Dissemination of patient navigation programs across the united states

OBJECTIVE: To use diffusion and dissemination frameworks to describe how indicators of economic and health care disparity affect the location and type of patient navigation programs.METHODS: A cross-sectional national Web-based survey conducted during 2009-2010 with support from 65 separate national and regional stakeholder organizations.PARTICIPANTS: A total of 1116 self-identified patient navigators across the United States.MAIN OUTCOME MEASURE: The location and characteristics of patient navigation programs according to economic and health care disparity indicators.RESULTS: Patient navigation programs appear to be geographically dispersed across the United States.Program differences were observed in navigator type, population served, and setting by poverty level.Programs in high-poverty versus low-poverty areas were more likely to use lay navigators (P <.001) and to be located in community health centers and agencies with religious affiliations (50.6 vs 36.4%, and 21.5% vs 16.7%.respectively; P ≤ 0.01).CONCLUSION(S): Results suggest that navigation programs have spread beyond initial target inception areas and also serve as a potentially important resource in communities with higher levels of poverty and/or relatively low access to care.In addition, while nurse navigators have emerged as a significant component of the patient navigation workforce, lay health navigators serve a vital role in underserved communities.Other factors from dissemination frameworks may influence the spread of navigation and provide useful insights to support the dissemination of programs to areas of high need.