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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
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)
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
Not reported
Ethnic minority cancer patients US • Improved adherence to screening • Increased screening rates
• Improved completion of screening
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
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
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)
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
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
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
  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