Grant: Project Grant

As the provision of health care becomes increasingly complicated, many complex interventions have been created to meet the needs of a diverse population. These interventions tend to contain many components that interact, and these components tend to be hard to define and describe. As a result, it is hard to know what these complex interventions really do, how they work, and ultimately how to replicate any successes seen. "Patient navigation" (PN) is one such example. Patients describe difficulty navigating their way through the health care system to access the right care provider or service in a timely manner. As a result, numerous PN programs have been developed to help facilitate and coordinate care in this fragmented system. These programs vary widely with no current definition or standards to guide them. Without such a foundation, there is great difficulty in developing, evaluating, and comparing PN programs. We propose an innovative way to study complex interventions-the creation of a typology, or a classification scheme, to characterize PN and how it works. Through a review of the literature, we will first explore how PN works, for whom, and in what circumstances. Then, we will elicit views from key stakeholders who are impacted by PN. These stakeholders include patients, health care providers, and health care administrators and decision-makers. A typology will be created based on these perspectives, outlining the key elements that form the core, or essence, of PN. We will then seek the input of patients and other stakeholders across the country to finalize this typology. The creation of a PN typology is an essential step to knowing how to develop these programs, where to implement them, and how to evaluate them. Patient involvement ensures that patient needs, perspectives, and values are incorporated into the very foundations of PN. This is a new approach to understanding a complex health intervention that can be applied to other interventions.