title: What is the scope of improving immigrant and ethnic minority healthcare using community navigators: A systematic scoping review.
abstract: BACKGROUND
  Immigrants are among the most vulnerable population groups in North America; they face multidimensional hurdles to obtain proper healthcare. Such barriers result in increased risk of developing acute and chronic conditions. Subsequently a great deal of burden is placed on the healthcare system. Community navigator programs are designed to provide culturally sensitive guidance to vulnerable populations in order to overcome barriers to accessing healthcare. Navigators are healthcare workers who support patients to obtain appropriate healthcare. This scoping review systematically searches and summarizes the literature on community navigators to help immigrant and ethnic minority groups in Canada and the United States overcome barriers to healthcare.
  
  
  METHODS
  We systematically searched electronic databases for primary articles and grey literature. Study selection was performed following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement. Articles were selected based on four criteria: (1) the study population was comprised of immigrants or ethnic minorities living in Canada or the United States; (2) study outcomes were related to chronic disease management or primary care access; (3) the study reported effects of community navigator intervention; (4) the study was published in English. Relevant information from the articles was extracted and reported in the review.
  
  
  RESULTS
  Only one study was found in the literature that focused on navigators for immigrants in Canada. In contrast, 29 articles were found that reported navigator intervention programs for immigrant minorities in the United States. In these studies navigators trained and guided members of several ethnic communities for chronic disease prevention and management, to undertake cancer screening as well as accessing primary healthcare. The studies reported substantial improvement in the immigrant and ethnic minority health outcomes in the United States. The single Canadian study also reported positive outcome of navigators among immigrant women.
  
  
  CONCLUSIONS
  Navigator interventions have not been fully explored in Canada, where as, there have been many studies in the United States and these demonstrated significant improvements in immigrant health outcomes. With many immigrants arriving in Canada each year, community navigators may provide a solution to reduce the existing healthcare barriers and support better health outcomes for new comers.
authors.affiliation: Department of Family Medicine, Room G012F, Health Sciences Center, University of Calgary, 3330 Hospital Drive Northwest, Calgary, AB, T2N 4N1, Canada. nsshommu@ucalgary.ca.
authors.forename: Nusrat Sharmeen
authors.initials: NS
authors.lastname: Shommu
authors.affiliation: Department of Family Medicine, Room G012F, Health Sciences Center, University of Calgary, 3330 Hospital Drive Northwest, Calgary, AB, T2N 4N1, Canada. salahmed@ucalgary.ca.
authors.forename: Salim
authors.initials: S
authors.lastname: Ahmed
authors.affiliation: Sleep Center, Foothills Medical Center, University of Calgary, 1403 29 Street NW, Calgary, AB, Canada. rumanasums@hotmail.com.
authors.forename: Nahid
authors.initials: N
authors.lastname: Rumana
authors.affiliation: Department of Family Medicine, Room G012F, Health Sciences Center, University of Calgary, 3330 Hospital Drive Northwest, Calgary, AB, T2N 4N1, Canada. gary.barron@ucalgary.ca.
authors.forename: Gary R S
authors.initials: GR
authors.lastname: Barron
authors.affiliation: Department of Family Medicine, Room G012F, Health Sciences Center, University of Calgary, 3330 Hospital Drive Northwest, Calgary, AB, T2N 4N1, Canada. kamcbrie@ucalgary.ca.|Department of Community Health Sciences, University of Calgary, 3280 Hospital Drive Northwest, Calgary, AB, T2N 4Z6, Canada. kamcbrie@ucalgary.ca.
authors.forename: Kerry Alison
authors.initials: KA
authors.lastname: McBrien
authors.affiliation: Department of Family Medicine, Room G012F, Health Sciences Center, University of Calgary, 3330 Hospital Drive Northwest, Calgary, AB, T2N 4N1, Canada. turin.chowdhury@ucalgary.ca.|Department of Community Health Sciences, University of Calgary, 3280 Hospital Drive Northwest, Calgary, AB, T2N 4Z6, Canada. turin.chowdhury@ucalgary.ca.
authors.forename: Tanvir Chowdhury
authors.initials: TC
authors.lastname: Turin
mesh_terms: D002170:Canada; D002908:Chronic Disease / Q000517:prevention & control; D055088:Early Detection of Cancer / Q000706:statistics & numerical data; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data*; D005006:Ethnicity / Q000706:statistics & numerical data*; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D054625:Healthcare Disparities / Q000208:ethnology*; D006801:Humans; D062526:Patient Navigation / Q000706:statistics & numerical data*; D014481:United States