ENCOMPASS: Expansion Study A, RCT

Summary

Some patients living with multiple long-term health conditions have difficulty accessing the services they need, despite available primary care and community resources. Patient navigation programs may help those with complex health conditions to improve their care and outcomes. Community health navigators (CHNs) are community members who help guide patients through the health care system. CHNs are not health professionals like a doctor or nurse, but they are specially trained to help patients get the most out of their health care and connect them to resources. The ENCOMPASS program of research evaluates a patient navigation program that connects patients living with long-term health conditions to CHNs. To understand if the CHN program can be scaled to a provincial level, the ENCOMPASS program of research is expanding to select primary care settings across Alberta. This study implements and evaluates the CHN program at Edmonton Oliver Primary Care Network in Edmonton, Alberta, Canada.

Conditions

• Hypertension
• Diabetes Mellitus, Type 2
• Chronic Kidney Diseases
• Ischemic Heart Disease
• Congestive Heart Failure
• Chronic Obstructive Pulmonary Disease
• Asthma

Interventions

BEHAVIORAL

Community Health Navigator Program

Patients will be matched to a community health navigator (CHN) who will conduct a needs assessment to determine the frequency of meetings. A CHN may perform any of the following: providing information to a patient's health care provider, translation, advocating for the patient, connecting the patient with resources (e.g., social, financial, insurance), helping patients set health-related goals, facilitating health care referrals and appointments, and monitoring appointments. These activities may require the CHN to be physically present at appointments or have direct contact with the patient's health care provider. Goal setting and support will be provided in-person or over the telephone using motivational interviewing principles.

Sponsors & Collaborators

• University of Alberta

  collaborator OTHER

• University of Calgary

  lead OTHER

Principal Investigators

• Kerry A McBrien, MD, MPH · University of Calgary

Study Design

Allocation

RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

NONE

Model

PARALLEL

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2021-01-22

Primary Completion

2022-07-03

Completion

2023-07-03

Countries

• Canada

Study Locations