Effectiveness of system navigation programs linking primary care with community-based health and social services: a systematic review

Teggart, Kylie; Neil-Sztramko, Sarah; Nadarajah, Abbira; Wang, Amy; Moore, Caroline; Carter, Nancy; Adams, Janet S.; Jain, Kamal; Petrie, Penelope; Alshaikhahmed, Aref; Yugendranag, Shreya; Ganann, Rebecca

doi:10.1186/s12913-023-09424-5

Cited by 7 publications

(6 citation statements)

References 66 publications

(260 reference statements)

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“…Caregivers often interacted with different sectors of healthcare systems (e.g., renal team, GP, teams supporting treatment of comorbidities) and non-renal healthcare professionals could have limited understanding of CKD [ 44 , 45 ]. To help caregivers navigate health and social care systems, system navigation support could be incorporated into interventions [ 71 , 72 ]. Existing roles, such as Renal Assistant Wellbeing Practitioners, could be leveraged to provide caregivers with support navigating healthcare systems and support implementation of interventions for caregivers through intervention endorsement and/or delivery [ 53 ].…”

Section: Discussionmentioning

confidence: 99%

“Systems seem to get in the way”: a qualitative study exploring experiences of accessing and receiving support among informal caregivers of people living with chronic kidney disease

Coumoundouros,

Farrand,

Sanderman

et al. 2024

BMC Nephrol

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Background The well-being of informal caregivers of people living with chronic kidney disease is influenced by their experiences with support, however, few studies have focused on exploring these experiences. This study aimed to explore informal caregivers’ experiences accessing and receiving support while caring for someone living with chronic kidney disease. Methods Informal caregivers of people living with chronic kidney disease (n = 13) in the United Kingdom were primarily recruited via community organisations and social media adverts to participate in semi-structured interviews. Interviews explored support needs, experiences of receiving support from different groups (e.g. healthcare professionals, family/friends), and barriers and facilitators to accessing support. Support was understood as including emotional, practical, and informational support. Data were analysed using reflexive thematic analysis. Results Three themes were generated: (1) “Systems seem to get in the way” – challenges within support systems, illustrating the challenges informal caregivers encountered when navigating complex support systems; (2) Relying on yourself, describing how informal caregivers leveraged their existing skills and networks to access support independently, while recognising the limitations of having to rely on yourself to find support; and (3) Support systems can “take the pressure off”, showing how support systems were able to help informal caregivers cope with the challenges they experienced if certain conditions were met. Conclusions In response to the challenges informal caregivers experienced when seeking support, improvements are needed to better consider informal caregiver needs within healthcare systems, and to develop interventions tailored to informal caregiver needs and context. Within the healthcare system, informal caregivers may benefit from system navigation support and better integration within healthcare teams to ensure their informational support needs are met. New interventions developed to support informal caregivers should fit within their existing support systems and incorporate the qualities of support, such as empathy, that were valued. Additionally, use of an equity framework and user-centered design approaches during intervention development could help ensure interventions are accessible and acceptable.

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Section: Discussionmentioning

confidence: 99%

“Systems seem to get in the way”: a qualitative study exploring experiences of accessing and receiving support among informal caregivers of people living with chronic kidney disease

Coumoundouros,

Farrand,

Sanderman

et al. 2024

BMC Nephrol

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“…A team-based system navigation could be the ideal approach to enhance patient experiences with care. 37 The HEPAS staff together with the professionals of the health promotion facility would be able to address the physiological and social determinants that push individuals into the cycle of disease, treatment, and relapse. We can list some limitations of this scenario.…”

Section: Discussionmentioning

confidence: 99%

Why Treat Patients with a Major Orthopaedic Surgery Only to Send Them Back to the Vulnerable Conditions That Made Them Sick in the First Place? A Conceptual Scenario to Improve Patient’s Journey

Briguglio,

Cordani,

Langella

et al. 2023

IJGM

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Individuals with severe cartilage degeneration of the hip or knee or collapsed vertebrae that cause spine deformities can suffer from joint and neuropathic pain in the back, disuse of the affected limb, and restriction of movements. Surgical intervention is the most widespread and successful solution to date. There is a general belief that eating healthy and staying physically and mentally active might have a preventive role against musculoskeletal disease occurrence, while instead, we are more certain of the benefits deriving from a healthy diet and exercise therapy after major orthopaedic procedures. These aspects are in fact vital components in enhanced recovery after surgery programmes. However, they are applied in hospital settings, are often centre-dependent, and lack primary and tertiary preventive efficacy since end once the patient is discharged. There is the lack of initiatives at the territorial level that ensure a continuum in the patient’s journey towards orthopaedic surgery, home transition, and a healthy and long-lasting life. The expert panel advocates the integration of an intermediate lifestyle clinic that promotes healthy eating, physical activity, and sleep hygiene. In this facility directed by professionals in enhancing recovery after surgery, patients can be referred after the surgical indication and before home discharge. Surgery is in fact a moment when individuals are more curious to do their best to heal and stay healthy, representing a timepoint and opportunity for educating patients on how lifestyle changes may optimise not only their surgical recovery but also long-term future health state.

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“…The three typologies of integrated service we identified are not intended to be a definitive list and others may emerge including hybrid service offerings that combine elements of each. However, the importance of effective system navigation was understood across all models (40, 42–45, 48), and its importance in accessing and engagement with care is widely recognised both in the UK and elsewhere (9, 84–86).…”

Section: Specific Findingsmentioning

confidence: 99%

Exploring the impact of integrated health and social care services on child health and wellbeing in underserved populations: a systematic review

Bird,

Harper,

Muslim

et al. 2024

Preprint

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ObjectiveTo explore the evidence for interventions that integrate child health and social care and support programmes and the impact they have on child health and wellbeing.Data sourcesThe Cochrane Library, Ovid Medline, Ovid Embase, Ovid Emcare, Ovid Health Management Information Consortium (HMIC) database, and Ovid Social Policy and Practice, Proquest Psychinfo and Ebscohost Cinahl.EligibilityPeer-reviewed original research that described an intervention integrating health care and social support or care interventions for children and young people (CYP) up to the age of 18 years in high-income countries. All databases were searched from inception to August 2023.Data extraction and synthesis16 studies were identified: 4 RCTs, 5 quantitative studies, 5 qualitative studies and 2 mixed methods studies. A narrative review and quality check of included studies was performed. Study heterogeneity meant a meta-analysis could not be completed.ResultsFive qualitative, five quantitative, two mixed methods and four randomised controlled trials were included. We identified three main models of delivering integrated health and social care services: targeted support for vulnerable groups, where the provision of packages of interventions focussed on target populations showed potential for decreasing the need for social support in the long-term but with limited evidence for reducing referrals into other services. They were more successful in meeting specific objectives such as lower rates of smoking, and reducing repeat pregnancies; collaborative health and social support were typically collocated services which improved collaborative working but with little impact on workload, job satisfaction, or service delivery; and school centred health and social care, which improved some aspects of CYP wellbeing and physical health but with concerns they added to teacher workload.ConclusionsIntegrated health and social support programmes offer promising solutions to addressing health inequity in children and young people in underserved populations. However, more robust and consistent study designs are needed to guide researchers and policy makers in their implementation and evaluation.What is already known on this topic.Integrated care that is equipped to mitigate at least some of the social determinants of health is considered key to improving health inequalities in children and young people in underserved populations.Despite increasing investment in integrating health and social support there is little evidence of which models of delivery are most effective in which circumstances nor of the precise impact on target groups and the wider healthcare system.What this study addsWe identified three models of integrating health and social support: Packages of interventions targeted at specific groups; Collaborative (and collocated) health and social support; and School-centered health and social care interventions.Results across the three models offered promise of improved care and support for the underserved, referral rates into other services tended to be lower and packages interventions achieved positive results for specific objectives. However, findings were inconsistent, drop-out rates were high, and there are concerns over sustainability without sufficient resources.How this study might affect research, practice and policyEmbedding iterative co-production in future research and interventions could improve engagement and outcomes and it’s important that further works explores their cost effectiveness and implications for other elements of health and care services.Appropriate resources and a longer-term commitment to promoting integrated health and social support is needed to fully understand the strengths and weaknesses of the offer and maximise the potential benefits.

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Effectiveness of system navigation programs linking primary care with community-based health and social services: a systematic review

Cited by 7 publications

References 66 publications

“Systems seem to get in the way”: a qualitative study exploring experiences of accessing and receiving support among informal caregivers of people living with chronic kidney disease

“Systems seem to get in the way”: a qualitative study exploring experiences of accessing and receiving support among informal caregivers of people living with chronic kidney disease

Why Treat Patients with a Major Orthopaedic Surgery Only to Send Them Back to the Vulnerable Conditions That Made Them Sick in the First Place? A Conceptual Scenario to Improve Patient’s Journey

Exploring the impact of integrated health and social care services on child health and wellbeing in underserved populations: a systematic review

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