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 journalArticlepeer-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 languageEnglish (US)
Article number101977
JournalEvaluation and Program Planning
Volume90
DOIs
StatePublished - 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

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