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Strengthen the Evidence for Maternal and Child Health Programs

New: MCHbest strategies database for sample ESMs

Evidence Tools
MCHbest. NPM 1: Well-Woman Visit

MCHbest Logo well-woman visit

Strategy. Patient Navigation

Approach. Support programs and adapt clinical protocols that assist women in scheduling preventing visits using patient navigators.

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Overview. Culturally and linguistically appropriate interventions may improve Pap testing levels among women in North America.”1

Evidence. Moderate. Interventions targeting the patient/consumer such as patient navigation appear to be effective. Access the peer-reviewed evidence through the MCH Digital Library. (Read more about understanding evidence ratings). There is strong evidence that patient navigator programs increase rates of cancer screening (Genoff 2016*, Muliira 2016*, Hou 2015*), especially for breast cancer (Krok-Schoen 2016, Marshall 2016*, Phillips 2010, Robinson-White 2010*). Additional evidence is needed to confirm effects for programs focused on other health conditions and outcomes. Note: this strategy is also summarized by the Robert Wood Johnson Foundation's What Works for Health Database: Read more in theĀ WWFH database report. Read more about WWFH's evidence ratings. (*Links to studies can be accessed through the WWFH database).

Target Audience. Patient/Consumer.

Outcome. Percent of women with a past year preventive visit. For detailed outcomes related to each study supporting this strategy, click on the peer-reviewed evidence link above and read the "Intervention Results" for each study.

Examples from the Field. Access descriptions of current ESMs that use this strategy directly or intervention components that align with this strategy. You can use these ESMs to see how other Title V agencies are addressing the NPM.

Sample ESMs. Using the approach “Support programs and adapt clinical protocols that assist women in scheduling preventing visits using patient navigators,” here are sample ESMs you can use as a model for your own measures using the Results-Based Accountability framewor (for suggestions on how to develop programs to support this strategy, see The Role of Title V in Adapting Strategies)k:

Quadrant 1:
Measuring Quantity of Effort
("What/how much did we do?")

  • Number of WIC clients who receives assistance with scheduling preventive visit appointments from WIC staff.
  • Number of women ages 18 through 44 connected to a patient navigator as a result of Title V efforts.

Quadrant 2:
Measuring Quality of Effort
("How well did we do it?")

  • Percent of WIC clients who receives assistance with scheduling preventive visit appointments from WIC staff.
  • Percent of women ages 18 through 44 connected to a patient navigator as a result of Title V efforts.

Quadrant 3:
Measuring Quantity of Effect
("Is anyone better off?")

  • Number of WIC clients who receive assistance with scheduling preventive visit appointments from WIC staff who attend the appointment.

Quadrant 4:
Measuring Quality of Effect
("How are they better off?")

  • Percent of WIC clients who receive assistance with scheduling preventive visit appointments from WIC staff who attend the appointment.

Note. ESMs become stronger as they move from measuring quantity to measuring quality (moving from Quadrants 1 and 3, respectively, to Quadrants 2 and 4) and from measuring effort to measuring effect (moving from Quadrants 1 and 2, respectively, to Quadrants 3 and 4).

Learn More. Read how to create stronger ESMs and how to measure ESM impact more meaningfully through Results-Based Accountability.


Reference:

1McKenney, K. M., Martinez, N. G., & Yee, L. M. (2018). Patient navigation across the spectrum of women’s health care in the United States. American journal of obstetrics and gynecology218(3), 280-286.

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.