Primary Care Clinician Perspectives on Patient Navigation to Improve Postpartum Care for Patients with Low Income

Abstract

Background: Birthing individuals experience significant physical and psychosocial transitions during the postpartum period. Despite amplified health needs, many individuals do not successfully transition from obstetric to primary care. Patient navigation provides a patient-centered solution that has been applied to other health care specialties resulting in improved care coordination and patient engagement for populations in greatest need. Our objective was to understand primary care clinician perspectives regarding the role of navigators in improving postpartum care for individuals with low income. Methods: In this qualitative investigation, we conducted focus groups with primary care clinicians from family and internal medicine specialties. Semistructured interview guides addressed clinician perceptions of navigator roles during the postpartum period and recommendations for navigator training. Focus group discussions were digitally recorded, transcribed, and analyzed via a constant comparative method. Results: Twenty-eight primary care clinicians, including 26 physicians and 2 advanced practice registered nurses, participated in 8 focus groups. Participants reported favorable attitudes toward implementation of a postpartum patient navigation program. Themes regarding useful navigation services included streamlining obstetric to primary care transition, enhancing visit effectiveness, creating personalized postpartum care, and providing patient- and clinician-focused education. Recommendations for navigator training included education on basic medical concerns that are common in the postpartum period, health information privacy and electronic health record use, health care systems, and community resources. Clinical Trial Registration number: NCT03922334. Conclusions: Primary care clinicians were highly receptive to the concept of patient navigation as a process to improve health in the postpartum period through enhanced care coordination and improved patient knowledge, engagement, and self-efficacy.

Evaluation of the effect of a nurse navigation program developed for postpartum mothers on maternal health: A randomized controlled study

“…In the study by Filicko et al. (2022) that evaluated the opinions of healthcare professionals working in primary care, the healthcare professionals reported a decrease in the incidence of postpartum complications and physical problems and timely treatment of any complications that emerged. Therefore, nursing navigation program‐based care may be an effective approach to alleviate and reduce the incidence of postpartum physical symptoms.…”

Trends in Cardiovascular Health Counseling Among Postpartum Individuals

“…The postpartum visit can serve as an important opportunity to screen for cardiovascular risk factors, assess barriers to achieving ideal CVH, and refer to services and clinicians (ie, primary care clinicians, obstetricians, or cardiologists) that best meet a patient’s needs. Several gaps in the transition to long-term preventive care exist, however, and include difficulty identifying in-network clinicians, fragmented medical systems, challenges accessing transportation and finding affordable childcare, and experiencing discrimination within the health care system . In addition to addressing these patient- and systems-level barriers, care transitions should be coupled with physician education regarding the associations between APOs and CVD risk.…”

Evaluating feedback from an implementation advisory board to assess the rollout of a postpartum patient navigation program

“…Meetings included a presentation by the research team to IAB members about the progress of the study as well as structured discussion in which IAB members provided feedback to the research team. Additionally, the research team offered tips and education to the IAB about the patient navigation program, provided updates on programmatic evolution in response to prior feedback, and shared initial research findings from early-phase work [11,12]. Meetings were initially in-person but converted to virtual at the start of the COVID-19 pandemic.…”