Scaling out a palliative compassionate community innovation: Nav-CARE

Abstract

Background: There is an urgent need for community-based interventions that can be scaled up to meet the growing demand for palliative care. The purpose of this study was to scale out a volunteer navigation intervention called Nav-CARE by replicating the program in multiple contexts and evaluating feasibility, acceptability, sustainability, and impact. Methods: This was a scale-out implementation and mixed-method evaluation study. Nav-CARE was implemented in 12 hospice and 3 nonhospice community-based organizations spanning five provinces in Canada. Volunteers visited clients in the home approximately every 2 weeks for 1 year with some modifications required by the COVID-19 public health restrictions. Qualitative evaluation data were collected from key informants ( n = 26), clients/family caregivers ( n = 57), and volunteers ( n = 86) using semistructured interviews. Quantitative evaluation data included volunteer self-efficacy, satisfaction, and quality of life, and client engagement and quality of life. Findings: Successful implementation was influenced by organizational capacity, stable and engaged leadership, a targeted client population, and skillful messaging. Recruitment of clients was the most significant barrier to implementation. Clients reported statistically significant improvements in feeling they had someone to turn to, knowing the services available to help them in their community, being involved in things that were important to them, and having confidence in taking care of their illness. Improvements in clients’ quality of life were reported in the qualitative data, although no statistically significant gains were reported on the quality of life measure. Volunteers reported good self-efficacy and satisfaction in their role. Conclusion: The feasibility, acceptability, and sustainability of the program were largely dependent on strong intraorganizational leadership. Volunteers reported that their involvement in Nav-CARE enabled them to engage in ongoing learning and have a meaningful and relational role with clients. Clients and families described the positive impact of a volunteer on their engagement and quality of life.

Competency development for a volunteer navigation program to support caregivers of people living with dementia: A modified e-Delphi method

“…All competencies developed through this study are essential to the success of this volunteer-led dementia navigation intervention. For example, the competencies pertaining to volunteers’ relational skills and their ability to support a clients’ wellbeing, as well as their own, are foundational to the efficacy of a navigation program (Pesut et al, 2022). While all competencies require an understanding of the experiences of care dyads, four competencies - knowledge of dementia, knowledge of dementia stigma, supporting the care dyad, and identifying and assisting with accessing healthcare services - require additional consideration and a deep understanding of the nuances of the dementia journey that is beyond that of a typical volunteer.…”

“…An example of a navigation program that provides support directly to people living with life limiting illnesses that could be adapted to support care-partners is Nav-CARE (Navigation - Connecting, Advocating, Resourcing, Engaging). Nav-CARE is an evidence-based volunteer led program that supports individuals in the community living with declining health (Pesut et al, 2022). It utilizes trained, experienced, and mentored volunteer navigators to support clients in their homes or over the phone throughout their illness journey (Pesut et al, 2022).…”

“…Nav-CARE is an evidence-based volunteer led program that supports individuals in the community living with declining health (Pesut et al, 2022). It utilizes trained, experienced, and mentored volunteer navigators to support clients in their homes or over the phone throughout their illness journey (Pesut et al, 2022). Volunteers are trained to address quality of life needs, advocate for clients and families, facilitate community connections, and promote active engagement (Pesut et al, 2020, 2022).…”

“…It utilizes trained, experienced, and mentored volunteer navigators to support clients in their homes or over the phone throughout their illness journey (Pesut et al, 2022). Volunteers are trained to address quality of life needs, advocate for clients and families, facilitate community connections, and promote active engagement (Pesut et al, 2020, 2022). Through consistent visits, relationship building takes place and clients can be supported with present and future planning and decision making, provided with a social safety net, and encouraged to engage with life (Pesut et al, 2020).…”