Background
Method
Key word | Search terms |
---|---|
Boundary spanning (concept) | “boundary spann*” OR “boundary cross*” OR “community guide*” OR “community aide” OR “community organi?er*” OR intermediary OR broker OR bridge* OR connector OR “translation agent” OR networker OR promatora OR navigator* |
Marginalised (population) | Marginali?ed. OR disadvantage* OR “hard to reach” |
Health services (context) | Hospital* OR “primary care” OR “community health” OR “health organi?ation*” OR “health service*” OR healthcare |
Inclusion criteria | Article type: research, discussion, review or scoping review Addressing all three conceptual areas: health; boundary spanning; marginalised population About boundary spanning between health setting and the community About use of boundary spanners from the community context not the institutional setting—i.e. from the community or with similar attributes to community being served Located in high-income countries (added as criteria at stage three) |
Exclusion criteria | Not in English Not peer-reviewed Published before 2007 Outlining a study that had not yet commenced |
First author and year | Health context | Population group | Boundary spanning type | Paid or unpaid | Purpose of boundary spanning | Activities | Outcome domains | |||
---|---|---|---|---|---|---|---|---|---|---|
Individual | Boundary spanner | Organisation | Community | |||||||
Aoun (2013) [61] | Weight loss | Rural middle aged to older men | Peer | Unpaid | Change in health behaviours and outcomes | Workshop/information sessions; individual provision of health advice/coaching | ✓ | ✓ | ✓ | |
Bailey (2015) [53] | General healthy lifestyle interventions | Prisoners and people with mental illness | Lay | Paid | Change in health behaviours and outcomes | Workshop/information sessions; individual provision of health advice/coaching; referrals to other organisations | ✓ | ✓ | ||
Barlow (2011) [54] | Perinatal/maternal health | Socio-eco deprived families | Peer | Paid and unpaid | Addressing organisational trust problem | Individual provision of health advice/coaching; home visits/phone calls; emotional/practical support; referrals to other organisations | ✓ | ✓ | ✓ | |
Bustillos (2015) [38] | Nutrition | Disadvantaged and hard to reach | CHW | Paid | Addressing organisational trust problem | Workshop/information sessions; individual provision of health advice/coaching | ✓ | ✓ | ||
Choi (2016) [39] | Cancer screening or care | Ethnic minority | CHW | Unstated | Increase participation rates in clinical services | Workshop/information sessions; home visits/phone calls; service navigation | ✓ | ✓ | ||
Doolan-Noble (2013) [62] | Chronic care | Rural with complex and chronic conditions | Navigator | Paid | Solution to workforce shortage | Home visits/phone calls; emotional and practical support; referrals to other organisations; patient follow up and documentation | ✓ | ✓ | ||
Felix (2011) [45] | Mild to moderate functional limitations | Long-term care needs: age and disability | CHW | Paid | Increase participation rates in clinical services | Home visits/phone calls; referrals to other organisations; service navigation | ✓ | ✓ | ||
Gampa (2017) [46] | Community health | Indigenous communities | CHW | Paid | Solution to workforce shortage | Individual provision of health advice/coaching; home visits/phone calls; emotional and practical support; referrals to other organisations; cultural brokering; case management; health service provision | ✓ | |||
Han (2007) [47] | Chronic care | Older migrants | CHW | Unpaid | Change in health behaviours and outcomes | Workshop/information sessions | ✓ | ✓ | ||
Hartman (2013) [60] | Exercise program | Ethnic minority mothers | Community entities | Paid | Change in health behaviours and outcomes | Workshop/information sessions; cultural brokering | ✓ | ✓ | ||
Hesselink (2011) [27] | Perinatal/maternal health | Ethnic minority women | CHW | Paid | Change in health behaviours and outcomes | Workshop/information sessions; individual provision of health advice/coaching; cultural brokering; health service provision | ✓ | ✓ | ||
Kennedy (2010) [55] | Nutrition | Less affluent neighbourhood | Lay | Paid and unpaid | Change in health behaviours and outcomes | Workshop/information sessions; individual provision of health advice/coaching; emotional and practical support | ✓ | ✓ | ✓ | ✓ |
Levinson (2015) [48] | Smoking cessation | Socio-eco disadvantaged | Lay | Paid | Increase participation rates in clinical services | Individual provision of health advice/coaching; home visits and phone calls; referrals to other organisations; patient follow up and documentation | ✓ | |||
Margellos-Anast (2012) [49] | Chronic care | Poor inner-city communities | CHW | Paid | Increase participation rates in clinical services | Individual provision of health advice/coaching; referrals to other organisations; case management. | ✓ | ✓ | ||
May (2007) [65] | Community health | Immigrants | CHW | Paid and unpaid | Solution to workforce shortage | Workshop/information sessions; individual provision of health advice/coaching; home visits/phone calls; emotional and practical support; referrals to other organisations | ✓ | ✓ | ✓ | ✓ |
McLeish (2015) [56] | Perinatal/maternal health | Vulnerable mothers | Peer | Unpaid | Addressing organisational trust problem | Workshop/information sessions; individual provision of health advice/coaching; emotional and practical support; service navigation | ✓ | ✓ | ||
Najafizada (2015) [63] | Community health | Marginalised people | CHW | Paid and unpaid | Increase participation rates in clinical services | Workshop/information sessions; individual provision of health advice/coaching; health service provision | ✓ | ✓ | ✓ | |
Otiniano (2012) [50] | Community health | Hard to reach communities | CHW | Stipend for the workshop | Addressing organisational trust problem | Workshop/information sessions; community-based research | ✓ | |||
Palmas (2014) [51] | Chronic care | Hispanic adults | CHW | Paid | Change in health behaviours and outcomes | Individual provision of health advice/coaching; home visits/ phone calls; emotional and practical support | ✓ | |||
Palomino (2017) [52] | Cancer screening or care | Ethnic minorities- rural | Navigator | Paid | Increase participation rates in clinical services | Service navigation; cultural brokering. | ✓ | |||
Rafie (2015) [40] | Cancer screening or care | African-American | Lay | Unpaid | Increase participation rates in clinical services | Workshop/information sessions | ✓ | ✓ | ||
Raj (2012) [41] | Cancer screening or care | Racially and ethnically diverse | Navigator | Paid | Increase participation rates in clinical services | Home visits/phone calls; service navigation; patient follow up and documentation | ✓ | |||
Rohan (2016) [42] | Cancer screening or care | Medically disadvantaged | Navigator | Paid | Increase participation rates in clinical services | Home visits/phone calls; emotional and practical support; service navigation; patient follow up and documentation | ✓ | |||
Shahidi (2015) [43] | Community health | Inner city neighbourhood “forgotten” | CHW | Paid | Addressing organisational trust problem | Workshop/information sessions; home visits/phone calls; emotional and practical support; service navigation; case management; health service provision | ✓ | |||
Sokol (2016) [64] | General healthy lifestyle interventions | Hardly reached | Peer | Paid and unpaid | Addressing organisational trust problem | Home visits/phone calls; emotional and practical support; service navigation; referrals to other organisations | ✓ | ✓ | ||
Thomson (2012) [57] | Perinatal/maternal health | Mothers in a deprived area | Peer | Paid and unpaid | Addressing organisational trust problem | Workshop/information sessions; home visits/phone calls; emotional and practical support | ✓ | ✓ | ||
Torres (2014) [67] | Perinatal/maternal health | New immigrants and refugees | CHW | Paid | Solution to workforce shortage | Workshop/information sessions; individual provision of health advice/coaching; home visits/phone calls; emotional and practical support; referrals to other organisations; cultural brokering; case management | ✓ | ✓ | ||
Wagoner (2015) [44] | Sexual health | Ethnic minority men- Latino | Peer | Unpaid | Change in health behaviours and outcomes | Workshop/information sessions; individual provision of health advice/coaching; emotional and practical support; referrals to other organisations | ✓ | ✓ | ✓ | |
White (2015) [58] | Mental health | High deprivation areas | Lay | Paid | Change in health behaviours and outcomes | Individual provision of health advice/coaching | ✓ | |||
Woodall (2013) [59] | Community health | Disadvantaged communities | Lay | Unpaid | Change in health behaviours and outcomes | Workshop/information sessions; individual provision of health advice/coaching; emotional and practical support | ✓ | ✓ | ✓ |
Findings
Health focus and country
Descriptions, titles and types
Type of boundary spanner: | Navigators | Community health workers | Lay workers | Peers | Community entities |
---|---|---|---|---|---|
Boundary spanner titles | Patient navigator | Community health worker Promatora Community connector Community multicultural health broker Community health representative | Champion Lay food worker Community breast health advocate Health volunteer Natural helper Health trainer Smoking solution guide | Peer support Champion Health coach Lay health advisor Male lay health advisor Mentor Buddy Companion Community parent Community supporter | Ethnically specific channel |
Number articles n = 30 | 4 | 13 | 6 | 6 | 1 |
Article reference | [60] | ||||
Organisational orientation • Technical • Service provision and access focus • Documented scope of practice • Alignment with mission and interests of health service | Community orientation • Not based in a health service • High degree flexibility • Relationship focus • Close knowledge of local community • Alignment with interests of the community |