通过导航获取社区资源：一项混合方法可行性研究的方案

Access to Resources in the Community Through Navigation: Protocol for a Mixed-Methods Feasibility Study.

作者信息

Dahrouge Simone, Gauthier Alain, Chiocchio Francois, Presseau Justin, Kendall Claire, Lemonde Manon, Chomienne Marie-Hélène, Perna Andrea, Toal-Sullivan Darene, Devlin Rose A, Timony Patrick, Prud'homme Denis

机构信息

Bruyere Research Institute, Department of Family Medicine, University of Ottawa, Ottawa, ON, Canada.

Centre for Rural and Northern Health Research, Laurentian University, Sudbury, ON, Canada.

出版信息

JMIR Res Protoc. 2019 Jan 24;8(1):e11022. doi: 10.2196/11022.

DOI:10.2196/11022

PMID:30679151

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6365876/

Abstract

BACKGROUND

Community-based health and social resources can help individuals with complex health and social needs achieve their health goals. However, there is often inadequate access to these resources due to a lack of physician and patient awareness of available resources and the presence of social barriers that limit an individual's ability to reach these services. Navigation services, where a person is tasked with helping connect patients to community resources, embedded within primary care may facilitate access and strengthen the continuity of care for patients.

OBJECTIVE

This study aims to describe the protocol to assess whether the implementation of the Access to Resources in the Community (ARC) navigation model (an innovative approach to navigation services) is feasible, including its potential to achieve its intended outcomes, and to assess the viability of the evaluation approach.

METHODS

The study consists of a single-arm, prospective, explanatory, mixed-methods, pre-post design feasibility study focusing on primary care practice settings with vulnerable populations. Participants include primary care providers and patients.

RESULTS

Enrollment is closed with 82 patients. Navigation services have ended for 69 patients.

CONCLUSIONS

The study of an innovative complex intervention requires an adequate assessment of the feasibility of the intended approach during which the potential challenges of the planned intervention and need for its adaptation may be uncovered. Undertaking a feasibility study of the ARC navigation model from a conceptually clear and methodologically solid protocol will inform on the practicality and acceptability of the approach, demand for the services, ease of implementation, quality of integration of the new services within primary care, and practicality and potential for efficacy prior to initiating a randomized controlled trial.

TRIAL REGISTRATION

ClinicalTrials.gov NCT03105635; https://clinicaltrials.gov/ct2/show/NCT03105635 (Archived by WebCite at hhttp://www.webcitation.org/75FrwXORl).

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR1-10.2196/11022.

摘要

背景

基于社区的健康和社会资源可帮助有复杂健康和社会需求的个体实现其健康目标。然而，由于医生和患者对现有资源缺乏了解，以及存在限制个体获得这些服务能力的社会障碍，往往难以获得这些资源。嵌入初级保健中的导航服务（即由专人负责帮助患者连接社区资源）可能有助于患者获得资源并加强护理的连续性。

目的

本研究旨在描述评估社区资源获取（ARC）导航模型（一种创新的导航服务方法）的实施是否可行的方案，包括其实现预期结果的潜力，并评估评估方法的可行性。

方法

该研究包括一项单臂、前瞻性、解释性、混合方法、前后设计的可行性研究，重点关注有弱势群体的初级保健实践环境。参与者包括初级保健提供者和患者。

结果

已招募82名患者，招募工作结束。69名患者的导航服务已经结束。

结论

对创新的复杂干预措施进行研究需要对预期方法的可行性进行充分评估，在此过程中可能会发现计划干预措施的潜在挑战及其调整的必要性。从概念清晰且方法可靠的方案对ARC导航模型进行可行性研究，将为该方法的实用性和可接受性、服务需求、实施的简易程度、新服务在初级保健中的整合质量以及在开展随机对照试验之前该方法的实用性和疗效潜力提供信息。