Community Health Navigators

This program aims to develop and evaluate the role of Community Health Navigators (CHNs) in health care in Australia.  It includes a range of projects and activities including:

1.     The CHECC study which is a NHMRC funded trial of CHNs providing support and care in the community after hospitalisation. 

2.     Trials of CHNs in bilingual general practices. 

The program has been supported by the development of an online training program and support materials for CHNs.  

Chief Investigators

Marki Harris, Elizabeth Harris, Sabuj Kanti Mistry, Fiona Haig, Margo Barr, Ben Harris-Roxas (SPH)

Program Coordinators

Cathy O'Callaghan

Collaborators

Lou-Anne Blunden, John Cullen, Debra Donnelly,  Miranda Shaw (SLHD), Fiona Doolan Noble (Curtin University), Sara Javanparast (Flinders University), Jean-Frederick Levesque, Regina Osten (ACI), Parisa Aslani (Sydney University), Simone Dahrouge (Ottawa), Nathalie Hansen, Brendan Goodger(CESPHN).

Project Rationale

The American Public Health Association defines a community health worker (CHW) as a “frontline public health worker who is a trusted member of and/or has an unusually close understanding of the community served. This trusting relationship enables the CHW to serve as a liaison/link/intermediary between health/social services and the community to facilitate access to services and improve the quality and cultural competence of service delivery”(40). There is increasing evidence of the effectiveness of CHWs in assisting patients to navigate their care and the complexities of referral and follow-up. CHW follow-up improved access to primary care while controlling recurrent readmissions in a high-risk population and they have been demonstrated to improve medication adherence post-discharge. CHWs have an important role in reducing health inequities by improving access to care for vulnerable and disadvantaged population groups especially indigenous and CALD populations. 

Project Aim/s

To develop and evaluate the role of Community Health Navigators (CHN) in health care in Australia especially in improving care of people with chronic diseases and disability in the community.  

Project Design and Method

Activities includes:

1. Systematic reviews of the literature on the role of CHW in improving preventive care in primary health care and on their role in healthcare navigation. 
2. Evaluation of the Xtend program in Sydney Local health District.  This involves CHWs in following patients up post discharge to prevent readmission.
3. The CHECC Study
4. Trials of CHNs in bilingual general practices.  This includes the following publications:
5. Workshops and seminars with visiting academics on the role of CHW in health care: Community Health Workers workshop, Lay Navigators workshop, Healthcare Access Seminar and Healthcare Access Forum. 

Documents

• XTend Program Description 
• EXTEND Program Summary  
• Sharma N, Harris E, Lloyd J, Mistry SK, Harris M. Community health workers involvement in preventative care in primary healthcare: a systematic scoping review. BMJ open. 2019 Dec 1;9(12).
• Mistry SK, Harris E, Harris MF. Role of community health workers as healthcare navigator in chronic disease management in primary care: a systematic review. Journal of General Internal Medicine 2021 DOI: 10.1007/s11606-021-06667-y
• Mistry SK, Harris E, Harris MF Scoping the needs, roles and implementation of bilingual community navigators in general practice settings Health and Social Care in the Community 2022, 30 6 e 5495 e 5505
• Mistry SK, Harris E, Harris MF.  Learning from a codesign exercise aimed at developing a navigation intervention in the general practice setting.  Family Practice, 2022, April 2 https://doi.org/10.1093/fampra/cmac020 
• Mistry SK, Harris E, Li X, Harris MF. Feasibility and acceptability of involving bilingual community navigators to improve access to health and social care services in general practice setting of Australia. BMC Health Services Research. 2023 May 11;23(1):476.  

Key Partners

Sydney LHD, CESPHN