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.
KW - Continuity of patient care
KW - Ethnicity
KW - HIV
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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U2 - 10.1016/j.evalprogplan.2021.101977
DO - 10.1016/j.evalprogplan.2021.101977
M3 - Article
C2 - 34373116
AN - SCOPUS:85111983802
SN - 0149-7189
VL - 90
JO - Evaluation and Program Planning
JF - Evaluation and Program Planning
M1 - 101977
ER -