de la Riva Erika E, Hajjar Nadia, Tom Laura S, Phillips Sara, Dong XinQi, Simon Melissa A
Northwestern University-Feinberg School of Medicine, Chicago, IL, USA.
Access DuPage, Carol Stream, IL, USA.
Health Promot Pract. 2016 May;17(3):382-90. doi: 10.1177/1524839916628865. Epub 2016 Mar 23.
The DuPage Patient Navigation Collaborative (DPNC) adapted and scaled the Patient Navigation Research Program's intervention model to navigate uninsured suburban DuPage County women with an abnormal breast or cervical cancer screening result. Recent findings reveal the effectiveness of the DPNC in addressing patient risk factors for delayed follow-up, but gaps remain as patient measures may not adequately capture navigator impact. Using semistructured interviews with 19 DPNC providers (representing the county health department, clinics, advocacy organizations, and academic partners), this study explores the critical roles of the DPNC in strengthening community partnerships and enhancing clinical services. Findings from these provider interviews revealed that a wide range of resources existed within DuPage but were often underused. Providers indicated that the DPNC was instrumental in fostering community partnerships and that navigators enhanced the referral processes, communications, and service delivery among clinical teams. Providers also recommended expanding navigation to mental health, women's health, and for a variety of chronic conditions. Considering that many in the United States have recently gained access to the health care system, clinical teams might benefit by incorporating navigators who serve a dual working purpose embedded in the community and clinics to enhance the service delivery for vulnerable populations.
杜佩奇患者导航协作组织(DPNC)对患者导航研究项目的干预模式进行了调整和扩展,用于为杜佩奇县郊区未参保且乳腺癌或宫颈癌筛查结果异常的女性提供导航服务。近期研究结果显示,DPNC在解决患者延迟随访的风险因素方面行之有效,但仍存在差距,因为患者相关指标可能无法充分体现导航员的影响。本研究通过对19名DPNC服务提供者(代表县卫生部门、诊所、倡导组织和学术合作伙伴)进行半结构化访谈,探讨了DPNC在加强社区伙伴关系和改善临床服务方面的关键作用。这些服务提供者访谈的结果显示,杜佩奇县有大量资源,但往往未得到充分利用。服务提供者表示,DPNC在促进社区伙伴关系方面发挥了重要作用,导航员改善了临床团队之间的转诊流程、沟通和服务提供。服务提供者还建议将导航服务扩展到心理健康、妇女健康以及各种慢性病领域。考虑到美国近期有许多人获得了医疗保健系统的服务,临床团队或许可以通过纳入兼具社区和诊所双重工作职能的导航员而受益,从而为弱势群体提供更好的服务。