A Stepped Care Model of Patient Navigation to Enhance Engagement with Perinatal Mental Health Care

DiSanza, Christina Bricca; Geller, Pamela A.; Bonacquisti, Alexa; Posmontier, Bobbie; Horowitz, June Andrews; Chiarello, Lisa A.

doi:10.1089/heq.2020.0077

Cited by 6 publications

(4 citation statements)

References 19 publications

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“…This protocol outlines the study design, methods and analyses that will be used to conduct a comprehensive evaluation of the ForWhen navigation programme. Navigation models have been adopted in a range of healthcare including PIMH, 35 but their impact on clinical outcomes and evaluation of implementation including barriers and enablers in the engagement with PIMH services is currently not well understood. The findings of this evaluation will advance understanding on the potential of navigation programmes such as ForWhen to enhance service connection and treatment for PIMH on a national scale, and help to inform sustainable and effective programme design in future.…”

Section: Discussionmentioning

confidence: 99%

ForWhenAustralian perinatal and infant mental health navigation programme: evaluation protocol

et al. 2023

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IntroductionMany parents and carers experience mental health challenges during pregnancy and early postpartum years, and there are cumulative shortfalls in the identification, follow-up, and treatment of those experiencing perinatal and infant mental health (PIMH) challenges. ForWhen is a new national navigation programme in Australia that aims to improve outcomes for families by supporting parents and carers to access PIMH services that best meet their needs. This paper presents the protocol of an evaluation of the ForWhen programme, to be conducted over the first 3 years of its implementation. The specific objectives of the evaluation include examining the characteristics of navigation service delivery, its implementation and clinical impact, and identifying potential moderators of change.Methods and analysisUtilising a mixed-methods design, this evaluation will incorporate three phases that reflect the stages of the programme life-cycle: (1) programme description, (2) implementation evaluation and (3) outcomes evaluation. The evaluation will use a mix of quantitative and qualitative data including deidentified routinely collected service data, participant observations, semistructured interviews, surveys and questionnaires, and a resource audit.DiscussionEvaluation findings will be used to inform the development of a refined clinical navigation model, identify barriers and facilitators to successful navigation programme implementation, examine the impact of the ForWhen programme on client clinical outcomes and health service utilisation, understand how the programme is/can be best embedded in the evolving service system, and assess the cost-effectiveness and sustainability of a national navigation programme in improving health outcomes for PIMH in Australia.Ethics and disseminationThis research was approved by South Western Sydney Local Health District Human Research Ethics Committee (2021/ETH11611). This study was registered on the Australian New Zealand Clinical Trials Registry (ACTRN12622001443785). Results will be disseminated at conferences, in scientific journals, and in a final evaluation report.

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Section: Discussionmentioning

confidence: 99%

ForWhenAustralian perinatal and infant mental health navigation programme: evaluation protocol

et al. 2023

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“…In response to the complexity of accessing appropriate PMH care, patient navigation (PN) models offer a promising patient‐centered approach to promote referral to appropriate services, treatment attendance, engagement, continuity of care, and retention among patients with varied health needs (DiSanza et al., 2020). The first PN program was initiated in 1990 at Harlem Hospital Center in New York as a means to address health disparities in cancer care, remove barriers, and promote access to timely diagnosis and treatment (Freeman & Rodriguez, 2011; Kelly et al., 2019).…”

Section: Introductionmentioning

confidence: 99%

“…PN models introduce the role of a “navigator” who is focused on connecting clients to available services, rather than providing their clinical care (DiSanza et al., 2020). PN is defined by partnership between patient (and/or patient's caregiver) and navigator, who guides patients through the complexities of the healthcare system, facilitates timely access to care, and fosters patient self‐management through education, capacity building, and support (Kelly et al., 2019).…”

Section: Introductionmentioning

confidence: 99%

“…A recent survey of existing PMH programs in the United States suggested that in almost a quarter of programs, PN services have been adopted (DiSanza et al., 2020). Yet there remains ambiguity in the literature regarding the scope and responsibilities of a navigator, and the ways in which navigation is different to other clinical roles (Kelly et al., 2019).…”

Section: Introductionmentioning

confidence: 99%

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Patient navigation models for mental health of parents expecting or caring for an infant or young child: A systematic review

Harris,

Harrison,

Hazell‐Raine

et al. 2023

Infant Mental Health Journal

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Patient navigation (PN) aims to improve timely access to healthcare by helping patients to “navigate” complex service provision landscapes. PN models have been applied in diverse healthcare settings including perinatal mental health (PMH). However, the practice models and implementation of PN programs vary widely, and their impact on engagement with PMH services has not been systematically investigated. This systematic narrative review study aimed to (1) identify and describe existing PMH PN models, (2) understand their effectiveness in improving service engagement and clinical outcomes, (3) review patient and provider perceptions, and (4) explore facilitators and barriers to program success. A systematic search of published articles/reports describing PMH PN programs/service delivery models targeting parents in the period from conception to 5 years postpartum was conducted. In total, 19 articles describing 13 programs were identified. The analysis yielded a number of commonalities and differences across program settings, target populations, and the scope of the navigator role. While there was promising evidence to support the clinical efficacy and impact on service utilization of PN programs for PMH, the current evidence base is sparse. Further research evaluating the efficacy of such services, and facilitators and barriers to their success, is warranted.

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Implementing a National Navigation Service for Perinatal and Infant Mental Health: Early Learnings from the ForWhen Model

Harris,

Eapen,

Kohlhoff

2023

Community Ment Health J

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A Stepped Care Model of Patient Navigation to Enhance Engagement with Perinatal Mental Health Care

Cited by 6 publications

References 19 publications

ForWhenAustralian perinatal and infant mental health navigation programme: evaluation protocol

ForWhenAustralian perinatal and infant mental health navigation programme: evaluation protocol

Patient navigation models for mental health of parents expecting or caring for an infant or young child: A systematic review

Implementing a National Navigation Service for Perinatal and Infant Mental Health: Early Learnings from the ForWhen Model

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