Community Volunteers and Primary Care Providers Supporting Older Adults in System Navigation: A Mixed Methods Study.

Jessica Gaber,Pamela Forsyth,Tracey Carr,Julie Datta,Tracy Browne,Sivan Bomze,Dee Mangin,Samina Talat,Doug Oliver,Sarah Marentette-Brown,Stephanie Di Pelino

doi:10.5334/ijic.5978

Jessica Gaber, Pamela Forsyth + Show 9 more

Open Access

https://doi.org/10.5334/ijic.5978

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Abstract

Introduction: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.Methods: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: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.Discussion: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.

Highlights

Primary care providers and community volunteers have important roles in supporting patient system navigation and utilization of community-based health and social services (CBHSS)
PARTICIPANTS Overall, there were 233 individual participants (67 health team members, 38 volunteers, and 128 clients) with data included in this manuscript
There were 38 volunteers who completed the volunteer system navigation function survey; they ranged in age 18 to 78 years

Summary

Introduction

Primary care providers and community volunteers have important roles in supporting patient system navigation and utilization of community-based health and social services (CBHSS). System navigation has expanded across settings, conditions, and the health care continuum from birth to death. Applied to a wide variety of health needs, these programmes are set in primary care, hospitals, or community-based care around the world, with heavier clusters in the US and UK [2–4]. Evidence suggests that system navigation can increase patient health care utilization and screening, assist transitions between health care settings, increase patient engagement and activation in managing health, and improve patient psychological and social well-being [2–6]. System navigation programmes can increase health care providers’ knowledge and skills in referring patients to community services, while enhancing their communication and trust with these services [6]. Providers often face challenges in providing connections to services due to a lack of awareness of them [7]

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