Table 1 Effect of community navigator intervention to improve chronic disease management and participation in primary care for cancer screening among immigrant and ethnic populations in the United States
Study | Immigrant Ethnic Population | Size (n) | Age (y) | Study period | Clinical Condition/Risk Factor | Primary Outcome | Major Effects of Intervention on Primary Outcome |
|---|---|---|---|---|---|---|---|
Islam et al. [23] | Sikh, Asian Indian | 108 | 18-75 | 6 months | Type 2 diabetes | BMI, weight, glucose level, blood pressure,total cholesterol. | Significant reduction in glucose level (22.4 %), weight (2.99 %) and BMI (2.88 %) and blood pressure (systolic 10.18 %, diastolic 6.14 %), all Ps < 0.01. No significant reduction in cholesterol. |
Islam et al. [34] | Korean American | 48 | 18-75 | 6 months | Type 2 diabetes | BMI, weight, glucose level, blood pressure, total cholesterol. | Positive directional changes for the treatment group, though none were statistically significant at P < 0.05 |
Lujan et al. [22] | Hispanic | 150 | Mean age 50 | 6 months | Type 2 diabetes | Blood HbA1c level (%) | Significant reduction by 0.45 % (P < 0.001) |
Corkery et al. [32] | Hispanic | 40 | NR | NR | Type 2 diabetes | Blood HbA1c level (%) | Significant reduction by 1.8 % (P < 0.004) |
Spencer et al. [30] | African American, Latino | 164 | ≥18 | 6 months | Type 2 diabetes | Blood HbA1c level (%) | Significant reduction by 0.8 % (P < 0.01) |
Fedder et al. [27] | African-American | 117 | Mean age 57 ± 12 | 28 months | Type 2 diabetes | Emergency Room (ER) visit, hospitalization | ER visits and hospitalization declined by 40 % and 33 % respectively (P = 0.02) |
Palmas et al. [33] | Hispanic | 360 | 35-70 | 12 months | Type 2 diabetes | Blood HbA1c level (%) | No significant improvement on HbA1c level |
Rothschild et al. [35] | Hispanic | 144 | ≥18 | 2 years | Type 2 diabetes | Blood HbA1c level (%) and blood pressure | Significant between group differences in blood HbA1c level at the end of year 1 (−0.55 P = .021) and year 2 (−0.69 P = .005). No significant reduction in blood pressure. |
Ingram et al. [37] | Hispanic | 70 | Average age 60 | 12 months | Type 2 diabetes | Blood HbA1c level (%) | Significant reduction by 1% (P = 0.01) |
Perez-Escamilla R et al. [36] | Latino | 211 | ≥21 | 18 months | Type 2 diabetes | Blood HbA1c level (%) | Significant group difference in reduction of HbA1c level (−0.55, P = 0.009) |
Prezio et al. [31] | Hispanic | 189 | 18-75 | 12 months | Type 2 diabetes | Blood HbA1c level (%) | Significant reduction by 0.7 % (P = 0.02) |
Ursua et al. [43] | Filipino | 39 | 25-75 | 4 months | Hypertension management | Blood pressure control, appointment keeping and medication adherence | 27.3 % increase in number of individuals with controlled blood pressure |
Hurtado et al. [4] | African American, American Indian, Hispanic and Filipino | 849 | Mean age 48 | 3 years | Cardiovascular risk factors | Heart healthy knowledge, heart healthy meal, CVD risk factor behavior | Heart healthy knowledge score and CVD risk factor behavior increased by 26 % and 44 % (P < 0.001) respectively. |
Sanchez et al. [41] | Latino | 96 | ≥18 | 9 weeks | Hypertension management | Food habit and physical activity | Significant improvement in self reported behavior |
Balcazar et al. [21] | Latino | 320 | NR | 6 months | Cardiovascular risk factors | Health habits, community referrals, screening, information sharing | 18 % improvement of average overall score (P < 0.001) |
Spinner et al. [40] | Latino | 435 | NR | 65 days | Cardiovascular risk factors | Physical activity, heart healthy knowledge, heart healthy meal | Significant increase in physical activity (21 %), heart health knowledge (27 %) and heart healthy meal preparation (15 %), all Ps < 0.001. |
Balcazar et al. [26] | Hispanic | 85 | NR | 12 months | Cardiovascular risk factors | Weight, BMI, blood pressure, LDL, HDL, triglyceride level, HbA1c | Significant reduction in LDL cholesterol (P < 0.001), triglyceride (P = 0.02) levels. |
de Heer et al. [39] | Hispanic | 328 | 30-75 | 4 months | Cardiovascular risk factors | Protective health behaviors, health beliefs, contextual and social factors | Improved nutritional consumption |
Balcazar et al. [38] | Hispanic | 98 | 52.3 | 9 weeks | Hypertension | Weight, BMI, blood pressure, food habit | Significant reduction in salt, sodium and fat intake |
Koniak-Griffin et al. [24] | Latino women | 223 | 35-64 | 32 months | Cardiovascular risk factors | Weight, BMI, blood pressure, lipids, blood glucose, food physical exercise | Significant improvements in dietary habits, waist circumference and physical exercise. |
Kandula et al. [42] | South Asian | 63 | 30-59 | 6 months | Cardiovascular risk factor | Weight, blood pressure, cholesterol, HbA1c level, health behaviors, knowledge, coping, and exercise confidence | Significant between group differences in weight (−3.2 lb, P = 0.04) and HbA1c (−0.43 %, P < 0.01) reductions. |
Hunter et al. [44] | Hispanic | 101 | 40-70 | 28 months | Chronic disease prevention | Participation in routine preventive chronic disease screening | Women in the intervention group were 35 % more likely to go for rescreening than those in the control group. |
Staten et al. [10] | Hispanic | 254 | ≥18 | 41 months | Chronic disease prevention | BMI, waist circumference, blood pressure, blood glucose, cholesterol, triglycerides, dietary habits and physical activity | Significant reduction in BMI (P = 0.04), waist circumference (P < 0.001), blood pressure (P < 0.001) and total cholesterol (P = 0.008) |
Schwartz et al. [28] | Hispanic | 450 | 18-84 | 3 years | Obesity and metabolic syndrome | BMI, waist circumference, blood pressure, cholesterol, glucose, HbA1c, dietary habits, physical activity. | 72 %, 69 %, 59 %, and 48 % of participants reduced weight, BMI, waist circumference and blood pressure respectively. Glucose, HbA1c and total cholesterol decreased by 6.3 %, 3.8 % and 2.3 % respectively. |
Martin et al. [25] | African-American | 42 | 21-50 | 6 months | Asthma | Asthma self efficacy | Significant improvement in asthma quality of life (P = 0.002) and coping (P = 0.01) |
Allen et al. [46] | Latina | 155 | ≥18 | 6 months | Breast, cervical and colorectal cancer screening | Adherence with screening recommendation | 24 % and 8 % increase in adherence with breast cancer and to all cancer screening recommendations for one’s age respectively, however, these changes were not statistically significant. |
Livaudais et al. [47] | Hispanic women | 70 | 40-79 | 6 months | Breast cancer screening | General Cancer knowledge, screening practices and intention to be screened | Significant improvement in knowledge on cancer prevention (26 %, P = 0.001), intention to do mammogram (8 %, P = 0.014) and discussing mammograms with doctor (30 %, P < 0.001) |
Percac-Lima et al. [29] | Latina | 786 | 22-86 | 88 months | Cervical cancer screening | Missing colposcopy appointment, time to colposcopy and severity of cervical pathology | Significant reduction in missing colposcopy (4.1 %, P = 0.024) and severity of cervical pathology (9.9 %, P = 0.035) |
Chen et al. [11] | African Americans and Hispanics | 532 | ≥50 | 31 months | Colon Cancer screening | Colonoscopy completion, endoscopic findings, and patient satisfaction about navigator | 66 % completed colposcopy screening, 16 % had adenomas, only 5 % had inadequate bowel prep, 66 % patients agreed that they would not do colonoscopy without navigation. |