7 results on '"NAVIGATORS"'
Search Results
2. Lost to Care and Back Again: Patient and Navigator Perspectives on HIV Care Re-engagement.
- Author
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Parnell HE, Berger MB, Gichane MW, LeViere AF, Sullivan KA, Clymore JM, and Quinlivan EB
- Subjects
- Adult, Female, HIV Infections therapy, Humans, Male, Middle Aged, Patient Acceptance of Health Care, Patient Dropouts, Patient-Centered Care, Qualitative Research, Social Support, Continuity of Patient Care organization & administration, HIV Infections epidemiology, Patient Navigation organization & administration
- Abstract
Engagement in HIV care is critical to achieve viral suppression and ultimately improve health outcomes for people living with HIV (PLWH). However, maintaining their engagement in care is often a challenging goal. Utilizing patient navigators, trained in an adapted ARTAS intervention, to help re-engage out-of-care PLWH has proven to be a valuable resource. This qualitative study describes the encounters between PLWH (n = 11) and their care re-engagement navigators (n = 9). Participants were interviewed in-person; interviews were transcribed and analyzed using the strengths model of case management. PLWH shared how working with navigators increased their motivation to return to HIV care and assisted them to overcome barriers that were a hindrance to care engagement. Navigators described a strengths-based approach to working with their clients, thus helping facilitate PLWH care re-engagement goals and successes. Results from this study may inform the development of effective HIV navigation programs to re-engage out-of-care PLWH, often the hardest-to-engage.
- Published
- 2019
- Full Text
- View/download PDF
3. Comparing enrolees with non-enrolees of cancer-patient navigation at end of life.
- Author
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Park G, Johnston GM, Urquhart R, Walsh G, and McCallum M
- Subjects
- Female, Health Resources, Humans, Male, Qualitative Research, Retrospective Studies, Nurses organization & administration, Patient Navigation organization & administration, Terminal Care methods
- Abstract
Background: Cancer-patient navigators who are oncology nurses support and connect patients to resources throughout the cancer care trajectory, including end of life. Although qualitative and cohort studies of navigated patients have been reported, no population-based studies were found. The present population-based study compared demographic, disease, and outcome characteristics for decedents who had been diagnosed with cancer by whether they did or did not see a navigator., Methods: This retrospective study used patient-based administrative data in Nova Scotia (cancer registry, death certificates, navigation visits) to generate descriptive statistics. The study population included all adults diagnosed with cancer who died during 2011-2014 of a cancer or non-cancer cause of death., Results: Of the 7694 study decedents, 74.9% had died of cancer. Of those individuals, 40% had seen a navigator at some point in their disease trajectory. The comparable percentage for those who did not die of cancer was 11.9%. Decedents at the oldest ages had the lowest navigation rates. Navigation rates, time from diagnosis to death, and time from last navigation visit to death varied by disease site., Conclusions: This population-based study of cancer-patient navigation enrolees compared with non-enrolees is the first of its kind. Most findings were consistent with expectations. However, we do not know whether the rates of navigation are consistent with the navigation needs of the population diagnosed with cancer. Because more people are living longer with cancer and because the population is aging, ongoing surveillance of who requires and who is using navigation services is warranted.
- Published
- 2018
- Full Text
- View/download PDF
4. Patient navigation across the spectrum of women's health care in the United States.
- Author
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McKenney KM, Martinez NG, and Yee LM
- Subjects
- Female, Health Status Disparities, Humans, Outcome Assessment, Health Care, Patient Navigation trends, United States, Patient Navigation organization & administration, Professional Role, Women's Health Services
- Abstract
Patient navigation is a patient-centered intervention that uses trained personnel to identify patient-level barriers, including financial, cultural, logistical, and educational obstacles to health care and then mitigate these barriers to facilitate complete and timely access to health services. For example, to assist a woman with Medicaid who is seeking postpartum care, a patient navigator could help her schedule an appointment before her insurance benefits change, coordinate transportation and child care, give her informational pamphlets on contraception options, and accompany her to the appointment to ensure her questions are answered. Existing studies examining the efficacy of patient navigation interventions show particularly striking benefits in the realm of cancer care, including gynecological oncology; patient navigation has been demonstrated to increase access to screening, shorten time to diagnostic resolution, and improve cancer outcomes, particularly in health disparity populations, such as women of color, rural populations, and poor women. Because of the successes in cancer care at reducing disparities in health care access and health outcomes, patient navigation has the potential to improve care and reduce disparities in obstetric and benign gynecological care. We review the concept of patient navigation, offer potential roles for patient navigation in obstetrics and gynecology, and discuss areas for further investigation., (Copyright © 2017 Elsevier Inc. All rights reserved.)
- Published
- 2018
- Full Text
- View/download PDF
5. Implementation of Client Incentives within a Recovery Navigation Program.
- Author
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Brolin M, Torres M, Hodgkin D, Horgan C, Lee M, Merrick E, Ritter G, Panas L, DeMarco N, Hopwood J, Gewirtz A, Straus J, Harrington J, and Lane N
- Subjects
- Humans, Health Care Costs statistics & numerical data, Motivation, Patient Navigation economics, Patient Navigation methods, Patient Navigation statistics & numerical data, Substance-Related Disorders economics, Substance-Related Disorders rehabilitation
- Abstract
Objective: Multiple detoxification admissions among clients with substance use disorders (SUD) are costly to the health care system. This study explored the impact on behavior and cost outcomes of recovery support navigator (RSN) services delivered with and without a contingent incentive intervention., Methods: New intakes at four detoxification programs were offered RSN-only (N=1116) or RSN plus incentive (RSN+I; N=1551) services. The study used a group-level cross-over design with the intervention in place at each clinic reversed halfway through the enrollment period. RSN+I clients could earn up to $240 in gift cards for accomplishing 12 different recovery-oriented target behaviors. All eligible clients entering the detoxification programs were included in the analyses, regardless of actual service use., Results: Among RSN+I clients, 35.5% accessed any RSN services compared to 22.3% in the RSN-only group (p<.01). Of RSN+I clients, 19% earned one, 12% earned two and 18% earned three or more incentives; 51% did not earn any incentives. The majority of incentives earned were for meeting with the RSN either during or after detoxification. Adjusted average monthly health care costs among clients in the RSN-only and RSN+I groups increased at a similar rate over 12 months post-detoxification., Discussion: Possible explanations for limited uptake of the incentive program discussed include features of the incentive program itself, navigator-client communication, organizational barriers and navigator bias. The findings provide lessons to consider for future design and implementation of multi-target contingency management interventions in real-world settings., (Copyright © 2016 Elsevier Inc. All rights reserved.)
- Published
- 2017
- Full Text
- View/download PDF
6. Impact of a nurse navigator on genomic testing and timely treatment decision making in patients with breast cancer.
- Author
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McAllister KA and Schmitt ML
- Subjects
- Female, Humans, Nurse-Patient Relations, Breast Neoplasms nursing, Clinical Decision-Making methods, Genetic Testing, Nurse's Role, Patient Navigation organization & administration
- Abstract
The purpose of this quality improvement project was to define best practices for identifying appropriate patients for genomic testing and improve timeliness for ordering tests and reporting results. An interdisciplinary team of surgeons, radiologists, medical oncologists, and nurses agreed that the RN navigator would be the key person to facilitate timely access to genomic profiling. AT A GLANCE: Genomic profiling has become the standard of care for patients with early-stage breast cancer to assist in developing individualized treatment plans. Nurse navigators can play a key role in improving timeliness of care. The APN-RN model led to improvements in turnaround time and complicance with the National Comprehensive Cancer Network's recommendations for genomic testing.
- Published
- 2015
- Full Text
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7. Reducing cancer screening disparities in medicare beneficiaries through cancer patient navigation.
- Author
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Braun KL, Thomas WL Jr, Domingo JL, Allison AL, Ponce A, Haunani Kamakana P, Brazzel SS, Emmett Aluli N, and Tsark JU
- Subjects
- Adult, Aged, Aged, 80 and over, Breast Neoplasms diagnosis, Breast Neoplasms ethnology, Colorectal Neoplasms diagnosis, Colorectal Neoplasms ethnology, Female, Hawaii, Humans, Male, Medicare, Middle Aged, Prostatic Neoplasms diagnosis, Prostatic Neoplasms ethnology, United States, Uterine Cervical Neoplasms diagnosis, Uterine Cervical Neoplasms ethnology, Asian psychology, Early Detection of Cancer statistics & numerical data, Healthcare Disparities ethnology, Native Hawaiian or Other Pacific Islander psychology, Patient Acceptance of Health Care ethnology, Patient Navigation
- Abstract
Significant racial disparities in cancer mortality are seen between Medicare beneficiaries. A randomized controlled trial tested the use of lay navigators (care managers) to increase cancer screening of Asian and Pacific Islander Medicare beneficiaries. The study setting was Moloka'i General Hospital on the island of Moloka'i, Hawai'i, which was one of six sites participating in the Cancer Prevention and Treatment Demonstration sponsored by the Centers for Medicare and Medicaid Services. Between 2006 and 2009, 488 Medicare beneficiaries (45% Hawaiian, 35% Filipino, 11% Japanese, 8% other) were randomized to have a navigator help them access cancer screening services (experimental condition, n = 242) or cancer education (control condition, n = 246). Self-reported data on screening participation were collected at baseline and exit from the study, and differences were tested using chi-square. Groups were similar in demographic characteristics and baseline screening prevalence of breast, cervical, prostate, and colorectal cancers. At study exit, 57.0% of women in the experimental arm and 36.4% of controls had had a Papanicolaou test in the past 24 months (P = .001), 61.7% of women in the experimental arm and 42.4% of controls had had a mammogram in the past 12 months (P = .003), 54.4% of men in the experimental arm and 36.0% of controls had had a prostate-specific antigen test in the past 12 months (P = .008), and 43.0% of both sexes in the experimental arm and 27.2% of controls had had a flexible sigmoidoscopy or colonoscopy in the past 5 years (P < .001). Findings suggest that navigation services can increase cancer screening in Medicare beneficiaries in groups with significant disparities., (© 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.)
- Published
- 2015
- Full Text
- View/download PDF
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