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Strengthen the Evidence for Maternal and Child Health Programs

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Evidence Tools
MCHbest. Well-Woman Visit.

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Strategy. Patient Navigation

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

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Overview. Patient navigation is a patient-centered intervention that uses trained personnel to identify patient-level challenges, including financial, logistical, and educational obstacles to health care, and then mitigate these challenges to facilitate complete and timely access to health services.[1,2,3] Appropriate interventions may also improve Pap testing levels among women in North America.[1,2,3]

Evidence. Moderate Evidence. Strategies with this rating are likely to work...

Access the peer-reviewed evidence through the MCH Digital Library or related evidence source.

Potential Data Sources. Data to support this strategy can be accessed through:

  • Program implementation plans, protocols, and timelines
  • Patient navigator activity logs and tracking data
  • Patient satisfaction survey data

Outcome Components. This strategy has shown to have impact on the following outcomes (Read more about these categories):

  • Access to/Receipt of Care. This strategy increases the ability for individuals to obtain healthcare services when needed, including preventive, diagnostic, and treatment services.
  • Patient Experience of Care. This study improves individuals' perceptions, feelings, and satisfaction with the healthcare services they receive.
  • Utilization. This strategy improves the extent to which individuals and communities use available healthcare services.

Detailed Outcomes. For specific outcomes related to each study supporting this strategy, access the peer-reviewed evidence and read the Intervention Results for each study.

Intervention Type. Case Management (Read more about intervention types and levels as defined by the Public Health Intervention Wheel).

Intervention Level. Community-Focused

Examples from the Field. Access descriptions of ESMs that use this strategy or aligned components.

Sample ESMs. Here are sample ESMs to use as models for your own measures using the RBA framework (see The Role of Title V in Adapting Strategies).

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

  • Number of healthcare facilities and community-based organizations implementing patient navigation programs to assist women in scheduling preventive visits. (Measures the adoption and spread of patient navigation interventions)
  • Number of patient navigators trained to identify and mitigate challenges to preventive care. (Measures the capacity building efforts to support effective patient navigation)

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

  • Percent of patient navigators who complete training on evidence-based strategies for identifying and addressing obstacles to preventive care. (Measures the quality and effectiveness of patient navigator workforce development)
  • Percent of healthcare facilities and community-based organizations that have established formal referral and communication protocols with patient navigators. (Measures the level of care coordination and system integration to support patient navigation)

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

  • Number of collaborative learning sessions and best practice sharing events conducted for patient navigators and program managers across healthcare facilities and community-based organizations. (Measures efforts to foster continuous improvement and innovation in patient navigation)
  • Number of patient navigators trained to collect and use data on patient challenges, service utilization, and outcomes to inform navigation strategies and quality improvement. (Measures the integration of data-driven approaches to enhance navigation effectiveness)
  • Number of women who receive their first well-woman visit or preventive screening as a result of patient navigation assistance. (Measures the intervention's success in reaching and engaging populations facing significant access challenges)
  • Number of patient navigators who report increased job satisfaction, self-efficacy, and professional growth as a result of their role in facilitating access to preventive care. (Measures the impact of navigation programs on developing and empowering the frontline workforce)

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

  • Percent of patient navigation programs that prioritize outreach and engagement efforts in communities with the lowest rates of preventive care utilization. (Measures the tailoring of navigation interventions)
  • Percent of patient navigation protocols and training curricula that are adapted to reflect the needs of the populations served. (Measures the responsiveness and patient-centeredness of navigation interventions)
  • Percent increase in well-woman visit and preventive screening rates among women who receive patient navigation services, compared to baseline rates and women without navigation assistance. (Measures the population-level impact of navigation on reducing access gaps)
  • Percent reduction in late-stage diagnoses and preventable complications among women engaged in patient navigation programs, compared to women not receiving navigation services. (Measures the intervention's effectiveness in facilitating early detection and timely treatment)

Note. When looking at your ESMs, SPMs, or other strategies:

  1. Move from measuring quantity to quality.
  2. Move from measuring effort to effect.
  3. Quadrant 1 strategies should be used sparingly, when no other data exists.
  4. The most effective measurement combines strategies in all levels, with most in Quadrants 2 and 4.

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

References

[1] McKenney, 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 gynecology, 218(3), 280-286.

[2] Batman, S. H., Varon, M. L., Daheri, M., Ogburn, T., Rivas, S. D., Guerra, L., Toscano, P. A., Gasca, M., Campos, L., Foster, S., Martin, M., Yvette Williams-Brown, M., Poindexter, Y., Reininger, v., Salcedo, M. P., Milbourne, A., Fellman, B., Fernandez, M. E., Baker, E., Gowen, R….Schemeler, K. M. (2023). Addressing cervical cancer disparities in Texas: Expansion of a community-based prevention initiative for medically underserved populations. Preventive medicine reports, 36, 102486.

[3] Falk, D., Cubbin, C., Salsman, J. M., Winkfield, K. M., Foley, K. L., Noel, L., & Jones, B. (2023). Navigating financial challenges to Papanicolaou tests and mammograms for young adult women residing in rural and border areas of Texas. Journal of adolescent and young adult oncology, 12(2), 159-167.

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.