Gaber Jessica, Di Pelino Stephanie, Datta Julie, Talat Samina, Browne Tracy, Marentette-Brown Sarah, Bomze Sivan, Forsyth Pamela, Oliver Doug, Carr Tracey, Mangin Dee
McMaster University Department of Family Medicine, 100 Main Street West, Hamilton Ontario L8P 1H6 Canada.
Canadian Red Cross, 5700 Cancross Court, Mississauga Ontario L5R 3E9 Canada.
Int J Integr Care. 2022 Mar 2;22(1):18. doi: 10.5334/ijic.5978. eCollection 2022 Jan-Mar.
Primary care providers and community volunteers have important roles in supporting patient system navigation and utilization of community-based health and social services (CBHSS). This study aimed to explore the experiences and impacts of system navigation in a complex intervention supporting older adults.
We used a convergent mixed methods design. Participants included primary care team members (n = 67), community volunteers (n = 38), and programme clients (n = 128) across six communities in Ontario, Canada. Data sources included focus groups, interviews, system navigation function survey for volunteers, CBHSS use survey for clients, and implementation data on CBHSS recommended by providers and volunteers and used by clients.
Results showed the different patterns of how CBHSS categories were recommended and ultimately used. Exercise-related CBHSS were both recommended and used, independence-related CBHSS were mostly only recommended with less uptake, and chronic health condition and diet/nutrition CBHSS were most often used by clients.
Primary care teams' practice of system navigation was impacted by programme participation, including through learning about local CBHSS. However, volunteers felt more confident in tasks that did not include connecting to CBHSS. The programme did seem to result in many referrals, though the actual client uptake tended to be to more clinical rather than healthy lifestyle resources.
初级保健提供者和社区志愿者在支持患者系统导航以及利用基于社区的健康和社会服务（CBHSS）方面发挥着重要作用。本研究旨在探讨在一项支持老年人的复杂干预措施中系统导航的经验和影响。
我们采用了收敛性混合方法设计。参与者包括加拿大安大略省六个社区的初级保健团队成员（n = 67）、社区志愿者（n = 38）和项目客户（n = 128）。数据来源包括焦点小组、访谈、志愿者系统导航功能调查、客户CBHSS使用情况调查，以及提供者和志愿者推荐并由客户使用的CBHSS实施数据。
结果显示了CBHSS类别被推荐及最终使用的不同模式。与运动相关的CBHSS既被推荐又被使用，与独立性相关的CBHSS大多仅被推荐但接受度较低，而患有慢性健康状况的客户以及饮食/营养CBHSS使用最为频繁。
初级保健团队的系统导航实践受到项目参与的影响，包括通过了解当地的CBHSS。然而，志愿者对不包括连接到CBHSS的任务更有信心。该项目似乎确实导致了许多转诊，尽管实际客户接受度倾向于更多的临床资源而非健康生活方式资源。
