April 10, 2023

CCHE evaluated a text-based navigator program to support birthing people

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According to the CDC, Black and African American birthing people are three times more likely to die from a pregnancy-related issue than their white counterparts. The fragmented nature of care further worsens difficulties addressing disparities. The California Health Care Foundation (CHCF) supported an initiative to improve outcomes for birthing persons using a community-based navigator alongside a text-messaging platform. Navigators supported pregnant and birthing people by providing recommended educational information, helping them adhere to specified perinatal care plans, and providing navigation support across ambulatory, inpatient, and community-based service providers.

CCHE evaluated the initiative to understand the impact of implementation of this navigation program at two hospitals in California. Evaluation findings show that:

  • Patients had an overall positive experience with the care they received at the hospital and the support they received from the navigators.
  • Patients, hospital staff, and navigation staff felt that the navigation improved patient knowledge and awareness and helped patients feel connected and cared for.
  • Patients who spoke Spanish engaged in the navigation program at a slightly higher frequency than those who preferred to speak English; we found no significant differences in engagement nor outcomes by race. 
  • Implementation at the two hospitals was challenging for a variety of complex reasons. Many of these implementation challenges were not unique to this program.
  • At both hospitals, navigators reached most patients post-delivery, and reached many others within the month prior to delivery. Therefore, the evaluation was unable to assess impact on birth outcomes.

Based on these findings, the evaluation offered considerations for future implementation of this program or similar programs, both for implementation and patient engagement.

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Read more about the project: HERE