Total number of navigator interactions with care team members by postpartum month.
INTERACTIONS
Navigators recorded all interactions with care team members using a standardized weekly log. Interactions with each care team member were quantified, stratified by participant and postpartum month. Data represent total navigator interactions with care team members for all participants (N = 50) for each postpartum month.1. Obstetric Clinic Administration includes patient service representatives and scheduling coordinators.2. Primary Care Team includes scheduling coordinators, primary care physicians, and primary care nurses.The majority of navigators’ communication with participants occurred via text message, ranging from 64.1% of all communications in postpartum month 1 to 83.6% of all communications in postpartum month 11 (Analysis of descriptive notes in navigator log entries illustrated the complexity of navigation activities. Narrative accounts of log entries recounted multiple tasks to address patient needs. For example, an entry which recounted one navigator’s attempts to assist a patient with breastfeeding support contained tasks including providing the patient with information regarding multiple resources, calling resources directly, motivating the patient to access resources as needed, and following up with the patient repeatedly. These complex interactions addressed patient needs but required intense navigator work that could span multiple days. High-task log entries were more prevalent for participants who regularly engaged in navigation, as demonstrated through a pattern of high levels of communication between patient and navigator, indicating navigation’s potentially increased benefit for high-needs patients with willingness to engage in care initiatives. Further, the content of log entries varied widely, demonstrating the breadth of navigation activities.CFIR-guided analysis of interviews with navigators revealed facilitators of and barriers to implementation across all 5 CFIR domains (