- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03550404
Improving Native American Elder Access to and Use of Healthcare
Improving Native American Elder Access to and Use of Healthcare Through Effective Health System Navigation
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
This five-year project was developed by investigators from the Behavioral Health Research Center of the Southwest (BHRCS), a center of the Pacific Institute of Research and Evaluation (PIRE), the Health Committee of the New Mexico Indian Council on Aging (NMICoA), and the University of New Mexico (UNM). The project combines qualitative and quantitative interviews with concept-mapping (CM) techniques and focus groups to study insurance coverage, help-seeking behavior, and the healthcare experiences of American Indian Elders (AIEs) in New Mexico (NM). Practical knowledge grounded in the actual perspectives of AIEs and other key stakeholders may improve healthcare practices and policies for a population largely excluded from national and state discussions of health reform. The study data will also inform the adaptation and development of culturally tailored programming to enrich understanding and facilitate negotiation of a changing landscape of healthcare by AIEs. Our four specific aims are to:
- Assess how AIEs understand, access, maintain, and use insurance coverage.
- Characterize AIE help-seeking and healthcare experiences in dominant service delivery settings, i.e., Indian Health Service (IHS), tribally-run 638 facilities, and managed care programs.
- Identify and compare factors that affect AIE access to health care as perceived by multiple stakeholders, i.e., AIEs, outreach workers (OWs), healthcare staff and providers, public sector administrators, and tribal leaders.
- Develop and assess implementation feasibility of a structured intervention for OWs that promotes enhanced patient navigation, in addition to healthcare literacy, access, and usage among AIEs.
Study Type
Enrollment (Anticipated)
Contacts and Locations
Study Locations
-
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New Mexico
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Albuquerque, New Mexico, United States, 87106
- Pacific Institute for Research and Evaluation
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Description
Navigators
Inclusion Criteria:
- Working in a health and health insurance outreach
- Routinely interacting with AIEs as part of their jobs
- Primary service region includes target AIEs.
Exclusion Criteria:
- Not Routinely interacting with AIEs as part of their jobs
- Not willing to be trained in or use the Seasons of Care app
American Indian Elders (AIEs) Inclusion
- Age 55+
- Identifying as AI
- Able to read in English
- Able to consent and complete study procedures
- Interacted with Navigator
Exclusion ● Individuals who cannot read in English or who have not interacted with a pilot test Navigator will not be eligible to participate
Healthcare Staff/providers Inclusion
- Individuals who have been in contact with a pilot test Navigator
- Work in a healthcare facility that serves AIEs in one of our 4 regions
Exclusion
● Individuals who have not interacted with a pilot test Navigator or do not work in a healthcare facility serving our primary population, will not be eligible to participate
Study Plan
How is the study designed?
Design Details
- Observational Models: Case-Only
- Time Perspectives: Prospective
Cohorts and Interventions
Group / Cohort |
Intervention / Treatment |
---|---|
Navigators
AIE Navigators will use the Seasons of Care app in the context of their everyday outreach work with AIEs over two four-month intervention periods (P1 and P2).
Their goal will be to facilitate health literacy to shift attitudes, beliefs, and behaviors to create a "Culture of Coverage" for AIEs at individual, organizational/community, and policy levels.
Separated by distance, the AIE Navigators will receive coaching as necessary, using virtual meeting space, to help refine their implementation skills from a member of the research team with experience in AIE health outreach.
|
A web-based mobile application (app) called the Seasons of Care Elder Navigation Guide will assist elders, their families/caregivers, healthcare providers, outreach workers, and other community members in navigating healthcare and insurance systems.
The app has the added advantage of being easy to update to respond to future changes in health care and insurance, and sustainable because it is not dependent on intensive training, developing, and retaining of individuals in professional navigation positions.
|
American Indian Elders (AIEs)
Elders will be exposed to the Seasons of Care app when they reach out to navigators for assistance navigating the healthcare system.
|
A web-based mobile application (app) called the Seasons of Care Elder Navigation Guide will assist elders, their families/caregivers, healthcare providers, outreach workers, and other community members in navigating healthcare and insurance systems.
The app has the added advantage of being easy to update to respond to future changes in health care and insurance, and sustainable because it is not dependent on intensive training, developing, and retaining of individuals in professional navigation positions.
|
Healthcare providers/staff
This cohort will be exposed to the Seasons of Care app via navigators and their patients.
|
A web-based mobile application (app) called the Seasons of Care Elder Navigation Guide will assist elders, their families/caregivers, healthcare providers, outreach workers, and other community members in navigating healthcare and insurance systems.
The app has the added advantage of being easy to update to respond to future changes in health care and insurance, and sustainable because it is not dependent on intensive training, developing, and retaining of individuals in professional navigation positions.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
User Evaluation Survey
Time Frame: Once at the end of P2 (Month 8 of 8)
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A semi-structured, in-person interview (or focus group, depending on availability) with AIEs and healthcare providers who interacted with a navigator using the Seasons of Care app to assess experiences with, and effects of, the Seasons of Care app; suggestions to improve the Seasons of Care app
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Once at the end of P2 (Month 8 of 8)
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Navigator Pre- and Post-Evaluation Interview
Time Frame: Month 1 and 4 (of 8) for P1 Navigators; Month 5 and 8 (of 8) for P2 Navigators
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A semi-structured, in-person interview comprised of open-ended questions to assess navigator's confidence and experiences with communicating health information to AIEs and healthcare providers; perceptions of the Seasons of Care app
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Month 1 and 4 (of 8) for P1 Navigators; Month 5 and 8 (of 8) for P2 Navigators
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Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
User Evaluation Demographic Survey
Time Frame: Once at the end of P2 (Month 8 of 8)
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A demographic survey with AIEs and healthcare providers who interacted with a navigator using the Seasons of Care app
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Once at the end of P2 (Month 8 of 8)
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Feasibility Questionnaire
Time Frame: Monthly for 8 months
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A written questionnaire to assess navigator's experiences with, and effects of, Seasons of Care app
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Monthly for 8 months
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Collaborators and Investigators
Investigators
- Principal Investigator: Cathleen Willging, Pacific Institute for Research and Evaluation
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Other Study ID Numbers
- 0784.01.01
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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