Exploring the application of the navigation model with people experiencing homelessness: a scoping review

ABSTRACT

People experiencing homelessness are known to be at risk of disproportionately poor health outcomes and often face barriers in accessing healthcare. Patient navigation (PN) has been identified as a way to address health disparities and engage underserved populations with healthcare services . This scoping review aims to understand how PN models have been utilized with people experiencing homelessness and other comparable populations to date and more specifically identify (a) the defining features, (b) the barriers and facilitators in implementation, and (c) the outcomes associated with PN models. Database searches were conducted in Web of Science, PubMed and SCOPUS on 15th June 2021 and 21 papers, comprising nine reviews and 12 individual studies, were selected. Results indicate that PN has consistently been associated with improvements in a range of health-related outcomes, including timely access to healthcare. While the implementation and measurement of PN varies, a series of consistent features, facilitators and barriers are identified. Interventions to date have utilized a longitudinal approach and non-clinical navigators who share characteristics with the patient, and whose role is facilitatory. To maximize success in future use of PN, further research that focuses on the feasibility of the approach outside the USA is warranted.

KEYWORDS:

• Homelessness
• underserved populations‌
• Patient Navigation model
• access to healthcare
• Scoping Review

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This project has received funding from the European Union's Horizon 2020 Research and Innovation Programme under grant agreement no. 965351. This publication reflects the author's views. The European Commission is not responsible for any use that may be made of the information it contains.

Notes on contributors

Christina Carmichael

Dr Christina Carmichael is a Postdoctoral Research Fellow at the Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, U.K.

Lee Smith

Professor Lee Smith is Professor of Public Health at the Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, U.K.

Edelweiss Aldasoro

Dr Edelweiss Aldasoro is a Senior Researcher at the International Foundation for Integrated Care, Oxford, U.K.

Alejandro Gil Salmerón

Alejandro Gil Salmeron is a Researcher at the International Foundation for Integrated Care, Oxford, U.K.

Tamara Alhambra-Borrás

Dr Tamara Alhambra-Borrás is a Researcher at the Polibienestar Research Institute, University of Valencia, Spain.

Ascensión Doñate-Martínez

Dr Ascensión Doñate-Martínez is a Researcher at the Polibienestar Research Institute, University of Valencia, Spain.

Radhika Seiler-Ramadas

Dr Radhika Seiler-Ramadas is a Research Associate at the Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Austria.

Igor Grabovac

Dr Igor Grabovac is Resident Physician at the Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Austria.