title: Evolution of a health navigator model of care within a primary care setting: a case study.
abstract: OBJECTIVE
  Patient navigation originated as an approach for reducing disparities in cancer care and consequent health outcomes. Over time navigator models have evolved and been used to address various health issues in differing contexts. This case study outlines the evolution, purpose and effects of a lay-led health navigator model in a deprived, sparsely populated, New Zealand rural setting, where primary care services are frequently understaffed and routinely overstretched.
  
  
  METHODS
  Routinely collected service utilisation data, survey results and health navigator interview data were utilised to illustrate the client group the service works with, why primary care refer to the service, as well as lessons learned from implementation to ongoing service provision.
  
  
  RESULTS
  Those referred to the navigator service generally represented the most vulnerable in the community. Survey respondents, overall, were highly satisfied with the service. Navigators identified barriers and facilitators to implementation, as well as ongoing obstacles and enablers to service provision.
  
  
  CONCLUSIONS
  This lay-led navigator service provided support to a group of unwell individuals, with few resources and multiple barriers to negotiate, and has effectively engaged with health and social care services, while overcoming various barriers and obstacles to its establishment and ongoing operation.
authors.affiliation: Department of Preventive and Social Medicine, University of Otago, PO Box 913, Dunedin 9054, New Zealand. Email: ;
authors.forename: Fiona
authors.initials: F
authors.lastname: Doolan-Noble
authors.forename: Danielle
authors.initials: D
authors.lastname: Smith
authors.forename: Robin
authors.initials: R
authors.lastname: Gauld
authors.forename: Debra L
authors.initials: DL
authors.lastname: Waters
authors.forename: Anthony
authors.initials: A
authors.lastname: Cooke
authors.forename: Helen
authors.initials: H
authors.lastname: Reriti
mesh_terms: D037001:Directive Counseling; D006801:Humans; D017146:Models, Organizational; D009520:New Zealand; D019982:Organizational Case Studies; D011320:Primary Health Care