A conceptual framework for examining healthcare access and navigation: a behavioral-ecological perspective

Abstract

This paper introduces a conceptual framework for investigating individual ability to navigate healthcare in the contexts of the built environment, social environment, and healthcare infrastructure in which a person is embedded. Given the complexity of healthcare delivery in the United States, consumers are expected to have an increasingly sophisticated set of skills in order to effectively navigate and benefit from the healthcare resources available to them. Addressing barriers to navigation in vulnerable populations may be essential to reducing health disparities. This paper builds on previous conceptual developments in the areas of healthcare use, navigation, and ecological perspectives on health in order to present a behavioral-ecological framework for examining healthcare navigation and access. The model posits that healthcare navigation is an ecologically informed process not only because of the spatial distribution of health services, but because of the spatial distribution of individual and environmental factors that influence decision-making and behavior with respect to service use. The paper discusses areas for further research on healthcare navigation, challenges for research, and implications for reducing health disparities.

Community perspectives on barriers and challenges to HIV pre-exposure prophylaxis access by men who have sex with men and female sex workers access in Nigeria

“…The study adapted the conceptual model by Ryvicker [22] on healthcare access, which had adopted a behaviour-ecological perspective. The model acknowledges that many factors affect healthcare consumers' access to the healthcare system.…”

The effect of mobility on HIV-related healthcare access and use for female sex workers: A systematic review

“…Applications of the behavioural model have under-explored the role of context and the environment (Babitsch et al, 2012;Phillips et al, 1998), although the model has been updated to emphasize these factors (Andersen et al, 2013). An ecological perspective may be conceptually more consistent with the structural determinants of health frameworks developed for sex-worker health (Bronfenbrenner, 1979;McLeroy et al, 1988) (see for example Baral et al (2013) for an application of the ecological model to HIV risk), and attempts have been made to combine this conceptually with the behavioural model (Ryvicker, 2017). A useful insight from the ecological perspective is that systems are operating a number of scales, and dynamically interact to define and change each other over time.…”

Disconnections between medical education and medical practice: A neglected dilemma

“…Also requiring educational attention are the local and global social trends (including complexity in accessing healthcare), with their powerful determining effects on health that create and sustain disparities and potentially threaten health and well-being. A behavioural-ecological perspective model is suggested for understanding how to access healthcare, as health outcomes depend on the ability to navigate healthcare in the spatial contexts of the built environment, social environment and health care infrastructures in which persons are embedded (Ryvicker, 2018).…”