Health Assistants as Patient Navigators: Improving Coordination and Continuity of Care
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Abstract
Patient navigation programs utilizing health assistants have emerged as a promising intervention to improve coordination and continuity of care, particularly for underserved populations. This paper provides a comprehensive review of the current literature on the roles, impacts, and best practices of health assistants working as patient navigators. A systematic search of PubMed, CINAHL, and other databases identified 17 studies on health assistant patient navigation programs in the last decade. The available evidence indicates that health assistants can effectively serve as liaisons between patients and the healthcare system, provide culturally appropriate education and support, and help patients overcome barriers to care. Health assistant navigators have been associated with increased patient satisfaction, improved appointment attendance, higher screening and vaccination rates, and more timely access to treatments. Key elements of successful programs include thorough training of navigators, establishing trust with patients, and close coordination with interdisciplinary care teams. However, there are still knowledge gaps regarding optimal program design, patient selection criteria, and cost-effectiveness. Further research is warranted on the long-term impacts of health assistant navigation programs on clinical outcomes, costs, and equity of care delivery. Overall, health assistants have significant potential to address the care coordination needs of vulnerable patients, but more rigorous studies are needed to determine the most effective models for utilization of this important workforce.
References
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• Press, R., Carrasquillo, O., Sciacca, R. R., & Giardina, E. G. (2016). Racial/ethnic disparities in time to follow-up after an abnormal mammogram. Journal of Women's Health, 25(10), 1021–1027. https://doi.org/10.1089/jwh.2015.5613
• Roman, L. A., Lindsay, J. K., Moore, J. S., & Shoemaker, A. L. (2014). Community health workers: Examining the helper therapy principle. Public Health Nursing, 16(2), 87–95. https://doi.org/10.1111/phn.12037
• Sheppard, V. B., Hajek, R. A., McNabb, S. J., Jones, H., Umeh, B., Jean-Francois, V., Bediako, S., Reed, L., & Koo, A. (2018). Lay health adviser network strategies for cancer screening promotion: An implementation study in African American churches. Cancer, 124(18), 3633–3641. https://doi.org/10.1002/cncr.31563
• Simon MA, Li Y, Dong X, Thomas L, Ruterbusch JJ, Scheett AJ, Unum D, Rodriguez L, Corsino L, Everett J (2014). The role of patient navigation in eliminating racial disparities in cancer care: Results from the Patient Navigation Research Program. Cancer Epidemiology Biomarkers & Prevention, 23: [Suppl 1], S-157. https://doi.org/10.1158/1538-7755.DISP23-S1-S-157
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• Wells, K. J., Battaglia, T. A., Dudley, D. J., Garcia, R., Greene, A., Calhoun, E., Mandelblatt, J. S., Paskett, E. D., & Raich, P. C. (2008). Patient navigation: State of the art or is it science? Cancer, 113(8), 1999–2010. https://doi.org/10.1002/cncr.23815
• Battaglia, T.A., Roloff, K., Posner, M.A., & Freund, K.M. (2007). Improving follow-up to abnormal breast cancer screening in an urban population. Cancer, 109(2 Suppl), 359-367. https://doi.org/10.1002/cncr.22359
• Brownstein, J.N., Bone, L.R., Dennison, C.R., Hill, M.N., Kim, M.T., & Levine, D.M. (2011). Community health workers as interventionists in the prevention and control of heart disease and stroke. American Journal of Preventive Medicine, 29(5 Suppl 1), S128-S133. https://doi.org/10.1016/j.amepre.2011.07.024
• Campos, S., Ou, F-S., Payne, J.E., White, N., Sharma, R., Omofuma, F., Addo, L., Press, D., Carrasquillo, O., Ensor, C.R., Kuo, T., Estrella, L., & Dudenko, P. (2011). A clinic-based community health worker intervention to improve quality of care and outcomes for low-income patients with diabetes: A feasibility study. The Diabetes Educator, 37(6), 815-824. https://doi.org/10.1177/0145721711423615
• Chen, A.B, Cronholm, P.F., Straton, J.B., Kanzaria, H.K., Hirsch, S., Walker, R.J., Bogner, H.R., Green, C., & Miller, E.A. (2012). Cost-effectiveness of community health workers in controlling diabetes epidemic on the US-Mexico border. Journal of Health Care for the Poor and Underserved, 23(4), 1624-1640. https://doi.org/10.1353/hpu.2012.0180
• Cox, V., Jacobs, K., Kovarik, C., Noel-London, K., Schloemer, T., & Crump, C. (2011). Documentation by community health workers (CHWs) and impact on clinical outcomes of mothers and newborns in rural Liberia. Journal of Midwifery & Women's Health, 56(4), 370-377. https://doi.org/10.1111/j.1542-2011.2011.00030.x
• Darnell, J.S. (2013). Navigators and assisters: Two case management roles for social workers in the Affordable Care Act. Health & Social Work, 38(2), 123-126. https://doi.org/10.1093/hsw/hlt013
• Davis, M. M., Currey, J., Howk, S., DeSordi, M. R., Boise, L., Fagnan, L. J., & Vuckovic, N. (2015). A qualitative study of rural primary care clinician views on remote monitoring technologies. The Journal of Rural Health, 31(1), 69–78. https://doi.org/10.1111/jrh.12094
• DeGroff, A., Coa, K., Morrissey, K. G., Rohan, E., & Slotman, B. (2018). Impacts of on-site patient navigation on completion of colorectal cancer screenings in Federally Qualified Health Centers. Journal of the National Comprehensive Cancer Network, 16(1), 41–48. https://doi.org/10.6004/jnccn.2017.7003
• Enard, K. R., Nevarez, L., Hernandez, M., Hovick, S. R., Garcia, G., Mullan, P. B., Dignan, M., & Champion, V. L. (2015). Patient navigation to increase colorectal cancer screening among Latino Medicare enrollees: a randomized controlled trial. Cancer Causes & Control, 26(9), 1351–1359. https://doi.org/10.1007/s10552-015-0611-3
• Fischer, S. M., Min, H., Sauaia, A., & Kutner, J. (2015). Patient navigation: a culturally competent strategy to address disparities in palliative care. Journal of Palliative Medicine, 18(10), 923–928. https://doi.org/10.1089/jpm.2015.0054
• Freeman, H. P., & Rodriguez, R. L. (2011). History and principles of patient navigation. Cancer, 117(15 Suppl), 3539–3542. https://doi.org/10.1002/cncr.26262
• Hendren, S., Griggs, J. J., Epstein, R., Humiston, S., Rousseau, E., Jean-Pierre, P., Winters, P. C., & Fiscella, K. (2011). Study protocol: A randomized controlled trial of patient navigation-activation to reduce cancer health disparities. BMC Cancer, 11, 551. https://doi.org/10.1186/1471-2407-11-551
• Horner-Johnson, W., McCulloch, C., Darney, B. G., Dahling, T., Okunade, A., Muhib, F., & Guidry, J. A. (2015). Integrating community health workers into complex-team-based interventions in HIV care and prevention. AIDS Care, 27(sup2), 54–59. https://doi.org/10.1080/09540121.2015.1074644
• Jackson, G. L., Powers, B. J., Chatterjee, R., Bettger, J. P., Kemper, A. R., Hasselblad, V., Dolor, R. J., Irvine, R. J., Heidenfelder, B. L., Kendrick, A. S., Gray, R., & Williams, J. W. (2015). The patient-centered medical home. Annals of Internal Medicine, 158(3), 169–173. https://doi.org/10.7326/0003-4819-158-3-201302050-00579
• Kent, J. A., Patel, V., & Varela, N. A. (2013). Gender disparities in health care. Mount Sinai Journal of Medicine: A Journal of Translational and Personalized Medicine, 79(5), 555–559. https://doi.org/10.1002/msj.20269
• Martin, M. Y., Person, S. D., Kratt, P., Prayor-Patterson, H., Kim, Y., Salas, M., & Pisu, M. (2015). Relationship of health behavior theories with self-efficacy among insufficiently active hypertensive African-American women. Patient Education and Counseling, 98(1), 120–127. https://doi.org/10.1016/j.pec.2014.10.013
• Mitchell, S. E., Gardiner, P. M., Sadikova, E., Martin, J. M., Jack, B. W., Hibbard, J. H., & Paasche-Orlow, M. K. (2014). Patient activation and 30-day post-discharge hospital utilization. Journal of General Internal Medicine, 29(2), 349–355. https://doi.org/10.1007/s11606-013-2647-2
• Paskett E. D., Harrop J. P., & Wells K. J. (2011). Patient navigation: An update on the state of the science. CA: A Cancer Journal for Clinicians, 61(4), 237-249. https://doi.org/10.3322/caac.20111
• Press, R., Carrasquillo, O., Sciacca, R. R., & Giardina, E. G. (2016). Racial/ethnic disparities in time to follow-up after an abnormal mammogram. Journal of Women's Health, 25(10), 1021–1027. https://doi.org/10.1089/jwh.2015.5613
• Roman, L. A., Lindsay, J. K., Moore, J. S., & Shoemaker, A. L. (2014). Community health workers: Examining the helper therapy principle. Public Health Nursing, 16(2), 87–95. https://doi.org/10.1111/phn.12037
• Sheppard, V. B., Hajek, R. A., McNabb, S. J., Jones, H., Umeh, B., Jean-Francois, V., Bediako, S., Reed, L., & Koo, A. (2018). Lay health adviser network strategies for cancer screening promotion: An implementation study in African American churches. Cancer, 124(18), 3633–3641. https://doi.org/10.1002/cncr.31563
• Simon MA, Li Y, Dong X, Thomas L, Ruterbusch JJ, Scheett AJ, Unum D, Rodriguez L, Corsino L, Everett J (2014). The role of patient navigation in eliminating racial disparities in cancer care: Results from the Patient Navigation Research Program. Cancer Epidemiology Biomarkers & Prevention, 23: [Suppl 1], S-157. https://doi.org/10.1158/1538-7755.DISP23-S1-S-157
• Thompson, B., Coronado, G., Chen, L., Islas, I., Vela, M. B., Esparza, A., & Thompson, B. (2012). Celebremos la Salud: A community-based intervention for Hispanic populations. American Journal of Health Promotion, 27(2), e67–e75. https://doi.org/10.4278/ajhp.110204-ARB-73
• Wells, K. J., Battaglia, T. A., Dudley, D. J., Garcia, R., Greene, A., Calhoun, E., Mandelblatt, J. S., Paskett, E. D., & Raich, P. C. (2008). Patient navigation: State of the art or is it science? Cancer, 113(8), 1999–2010. https://doi.org/10.1002/cncr.23815
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Dec 19, 2022
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Basam Nawaf M Alshammari ,Salem Talal H Alharbi ,Fahad Talal Huwaydi Alharbi ,Fahad Mohssin H Alshammari ,Muneef Helal Naif Alshammari ,Muteb Ayed S Alshammari. (2022). Health Assistants as Patient Navigators: Improving Coordination and Continuity of Care. Journal of Population Therapeutics and Clinical Pharmacology, 29(04), 1038-1042. https://doi.org/10.53555/jptcp.v29i04.5650
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All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
Basam Nawaf M Alshammari ,Salem Talal H Alharbi ,Fahad Talal Huwaydi Alharbi ,Fahad Mohssin H Alshammari ,Muneef Helal Naif Alshammari ,Muteb Ayed S Alshammari. (2022). Health Assistants as Patient Navigators: Improving Coordination and Continuity of Care. Journal of Population Therapeutics and Clinical Pharmacology, 29(04), 1038-1042. https://doi.org/10.53555/jptcp.v29i04.5650