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Table 3 Characteristics of system navigation models and their purpose

From: Navigation delivery models and roles of navigators in primary care: a scoping literature review

Study Location of study Components of the model Purpose Reported or perceived outcomesa
Studies of lay person navigators (n = 12)
Retkin et al., 2013 New York City, US Name: Healthcare Legal Partnership (HeLP) To improve health and well-being of vulnerable communities by integrating legal assistance in patient navigation PO - improvements in general health and wellness, patients who were connected to legal services reported positive impacts on finances and even improved compliance with medical appointments and treatment
PNO - increased understanding of the law and skills to address patient’s needs
Type of Navigator: Lay patient navigator trained in legal issues with support of attorneys
Population: People with Cancer and HIV
Esperat et al., 2012 Texas, US Name: Transformacion Para Salud (Transformation for Health) A chronic disease self-management model to develop a culturally sensitive intervention to facilitate patient behavior changes PO - improvements in general health and wellness, Improved self-efficacy, self-management or empowerment
HSO - Reduction in emergency room and/or hospital use
Type of Navigator: Certified community health workers
Population: Underserved populations with chronic diseases
Layne et al., 2012 Atlanta, US Name: Good Samaritan Health Centre To assist new patients in establishing a healthcare home, to prevent disease, detect health conditions
at an earlier stage and provide more successful treatment, and reduce preventable ED visits
PO- Increased access to care
HSO - Reduction in emergency room and/or hospital use
Type of Navigator: Patient Navigator assisting with financial and medical system practices working with primary care providers
Populations: Uninsured adult patients living in poverty with no regular primary care provider
Spiro et al., 2012 Massachusetts, US Name: The MGH Chelsea community health improvement team To provides support for everyone involved in patient care: patients, providers, the community at large, and the internal CHW staff PO - improvements in general health and wellness, increased patient satisfaction
PNO - satisfaction with navigation programs, opportunity to redevelop as professionals
Type of Navigator: Community Health Worker
Population: Vulnerable sub-populations including refugees/immigrants, Latinos, an those facing significant economic, education and health challenges
Brown et al., 2011 Brooklyn, US Name: Healthy Programs Brooklyn To increase access to care, improve health education and ease navigating the health care system PNO - increased knowledge and skills
Type of Navigator: Trained lay navigators
Population: Residents living in New York City housing authority developments
Linkins et al. 2011 Minnesota, US Name: Stay Well, Stay Working (SWSW) To offer working persons with serious mental illness a comprehensive set of health, behavioral health, and employment support services PO - improvements in general health and wellness, increased access to care, increased employment and reduced financial stresses, reduced numbers of mental health patients who applied for disability benefits, and a significantly higher percentage of behavioural health claims compared to controls
Type of Navigator: Navigators trained in vocational rehabilitation serving an employment support role
Population: Social Security Disability beneficiaries with psychiatric illnesses
Carroll et al., 2010 New York, US Name: Cancer Patient Navigation Program To assess and alleviate barriers to adequate health care PO - Negative experiences were reported in a cancer patient navigation program delivered by community health workers (CHW), from a variety of settings including primary care
Type of Navigator: Community Health Workers
Population: Newly diagnosed patients with breast or colorectal cancer
Gimpel et al., 2010 Dallas, US Name: Project Access Dallas To provide access to health and social care for the “working poor” who are ineligible for existing, publicly-funded health care PO - improvements in general health and wellness, Improved self-efficacy, self-management or empowerment, working poor served in one study noted that services were now affordable
Type of Navigator: Community Health Workers (CHWs)
Population: Uninsured, low income residents requiring access to health care
Clark et al., 2009 Boston, US Name: Boston REACH 2010 Breast and Cervical Cancer Coalition Women’s Health Demonstration Project To identify and reduce medical and social obstacles to breast cancer screening and following up abnormal results PO - Increased access to care
Type of Navigator: Case managers
Population: Women of African descent
Mayhew et al., 2009 London, UK Name Integrated Care Co-ordination Service (ICCS) To provide supports to older adults to prevent hospital admissions and early admissions to long-term care HSO - Reduction in emergency room and/or hospital use
Type of Navigator: Care coordinators
Population: Adults age 65 and over with one or more chronic conditions
McCloskey et al., 2009 New Mexico, US Name: LA VIDA (lifestyle and values impacting diabetes awareness) To reduce barriers to health and social services and supports for Hispanics living with diabetes PO - improvements in general health and wellness, Improved self-efficacy, self-management or empowerment, Increased access to care
PNO - empowered in their community advocacy role and some were promoted into supervisory roles
Type of Navigator: Promotores du salud (community members who act as healthcare navigators) in a community health centres
Population: Hispanics with diabetes or at risk for diabetes
Bradford et al., 2007 Portland, Seattle, Boston, Washington, US Name: HIV Systems Navigation To increase engagement and retention in HIV primary medical care for individuals previously unconnected or tenuously connected to care PO - improvements in general health and wellness, Increased access to care
Type of Navigator: Non-clinical staff with Bachelor’s degree in social science or healthcare
Population: HIV-infected individuals with co-occurring mental and substance abuse disorders
Studies of Nurse Navigators (n = 10)
Wolff et al. 2009; Boult et al. 2010; Foret Giddens et al. 2009; Boyd et al. 2007 Three mid-Atlantic health regions, US Name: Guided Care Model To improve the quality of life, quality of care, and efficiency of resource use for medically complex older adults To support caregivers of older adults with complex health-related needs; to improve patients’ health and the well-being of their families and friends PO- Improved self-efficacy, self-management or empowerment, increased access to care, improvements in caregiver depression and strain
PNO - satisfaction with navigation programs, increased trust, increased communication between primary care providers and community services, and among providers
Type of Navigator: Guided Care Nurses (registered nurses) and interdisciplinary primary care team
Population: Medically complex older adults and caregivers of older adults
Maeng et al. 2013 Rural central Pennsylvania, US Name: Proven Health Navigator (PHN) To provide chronic care and patient-centred primary care services in rural communities PO- Increased access to care
HSO- Reduction in emergency room and/or hospital use
Type of Navigator: Nurse case managers
Population: Adults with severe or multiple chronic conditions requiring case management
Kramer et al. 2012 Large Mid-western city, US Name: Safe Mom, Safe Baby (SMSB) To provide interdisciplinary case management to support pregnant women experiencing Intimate Partner Violence (IPV) PO - improvements in general health and wellness
Type of Navigator: Registered nurse and domestic violence advocate
Population: Marginalized women who self-disclose Intimate Partner Violence (IPV) who are pregnant or recently pregnant
Burton et al., 2010 US Name: Patient-centered chronic care management To educate as a support to patients and their families, and facilitate access to community resources PO- Improved self-efficacy, self-management and empowerment
Type of Navigator: Nurse case managers
Population: Patients with primary immunodeficiency disease (PIDD)
Williams et al., 2010 UK Name: Community Matrons To improve patient self-management and education, and enhance co-ordination between primary and social care. PO - improvements in general health and wellness, access, patient advocacy, and psychosocial support.
Type of Navigator: Advanced Practice Nurse
Population: people living with long-term conditions in the community
McCann & Clark, 2005 UK Name: Community mental health nurses To promote wellness and caring Outcomes not measured
Type of Navigator: Community mental health nurses (registered nurses)
Population: Young adults with early episode of schizophrenia
Pfeffer et al., 1995 San Diego, US Name: Special Infectious Disease (SPID) Case Management Model A framework to provide cost-effective, accessible, continuous, quality health care. PO - Increased access to care
Type of Navigator: Advanced Practice (Nurse practitioners)
Population: Veterans with HIV-related illnesses and AIDS
Studies of Social Work Navigators (n = 1)
Ferrante et al., 2010 US Name: Patient Navigator pilot To help patients use the health care system efficiently in primary care practices PO - Increased access to care
Type of Navigator: Social worker
Population: Elderly patients (mostly female)
Studies of Student Navigators (n = 1)
Bishop et al. 2009 Charlottesville, US Name: Charlottesville Health Access (CHA) To provide access to health and social services and connect homeless adults to permanent primary care services None reported
Type of Navigator: Medical and nursing students trained in navigation
Population: Homeless adults
Studies of Navigation Delivered by Teams of Health Professionals and Lay Persons (n = 6)
Tejeda et al. 2013 Chicago, US Name: Chicago Patient Navigation Research Program (PNRP) To identify and remove barriers faced by African-American and Latina women receiving cancer diagnoses and treatment PO - Increased access to care
Type of Navigator: Lay navigators and clinical social workers
Population: African-American and Latina women with breast or cervical cancer diagnoses without prior treatment
Mullins et al., 2012 Baltimore, US Name: Community Partnership Program To foster community collaboration and raise awareness of the need to improve health in the community and to identify and connect patients to existing resources and services PO increased patient satisfaction, increased access to care
PNO - satisfaction with navigation programs, increased communication between primary care providers and community services
Type of Navigator: Health care professionals, community health workers, faith-based ministries and community leaders
Population: African American and Hispanic communities
Bohman et al., 2011 Houston, US Name: The Texas Demonstration to Maintain Independence and Employment To coordinate a set of health benefits and employment supports to help low-income, working adults maintain their employment and remain independent of publicly funded disability assistance PO- improvements in general health and wellness, increased patient satisfaction, increased access to care, no differences in employment, hours worked or earnings
Type of Navigator: Nurses, social worker and vocational specialists
Population: Uninsured working adults with chronic mental, behavioral and physical health conditions
Hendren et al. 2011 Rochester, US Name: Patient Navigation Research Program (PNRP) To understand health disparities related to barriers to care for newly-diagnosed cancer patients None reported
Type of Navigator: Community health workers (CHW) and hospital and primary care teams
Population: Newly diagnosed breast and colorectal cancer patients
Palinkis et al., 2011 California, US Name: Multi-faceted Depression and Diabetes Program (MDDP) To prevent depression relapse through chronic illness management interventions including problem solving treatment and patient/family education None reported
Type of Navigator: Patient navigator, social worker, psychiatric consultant
Population: Hispanic diabetic patients with depression
Tataw et al. 2011 Los Angeles, US Name: South Central Los Angeles Health Care Alliance (SCHCA) To provide case management support aimed at empowering families to navigate the health care system PO- Improved self-efficacy, self-management or empowerment, increased patient satisfaction, increased access to care
Type of Navigator: Community health workers (CHW) and pediatric primary care teams
Population: Low-income urban children and families without a regular source of healthcare
Studies of Navigation Delivered by Teams of Health Professionals (n = 3)
Anderson et al. 2009; Anderson et al. 2009 Western Canada Name: Sooke Navigator Project To provide a community-based intervention to support access to mental health and social support services PNO - increased communication between primary care providers and community services, increased trust
Type of Navigator: Two navigators with training in social work and psychiatric rehabilitation
Population: Adults with mental health and addictions
Halkitis et al. 2010 New York City, US Name: AIDS Service Organizations (ASO) To raise the level of health, mental health, and quality of life for HIV-positive women None reported
Type of Navigator: Case manager and interdisciplinary team of physicians, nurses, mental health professionals, social workers, and community representatives
Population: Black and Latina HIV-positive women
  1. aPO Patient outcomes, PNO Provider or navigator outcomes, HSO Health system outcomes