Training student volunteers as community resource navigators to address patients' social needs: A curriculum toolkit.

Introduction: Few resources are available to train students to provide patients assistance for obtaining needed community-based services. This toolkit outlines a curriculum to train student volunteers to become "community resource navigators" to serve patients via telephone at partner health sites. Methods: University students co-designed the Help Desk navigator program and training for volunteer navigators as part of an academic-community partnership with a local Federally Qualified Health Center (FQHC). The multi-modal curricula consisted of five components: didactic instruction on social determinants of health and program logistics, mock patient calls and documentation, observation of experienced navigator interaction with patients, supervised calls with real patients, and homework assignments. In 2020, training materials were adapted for virtual delivery due to the COVID-19 pandemic. Trainees completed a survey after completion to provide qualitative feedback on the training and preparedness. Results: The training was offered for the first cohort of 11 student volunteer navigators in 2019, revised and then offered for 13 undergraduate and nursing students over 6 weeks in 2020. In the training evaluation, trainees described the new knowledge and skills gained from the training, the long-term benefits toward their educational and professional career goals, and helpful interactive delivery of the training. Trainees also highlighted areas for improvement, including more time learning about community resources and practicing challenging patient conversations. Conclusions: Our peer-to-peer, multi-modal training prepares student volunteers to become community resource navigators. Student, eager for meaningful clinical experiences, are an untapped resource that can help patients with their social needs.

A Community Resource Navigator Model: Utilizing Student Volunteers to Integrate Health and Social Care in a Community Health Center Setting.

INTRODUCTION: While unmet social needs are major drivers of health outcomes, most health systems are not fully integrated with the social care sector to address them. In this case study, we describe the development and implementation of a model utilizing student volunteer community resource navigators to help patients connect with community-based organizations (CBOs). We then detail initial implementation outcomes and practical considerations for future work. METHODS: We used the Ten Essential Public Health Services Framework to guide program planning of a student "Help Desk" model for a community health center. Planning included a literature review, observation of exemplar programs, development of a CBO directory, and evaluation of the center's patient population, clinical workflows, and data infrastructure. We piloted the model for two months. After pilot completion, we reviewed patient data to understand the feasibility of the student "Help Desk" model. We utilized planning and pilot execution materials, as well as pilot data, to develop and discuss practical considerations. RESULTS: Design and implementation complemented ongoing social needs screening and referral to CBOs by center case managers. Patients were asked if they would accept telephone follow-up by volunteers two and four weeks after the clinic visit. Of 61 patients screened, 29 patients were referred for follow-up. Ninety percent were reached at least once during the follow-up period, and 48% of patients referred reported connecting to at least one CBO. Only 27% of patients required escalation back to case managers, and no emergency escalation was needed for any patients. Students, faculty advisors, and community health center frontline staff and leadership supported the scale up and continuation of the "Help Desk" model at the community health center. DISCUSSION: Successful implementation required multi-sectoral collaboration, well-defined scope of practice, and data interoperability. Student volunteers are untapped resources to support integrated health and social care.

Perceived barriers and supports to accessing community-based services for Uganda's pediatric post-surgical population.

BACKGROUND: Access to pediatric surgical intervention in low-income countries is expanding, but investments in post-surgical care have received less attention. This study explored the barriers and supports for school-aged children to access post-surgical, community-based follow-up care in Uganda as perceived by community stakeholders. MATERIALS AND METHODS: This qualitative exploratory case study used in-depth, semi-structured interviews and in-country site visits among Ugandan organizations providing follow-up care to school-aged children in Uganda after surgery. Data from eight interviews and eight site visits were coded, analyzed, and cross-tabulated with a modified grounded theory approach. RESULTS: Four key barriers to community-based follow-up care were identified: discrimination, financial barriers, geographical barriers (including transportation), and caregiver limitations to support recovery. Three key supports to successful access to and participation in community-based post-surgical recovery were identified: disability awareness, the provision of sustained follow-up care, and caregiver supports for reintegration. CONCLUSIONS: Increasing awareness of disability across local Ugandan communities, educating caregivers with accessible and culturally aware approaches, and funding sustainable follow-up care programming provide promising avenues for pediatric post-surgical recovery and community reintegration in contemporary Uganda.Implications for rehabilitationMultiple, intersecting factors prevent or promote access to post-surgical community-based services among school-aged children in Uganda.The most prominent barriers to pediatric community reintegration in Uganda include discrimination, lack of financial resources, geographical factors, and caregiver limitations.Community and interprofessional alliances must address disability awareness and sources of stigma in local contexts to promote optimal recovery and reintegration after surgery.Collaborative efforts are needed to develop sustainable funding for community-based care programs that specifically support pediatric post-surgical recovery and reintegration.Efforts to provide appropriate and empowering caregiver education are critical, particularly in geographical regions where ongoing access to rehabilitation professionals is minimal.