270720 Factors that predict successful navigation of medically underserved patients by nurse and lay navigators

Sunday, October 28, 2012

Alexis Bakos, PhD, MPH, RN , Bureau of Health Professions, Health Resources and Services Administration, Rockville, MD
Shanita Williams, PhD, MPH, APRN , Bureau of Health Professions, Health Resources and Services Administration, Rockville, MD
Lisbeth Jarama, PhD , NOVA Research, Bethesda, MD
Background: The Health Resources and Services Administration has administered the Patient Navigator Outreach and Chronic Disease Prevention Demonstration Program (PNDP) since 2008, funding 14 grantees to develop and utilize navigator programs to reduce health disparities among medically underserved communities. Nurses played a critical role in the development and implantation of the navigator programs. Both nurse and lay navigators from the community addressed patients' barriers to care related to lack of knowledge, resources, or insurance by providing education and coordinating services. Under PNDP, the navigation model included cancer and chronic diseases such as diabetes, hypertension, and cardiovascular disease. Methods: PNDP grantees collected information on a series of common data elements related to patient and navigator characteristics, navigator encounters, clinical measures, and health care visits. These data elements provided the basis for the quantitative results of the evaluation and informed predictors of program success as defined by improvements in intermediate health outcomes and clinic performance. Results: Over 10,000 patients were served by PNDP; the primary conditions navigated were cancer and diabetes. We review the characteristics of the patient population, navigators, and encounters, as well as outcomes related to health care visits and clinical measures. We then identify which factors such as patient comorbidities, lack of Medicaid coverage, navigator background (nurse or community health worker), and intervention characteristics (e.g., number of face-to-face encounters) were related to outcome. Conclusion: Findings will help to optimize the effectiveness of future patient navigation programs as interventions for the prevention and treatment of chronic disease and cancer.

Learning Areas:
Chronic disease management and prevention
Conduct evaluation related to programs, research, and other areas of practice
Public health or related nursing
Public health or related research

Learning Objectives:
1. Demonstrate positive outcomes associated with the navigation of medically underserved patients. 2. Identify patient and program factors associated with successful navigation of medically underserved patients.

Keywords: Access to Health Care, Underserved Populations

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the project officer that manages and is responsible for the evaluation of this federally funded grant program from the Health Resources and Services Administration, U.S. Dept of Health and Human Services.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.