The Effectiveness of the Patient Navigator Program
Theory. The Transformation for Health (TFH) Framework aims to explore human health behavior transformation processes. It helped to formulate health disparity intervention strategies in multiple (i.e., individual, family, community, and society) levels. Program. The Patient Navigator Program (PNP) was a two-year community-based intervention program that was designed to improve health outcomes for medically underserved individuals who had chronic diseases, which was implemented in West Texas. Promoteres (i.e., certified community health workers, or, CHWs) delivered health education to participating patients through a family visitation program. The Transformation for Health Framework was an underlying theoretical framework for this program. Purpose. The purpose of this study was to evaluate the effectiveness of the Patient Navigator Program in improving individuals' behavioral and psychological outcomes across time. Method. The study sample included 139 patients who were enrolled in the Patient Navigator Program. Behavioral outcomes (i.e., self-care activities for diabetes) and psychological outcomes (i.e., self-efficacy for managing chronic disease, self-efficacy for diabetes, feeling of depression, general physical health condition, and general mental health condition) were measured using established survey questionnaires. Depression was measured by the 9-item Patient Health Questionnaire Depression Scale. Patients’ general physical and mental health conditions were measured by the 12-item Veteran Rand instrument. CHWs conducted self-reported surveys through personal interviews for each outcome measure once every three months. Results. By using the behavioral and psychological outcomes collected by CHWs, growth curve analyses were conducted through Hierarchical Linear Modeling (HLM). Significant improvements were found on self-efficacy for managing chronic diseases and self-care for foot but not for all study variables. Self-care for specific diet had a trend of improvement at the .10 level. Though not statistically significant, there was a consistent pattern of improvements in other behavioral and psychological outcome variables. Conclusions. The growth curve analysis through Hierarchical Linear Modeling (HLM) supported the effectiveness of the Patient Navigator Program in improving individuals' behavioral and psychological outcomes, which in turn, supported the program design and the effectiveness of using CHWs in health intervention programs. For future study, the effectiveness of the Patient Navigator Program in improving participants' clinical outcomes can be explored.