Table 3.

Didactic Training for Patient Navigators

Content	Source	Key Learning Points
Formal Training Courses
Fundamentals of Patient Navigation (8 week course)52	Patient Navigator Training Collaborative (PNTC) course	Learned about the history of patient navigation and the navigator role and responsibilities Learned effective communication techniques, problem-solving strategies health promotion principles, and introductory motivational interviewing skills Provided tools to assess patient needs and barriers to care Learned relationship building strategies to help establish rapport with patients and maintain professional boundaries and importance of providing materials appropriately matching patients’ health literacy level Learned the importance of self-care to avoid navigator burn out
Care Coordination Course (4 week course)51	PNTC course	Emphasized team-based care coordination and understanding roles/responsibilities of care team members Promoted patient engagement, safety, helping reduce barriers for patients, reducing health care costs and enhancing productivity. Learned skills to effectively collaborate with care team and reduce fragmentation in care via a patient-centered approach with outlined team responsibilities and a shared plan of care
Introduction to Chronic Disease54	PNTC course	Learned the basics of common chronic diseases (characteristics, symptoms, treatments, risk factors)
Introduction to Healthcare System55	PNTC course	Introduced to private, public and non-profit hospital systems Received an overview of the health insurance plans and programs Learned about the Patient Bill of Rights, HIPPA and protected health information
Preventive Healthcare 10156	PNTC course	Understood methods to encourage formation of healthy habits and prevention of harmful habits among patients
Motivational Interviewing57	PNTC course	Introduced to motivational interviewing, identifying the stages of change and interaction techniques
Readings
Patient Navigation: Overcoming Barriers to Care46	Textbook	Introduced to principles of navigation Learned about prior studies of patient navigation and navigation implementation in the healthcare system
National Navigation Roundtable (NNRT) materials58	NNRT	Understood about promising evidence-based practices in patient navigation Learned about health policies and organizational systems to promote patient navigation
Motivational Interviewing59	ACOG	Applied motivational interviewing as a tool to improve health behaviors and outcomes
Benefits to Women of Medicaid Expansion Through the Affordable Care Act60	ACOG	Learned about the adverse health outcomes for the uninsured population and provided a rationale for Medicaid expansion and improving reimbursement rates
Breastfeeding in Underserved Women61	ACOG	Learned about low rates of breastfeeding in underserved population Learned about the role of healthcare providers and government agencies to advocate for patients and promote breastfeeding through education and outreach
Optimizing Support for Breastfeeding (ACOG Breastfeeding Toolkit)62	ACOG	Described the evidence and the specific benefits of breastfeeding for moms and babies Understood the recommendations for providers such as providing breastfeeding education and support and starting conversations about breastfeeding early in prenatal care Provided tips and suggestions for educating patients and helpful information for breastfeeding support
Healthcare for Homeless Women63	ACOG	Understood specific health issues the homeless population faces and the barriers to accessing health care Understood recommendation to help identify patients experiencing homelessness and ways to manage their care
Challenges for Overweight and Obese Women64	ACOG	Learned about specific health issues overweight and obese women face and how those risks contribute to developing health conditions (diabetes, hypertension, etc.) Learned about the role of motivational interviewing and education as tools to promote lifestyle changes and improve health
Access to Contraception65	ACOG	Learned about barriers women face to accessing birth control (lack of education, cost, health inequities, etc.) Learned about legislation impeding on access to contraception for minors
Immediate Postpartum Long-Acting Reversible Contraception66	ACOG	Understood background information on long-acting reversible contraception (LARC) Learned about the advantages of LARC and the clinical considerations, risks, and common concerns Learned about the effect on breastfeeding and the concerns associated with LARC
Bedsider Birth Control Support Network67	Website	Accessed web-based information about different birth control methods including cost, usage, side effects, and problems
Health Literacy to Promote Quality of Care68	ACOG	Understood importance of health literacy in providing care to improve patient outcomes
Racial and Ethnic Disparities in Obstetrics and Gynecology69	ACOG	Learned about the role of healthcare providers in alleviating racial and ethnic health disparities Learned about the importance of a culturally sensitive approach to care in alleviating disparities
Health Care for Unauthorized Immigrants70	ACOG	Learned about the challenges immigrant women face to accessing healthcare, specifically prenatal care and preventative care, and the need for immigrant advocacy
Importance of Social Determinants of Health and Cultural Awareness in the Delivery of Reproductive Health Care71	ACOG	Obtained awareness on the importance of social determinants of health to better understand patients Learned about recognizing cultural matters in clinical settings and the importance of showing humility and cultural respect Learned about tools healthcare providers can use to implement in their practice to address social determinants of health
Health Disparities in Rural Women72 and Providing Safe, High-Quality Maternity Care in Rural US Hospitals73	ACOG and Institute for Healthcare Improvement	Understood the unique barriers experienced by individuals in rural areas and how to advocate for patients with rural health disparities
Implicit Bias in Healthcare Professionals: A Systematic Review74	Article	Recognized the evidence analyzed from peer reviewed articles indicating healthcare professionals show the same levels of implicit bias as the wider population Learned about how implicit bias can influence the care provided to patients by healthcare professionals
Optimizing Postpartum Care15	ACOG	Understood the importance of engaging patients in postpartum care through a patient-centered approach Learned about the importance of advising mothers with chronic health conditions to continue management
Screening for Perinatal Depression75	ACOG	Learned about perinatal depression, the screening process, and appropriate treatments Learned about the importance of connecting patients with mental health services
Expression of Emotion Through Nonverbal Behavior in Medical Visits76	Article	Demonstrated how nonverbal behavior and emotions can influence the care process for patients and physicians Learned about methods used to assess nonverbal behavior and nonverbal sensitivity
Project Implicit77	Project Implicit	Learned about implicit bias via implicit association tests, web-based readings on implicit bias, and resources on implicit bias
Webinars
Managing difficult encounters78	PNTC Webinar	Developed insight into managing “challenging” patients by reframing encounters from patient perspectives, diffusing tension and discussing with the care team
LGBTQ Cultural Responsiveness79	PNTC Webinar	Learned about the importance of gender-affirming pronouns and creating a supportive environment for LGBTQ individuals
Seminar on Poverty and Self-Sufficiency80	PNTC Webinar	Explored data on family incomes and perspective on the relationship between geographic location and self-sufficiency
Culturally and Linguistically Appropriate Services Standards for Navigators81	PNTC Webinar	Learned about the importance of appropriate cultural and linguistic services to prevent written and oral miscommunications
Basic Crisis Management Skills for Patient Navigators82	PNTC Webinar	Learned to manage and respond to patients in crisis through “emotional first aid”
Healthier Pregnancy Interventions to Promote Breastfeeding83	ACOG	Learned about the importance of promoting breastfeeding and evidence-based support in hospital settings to help women reach their breastfeeding goals Learned about the importance of educating patients on resources to promote breastfeeding, for example, insurance covered breast pumps and support groups
Maintaining Breastfeeding beyond the First Week84	ACOG	Understood the importance of identifying and creating a plan to address barriers to breastfeeding (postpartum depression, physical breast issues, etc.) Learned about informing patients about the benefits of breastfeeding beyond three months
Implicit Bias Video Series85	UCLA Know Implicit Bias Series	Learned about biases, heuristics, stereotypes, and explicit versus implicit bias Learned about the role of implicit biases in health and health care
Grand Rounds and other in-person lectures
Bipolar Disorder in the Perinatal Patient	Lecture	Learned about the high risk of postpartum psychosis among women with bipolar disorder Introduced to dangers of postpartum psychosis and treatment options
Housing as a Structural Determinant of Perinatal Health	Lecture	Learned about the effects of homelessness on perinatal health Learned about different styles of housing programs
Perinatal Depression Screening and Treatment	Lecture	Learned about the recommendations for depression screening throughout pregnancy and postpartum Learned about the importance of collaborative care through mental health services, obstetrical care, and social services Learned about diagnostic tools and treatment options for perinatal depression
Gestational Diabetes Mellitus	Lecture	Learned about management and long-term health risks associated with gestational diabetes mellitus, as well as associated disparities

ACOG, American College of Obstetricians and Gynecologists