A mixed-method evaluation of a volunteer navigation intervention for older persons living with chronic illness (Nav-CARE): findings from a knowledge translation study

Abstract

Background Volunteer navigation is an innovative way to help older persons get connected to resources in their community that they may not know about or have difficulty accessing. Nav-CARE is an intervention in which volunteers, who are trained in navigation, provide services for older persons living at home with chronic illness to improve their quality of life. The goal of this study was to evaluate the impact of Nav-CARE on volunteers, older persons, and family participating across eight Canadian sites. Methods Nav-CARE was implemented using a knowledge translation approach in eight sites using a 12- or 18-month intervention period. A mixed method evaluation was used to understand the outcomes upon older person engagement; volunteer self-efficacy; and older person, family, and volunteer quality of life and satisfaction with the intervention. Results Older persons and family were highly satisfied with the intervention, citing benefits of social connection and support, help with negotiating the social aspects of healthcare, access to cost-effective resources, and family respite. They were less satisfied with the practical help available for transportation and errands. Older persons self-reported knowledge of the services available to them and confidence in making decisions about their healthcare showed statistically significant improvements (P < .05) over 12–18 months. Volunteers reported satisfaction with their role, particularly as it related to building relationships over time, and good self-efficacy. Volunteer attrition was a result of not recruiting older persons in a timely manner. There was no statistically significant improvement in quality of life for older persons, family or volunteers from baseline to study completion. Conclusions Findings from this study support a developing body of evidence showing the contributions volunteers make to enhanced older person and family well-being in the context of chronic illness. Statistically significant improvements were documented in aspects of client engagement. However, there were no statistically significant improvements in quality of life scores even though qualitative data illustrated very specific positive outcomes of the intervention. Similar findings in other volunteer-led intervention studies raise the question of whether there is a need for targeted volunteer-sensitive outcome measures.

How do inner and outer settings affect implementation of a community-based innovation for older adults with a serious illness: a qualitative study

“…A large mixed-methods study that trialed Nav-CARE in eight sites across three Canadian provinces found it benefited older adults [38,39,41]. The qualitative portion of this study conducted semi-structured individual and group interviews with participants who had delivered or managed Nav-CARE.…”

“…Evidence from the field of implementation science indicates innovations need to be tailored to the context where they are being implemented [37]. Our study supplemented data from a larger study [38,39] with stakeholder interviews in a single community to explore context-specific factors affecting successful implementation within that community; it focused on the inner and outer setting domains in the CFIR framework. The rationale for focusing on the inner and outer setting domains was an interest in understanding how organizational support for Nav-CARE and links between organizations affected implementation.…”

Developing competencies for volunteer navigators to support caregivers of children living with medical complexity: a mixed-method e-Delphi study

“…Volunteers feel well-prepared and satisfied in their role; older persons and families who have participated in the program have indicated that having a volunteer navigator has improved their engagement with life, their ability to manage their illness, and their overall quality of life. 21 Such results may hold promise for a similar model that can assist family caregivers of children living with medical complexity. The research described in this paper is a first step in preparing such an adaptation.…”

“…20 This model, called Nav-CARE (Navigating-Connecting, Advocating, Resourcing, Engaging) provides additional training to hospice volunteers to enable them to provide assistance for the day-to-day challenges experienced by persons living with declining health at home with an emphasis on improving their quality of life. 20,21 Nav-CARE has been implemented and evaluated in multiple sites across Canada with good impact. Volunteers feel well-prepared and satisfied in their role; older persons and families who have participated in the program have indicated that having a volunteer navigator has improved their engagement with life, their ability to manage their illness, and their overall quality of life.…”

Research on Optimization of Agricultural Machinery Fault Monitoring System Based on Artificial Neural Network Algorithm

“…Pesut B. pointed out that intelligent video surveillance system, as a higher-end video surveillance application, can solve a series of problems such as management, forensics and so on. It combines machine vision algorithm with traditional video surveillance system by virtue of computer's powerful computing ability and data processing ability, thus improving the intelligent processing ability of surveillance system (Pesut B et al, 2020). Pi J. et al pointed out that in the development of agricultural remote monitoring; video technology plays a direct role in determining the quality of monitoring.…”