Table 4

Impacts/outcomes analysis for the included studies

StudyImpacts/outcomes
Evaluation: impact on patient behaviours, risk factorsEvaluation: impact on patient health service use, screeningEvaluation: impact on disease incidence, mortality, quality of lifeEconomic evaluation
Balcázar et al, 200946Changes in heart-healthy behaviourN/AThe positive changes further observed in some clinical outcomes (eg, low density lipoprotein (LDL) cholesterol level, triglyceride level, waist circumference, diastolic blood pressure, weight and glycosylated haemoglobin (HbA1c)
Balcazar et al, 201147N/AN/AN/AN/A
Balcázar et al, 201248Improved self-reported attitudes and perceptions towards cardiovascular disease (CVD) risk reduction, improved self-reported dietary behaviours and improved clinical outcomes such as total cholesterol, non-high density lipoprotein cholesterol and low density lipoprotein cholesterol among othersN/AN/AN/A
Balcazar et al, 200928Positive change in blood pressure reduction but not significantly. Changes in dietary/food habits associated with control blood pressureN/APositive change in blood pressure reductionN/A
Balcázar et al, 201029Changes were seen in risk factors for cardiovascular disease (CVD) on study population observed in terms of decreased in weight, low-density lipoprotein cholesterol, and total cholesterol, and non-high density lipoprotein cholesterol, systolic and diastolic pressure for the control groupN/AN/AN/A
Barnes-Boyd et al, 200150N/AN/APositive results were observed in terms of infant’s health outcomes. Low incidence of infant deaths suggested that the programme had positive impact on postneonatal mortality when compared with prevailing citywide and community rates. Immunisation rate was higher compared with the previous programme and to local and national statisticsN/A
Braschi et al, 201430N/AIncreased screening colonoscopy completion by ~30% above the recent estimation for physicians-referred patientsN/AN/A
Christina Esperat et al, 201251Significant improvements in the targeted clinical indicators (systolic and diastolic blood pressure; Haemoglobin, level of lipid panels such as cholesterol, triglycerides, HDL, LDL, and emergency hospitalisation and emergency visits) that were tracked at baseline, at 6 months, and at the end of 12 months of intervention. Patient’s behaviour change were evaluated through t-test. There were several behavioural improvements identified through the navigation programme. Self-efficacy of chronic disease management were improved. Diabetes self-activities were significantly improves, patients were following healthful diet plans, doing more exercise and monitoring blood sugar regularlyN/AN/AProgramme was too short to make a conclusion on economic evaluation of the programme
Cruz et al, 201349Among diabetic participants, a significant improvement was observed on diabetes knowledge when comparing pre-test and post-test scores (13.7 vs 18.6, p=0.001; Cohen’s d=1.2). Among non-diabetic participants, diabetes knowledge also increased significantly after one-single training session (12.9 vs 18.2, p=0.001; Cohen’s d=1.2).N/AN/AN/A
DeGroff et al, 201731N/ANavigation significantly improved colonoscopy screening completion among a racially diverse, low-income population. Colonoscopy completion was significantly higher for navigated patients (61.1%) than control group patients receiving usual care (53.2%, p=0.021)N/AN/A
Denman et al, 201452Participants who completed the Meta Salud programme demonstrated important physiological changes from baseline to 3-month follow-up. There was a significant decrease in body mass index (BMI), waist circumference, weight, low density lipoprotein (LDL) cholesterol and glucose; they also had a significant increase in high density lipoprotein (HDL) cholesterolN/AN/AN/A
Goelen et al, 201032N/AThe telephone reminder call caused a 22% increase in mammography screening among women who had not attended the Belgian breast cancer-screening programme in previous year.N/ATwo hours of volunteer time and 17 telephone contact were needed on average to realise an additional screening of mammogram by the number varied by site. The financial cost is limited if the reminder is operated by volunteers; expense then can be determined mainly by the cost of phone conversations and office space
Hoffman et al, 201233N/AThe diagnostic time was shorted for navigated woman than no navigated women. For those who required biopsy, navigated women reached their diagnostic resolution faster than non-navigated womenN/AN/A
Honeycutt et al, 201363The Intervention patients were more likely to receive a colonoscopy referral. Patient navigation, delivered through the Community Cancer Screening Program (CCSP) can be an effective approach to promote adherence to screening referrals and to ensure that lifesaving, preventive health screenings (colonoscopies) are provided to low-income adults at average risk for colorectal cancer (CRC)The CCSP is intended to reach low-income individuals. It addresses both system-level and patient-level barriers to screeningN/ANot evaluated: out of the scope of the study
Horne et al, 201534N/APatient navigation increased colorectal cancer (CRC) screeningN/AN/A
Hunter et al, 200435N/AWomen in the Promotora group were 35% more likely to go for rescreening than those who received a postcard reminder only. Home visits by a CHW showed positive impact on patient’s medical service utilisationN/ANo economic evaluation
Jandorf et al, 201336Increased colonoscopy screening rate by 15%Promote adherence to screening colonoscopyN/AN/A
Jandorf et al, 201337High adherence to colonoscopy screening in both peer- patient navitation (PN) and pro-PN group patientsN/AN/AN/A
Kegler and Malcoe, 200453Lead levels and preventive behaviours changes among intervention population. Among Native American children, mean blood lead levels decreased significantly from T1 (6.00 µg/dL) to T2 (4.97 µg/dL) (p=0.047) in Superfund communities and from 4.81 to 3.34 μg/dL (p<0.001) outside the Superfund areaAt T1, 14% of the Native American children in Superfund communities had received a blood lead test within the last year; this proportion increased to 29% at T2, we observed improvements among Native Americans in 2 lead prevention behaviours—knowledge about lead poisoning and perceived susceptibility to lead—and in the self-efficacy of 3 lead prevention behavioursQuality of life improvedN/A
Kieffer et al, 201338Reduction in the depression symptoms: Depressive symptoms decreased in both the mothers on the move (MOMs) and control groups from baseline to postpartumN/AThe MOMs intervention is supposed to have reduced the number of participants with high levels of depressive symptoms by half when compared with control participantsN/A
Koniak-Griffin et al, 201539Behaviours: change in diet and physical activityReduced waist circumferenceN/AN/A
Krantz et al, 201762Improvements in low density lipoprotein (LDL) cholesterol or systolic blood pressure (SBP)An urban, community-based CHW-led programme improved risk factor control for underserved LatinosN/AN/A
Larkey et al, 201240Participants continue to support healthy behaviourHigher rate of adherence to cancer screeningN/AThe findings regarding cost suggest that community programmes targeting groups maybe not only as effective as one-on-one, time-consuming interventions but also cost substantially less to implement person reached and per screening obtained
Marshall et al, 201641At study exit, a greater proportion of participants receiving the patient navigation intervention reported getting a mammogram than those in the control group (93.3% and 87.5%), respectively; among women who were not screening-adherent at baseline, the incidence of mammography screening at study exit was 73.4% for those in the intervention group, compared with only 45.6% for those in the control group; Among women who were not up to date at baseline, the intervention was associated with a significant increase in the rate of screening at exit (OR 3.63, 95% CI 2.10 to 6.26)The use of patient navigation services among African-American older women in an urban area increased the odds of self-reported receipt of a screening mammogram by the time of exit from the study. In addition, the association between patient navigation services and mammography was stronger for women who were not up to date with their screening at baselineN/AN/A
Mojica et al, 201654Positive changes in cancer screening behaviour and knowledge of screening guidelines and the belief in early detectionNavigation by CHWs increases patient compliance with screening and follow-up of breast, cervical and colorectal cancer screeningN/AN/A
Molina et al, 201845N/ANavigated women having noncancerous result on initial mammogram had higher follow-up screenings (adjusted OR=1.25; 95% CI 1.02 to 1.54) than those receiving standard careN/AN/A
Parra-Medina et al, 201555Vaccine initiation rates in both groups (84%) were substantially higher than the initiation rates reported for Texas (58%) and the nation (65%)N/AN/A
Percac-Lima et al, 201642The patient navigation (PN) intervention improved screening rates among those overdue for breast, cervical and CRC screeningPatients randomised to the PN intervention had significantly higher rates of comprehensive preventive cancer screening compared with patients receiving usual careN/AThe programme was beneficial for all high-risk patients regardless of age, sex, insurance or language spoken
Percac-Lima et al, 201356N/ANavigated women had better rates of colposcopy clinic attendance, shorter time to colposcopy clinic follow-up, and a less severe grade of cervical abnormality at colposcopyThe grade of cervical abnormality among navigated women decreased from a numerical score of 2.03 to 1.83 (p=0.035) over the two time intervals, while the severity of pathological score in the no navigated group did not change significantly from 1.83 to 1.92 (p=0.573) in the same interval. Comparison of trends in pathological score over time showed a decrease in the severity of cervical abnormality for navigated participants compared with the non-navigated group (p<0.001)N/A
Percac-Lima et al, 201457N/AThe rates of screening among Latinos at the community health centre with patient navigators (PN) were as high as the rates among patients who received care in private practices with the primary healthcare networkN/AN/A
Simmons et al, 200843The intervention was associated with weight loss in the communities, a major factor in diabetes preventionN/aN/AN/A
Staten et al, 201258The Pasos Adelante programme demonstrated significant decreases in key risk factors for cardiovascular disease (CVD) and diabetes, many of which were maintained 12 weeks after completion of the programmeN/ATotal and HDL cholesterol, and glucose show a downward trend from baseline to programme conclusion and additional declines at follow-up in body mass index (BMI) and hip circumference. BMI, waist and hip circumferences, waist-to-hip ratio, and both diastolic and systolic blood pressures were significantly lower at the conclusion of the programme compared with baselineN/A
Treadwell et al, 201059Participant’s had greater knowledge about strategies for prevention and management of obesity and diabetes, decreased blood pressure, weight and body mass index levelsParticipants visited a primary care doctor more frequentlyParticipants had increased engagement in exercise and fitness activitiesN/A
Wagoner et al, 201564N/AN/AN/AN/A
Wells et al, 201260N/AExpanding demand of cervical screening, additional demand of colposcopy clinicN/AN/A
Wilson et al, 201561N/ACulturally competent patient navigation team and physician—coupled with social support from spouses, partners, family and social networks—may increase the likelihood that Hispanic men will complete CRC screening.
The CCMN Programme resulted in a participation rate of 80%; in contrast, only 16% of Hispanic men in care link receiving usual care through the normal referral process reported having received a colonoscopy within 10 years
N/ACost-effectiveness analysis suggests that this patient navigator programme increases life expectancy and quality adjusted life years lost (QALYs) and also results in predicted medical cost savings compared with status quo
Woodruff et al, 201044The evaluation for this study was focused on the satisfaction of the community health workers, thus does not focus on the impacts of intervention on patients behaviours. But the community health workers shared satisfaction with their participation on the intervention projectsN/AN/AN/A
  • CHWs, community health workers.