Shommu Nusrat Sharmeen, Ahmed Salim, Rumana Nahid, Barron Gary R S, McBrien Kerry Alison, Turin Tanvir Chowdhury
Department of Family Medicine, Room G012F, Health Sciences Center, University of Calgary, 3330 Hospital Drive Northwest, Calgary, AB, T2N 4N1, Canada.
Sleep Center, Foothills Medical Center, University of Calgary, 1403 29 Street NW, Calgary, AB, Canada.
Int J Equity Health. 2016 Jan 15;15:6. doi: 10.1186/s12939-016-0298-8.
Immigrants are among the most vulnerable population groups in North America; they face multidimensional hurdles to obtain proper healthcare. Such barriers result in increased risk of developing acute and chronic conditions. Subsequently a great deal of burden is placed on the healthcare system. Community navigator programs are designed to provide culturally sensitive guidance to vulnerable populations in order to overcome barriers to accessing healthcare. Navigators are healthcare workers who support patients to obtain appropriate healthcare. This scoping review systematically searches and summarizes the literature on community navigators to help immigrant and ethnic minority groups in Canada and the United States overcome barriers to healthcare.
We systematically searched electronic databases for primary articles and grey literature. Study selection was performed following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement. Articles were selected based on four criteria: (1) the study population was comprised of immigrants or ethnic minorities living in Canada or the United States; (2) study outcomes were related to chronic disease management or primary care access; (3) the study reported effects of community navigator intervention; (4) the study was published in English. Relevant information from the articles was extracted and reported in the review.
Only one study was found in the literature that focused on navigators for immigrants in Canada. In contrast, 29 articles were found that reported navigator intervention programs for immigrant minorities in the United States. In these studies navigators trained and guided members of several ethnic communities for chronic disease prevention and management, to undertake cancer screening as well as accessing primary healthcare. The studies reported substantial improvement in the immigrant and ethnic minority health outcomes in the United States. The single Canadian study also reported positive outcome of navigators among immigrant women.
Navigator interventions have not been fully explored in Canada, where as, there have been many studies in the United States and these demonstrated significant improvements in immigrant health outcomes. With many immigrants arriving in Canada each year, community navigators may provide a solution to reduce the existing healthcare barriers and support better health outcomes for new comers.
移民是北美最脆弱的人群之一；他们在获得适当医疗保健方面面临多方面的障碍。这些障碍导致患急性和慢性疾病的风险增加。随后，医疗保健系统承受了巨大的负担。社区导航项目旨在为弱势群体提供具有文化敏感性的指导，以克服获得医疗保健的障碍。导航员是支持患者获得适当医疗保健的医护人员。本范围综述系统地检索和总结了关于社区导航员的文献，以帮助加拿大和美国的移民及少数族裔群体克服医疗保健障碍。
我们系统地在电子数据库中搜索原始文章和灰色文献。研究选择遵循系统评价和荟萃分析的首选报告项目（PRISMA）声明进行。根据四个标准选择文章：（1）研究人群包括居住在加拿大或美国的移民或少数族裔；（2）研究结果与慢性病管理或初级保健获取有关；（3）研究报告了社区导航员干预的效果；（4）研究以英文发表。从文章中提取相关信息并在综述中报告。
在文献中仅发现一项针对加拿大移民导航员的研究。相比之下，发现有29篇文章报告了针对美国移民少数群体的导航员干预项目。在这些研究中，导航员培训和指导了几个族裔社区的成员进行慢性病预防和管理、进行癌症筛查以及获得初级医疗保健。这些研究报告称，美国移民和少数族裔的健康结果有了显著改善。加拿大的唯一一项研究也报告了导航员对移民女性产生的积极结果。
在加拿大，导航员干预尚未得到充分探索，而在美国已有许多相关研究，这些研究表明移民健康结果有了显著改善。随着每年有许多移民抵达加拿大，社区导航员可能为减少现有的医疗保健障碍并为新移民带来更好的健康结果提供一种解决方案。
