Navigating public housing residents into cardiovascular prevention programs: A multi-site intervention study

The Boston University Partners in Health and Housing Prevention Research Center conducted a quasi-experimental intervention study across six public housing developments in Boston. Eligible residents were 18+ years of age, English or Spanish speaking, and screened positive for one or more risk factors (overweight/obese, hypertension, hypercholesterolemia, diabetes, or smoking). Three developments were assigned a Patient Navigator (a resident health advocate with advanced training) and three served as control sites. Navigated residents received in person and telephone support. A baseline and follow-up survey collected socio-demographics and healthcare utilization outcomes. 326 eligible residents (72%) enrolled (152 intervention, 174 control): mean age 50; 75% female; 28% Black, 51% Hispanic; 84% public health insurance, 10% no health insurance, nearly half never graduated high school (44%) and were foreign born (47%). Overall, 79% were overweight or obese, 78% had hypertension, 66% had diabetes, 47% had high cholesterol, and 32% reported current tobacco smoking. McNemar's tests showed that navigated residents reported a significant increase in outcome utilization pre-post intervention: attending a primary care visit (53% to 71%, p<0.01), participating in community programs (29% to 54%, p<0.01), and either attending a community program or a primary care visit (66% to 87%, p<0.01). Residents at the control sites recorded no significant changes. This multi-site navigation intervention study documents the impact of navigation on improving healthcare delivery among a vulnerable population living in public housing.