Apoyo con Cariño

Fink, Regina; Kline, Danielle; Siler, Shaunna; Fischer, Stacy

doi:10.1097/njh.0000000000000666

Cited by 15 publications

(18 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The majority of included articles were quantitative studies (n = 36), 28 , 41 - 75 with a few qualitative (n = 16) 76 - 91 and mixed methods (n = 6). 92 - 97 Of the quantitative studies, 6 studies were randomized control trials.…”

Section: Resultsmentioning

confidence: 99%

“… 92 - 97 Of the quantitative studies, 6 studies were randomized control trials. 47 , 53 - 55 , 63 , 71 , 83 The United States (n = 50) 28 , 41 - 45 , 47 , 49 - 55 , 57 , 58 , 60 - 73 , 75 - 80 , 82 - 84 , 86 - 91 , 93 , 94 , 96 , 98 and Canada...…”

Section: Resultsmentioning

confidence: 99%

“…The initiatives varied in terms of the target chronic condition and the type of healthcare setting in which PNPs were implemented. Most programs were implemented in community settings such as outpatient clinic settings or individuals’ homes (n = 29) 41 - 43 , 49 , 51 - 53 , 56 , 57 , 62 , 64 , 69 - 73 , 76 - 80 , 84 , 88 , 90 - 92 , 95 , 97 , 100 followed by hospitals (n = 26). 28 , 44 , 45 , 47 , 48 50 , 58 - 61 , 63 65 - 68 , 74 75 , 81 85 - 87 , 89 93 , 96 ...…”

Section: Resultsmentioning

confidence: 99%

“…77 Ten studies utilized follow-up care through home-visits. 49 , 53 , 61 , 70 , 77 , 79 , 80 , 91 , 95 Three programs used a virtual (web or phone-based) application. 54 , 83 , 94 .…”

Section: Resultsmentioning

confidence: 99%

“…The initiatives most commonly targeted cancer (n = 40) (including breast, colorectal, cervical, head, and neck), 28 , 41 , 43 44 , 47 - 50 , 52 54 - 56 , 58 60 , 62 63 , 65 - 69 , 71 - 76 , 78 80 - 84 , 87 90 , 92 94 , 96 - 98 HIV (n = 5), 42 , 61 , 64 , 88 , 91 diabetes (n = 1), 57 heart failure/cardiovascular disease (n = 2), 45 , 59 Hepatitis C (n = 2), 51 , 70 patients with complex social needs/multiple chronic conditions (n = 6), 46 , 53 , 77 , ...…”

Section: Resultsmentioning

confidence: 99%

See 4 more Smart Citations

Factors Influencing the Implementation of Patient Navigation Programs for Adults with Complex Needs: A Scoping Review of the Literature

Kokorelias

Shiers-Hanley

Rios

et al. 2021

Health�Serv�Insights

View full text Add to dashboard Cite

Patient navigation is a model of care that aims to improve access to care by reducing the complexity of navigating health, education, and social services across the continuum of care and care settings. Little is known about the processes that facilitate or impede the implementation of patient navigation programs (PNPs). We conducted a scoping review to identify and summarize the current state of knowledge regarding the implementation and outcomes of existing implemented PNPs. We employed a 6-stage scoping review framework to identify and review eligible articles. Sixty-articles met the inclusion criteria (58 peer-reviewed and 2 grey literature). The Consolidated Framework for Implementation Research served as the theoretical framework during analysis to help extract factors relevant to implementation of navigator programs. Results of the scoping review are reported thematically. Influences on implementation were identified: (a) planning to ensure alignment with organizational need (b) funding (c) multidisciplinary engagement (d) establishing workflow (e) mechanisms for communication (f) stakeholders to encourage buy-in (g) appropriate caseload (h) in kind resources. PNPs improve the experiences of patients and families. The findings of this scoping review provides implementation considerations of PNPs across global care settings. Strategies for overcoming pragmatic and logistical issues must be developed for optimal implementation.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…77 Ten studies utilized follow-up care through home-visits. 49 , 53 , 61 , 70 , 77 , 79 , 80 , 91 , 95 Three programs used a virtual (web or phone-based) application. 54 , 83 , 94 .…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Factors Influencing the Implementation of Patient Navigation Programs for Adults with Complex Needs: A Scoping Review of the Literature

Kokorelias

Shiers-Hanley

Rios

et al. 2021

Health�Serv�Insights

View full text Add to dashboard Cite

show abstract

Patient Navigator Intervention to Improve Palliative Care Outcomes for Hispanic Patients With Serious Noncancer Illness

Fischer,

Min,

Kline

et al. 2024

JAMA Intern Med

Self Cite

View full text Add to dashboard Cite

ImportanceDisparities persist across the trajectory of serious illness, including at the end of life. Patient navigation has been shown to reduce disparities and improve outcomes for underserved populations.ObjectiveTo determine the effectiveness of a lay patient navigator intervention, Apoyo con Cariño, in improving palliative care outcomes among Hispanic patients.Design, Setting, and ParticipantsThis was a multicenter randomized clinical trial that took place across academic, nonprofit, safety-net, and community health care systems in urban, rural, and mountain/frontier regions of Colorado from January 2017 to January 2021. Self-identifying Hispanic adults with serious noncancer medical illness and limited prognosis were recruited. Data were collected and analyzed from July 2022 to July 2023.InterventionsParticipants randomized to the intervention group received 5 home visits from a bilingual, bicultural lay patient navigator; participants randomized to control received care as usual. Both groups received culturally tailored educational materials. Investigators/outcome accessors remained blinded to participant assignment.Main Outcomes and MeasuresChange in score from baseline to 3 months on the Functional Assessment of Chronic Illness Therapy (FACIT) General quality of life (QOL) scale (primary outcome), Advance Care Planning (ACP) Engagement Survey, Brief Pain Inventory, Edmonton Symptom Assessment Scale, and FACIT Spiritual Well-Being subscale; at 6 months, advance directive (AD) documentation; and at 46 months or death, hospice utilization and length of stay, as well as aggressiveness of care at end of life.ResultsOf 209 patients enrolled (mean [SD] age, 63.6 [14.3] years; 108 [51.7%] male), 105 patients were randomized to control and 104 patients to the intervention. There were no statistically significant differences in the change in mean (SD) QOL score between the intervention and control groups (5.0 [16.5] vs 4.3 [15.5]; P = .75). Participants in the intervention group, compared with the control group, had statistically significant greater increases in mean (SD) ACP engagement (0.8 [1.3] vs 0.1 [1.4]; P &lt; .001) and were more likely to have a documented AD (62 of 104 [59.6%] vs 28 of 105 [26.9%]; P &lt; .001). There were no statistically significant differences in mean (SD) change in pain intensity score (0-10) between patients in the intervention group compared with control (−0.4 [2.6] vs −0.5 [2.8]; P = .79), nor pain interference (−0.2 [3.7] vs −0.4 [3.7]; P = .71). Patients receiving the intervention were more likely to be referred to hospice compared with patients receiving control (19 of 43 patients [44.2%] vs 7 of 33 patients [21.2%]; P = .04) and less likely to receive aggressive care at end of life (27 of 42 patients [64.3%] vs 28 of 33 patients [84.8%]; P = .046).Conclusion and RelevanceIn this randomized clinical trial, a culturally tailored patient navigator intervention did not improve QOL for patients. However, the intervention did increase ACP engagement, AD documentation, and hospice utilization in Hispanic persons with serious medical illness.Trial RegistrationClinicalTrials.gov Identifier: NCT03181750

show abstract

Disparities in Care Management During Terminal Hospitalization Among Adults With Metastatic Cancer From 2010 to 2017

et al. 2021

View full text Add to dashboard Cite

Key Points Question Is variation in care management during terminal hospitalization among adults with metastatic cancer associated with sociodemographic status? Findings In this cross-sectional study of 21 335 patients with metastatic cancer who died in the hospital, racial and ethnic minority patients and those with Medicare or Medicaid coverage were more likely to receive low-value, high-cost aggressive medical interventions at the end of life. Meaning This study’s findings suggest that identifying and understanding factors associated with the observed disparities will be helpful to inform communications with patients with metastatic cancer about end-of-life care.

show abstract

Apoyo con Cariño

Cited by 15 publications

References 23 publications

Factors Influencing the Implementation of Patient Navigation Programs for Adults with Complex Needs: A Scoping Review of the Literature

Factors Influencing the Implementation of Patient Navigation Programs for Adults with Complex Needs: A Scoping Review of the Literature

Patient Navigator Intervention to Improve Palliative Care Outcomes for Hispanic Patients With Serious Noncancer Illness

Disparities in Care Management During Terminal Hospitalization Among Adults With Metastatic Cancer From 2010 to 2017

Contact Info

Product

Resources

About