An Assessment of Patient Navigator Program Strategies and Their Effects on the Social Determinants of Health and Health Outcomes of Patients with Type II Diabetes
Charles R. Drew University/David Geffen School of Medicine at UCLA
Raslyn Preston, Taylor Henderson, Rosa Argueta, Karen Linares, Daisy Salazar, Gabriel Vera
Charles R. Drew University/David Geffen School of Medicine at UCLA, University of North Carolina School of Medicine, California State University Los Angeles, Williams College, Biola University, University of California, Los Angeles, NMF Primary Care Leadership Program, AltaMed Health Careers Opportunity Program
AltaMed Health Services, the largest independent federally qualified health center in the nation, primarily serves individuals who come from low-income backgrounds, are covered by Medi-Cal, or are uninsured. Appointment no-show rates are especially high for patients with these backgrounds and for patients with poorly controlled Type II Diabetes Mellitus (DM), a chronic condition that requires physician supervision and proper self-management by the patient for optimal control. Patient navigator (PN) programs, originally designed for patients with cancer, are “community-based service delivery interventions designed to promote access to timely diagnosis and treatment of … chronic diseases by eliminating barriers to care.” AltaMed’s PN program, Health Navigators, aims to improve diabetic patient health outcomes by increasing appointment adherence, screening for social determinants of health (SDoH), and connecting patients to community resources. To develop a list of actionable recommendations to improve AltaMed’s PN program and to provide guidelines for designing PN programs, we completed a review of literature describing the strategies and outcomes of PN programs that improved the health status and addressed the SDoH of patients with Type II DM. Major suggestions for implementation are to: 1) employ PNs with medical training, as they can evaluate and address psychosocial needs, provide health education, and streamline clinic documentation, 2) expand PN training to include motivational interviewing, empowerment theory, and diabetes management to increase patient self-efficacy and self-management skills, and 3) create and maintain an organization resource bank of clinic and community resources by city/county based on services most frequently requested by patients.
Keywords: patient navigators, FQHC, diabetes