113 Patient navigation for improving outcomes in child and youth development and mental health: A prospective cohort study comparing patients who did and did not receive navigator services after program referral
Bibliographic record
Abstract
Abstract Background Mental health and developmental conditions are common among Canadian children and youth and require multiple supports in both clinical and community settings. However, many families may find it difficult to access all of the appropriate services available to them. Thus, pediatric patient navigator programs have been developed to help families connect to resources that will support their child’s diagnosis. However, little is known about what barriers may prevent families from actually connecting with the patient navigator following an appropriate referral. Objectives The purpose of this study was to evaluate a Canadian Pediatric Patient Navigation Program (PPNP) for children with a formal or provisional mental health or developmental diagnosis. The primary objective was to determine which physician-identified barriers may prevent families from connecting with the pediatric patient navigator (PPN) once an appropriate referral has been made. Of those who did not connect, we were interested in families who booked but did not attend their appointment (i.e., no-show) and families who were unable to be contacted by administrative staff to schedule an appointment despite contact attempts (i.e., no-contact). Design/Methods This prospective cohort study included patients referred to a Canadian PPNP between October 1st 2017 and October 31st 2018. Data was collected via standardized PPNP referral forms. Statistical analyses were conducted using chi-square tests of independence. Results Of those who met the inclusion criteria (n=524), 78% connected with the PPN and 22% did not connect with the PPN. Of those who did not connect, 41% were classified as no-show and 40% were classified as no-contact. There were no significant differences between groups in terms of sex, diagnosis and time since diagnosis. Those who connected with the PPN were significantly more likely to have a settlement barrier identified compared to those who did not connect (29% vs. 18%, p<.05). Those who no-showed were significantly more likely to have parental mental health identified as a barrier compared to those who connected (15% vs. 5%, p<.05). Finally, families were significantly more likely to have a language/literacy barrier identified if there was no-contact compared to if they no-showed (35% vs. 15%, p<.05). Conclusion Parental mental health issues may prevent families from showing up to booked appointments, highlighting the importance of ensuring concurrent parental mental health support. Additionally, language/literacy barriers are a key factor contributing to the inability of administrative staff to contact families, highlighting the need for interpreter services to aid in booking appointments.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.003 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".