(12), 3391-3399.
Publication 2008
Cancer Screening Case Management Continuity of Patient Care Diagnosis Emotions Ethnic Minorities Follow-Up Care Health Educators Health Literacy Health Personnel Homo sapiens Low-Income Population Malignant Neoplasms Nurses Patient Navigation Patient Navigators Patients Quality of Health Care Racial Minorities
2
Literature Review on Cancer Patient Navigation
The goal of the literature review was to identify and summarize both descriptive and efficacy literature on patient navigation. A review of research literature in the National Library of Medicine was conducted in October 2007 by searching the PubMed database to identify articles describing patient navigation programs that were published at any time in English with human participants. Reference lists of identified articles were also reviewed for relevant publications. The inclusion criteria specified: (1) published original articles; and (2) a description of a patient navigator program related to cancer treatment, diagnosis, or screening. The PubMed database was searched using the keywords “navigator” or “navigation” and “cancer.” The search produced 893 citations, however, when abstracts of each article were reviewed only 35 were related to cancer patient navigation.23 (link),27 (link)-60 An additional seven studies were found in reference lists of articles identified in the search or were included in the same journal issue as another published paper.19 (link),21 -22 ,61 (link)-64 (link) Three additional articles were identified by study authors.65 (link)-67 (link) All forty-five articles were reviewed, and any article that described a patient navigator program was retained for further analysis. Twenty-eight articles provided descriptive information on cancer patient navigator programs in sites across the United States and Canada. Of these articles, sixteen provided information on outcomes of a patient navigation intervention (Table 1). These articles were used to provide descriptive information on patient navigation and evidence regarding its efficacy.
Wells K.J., Battaglia T.A., Dudley D.J., Garcia R., Greene A., Calhoun E., Mandelblatt J.S., Paskett E.D, & Raich P.C. (2008). PATIENT NAVIGATION: STATE OF THE ART, OR IS IT SCIENCE?. Cancer, 113(8), 1999-2010.
Publication 2008
Diagnosis Homo sapiens Malignant Neoplasms Patient Navigation Patient Navigators Therapy-Associated Cancers
3
Development and Validation of the Patient-Reported Navigator Interaction (PSN-I) Measure
The development of the PSN-I involved a multidisciplinary team of investigators and research staff from the nine geographically different sites of the NCI-sponsored PNRP. Members of the PSN-I measurement development team had experiences in clinical research and practice with individuals from diverse racial/ethnic, socio-cultural and economic backgrounds, as well as expertise in psychometric development and validation. Through an iterative process involving multiple revisions, the PSN-I development team carefully generated items thought to reflect key interpersonal aspects of PN. The resulting 9-item PSN-I (Table 2) assesses adequacy of time spent with patient, patient’s level of comfort, perceived navigator’s dependability, courtesy and respect, and listening ability, as well as ease of patient-navigator communication, perception of a caring relationship, navigator’s problem solving, and accessibility of the navigator.
Jean-Pierre P., Fiscella K., Winters P.C., Post D., Wells K.J., McKoy J.M., Battaglia T., Simon M.A, & Kilbourn K. (2011). Psychometric Development and Reliability Analysis of a Patient Satisfaction with Interpersonal Relationship with Navigator Measure: A Multi-Site Patient Navigation Research Program Study. Psycho-oncology, 21(9), 986-992.
Publication 2011
Patient Navigators Patients Psychometrics
4
Evaluating Intervention Effects on Depressive Symptoms
Intent-to-treat analysis was conducted to evaluate intervention effects. Clinically meaningful improvement of depressive symptoms was assessed as a ≥50% reduction in baseline SCL-20 or PHQ-9; depression remission was assessed by SCL-20 <0.5 or PHQ-9 <5. Logistic regression models were conducted to compare the odds of achieving clinically meaningful improvement (≥50% decrease in depressive symptoms), remission of depressive symptoms, or persistent major depression between enhanced usual care and the intervention at 6-, 12-, and 18-month follow-up. General linear mixed-effects models implemented in SAS Proc Mixed procedure were fitted with longitudinal data from baseline to 18 months to evaluate intervention effects on functional, socioeconomic, and clinical outcomes (21 ). Unstructured covariance was specified in the mixed-effects model to account for within-patient correlations of repeated observations over time. Fixed effects of time, study group, and their interactions were examined. Both logistic regression and linear mixed-effects models were adjusted for clinic site, baseline depression severity (PHQ-9 score <15 vs. ≥15) and dysthymia, birth place, language, and years in the U.S. (<10 vs. ≥10). Two sensitivity analyses, with the first excluding non-Hispanics and the second excluding type 1 diabetic patients, were conducted. Analyses used SAS software version 9.1 (SAS Institute, Cary, NC).
Follow-up study attrition did not vary between groups (21.6% in the EUC group vs. 21.8% in the INT group at 6 months, 28.4% in the EUC group vs. 26.4% in the INT group at 12 months, and 29.4% in the EUC group vs. 25.4% in the INT group at 18 months) or in patients refusing continuing trial participation or no longer receiving care at clinics (10.9, 15.5, and 17.9% at 6, 12, and 18 months, respectively) (Fig. 1). Baseline depression, quality-of-life clinical outcomes, and most demographics were similar between attrition and retention groups. Hot-deck imputation as well as multiple imputations with the predictive model–based approach were implemented in SOLAS software version 3.2 (Statistical Solution, Saugus, MA). Imputed data for depression improvement and functional and clinical outcomes were consistent with results analyzed with all available data, so we report the latter. With 130 patients per group, 80% power was projected to detect a minimum 10% absolute difference in response rates with a two-tailed α level of 0.05. Enrolling 350 patients allowed a 30% attrition rate.
Intervention costs were measured as actual budget-based cost (not charges) for all DDCS and patient navigator services, using actual salary plus 32% fringe benefits. Resulting unit costs were $71 per patient visit (90 min), $35 per DDCS telephone follow-up (45 min), and $10 for each patient navigation call (10–15 min). Estimates included record-keeping time. Additional costs included $10 for relaxation tape, $136 per patient for DDCS communication with PCP, and $21 per patient for clinical supervision.
Ell K., Katon W., Xie B., Lee P.J., Kapetanovic S., Guterman J, & Chou C.P. (2010). Collaborative Care Management of Major Depression Among Low-Income, Predominantly Hispanic Subjects With Diabetes: A randomized controlled trial. Diabetes Care, 33(4), 706-713.
Publication 2010
Depressive Symptoms Dysthymic Disorder Hispanics Hypersensitivity Major Depressive Disorder Patient Navigation Patient Navigators Patients Retention (Psychology) Tooth Attrition Zalcitabine
5
Integrating Food Insecurity Screening into Pediatric Primary Care

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Publication 2019
Child Food Hispanic or Latino Hunger Legal Guardians Minority Groups Nurses Parent Patient Navigators Patients Physicians Primary Health Care Residency Signs, Vital

Most recents protocols related to «Patient Navigators»

1
Volunteer-led Patient Navigator Outreach
A team of volunteer patient navigators attempted to call all of the patients described above. Using a non-structured approach, the volunteers asked about a variety of topics related to health and healthcare, as well as social determinants of health (SDoH). Each patient was called once per month. The patients' answers were collected by multiple volunteers and stored in a secure online spreadsheet.
Claus D., Draganich C., Berliner J., Niehaus W., Berliner J., Magnusson D, & Smith A.C. (2023). Needs of an uninsured equity-deserving minority patient cohort with physical disabilities during the first wave of the COVID-19 pandemic. Frontiers in Rehabilitation Sciences, 4, 1000838.
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Publication 2023
Patient Navigators Patients Voluntary Workers
2
Exploring Smoking Cessation Interventions for Homeless During COVID-19

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Publication 2023
Acquired Immunodeficiency Syndrome COVID 19 Monoxide, Carbon Patient Navigators Precipitating Factors Retention (Psychology)
3
Empowering Adolescents for Diabetes Management
We will place adolescents into a group with nine others (n = 10 adolescents per group; gender-balanced). Individuals will attend all sessions with the same group. Groups will meet 12 times over six months with sessions lasting approximately 90 minutes each. Intervention sessions will be led by two American Samoan facilitators and delivered using a facilitated discussion approach.
Intervention content will focus on five key behaviors: (1) medication adherence, (2) primary care utilization, (3) physical activity, (4) mindful eating and consumption of less energy dense foods, and (5) stress reduction/sleep, all of which could be hypothesized to have a positive impact on our primary outcomes [27 (link)–30 (link)]. A prior nurse-community health worker led intervention study in American Samoa showed that increasing adherence to medication and improving primary care utilization can be effective in improving glycemic control [31 (link)]. Specific attention will be paid to these topics, by introducing them early in the curriculum (Table 1) and repeatedly reinforcing the importance of these behaviors. Adolescents will be encouraged to join their paired family member at health care appointments and will be equipped with skills necessary to facilitate their family member’s medication adherence.
Because the goal of this intervention is to empower and equip adolescents to support their family members in managing their diabetes, and the expectation is that adolescents will act as conduits for diabetes knowledge and agents of behavioral change, the intervention will build leadership and communication skills into each session to facilitate knowledge transfer between the adolescent and paired family member. Materials and activities are based on those used for a leadership and life skills camp successfully delivered to high-school and college athletes in American Samoa in 2015, 2017, and 2019 and accounts for Samoan-specific elements of the family environment and the unique roles and responsibilities of adolescents in this context. We will also use elements of the widely adopted Patient Navigator Training program, developed to train patient navigators to support interactions with cancer care [32 (link)]. Specifically, we will focus on activities from that curriculum that build foundational understanding of health behavior (grounded in dual-process and self-determination theory [33 ,34 (link)]), promote empathy, help adolescents provide information to their paired adult about their health condition in a way that they are able to understand, and educate adolescents to identify and address the structural and emotional barriers faced by their partner in managing their condition.
Finally, multiple studies—from the education literature to health interventions—have demonstrated that prior to adulthood, experiential learning is more effective for retention of information and behavior change [35 (link)]. Several behavioral interventions for diabetes have successfully incorporated cooking demonstrations and group physical activity [36 (link)–40 (link)]; we will include similar opportunities for experiential learning, with a focus on using local, healthy foods for cooking and exercise that can be tailored to suit all family members.
Hawley N.L., Rivara A.C., Naseri J., Faumuina K., Potoa’e-Solaita N., Iopu F., Faiai M., Naveno E., Tasele S., Lefale T., Lantini R., Carlson J.C., Rabin T.L., Semaia P., Mugadza P, & Rosen R.K. (2023). Protocol: Implementation and evaluation of an adolescent-mediated intervention to improve glycemic control and diabetes self-management among Samoan adults. PLOS ONE, 18(2), e0279084.
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Publication 2023
Adolescent Adult Attention Behavior Therapy College Athletes Community Health Workers Diabetes Mellitus Emotions Family Member Food Gender Glycemic Control Malignant Neoplasms Mindfulness Nurses Patient Navigation Patient Navigators Primary Health Care Retention (Psychology) Sleep Teaching
4
Comprehensive Addiction Care Coordination
Candidate patients were identified in DACs by specialists in drugs and addictions. The information about them (including history of drug addiction) was transmitted by them to the Disease Service, where the study coordinator assigned a patient navigator responsible for the recruitment and monitoring of patients and provided risk assessment, health education, treatment adherence counseling, and medication coordination. To carry out this task, two patient navigators were hired (a nurse and a nursing assistant) with full dedication to the project. The patient navigators contacted each of the assigned patients to agree on a face-to-face appointment. This contact was repeated with at least three additional contact attempts for those patients who did not respond to the initial contact until the appointment was made. Patients who did not attend the scheduled appointment were repeatedly contacted until they attended.
A multidisciplinary and coordinated care plan was supervised by the study coordinator and designed for individuals involved in the strategy: addiction physicians, infectious disease specialists, hepatologists, social workers, pharmacists, nurses and patient navigators.
Corona-Mata D., Rivero-Juárez A., Camacho Á., Ruiz-Torres L., Ruiz-Cáceres I., de la Fuente Darder B., Cáceres-Anillo D., de Guía Castro-Granados M., Lizaur-Barbudo M., Victoria Cabrera-Gisbert M., Redondo-Écija J., Aparicio-Aparicio A., Manchado-López L., Cobos L., Pérez-Valero I, & Rivero A. (2023). Efficacy of a comprehensive strategy for the detection and treatment of hepatitis C infection in a population attending addiction centers. Frontiers in Public Health, 11, 1092960.
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Publication 2023
Addictive Behavior Communicable Diseases Drug Dependence Face Health Education Health Risk Assessment Hepatologists Nurses Nursing Assistants Patient Monitoring Patient Navigators Patients Pharmaceutical Preparations Physicians Specialists
5
Expanding Cancer Exercise Referral Network
Hub CEPs led outreach to rural and regional cancer centres, hospitals, primary care networks, universities/research teams, and community healthcare clinics (e.g., cancer physiatry clinics) to build the HCP network. HCPs were able to join the EXCEL network at any time, either via our outreach or on their own accord. HCPs included oncologists, physiatrists, primary care physicians, nurses, social workers, physiotherapists, registered dieticians, patient navigators, and care coordinators. Outreach efforts include educational presentations, emails, and phone calls to share resources and information. Specifically, HCP in-person and online education sessions were offered to disseminate general exercise-oncology information (i.e., exercise guidelines and currently available exercise oncology resources) and EXCEL-specific referral information. Regular email outreach included emailing cancer centre contacts with recruitment materials for EXCEL, including posters and brochures (see Supplemental Files S1 and S2). Email outreach to the HCP network occurred six weeks prior to a new EXCEL program, with additional emails sent every two weeks until the program start date to remind them about the referral process (see sample referral form in Supplemental File S3). Finally, phone calls were also made to HCPs at least twice a year, providing information about EXCEL and addressing any referral needs. Markers of adoption in building the HCP network included the number and type of HCPs (i.e., HCP professional/clinical role and organization) and details from the HCP organizations that received educational/referral materials (i.e., brochures and information sessions provided by the EXCEL team).
Wagoner C.W., Dreger J., Keats M.R., Santa Mina D., McNeely M.L., Cuthbert C., Capozzi L.C., Francis G.J., Trinh L., Sibley D., Langley J., Chiekwe J., Ester M., Foucaut A.M, & Culos-Reed S.N. (2023). First-Year Implementation of the EXercise for Cancer to Enhance Living Well (EXCEL) Study: Building Networks to Support Rural and Remote Community Access to Exercise Oncology Resources. International Journal of Environmental Research and Public Health, 20(3), 1930.
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Publication 2023
Community Health Care Dietitian Malignant Neoplasms Neoplasms Nurses Oncologists Patient Navigators Physiatrists Physical Therapist Primary Care Physicians Primary Health Care

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1
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More about "Patient Navigators"

Patient Navigators, also known as healthcare advocates or care coordinators, are crucial professionals who guide individuals through the complex healthcare system.
They help patients access and coordinate vital medical services, overcome barriers to care, and ultimately improve health outcomes.
These experts play a pivotal role in enhancing the reproducibility and accuracy of research by facilitating the identification of relevant protocols from literature, preprints, and patents, as well as enabling AI-powered comparisons to identify the best protocols and products.
This can significantly enhance the research process, leading to more reliable and trustworthy results.
Patient Navigators utilize a variety of tools and methodologies to support patients, including those found in Stata 13 and QSR NVivo 11.
Stata 13, a powerful statistical software, can be employed by Patient Navigators to analyze data and identify patterns that inform their interventions.
Similarly, QSR NVivo 11, a qualitative data analysis tool, can be used to organize and interpret patient experiences, enabling Patient Navigators to tailor their services to individual needs.
By leveraging these advanced technologies and techniques, Patient Navigators can streamline the research process, improve data quality, and ultimately contribute to the development of more effective healthcare solutions.
Their role in navigating the complexities of the healthcare system and facilitating seamless access to care is invaluable, making them indispensable members of the healthcare team.