Oral Concurrent Session 4 - Equity, Public Health, and Public Policy
Oral Concurrent Sessions
Sydney L. Raucher, BA
Medical Student
Northwestern University Feinberg School of Medicine
Chicago, Illinois, United States
Brittney R. Williams, MPH
MFM Research Program Manager
Northwestern University Feinberg School of Medicine
Chicago, Illinois, United States
Joseph M. Feinglass, PhD
Research Professor of Medicine
Northwestern University Feinberg School of Medicine
Chicago, Illinois, United States
Ying Cheung, MS
Biostatistician
Northwestern University Feinberg School of Medicine
Chicago, Illinois, United States
Laura Diaz, MPH
Patient Navigator
Northwestern University Feinberg School of Medicine
Chicago, Illinois, United States
Ka'Derricka Davis, MPH
Research Coordinator
Northwestern University Feinberg School of Medicine
Chicago, Illinois, United States
Michelle A. Kominiarek, MD, MS
Associate Professor
Northwestern University Feinberg School of Medicine
Chicago, Illinois, United States
William A. Grobman, MBA, MD
Professor
Warren Alpert Medical School of Brown University
Providence, Rhode Island, United States
Lynn M. Yee, MD, MPH (she/her/hers)
Associate Professor
Northwestern University Feinberg School of Medicine
Chicago, Illinois, United States
To evaluate whether a patient navigation (PN) program improves patient-reported outcomes (PROs) regarding perceived health status in the first year after birth.
Study Design:
This pre-planned analysis of a randomized trial evaluated whether postpartum (PP) PN improved self-reported health among low-income birthing people. Eligible people (≥16 years, English- or Spanish-speaking, public insurance) were randomized 1:1 ( >30 weeks’ gestation) to receive usual care or PP PN. PN participants were assigned to a trained lay navigator who offered non-clinical assistance (e.g., social needs assessment, appointment coordination, emotional support) through one year PP. Researchers administered PRO measures selected to reflect health status at enrollment, 4–12 weeks (w) PP, and 11–13 months (m) PP. PROs were scored using standard methods. Differences between groups at each interval were determined using bivariable tests. Effect modification by health literacy (HL) status was found to exist for patient activation (p=0.02 at 4-12w) but not for other PROs; therefore, stratified analyses by HL status were performed for patient activation.
Results:
From 1/2020 to 6/2023, 405 individuals were randomized (203 PN, 202 usual care), of whom 89.4% were retained through one year (Fig 1). Most participants identified as non-Hispanic Black (50%) or Hispanic (41%). At enrollment, participants reported an overall high degree of well-being, and PROs were similar in each group. At 4-12w and 11-13m, there was no significant difference between groups in any PRO evaluated, including global health, self-efficacy, informational support, stress, PP knowledge and preparedness, care satisfaction, and depressive symptoms (Table 1). At 4-12w, those with inadequate HL who received PN demonstrated improved patient activation (β 3.8, 95% CI 1.2-6.4, p=0.004); patient activation did not differ (β -1.0, 95% CI -3.9 to 1.8, p=0.48) for those with adequate HL.
Conclusion:
Although a PP PN program did not improve PROs among low-income people in the first year after birth, PN may improve patient activation for those with inadequate HL.