A randomized controlled trial on the use of patient navigators to facilitate health outcomes in formerly incarcerated individuals during community re-entry
Method: Eligible patients were randomly assigned to the patient navigator (PN) intervention or usual care. The patient navigators were provided training in motivational interviewing and health education. PNs assisted patients with follow-up appointments, obtaining/taking medications, transportation, linking/escorting patients to social services. Demographic and clinical data were extracted from the electronic medical record.
Results: We have enrolled 104 patients with 52 patients randomized to each arm (patient navigator intervention and treatment as usual. Mean age of patients is 46 years (range of 21-68 years of age). The majority of participants are: male (90%), single (70%), Black, non-Hispanic (48%), Hispanic/Latino (36%), Medicaid recipients (84%), and have children (48%). Median time from release to enrollment was 2 months (range of 0-6 months). The majority of participants were incarcerated in the prison system (84%) with a mean duration of incarceration of 6 years (0-32 years). There is a high prevalence in participants of chronic medical illness (67%) and mental health disorder (47%) at enrollment. Hypertension (40%), hyperlipidemia (25%), and HIV infection (15%) are the most common chronic medical conditions, while depression is seen in 26% of participants. Nearly two-thirds of participants reported a history of substance abuse or dependence, most commonly involving cocaine (38%) and cannabis (32%).
Conclusions: Preliminary results reveal a high prevalence of chronic disease, substance use, and mental illness in our patient population and a trend towards better health outcomes in patients assigned to a patient navigator intervention (at 6 month follow-ups).
Learning Areas:Advocacy for health and health education
Assessment of individual and community needs for health education
Clinical medicine applied in public health
Conduct evaluation related to programs, research, and other areas of practice
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Demonstrate the effect that patient navigators have on health outcomes on formerly incarcerated individuals during community re-entry (post-release)
Keyword(s): Patient-Centered Care, Health Disparities/Inequities
Qualified on the content I am responsible for because: I am the lead investigator of this study. Among my scientific interests has been the development of strategies for patient health education, engagement, and management and/or prevention of chronic diseases.
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.