Womens Health Nurs.  2024 Mar;30(1):26-40. 10.4069/whn.2024.03.15.

Patient navigation in women’s health care for maternal health and noncancerous gynecologic conditions: a scoping review

• Oh J

• KMID: 2554188
• DOI: http://doi.org/10.4069/whn.2024.03.15

Abstract

Purpose
This study investigated the scope of patient navigation studies on women’s health care for maternal health and noncancerous gynecologic conditions and aimed to report the characteristics of the identified patient navigation programs.
Methods
A scoping review was conducted following Arksey and O’Malley’s framework. Five electronic databases were searched for relevant studies published in English: PubMed, Embase, Cochrane Library, CINAHL, and PsycInfo. There were no restrictions on the publication date and the search was completed in July 2023.
Results
This scoping review included 14 studies, which collectively examined seven patient navigation programs. All selected studies were related to maternal health issues (e.g., perinatal health problems and contraception for birth spacing). Close to two-thirds of the patient navigation services were provided by women (n=9, 64.3%) and half by lay navigators (n=7, 50.0%). The majority incorporated the use of mobile health technologies (n=11, 78.6%). All of the patient navigation programs included in the review coordinated the necessary clinical and social support services to improve women’s access to care.
Conclusion
Patient navigation appears to be in its nascent phase in the field of maternal health. The results of this study suggest that the implementation of patient navigation services could potentially improve access to care for socially disadvantaged women and families. Furthermore, providing patient navigation services that are specifically tailored to meet women’s needs could improve the quality of maternity care.

Keyword

Maternal health services; Patient-centered care; Patient navigation; Review

Figure

• 

  Figure 1. Flowchart of the study selection process

Reference

References

1. Freeman HP, Rodriguez RL. History and principles of patient navigation. Cancer. 2011; 117(15 Suppl):3539–3542. https://doi.org/10.1002/cncr.26262.

2. Freeman HP. A model patient navigation program: breaking down barriers to ensure that all individuals with cancer receive timely diagnosis and treatment. Oncology Issues. 2004; 19(5):44–46. https://doi.org/10.1080/10463356.2004.11884227.

3. McBrien KA, Ivers N, Barnieh L, Bailey JJ, Lorenzetti DL, Nicholas D, et al. Patient navigators for people with chronic disease: a systematic review. PLoS One. 2018; 13(2):e0191980. https://doi.org/10.1371/journal.pone.0191980.

4. Peart A, Lewis V, Brown T, Russell G. Patient navigators facilitating access to primary care: a scoping review. BMJ Open. 2018; 8(3):e019252. https://doi.org/10.1136/bmjopen-2017-019252.

5. United Nations. Sustainable development goals 3: ensure healthy lives and promote well-being for all at all ages [Internet]. New York: Author;2023. [cited 2023 Oct 25]. Available from: https://sdgs.un.org/goals/goal3#overview.

6. Khalil A, Samara A, O'Brien P, Coutinho CM, Quintana SM, Ladhani SN. A call to action: the global failure to effectively tackle maternal mortality rates. Lancet Glob Health. 2023; 11(8):e1165–e1167. https://doi.org/10.1016/S2214-109X(23)00247-4.

7. Dol J, Hughes B, Bonet M, Dorey R, Dorling J, Grant A, et al. Timing of maternal mortality and severe morbidity during the postpartum period: a systematic review. JBI Evid Synth. 2022; 20(9):2119–2194. https://doi.org/10.11124/JBIES-20-00578.

8. The American College of Obstetricians and Gynecologists (ACOG). ACOG Committee opinion No. 736: optimizing postpartum care. Obstet Gynecol. 2018; 131(5):e140–e150. https://doi.org/10.1097/AOG.0000000000002633.

9. Bellerose M, Rodriguez M, Vivier PM. A systematic review of the qualitative literature on barriers to high-quality prenatal and postpartum care among low-income women. Health Serv Res. 2022; 57(4):775–785. https://doi.org/10.1111/1475-6773.14008.

10. World Health Organization. Contraception [Internet]. Geneva: Author;c2024. [cited 2023 Oct 25]. Available from: https://www.who.int/health-topics/contraception#tab=tab_1.

11. The American College of Obstetricians and Gynecologists (ACOG). Committee opinion no. 615: access to contraception. Obstet Gynecol. 2015; 125(1):250–255. https://doi.org/10.1097/01.AOG.0000459866.14114.33.

12. Gele AA, Musse FK, Shrestha M, Qureshi S. Barriers and facilitators to contraceptive use among Somali immigrant women in Oslo: a qualitative study. PLoS One. 2020; 15(3):e0229916. https://doi.org/10.1371/journal.pone.0229916.

13. Potasse MA, Yaya S. Understanding perceived access barriers to contraception through an African feminist lens: a qualitative study in Uganda. BMC Public Health. 2021; 21(1):267. https://doi.org/10.1186/s12889-021-10315-9.

14. American College of Obstetricians and Gynecologists’ Committee on Health Care for Underserved Women, Contraceptive Equity Expert Work Group, and Committee on Ethics. Patient-centered contraceptive counseling: ACOG Committee statement number 1. Obstet Gynecol. 2022; 139(2):350–353. https://doi.org/10.1097/AOG.0000000000004659.

15. Mosquera I, Todd A, Balaj M, Zhang L, Benitez Majano S, Mensah K, et al. Components and effectiveness of patient navigation programmes to increase participation to breast, cervical and colorectal cancer screening: a systematic review. Cancer Med. 2023; 12(13):14584–14611. https://doi.org/10.1002/cam4.6050.

16. Chan RJ, Milch VE, Crawford-Williams F, Agbejule OA, Joseph R, Johal J, et al. Patient navigation across the cancer care continuum: an overview of systematic reviews and emerging literature. CA Cancer J Clin. 2023; 73(6):565–589. https://doi.org/10.3322/caac.21788.

17. McKenney KM, Martinez NG, Yee LM. Patient navigation across the spectrum of women's health care in the United States. Am J Obstet Gynecol. 2018; 218(3):280–286. https://doi.org/10.1016/j.ajog.2017.08.009.

18. Arksey H, O’Malley L. Scoping studies: towards a methodological framework. Int J Soc Res Methodol. 2005; 8(1):19–32. https://doi.org/10.1080/1364557032000119616.

19. Tricco AC, Lillie E, Zarin W, O'Brien KK, Colquhoun H, Levac D, et al. PRISMA Extension for Scoping Reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med. 2018; 169(7):467–473. https://doi.org/10.7326/M18-0850.

20. Oncology Nursing Society; Association of Oncology Social Work; National Association of Social Workers. Oncology Nursing Society, the Association of Oncology Social Work, and the National Association of Social Workers joint position on the role of oncology nursing and oncology social work in patient navigation. Oncol Nurs Forum. 2010; 37(3):251–252.

21. Dohan D, Schrag D. Using navigators to improve care of underserved patients: current practices and approaches. Cancer. 2005; 104(4):848–855. https://doi.org/10.1002/cncr.21214.

22. Austad K, Juarez M, Shryer H, Moratoya C, Rohloff P. Obstetric care navigation: results of a quality improvement project to provide accompaniment to women for facility-based maternity care in rural Guatemala. BMJ Qual Saf. 2020; 29(2):169–178. https://doi.org/10.1136/bmjqs-2019-009524.

23. Austad K, Juarez M, Shryer H, Hibberd PL, Drainoni ML, Rohloff P, et al. Improving the experience of facility-based delivery for vulnerable women through obstetric care navigation: a qualitative evaluation. BMC Pregnancy Childbirth. 2021; 21(1):425. https://doi.org/10.1186/s12884-021-03842-1.

24. Blake-Lamb T, Boudreau AA, Matathia S, Perkins ME, Roche B, Cheng ER, et al. Association of the First 1,000 Days systems-change intervention on maternal gestational weight gain. Obstet Gynecol. 2020; 135(5):1047–1057. https://doi.org/10.1097/AOG.0000000000003752.

25. Simione M, Moreno-Galarraga L, Perkins M, Price SN, Luo M, Kotelchuck M, et al. Effects of the First 1000 Days Program, a systems-change intervention, on obesity risk factors during pregnancy. BMC Pregnancy Childbirth. 2021; 21(1):729. https://doi.org/10.1186/s12884-021-04210-9.

26. Taveras EM, Perkins ME, Boudreau AA, Blake-Lamb T, Matathia S, Kotelchuck M, et al. Twelve-month outcomes of the First 1000 Days program on infant weight status. Pediatrics. 2021; 148(2):e2020046706. https://doi.org/10.1542/peds.2020-046706.

27. Morris MH, Barton M, Zane M, Hutson SP, Raman R, Heidel RE. A nurse-navigated, postpartum support text messaging intervention: satisfaction among primiparous women. J Perinat Neonatal Nurs. 2021; 35(4):330–339. https://doi.org/10.1097/JPN.0000000000000596.

28. Salmen CR, Ndunyu L, Ssenkusu JM, Marshall D, DesLauriers N, Anebarassou AV, et al. Falling through the net: an adaptive assessment of the 'Three Delays' encountered by patients seeking emergency maternal and neonatal care within a remote health system on Lake Victoria, Kenya. Glob Public Health. 2022; 17(9):2156–2175. https://doi.org/10.1080/17441692.2021.1966640.

29. Svikis DS, Kelpin SS, Keyser-Marcus L, Bishop DL, Parlier-Ahmad AB, Jones H, et al. Increasing prenatal care compliance in at-risk black women: findings from a RCT of patient navigation and behavioral incentives. J Racial Ethn Health Disparities. 2022; 9(2):630–640. https://doi.org/10.1007/s40615-021-00995-9.

30. Yee LM, Martinez NG, Nguyen AT, Hajjar N, Chen MJ, Simon MA. Using a patient navigator to improve postpartum care in an urban women's health clinic. Obstet Gynecol. 2017; 129(5):925–933. https://doi.org/10.1097/AOG.0000000000001977.

31. Hu F, Strohbach A, Martinez NG, Simon MA, Yee LM. Patient and provider perceptions of a patient navigation program to improve postpartum care among publicly insured women. Am J Perinatol. 2021; 38(3):248–257. https://doi.org/10.1055/s-0039-1696671.

32. Kominiarek MA, Summerlin S, Martinez NG, Yee LM. Postpartum patient navigation and postpartum weight retention. AJP Rep. 2019; 9(3):e292–e297. https://doi.org/10.1055/s-0039-1694700.

33. Martinez NG, Yee LM, Miller ES. Is postpartum patient navigation uniquely beneficial for women with antenatal depressive symptoms? Am J Perinatol. 2022; 39(11):1189–1195. https://doi.org/10.1055/s-0040-1721696.

34. Strohbach A, Hu F, Martinez NG, Yee LM. Evaluating the use of text message communication in a postpartum patient navigation program for publicly insured women. Patient Educ Couns. 2019; 102(4):753–759. https://doi.org/10.1016/j.pec.2018.10.028.

35. Caballero TM, Miramontes-Valdes E, Polk S. Mi Plan: using a pediatric-based community health worker model to facilitate obtainment of contraceptives among Latino immigrant parents with contraceptive needs. Jt Comm J Qual Patient Saf. 2022; 48(11):591–598. https://doi.org/10.1016/j.jcjq.2022.08.004.

36. Kroll-Desrosiers AR, Crawford SL, Moore Simas TA, Rosen AK, Mattocks KM. Improving pregnancy outcomes through maternity care coordination: a systematic review. Womens Health Issues. 2016; 26(1):87–99. https://doi.org/10.1016/j.whi.2015.10.003.

37. Shusted CS, Barta JA, Lake M, Brawer R, Ruane B, Giamboy TE, et al. The case for patient navigation in lung cancer screening in vulnerable populations: a systematic review. Popul Health Manag. 2019; 22(4):347–361. https://doi.org/10.1089/pop.2018.0128.

38. Tebeje TH, Klein J. Applications of e-health to support person-centered health care at the time of COVID-19 pandemic. Telemed J E Health. 2021; 27(2):150–158. https://doi.org/10.1089/tmj.2020.0201.

39. Oh J, Ahn S. Effects of nurse navigators during the transition from cancer screening to the first treatment phase: a systematic review and meta-analysis. Asian Nurs Res (Korean Soc Nurs Sci). 2021; 15(5):291–302. https://doi.org/10.1016/j.anr.2021.10.001.

40. World Health Organization. Maternal and perinatal health [Internet]. Geneva: Author;c2024. [cited 2023 Oct 25]. Available from: https://www.who.int/teams/sexual-and-reproductive-health-and-research-(srh)/areas-of-work/maternal-and-perinatal-health.