Comparing community- vs clinic- based community health navigators (CHNs) intervention models for cancer screening education and promotion

Background: Community health navigators (CHNs) programs have gained increased attention for reaching racial / ethnic minorities to address cancer disparities due to the important roles CHNs play as “cultural brokers”. This study examined existing CHN interventions to identify best practice models. Methods: The combination key terms of “community health workers or navigators” and “cancer screening” was used in two major databases (Medline and CINAHL) searches. A total of 15 articles met study criteria and were included. Results: Two major CHN models were identified: community-based (8 studies) and clinic/hospital-based (7 studies). While both models used the term “navigators”, most community-based programs referred them as community health workers / navigators / advisors, where as clinic-based programs often called them patient navigators. Most community-based CHN interventions targeted specific racial/ethnic minority or rural groups, and clinic-based programs targeted urban low income or diverse ethnic groups. Client identification and recruitment were also varied, with community-based CHNs outreaching members from community networks or churches, and clinic-based CHNs working with pre-identified in-service clients. Analyses also showed that community-based model often used “community-based method” to identify true natural helpers, rather than traditional recruitment methods (flyers, placing ads) which most clinic-based model used. Overall, regardless model type, CHNs had similar roles and responsibilities and interventions were effective. Conclusion: This review identifies and describes characteristics of two major CHN models. Lessons learned have implication on selecting different CHN models, and maximizing strengths from each model for both outreach and in-reach members from the disadvantaged communities.