Mapping client outcomes of patient navigation across care contexts: a scoping review

Patient navigation has been used to reduce barriers to care and improve access to health and social services across diverse health conditions, populations, and care settings. Past scoping and systematic reviews have synthesized reported client outcomes within specific care contexts; however, a comprehensive synthesis of client outcomes reported across the broader patient navigation literature is lacking. This scoping review mapped client outcomes reported in studies of patient navigation across care contexts. A scoping review was conducted following Joanna Briggs Institute methodology. Searches were conducted in 2024 in the databases MEDLINE, CINAHL, APA PsycINFO, Social Work Abstracts, EMBASE, and ProQuest Nursing & Allied Health. Reference lists of included articles were also hand-searched. This review included research articles published in English or French since 1990 that reported outcomes of patient navigation interventions. Quantitative data were summarized using descriptive statistics, while qualitative findings were analyzed using qualitative content analysis. Results were synthesized narratively to map the range of client outcomes reported in the literature. The review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses-Extension for Scoping Reviews (PRISMA-ScR) guidelines. A total of 470 reports were included. Studies spanned diverse care contexts, including cancer care, chronic disease care, mental health and addiction care, communicable/infectious disease care, reproductive/maternal care, and palliative and end-of-life care. Quantitative studies most commonly reported favourable outcomes related to health service utilization, including access to care, engagement, screening, service uptake, and retention, as well as care satisfaction, knowledge, health literacy, and self-efficacy. Findings for therapeutic, behavioural, and self-reported health outcomes were more variable across care contexts. Relatively few studies quantitatively assessed client-facing care delivery outcomes, such as perceived coordination, communication, and continuity. Qualitative studies described favourable outcomes related to health service utilization, knowledge and self-efficacy, health and well-being, care satisfaction, and care delivery processes, while also highlighting the value clients placed on relationship building and trust. Patient navigation interventions were associated with a broad range of client outcomes across diverse care contexts. Future research would benefit from clearer and more consistent definitions of patient navigation, more transparent reporting of intervention components, and greater use of implementation science approaches to understand how contextual factors influence the delivery of patient navigation and reported client outcomes.