141st APHA Annual Meeting and Exposition

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287857
Do lay health advisors effectively improve access to cardiac services among women?


Monday, November 4, 2013 : 8:45 a.m. - 9:00 a.m.

Lisa Benz Scott, PhD, MS, Program in Public Health, Stony Brook University Health Sciences Center, Stony Brook, NY
Shannon Gravely, PhD, Graduate Program in Public Health, Stony Brook University Health Sciences Center, Stony Brook,, NY
Objectives: Lay health educators trained as patient navigators (PN) have improved use of cancer services among under-served populations by overcoming access barriers, but little is known about the effectiveness of navigators to improve access to cardiac services such as outpatient cardiac rehabilitation (OCR). Despite compelling evidence of the public health benefits of OCR, enrollment is low, and disproportionately for women. Building on an academic-community partnership among 6 community-based OCR programs and an academic team, this study assessed if navigators differentially impacted OCR awareness and enrollment rates between male and female cardiac patients, compared to Usual Care (UC).

Methods: Eligible patients were consented during inpatient cardiac care and randomly assigned to PN (n= 90) or UC (n=91). Navigators (2 African American women) were trained using role plays and content-specific instruction to provide education and support during face-to-face and phone-based contact with PN patients. Awareness of OCR was assessed by telephone at 12-weeks post-hospitalization, and OCR programs confirmed OCR enrollment.

Results: Both genders were 5 times more aware of OCR in PN compared to UC. There were no differential effects of awareness between genders. PN males were more likely to enroll in an OCR program compared to UC males (24.6% vs. 3.3%, P=0.004). PN did not have a significant effect on enrollment among women (14.3% of UC vs. 21.9% of PN women enrolled).

Conclusions: Lay educators significantly improved OCR awareness for both men and women. Navigation significantly improved OCR enrollment for men, but was not successful to overcome barriers among women.

Learning Areas:

Chronic disease management and prevention
Conduct evaluation related to programs, research, and other areas of practice
Implementation of health education strategies, interventions and programs
Public health or related research
Social and behavioral sciences

Learning Objectives:
Assess if lay health educators, trained as patient navigators, could effectively improve the awareness of and enrollment in outpatient rehabilitation services among women and men; and assess if patient navigators have differential effectiveness on the above outcomes, depending on gender

Keyword(s): Access and Services, Women's Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Lisa Benz Scott is Director of the Program in Public Health at Stony Brook University Health Sciences Center, and Associate Professor of Health Technology & Management, and Medicine. She is an alumnus of the W.K. Kellogg Community Health Scholars Program (Johns Hopkins University) trained in community-based participatory research. She earned a PhD at the Bloomberg School of Public Health, a Masters (Health Education and Promotion) at Purdue University, and a BA at Stony Brook University.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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