Implementation and evaluation of patient navigation in Chicago: Insights on addressing the social determinants of health and integrating HIV prevention and care services

George J. Greene; Emma Reidy; Dylan Felt; Rachel Marro; Amy K. Johnson; Gregory Phillips; Evelyn Green; Patrick Stonehouse

doi:10.1016/j.evalprogplan.2021.101977

Implementation and evaluation of patient navigation in Chicago: Insights on addressing the social determinants of health and integrating HIV prevention and care services

George J. Greene^*, Emma Reidy, Dylan Felt, Rachel Marro, Amy K. Johnson, Gregory Phillips, Evelyn Green, Patrick Stonehouse

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

8 Scopus citations

Abstract

Patient navigation is a primary element in linkage to HIV pre-exposure prophylaxis (PrEP) care and linkage to or re-engagement in HIV care, depending on the HIV status of the individual. However, there is a dearth of literature describing navigation services in these areas. In the context of Chicago Project PrIDE, this project conducted process and implementation evaluations with eight agencies leading demonstration projects to address these gaps. The evaluation team conducted semi-structured, individual interviews with agency staff (N = 20) assessing navigation implementation and fit, as well as project successes and challenges. Additionally, agency staff collected patient surveys (N = 300) assessing services provided, service quality, and satisfaction. The interview transcripts were coded and analyzed thematically and descriptive analyses were performed on the survey data. Analyses indicated that screening for social determinants of health, providing healthcare engagement guidance, and providing service referrals were frequently cited navigation activities. Most staff members indicated that navigation fits well within their agencies, and that limited staff and clinic capacity were often barriers to navigation. Patient navigation to support engagement in HIV prevention and care services is critical due to the extensive support provided by navigators to address social determinants of health impacting HIV disparity populations.

Original language	English (US)
Article number	101977
Journal	Evaluation and Program Planning
Volume	90
DOIs	https://doi.org/10.1016/j.evalprogplan.2021.101977
State	Published - Feb 2022

Funding

Emma Reidy , MPH, is currently a Senior Research Project Manager at Brigham and Women’s Hospital, where she manages the development, implementation, and evaluation of a national multi-site trial to reduce disparities in surgical outcomes. Previously, she was a Research Project Coordinator at Northwestern University, working on Project PrIDE funded by the CDC and the Chicago Department of Public Health. The Chicago Department of Public Health provided financial support for the conduct of this evaluation and the preparation of this manuscript. Health department staff participated in the formulation of the overarching evaluation design, contributed to the interpretation of data, and provided critical review during the pre-publication stages. Health department staff supported the decision to submit this manuscript for publication and are included as co-authors. The Evaluation, Data Integration, and Technical Assistance Program of the Northwestern University Institute for Sexual and Gender Minority Health and Wellbeing provided financial support to the evaluation interns.

Keywords

Continuity of patient care
Ethnicity
HIV
Healthcare disparities
Patient navigation
Pre-exposure prophylaxis
Program evaluation
Race
Sexual and gender minorities
Social determinants of health

ASJC Scopus subject areas

Public Health, Environmental and Occupational Health
Geography, Planning and Development
Social Psychology
Business and International Management
Strategy and Management

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.evalprogplan.2021.101977

Cite this

Greene, G. J., Reidy, E., Felt, D., Marro, R., Johnson, A. K., Phillips, G., Green, E., & Stonehouse, P. (2022). Implementation and evaluation of patient navigation in Chicago: Insights on addressing the social determinants of health and integrating HIV prevention and care services. Evaluation and Program Planning, 90, Article 101977. https://doi.org/10.1016/j.evalprogplan.2021.101977

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title = "Implementation and evaluation of patient navigation in Chicago: Insights on addressing the social determinants of health and integrating HIV prevention and care services",

abstract = "Patient navigation is a primary element in linkage to HIV pre-exposure prophylaxis (PrEP) care and linkage to or re-engagement in HIV care, depending on the HIV status of the individual. However, there is a dearth of literature describing navigation services in these areas. In the context of Chicago Project PrIDE, this project conducted process and implementation evaluations with eight agencies leading demonstration projects to address these gaps. The evaluation team conducted semi-structured, individual interviews with agency staff (N = 20) assessing navigation implementation and fit, as well as project successes and challenges. Additionally, agency staff collected patient surveys (N = 300) assessing services provided, service quality, and satisfaction. The interview transcripts were coded and analyzed thematically and descriptive analyses were performed on the survey data. Analyses indicated that screening for social determinants of health, providing healthcare engagement guidance, and providing service referrals were frequently cited navigation activities. Most staff members indicated that navigation fits well within their agencies, and that limited staff and clinic capacity were often barriers to navigation. Patient navigation to support engagement in HIV prevention and care services is critical due to the extensive support provided by navigators to address social determinants of health impacting HIV disparity populations.",

keywords = "Continuity of patient care, Ethnicity, HIV, Healthcare disparities, Patient navigation, Pre-exposure prophylaxis, Program evaluation, Race, Sexual and gender minorities, Social determinants of health",

author = "Greene, {George J.} and Emma Reidy and Dylan Felt and Rachel Marro and Johnson, {Amy K.} and Gregory Phillips and Evelyn Green and Patrick Stonehouse",

note = "Funding Information: Emma Reidy , MPH, is currently a Senior Research Project Manager at Brigham and Women{\textquoteright}s Hospital, where she manages the development, implementation, and evaluation of a national multi-site trial to reduce disparities in surgical outcomes. Previously, she was a Research Project Coordinator at Northwestern University, working on Project PrIDE funded by the CDC and the Chicago Department of Public Health. Funding Information: The Chicago Department of Public Health provided financial support for the conduct of this evaluation and the preparation of this manuscript. Health department staff participated in the formulation of the overarching evaluation design, contributed to the interpretation of data, and provided critical review during the pre-publication stages. Health department staff supported the decision to submit this manuscript for publication and are included as co-authors. The Evaluation, Data Integration, and Technical Assistance Program of the Northwestern University Institute for Sexual and Gender Minority Health and Wellbeing provided financial support to the evaluation interns. Publisher Copyright: {\textcopyright} 2021 Elsevier Ltd",

year = "2022",

month = feb,

doi = "10.1016/j.evalprogplan.2021.101977",

language = "English (US)",

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Greene, GJ, Reidy, E, Felt, D, Marro, R, Johnson, AK , Phillips, G, Green, E & Stonehouse, P 2022, 'Implementation and evaluation of patient navigation in Chicago: Insights on addressing the social determinants of health and integrating HIV prevention and care services', Evaluation and Program Planning, vol. 90, 101977. https://doi.org/10.1016/j.evalprogplan.2021.101977

TY - JOUR

T1 - Implementation and evaluation of patient navigation in Chicago

T2 - Insights on addressing the social determinants of health and integrating HIV prevention and care services

AU - Greene, George J.

AU - Reidy, Emma

AU - Felt, Dylan

AU - Marro, Rachel

AU - Johnson, Amy K.

AU - Phillips, Gregory

AU - Green, Evelyn

AU - Stonehouse, Patrick

N1 - Funding Information: Emma Reidy , MPH, is currently a Senior Research Project Manager at Brigham and Women’s Hospital, where she manages the development, implementation, and evaluation of a national multi-site trial to reduce disparities in surgical outcomes. Previously, she was a Research Project Coordinator at Northwestern University, working on Project PrIDE funded by the CDC and the Chicago Department of Public Health. Funding Information: The Chicago Department of Public Health provided financial support for the conduct of this evaluation and the preparation of this manuscript. Health department staff participated in the formulation of the overarching evaluation design, contributed to the interpretation of data, and provided critical review during the pre-publication stages. Health department staff supported the decision to submit this manuscript for publication and are included as co-authors. The Evaluation, Data Integration, and Technical Assistance Program of the Northwestern University Institute for Sexual and Gender Minority Health and Wellbeing provided financial support to the evaluation interns. Publisher Copyright: © 2021 Elsevier Ltd

PY - 2022/2

Y1 - 2022/2

N2 - Patient navigation is a primary element in linkage to HIV pre-exposure prophylaxis (PrEP) care and linkage to or re-engagement in HIV care, depending on the HIV status of the individual. However, there is a dearth of literature describing navigation services in these areas. In the context of Chicago Project PrIDE, this project conducted process and implementation evaluations with eight agencies leading demonstration projects to address these gaps. The evaluation team conducted semi-structured, individual interviews with agency staff (N = 20) assessing navigation implementation and fit, as well as project successes and challenges. Additionally, agency staff collected patient surveys (N = 300) assessing services provided, service quality, and satisfaction. The interview transcripts were coded and analyzed thematically and descriptive analyses were performed on the survey data. Analyses indicated that screening for social determinants of health, providing healthcare engagement guidance, and providing service referrals were frequently cited navigation activities. Most staff members indicated that navigation fits well within their agencies, and that limited staff and clinic capacity were often barriers to navigation. Patient navigation to support engagement in HIV prevention and care services is critical due to the extensive support provided by navigators to address social determinants of health impacting HIV disparity populations.

AB - Patient navigation is a primary element in linkage to HIV pre-exposure prophylaxis (PrEP) care and linkage to or re-engagement in HIV care, depending on the HIV status of the individual. However, there is a dearth of literature describing navigation services in these areas. In the context of Chicago Project PrIDE, this project conducted process and implementation evaluations with eight agencies leading demonstration projects to address these gaps. The evaluation team conducted semi-structured, individual interviews with agency staff (N = 20) assessing navigation implementation and fit, as well as project successes and challenges. Additionally, agency staff collected patient surveys (N = 300) assessing services provided, service quality, and satisfaction. The interview transcripts were coded and analyzed thematically and descriptive analyses were performed on the survey data. Analyses indicated that screening for social determinants of health, providing healthcare engagement guidance, and providing service referrals were frequently cited navigation activities. Most staff members indicated that navigation fits well within their agencies, and that limited staff and clinic capacity were often barriers to navigation. Patient navigation to support engagement in HIV prevention and care services is critical due to the extensive support provided by navigators to address social determinants of health impacting HIV disparity populations.

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KW - Healthcare disparities

KW - Patient navigation

KW - Pre-exposure prophylaxis

KW - Program evaluation

KW - Race

KW - Sexual and gender minorities

KW - Social determinants of health

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Implementation and evaluation of patient navigation in Chicago: Insights on addressing the social determinants of health and integrating HIV prevention and care services

Abstract

Funding

Keywords

ASJC Scopus subject areas

UN SDGs

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