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Table 2 Patient navigator interventions with a focus on screenings of diseases

From: The role of patient navigators in ambulatory care: overview of systematic reviews

Skill-mix interventions Outcomes
Details of the intervention Profession(s) Population Countries Patient-related outcomes Health-system related outcomes Source
Patient navigation interventions in person or via phone focussing on screening uptake (e.g. barrier assessment, appointment scheduling, emotional support, education) Intervention: Lay persons, peers, professional workers
Comparison:
Not reported
Patients eligible for cancer screening US, CA, FR • Improved completion of screening   [12]a
Patient navigator interventions either as face-to-face, mail or phone interventions (e.g. education or support in identifying barriers, setting up appointments and making reminder calls) Intervention:
Trained lay-persons or health professionals (e.g. nurse)
Comparison:
Control group without PN or intervention group before intervention
Patients in primary care completing screening for colorectal, cervical and breast cancers and hepatitis B (often vulnerable patients) BD, CA, US • Increased probability to attend recommended care events (OR 2.48, 95% CI, 1.27 to 5.10, p = 0.008) • Increased access to screenings (OR: 2.48, 95% CI, 1.93 to 3.18, p < 0.00001) [15]
Patient navigator intervention to improve screening, diagnosis and treatment of cancer in ethnic minority patients (e.g. scheduling appointments, outreach, assistance with transportation, telephone support) Intervention:
Nurses, lay health educators, lay health workers, NPs, community health aides, physicians
Comparison:
Not reported
Ethnic minority cancer patients US • Improved adherence to screening • Increased screening rates
• Improved completion of screening
[16]a
Patient navigation in breast cancer care involving non-health professionals (e.g. follow-up to screening and clinical breast abnormalities, education, counselling, referral, translation and scheduling) Intervention:
Breast cancer survivors, lay community health workers, nurse navigators in cooperation with lay navigators and social workers, lay persons
Comparison:
Professions not defined
Breast cancer patients (66% of sample were non-white women) CA, US • Improved adherence to breast screening and diagnostic follow-up (e.g. after abnormal radiographic screening, attending genetic counselling) • Reduced waiting time for biopsy/diagnostic intervals
• Decreased time to appointment with genetic counsellor
[11]a
Patient navigator interventions targeting screening and diagnosis of cancer (e.g. partnerships with health and non-healthcare services, education, scheduling, outreach, communication, follow-ups) Intervention:
Lay health advisors, promotora, case managers, community outreach specialists, lay health educators, lay health worker), partners (e.g. academic researchers, community members, community activists, public health officials)
Comparison:
Not reported
Medically underserved population (incl. Urban cities, rural counties, suburban neighbourhoods, border regions), screenings for breast, cervical and colorectal cancer US • Improved completion of diagnostics, especially for patients who missed a follow-up diagnostic appointment
• Improved referral and follow up
• Improved breast, cervical, or colorectal cancer screening rates for mammography, pap tests, screening with colonoscopy
• Shorter time to diagnosis for abnormal screening results
[29]
Patient navigation included assisting patients in navigating through cancer screening (e.g. setting up appointments and making reminder calls along with providing language services such as interpreting and one-to one educational sessions) Intervention:
Patient navigators, bilingual staff, health educators, family members, professional interpreters
Comparison:
Not reported
Non-proficient English-speaking population groups in need for cancer care US   • Significant increased screenings rates for breast, cervical, or colorectal cancer (14/15 studies)
• Breast cancer screening rates increased by 17–25%
• Colorectal screening rates increased by 13–40%
• Cervical cancer screening showed a nearly 60% increase
[30]
  1. CI Confidence Interval, OR Odds Rati, p p-value, asystematic reviews covering screening, diagnostic and treatment and therefore listed twice; Country abbreviations: CA Canada, BD Bangladesh, FR France, US United States of America, promotora = lay health workers of a community (mostly female) providing a range of services as liaison between Hispanic communities and healthcare services