Promoting health and social equity through family navigation to prevention and early intervention services: a proof of concept study

Abstract

Background Health and social inequality are associated with multiple adverse childhood experiences including poverty, mental illness, and child maltreatment. While effective interventions currently exist for many health and social problems, large segments of the population experience barriers accessing needed services. In alignment with broader public health efforts to reduce health and social inequality in one state in the U.S.A., the current study describes the development and formative evaluation of a brief, low cost, portable model of prevention-oriented family service navigation called Navigate Your Way. Methods Caregivers of children experiencing significant unmet health or social service needs were recruited to the study. Participants completed an initial and closing telephone interview which included measures of past and current family health and social service utilization, service barriers, parenting stress, and child internalizing/externalizing behaviors. Between interviews participants created a family service plan and received 10 weeks of telephone and web-mediated family navigation, at which time process and fidelity of implementation data were collected. Frequency and descriptive statistics are provided for participant demographic characteristics, service barriers, intervention engagement, and primary and secondary study outcomes. Paired samples t-tests examined changes in study outcomes between initial and closing telephone interviews. Results Thirty two caregivers enrolled, twenty-nine completed the study. The age range was 20–59 (M = 39.5, SD = 10.0). The majority identified as female (96.9%, n = 31), racial/ethnic minority (56.2%, n = 18), and reported an average 10 barriers to care (M = 10.4, SD = 4.1). The most frequently reported service needs were mental health care, housing, food security, transportation, and health insurance. The mean duration of intervention delivery was 83 days. Most participants (82.8%, n = 24) were connected to one or more health or social services. Caregivers reported significant improvements to youth internalizing behaviors (d = 2.5, p = .05) and high levels of overall satisfaction with the navigation approach. Conclusion Telephone and web-mediated service navigation is a feasible and practical approach to supporting families in rapidly connecting to health and social care. Future research investigating the efficacy and implementation of Navigate Your Way in routine settings is indicated.

Connecting and engaging with health and social care: Exploring the core components of a telephone and web‐mediated family navigation prevention service

“…This information may help improve service access, strengthen child and family well-being and prevent the downstream consequences of health and social inequality. To address this need the current study examined participant feedback and process of implementation data from a formative evaluation of a prevention-oriented model of service navigation called Navigate Your Way (Waid et al, 2022). The study aims were to identify the specific intervention activities navigators engaged in; explore participants and navigators' perceptions of the model they perceived as essential for supporting early child and family engagement with health care, mental health care, and social services; The purpose of the navigator model is to rapidly engage families affected by health and social inequality; support timely child and family access and engagement with health care, mental health care, and social services; promote children's mental health and family wellbeing; and reduce the downstream occurrence of mental illness, child maltreatment, and other adverse childhood experiences.…”

“…Navigators reported significant reductions to the number of barriers families experienced, while caregivers reported improvement to their child's mental health difficulties. For a full description of the formative evaluation and primary study outcomes, see Waid et al (2022).…”