BACKGROUND:Dementia care is often fragmented and difficult to navigate. Patient navigation is a promising solution to support individuals with dementia and their care partners. OBJECTIVE:A bilingual patient navigation program was piloted in New Brunswick, Canada, embedding six patient navigators in primary care clinics across the province. METHODS:A mixed-methods study explored participant characteristics, satisfaction, and experiences with the program. FINDINGS:Among 150 navigation cases, primary needs included access to informational resources and social services. Survey results showed high overall satisfaction with the program, along with improved knowledge and access to dementia-related health and social services. Qualitative findings further emphasized that patient navigators successfully linked participants to appropriate resources and services while also reducing care partner burden. However, systemic barriers such as long wait times and financial constraints persisted. DISCUSSION:This study highlights the need for early intervention and sustained navigation support to enhance dementia care coordination and accessibility in aging populations.

Episodic virtual care (EVC) offers patients rapid access to virtual primary care services but lacks relational continuity with a primary care clinician or team. We investigated patients’ experiences with EVC and examined differences based on access to a regular primary care clinician and self-reported complexity of medical needs. In this convergent parallel mixed methods study, we conducted a descriptive and exploratory survey of EVC users’ health service access, self-reported medical needs, EVC use, and demographics. Participants included adults (aged ≥ 18) living in Nova Scotia or New Brunswick who self-reported using EVC in the past year. We used descriptive statistics to summarize numeric and ordinal data of patient experience and stratified findings by having a regular primary care clinician and medical complexity. We conducted inductive content analysis of free-text survey responses. We integrated quantitative and qualitative data at the interpretation phase. We identified mixed experiences among EVC users, with quantitative data portraying virtual care experiences more favourably than free-text responses. Most users felt EVC met their health needs, although those without a regular primary care clinician and with greater medical complexity tended to rate experiences less favourably. In free-text responses, some participants expressed concerns with the technological aspects of virtual visits and voiced preferences for in-person care. Patients with a regular primary care clinician tended to access EVC for short-term health concerns, whereas those without a regular primary care clinician sought care for ongoing/chronic problems and prescription renewals. EVC is helping to address some gaps in access, particularly for patients without a regular primary care clinician, by providing care where there might otherwise be none. However, EVC often falls short of meeting ongoing and more comprehensive care needs, underscoring the importance of improving access to longitudinal primary care.

Research teams increasingly rely on patient engagement–where patients are engaged as partners in knowledge production–to improve the quality and relevance of health research. An ongoing challenge is how best to compensate patient partners for their time and expertise, given diverse personal, financial, and institutional contexts. This study identifies common barriers and facilitators to patient partner compensation; examines how compensation practices actively shape who can participate in patient-oriented research, enabling or constraining equity, diversity, and inclusion within health research teams; and explores strategies to mitigate barriers to equitable compensation and boost diverse and inclusive patient engagement in health research. Using a qualitative descriptive design, and with active involvement from patient partners on our research team, we recruited geographically and socially diverse participants from across the spectrum of patient-oriented research in Canada, including patient partners, research staff, administrative and finance employees, and funding organization staff. Semi-structured interviews (n = 25) and focus groups (10 in number, n = 24), conducted between 2023 and 2025, elicited respondents’ impressions of the interactions between patient partnership, compensation practices, and equity, diversity, and inclusion. We applied inductive thematic analysis to identify shared values and common experiences, and explore solutions to compensation practices that challenge equitable patient engagement. Thematic analysis of interviews and focus groups generated seven themes: Clear expectations and processes, Bureaucratic inertia, Reproduction of privilege, Institutional mistrust, Tax and benefit implications, Funding cycles, and Relational dynamics. Compensation is an integral component of effective patient-oriented research and has significant implications for research engagement among structurally marginalized communities. We propose recommendations for advancing equitable and inclusive compensation practices within Canadian patient-oriented research. These days, health research teams often include patient partners. Patient partners are people with lived experience of a health condition or the healthcare system, who use that experience to help with the planning, design, conduct, and sharing of health research. Their input and perspectives help to make research fit better with the real-life concerns of people who live with health conditions. One challenge is how best to reward patient partners for their work. Sometimes, there are rules and regulations that make payment complicated. We spoke with patient partners, researchers, and people who work for research and funding organizations from across Canada. We asked them about what works well and what does not when it comes to paying patient partners. We also asked about how the ways that we pay people for helping with research affect participation by people from diverse communities. We identified seven themes to describe what we found: Clear expectations and processes, Bureaucratic inertia, Reproduction of privilege, Institutional mistrust, Tax and benefit implications, Funding cycles, and Relational dynamics. Based on these themes, we give suggestions for changes that could make payment for research partnership easier and more inclusive.

Background:Youth with brain-based disabilities (BBD) need tailored support when preparing for adult healthcare. We originally designed a full randomized controlled trial (RCT) to test whether the MyREADY Transition™ BBD App improved transition readiness among youth aged 15-17 years with autism spectrum disorder, cerebral palsy, epilepsy, fetal alcohol spectrum disorder, or spina bifida. Due to slow recruitment, the full RCT was halted and pivoted to a stand-alone pilot and feasibility trial. Methods:This mixed method, patient-oriented pilot RCT (2019-2022, Canada) evaluated process, resource, management, and scientific feasibility, along with engagement with the App. Scientific feasibility focused on self-management outcomes (TRAQ and Transition-Q) among 43 youth (mean age 15.9 ± 0.8; 19 intervention, 24 control). Interviews and surveys provided additional perspectives on feasibility and user experience. Results:Recruitment achieved only 43 of the planned 264 participants, and App engagement was modest. Almost all intervention participants logged into the App at least once, but on average completed less than one third of the curriculum. Qualitative findings suggested the App's content was relevant and useful. Participants, caregivers, and healthcare providers emphasized the need for tailored, collaborative approaches to transition preparation. Conclusion:Challenges included slow recruitment and limited sustained use of an e health intervention among youth with BBD. Despite the pivot, the trial generated pragmatic insights for future transition research. Youth and parent recommendations underscored the importance of customizable content and strategies that enhance motivation and engagement. Additional pilot work is needed to refine and optimize digital transition supports.

As the rates of dementia continue to rise across Canada, accessing care remains a challenge for people living with dementia, their caregivers, and members of the care team. Patient navigation offers a promising approach to reducing these barriers and enhancing the integration of care for this population. Many such programs already exist in Canada. This scan identified 11 programs across six provinces, detailing their characteristics, implementation processes, facilitators, and barriers to their implementation. Findings highlight the importance of person-centered care, early access, effective collaboration, and adequate funding as key facilitators. In contrast, barriers included insufficient funding, insufficient capacity for collaboration, and system-level challenges, like "navigation to nowhere" and disruptions caused by COVID-19. By reporting on successful practices and areas for improvement, this scan aims to inform the development and implementation of effective dementia patient navigation programs.

BACKGROUND:Receiving a dementia diagnosis is a complex experience that can provide clarity about symptoms but often creates uncertainty. Support during and after diagnosis is essential to help individuals navigate living with dementia. This qualitative descriptive study examined experiences during and after diagnosis among people with dementia and care partners in New Brunswick, Ontario, and Quebec. METHODS:Interviews with 5 people with dementia and 15 care partners were conducted and then analysed using qualitative content analysis to identify barriers, facilitators, and contextual influences related to a positive experience. RESULTS:Barriers included limited resources, poorly coordinated care, disorganized diagnostic pathways, and stigma. Facilitators included access to information, person-centred care, support networks, recognition of personhood, and structured care navigation. The COVID-19 pandemic further shaped experiences. CONCLUSION:Findings highlight the importance of compassionate care, accessible information, and coordinated services while underscoring systemic gaps, stigma, and the impact of the pandemic.

IntroductionChatbots are accessible and cost-effective tools that may be able to provide navigation support to people who lack access to conventional patient navigation services. To date, little is known about people's interest in using chatbots for patient navigation. It is also unclear what specific types of support people would like to see incorporated into patient navigation chatbots. The purpose of this study was to gain insight into these topics.MethodsParticipants were recruited through the Prolific research platform. They completed a cross-sectional survey that captured information on respondent characteristics, general interest in using a patient navigation chatbot, and interest in various navigation support functions. Data were analyzed using descriptive statistics and ANOVA and hierarchical regression statistical tests.ResultsA total of 276 participants (141 women; M age = 38.99 years, SD = 12.90) were included in the analysis. In general, participants were moderately interested in using a patient navigation chatbot. They had greater interest in functions related to care coordination, linkage to services and resources, and general education than functions related to needs assessment and treatment support. Interest varied by certain respondent characteristics, particularly demographic and personality factors.DiscussionThe findings from this study will help inform the design and marketing of patient navigation chatbots. The effective implementation of this technology may fill some of the accessibility gaps that characterize conventional patient navigation programs.

Background Individuals with multimorbidity often have complex health and social care needs and experience frequent transitions across various settings and providers, including home, community services, primary care, and hospitals. These transitions represent pivotal moments within their care trajectories, where the risk of care fragmentation is significantly increased. Although these transitions play an important role in shaping patient experiences and outcomes, the factors associated with them remain insufficiently documented. Objective This study aimed to identify individual and environmental factors associated with either positive or negative experiences of care transition among individuals with complex needs. Design Using a prospective correlational design, participants were recruited from emergency departments at three sites in two Canadian provinces. Eligible individuals had ≥3 ED visits in the past year, screened positive on the COmplex NEeds Case-finding Tool–6 (CONECT-6), and had complex needs confirmed by an INTERMED Self-Assessment (IMSA) score of 19 or higher. Baseline data included sociodemographic, clinical, and psychosocial variables; environmental variables were derived from geocoded postal codes. At six months, participants completed a 12-item scale on care transitions adapted from the Patient Experience of Integrated Care Scale (PEICS). Multivariable linear regression identified factors associated with transition experiences. Results Of 292 participants recruited, 167 completed the follow-up. Biopsychosocial complexity, self-management capacity, and recruitment site were significantly associated with transition experiences. Higher complexity was associated with less favorable experiences, while stronger self-management was linked to more positive transitions. Conclusion Care transition experiences are associated with biopsychosocial complexity and self-management abilities, with site-level differences point to organizational and systemic influences. Further research is needed to examine how organizational and system-level factors shape transition experiences for individuals with complex needs.

Background: Realist synthesis is a comprehensive method of review for evaluating complex programs such as integrated models of care. The first step of the synthesis is to clarify the scope of the review and to explore existing theories in the literature related to targeted programs. The aim is to elicit an initial program theory in the form of context (C), mechanism (M) and outcome (O) configurations, which serve as a reference model for data collection and analysis from studies included in the synthesis. Objective: To develop an initial program theory about scale-up of integrated care programs. Study Design: This first step of our realist synthesis was conducted using a participatory approach with stakeholders (patient partners, clinicians, decision-makers, and academic researchers). This step requires active and ongoing dialogue with the people who develop, deliver, or use the program. Working sessions, as well as training on the realist approach, were organized with stakeholders to identify the research question, refine the purpose of the review, and articulate key theories to be explored. Program: This synthesis is part of a realist evaluation of a case management intervention in primary healthcare for people with complex needs in three Canadian provinces as part of the PriCARE Integration research program. Results: Thirteen theories were identified based on a preliminary exploration of the literature on implementation research and scale up of integrated care programs. The Normalization Process Theory (Murray et al., 2018), the ExpandNet/WHO framework for scaling up (WHO and ExpandNet, 2009), and the theory of community-integrated care approaches (Mukumbang et al., 2022) were selected based on their relevance for describing the actors, mechanisms, contexts, and outcomes of scale-up of integrated care programs. These theories were presented to stakeholders during a working session for feedback and an initial program theory was developed with CMO configurations. This theory will be exhibited in detail during the presentation. Learnings: The presentation will provide guidance to international academic researchers, patient partners and healthcare providers on how to engage stakeholders in a realist synthesis, especially during preliminary steps; it could also be useful for stakeholders interested in the scale up of integrated care programs to facilitate reasoning about the contextual elements and the mechanisms they need to consider for scaling up. Next steps: The second step of the realist synthesis will be a literature search conducted to identify relevant material than can contribute to the initial program theory and make recommendations for the scale up of the case management program. A realist evaluation will then be conducted to test and iteratively refine the program theory.

Abstract Introduction Receiving a dementia diagnosis can be overwhelming for persons living with dementia (PLWD) and their carers. Accessing information and home supports can be challenging. Having access to a Patient Navigation (PN) program is one way that may assist PLWD and their carers. Methods This study used a mixed methods design and involved the implementation of a Patient Navigation (PN) program in 6 primary care settings in New Brunswick, Canada, between July 2022–July 2023. PLWD/carers living in their own homes were eligible to enrol. Results There were 150 PLWD with a mean age of 76.4 (SD = 9.4) years and 51.4% were male. The majority (60.7%) were living in rural communities. Most (50.7%) had been diagnosed within the past 2 years with 50.7% having seen a specialist, most commonly a geriatrician. Almost all (88.7%) had a primary care provider; however, only 25.2% were connected to the social care system, and 19.8% were connected to the home care system. The most common reasons for enrolling were gaining access to social programs and home supports and seeking dementia specific information. The average number of goals per PLWD/carer was 3.79 (SD = 1.7). The average time in the program was 121.7 days (SD = 100.0) and 76.6% achieved their goals. The majority (84.0%) were somewhat to very satisfied with the PN program. Carers stated that with increased knowledge, access, and support there was a decrease in social isolation as well as improved confidence, which allowed PLWD to remain in the community longer. Conclusions Most PLWD/carers were connected to the health system, but the minority were connected to social and home care programs. Through connection to the PN program, carers increased their confidence; improved their knowledge; and increased their access to home supports and other care programs, allowing PLWD to remain in the community longer.

Introduction: Case management (CM) is an effective integrated model of care for patients with chronic conditions and complex care needs, given the focus on improving patient engagement in healthcare and improving self-management skills. While CM often leads to positive outcomes, little is known about the factors which promote or hinder implementation. Objective: This study seeks to examine factors which facilitated and hindered the implementation of a 12-month CM intervention in primary care clinics for individuals with chronic conditions and complex care needs, and report outcomes from the perspective of patients, nurse case managers, clinic managers, and providers. Intervention: A CM intervention was delivered by a nurse case manager (NCM), which included four activities: patient needs assessment, care planning, coordination of services, and self-management support. Design: We employed a qualitative descriptive design, using a participatory approach. The implementation was co-designed and co-led by researchers, clinicians, and patient partners, in collaboration with primary care clinics in five Canadian provinces. Participatory approach: This study involved various stakeholders, including patient partners, clinicians, researchers, and decision-makers. Patient partners were active members of the research team and played a major role in the development and governance of the larger study. Data collection: Semi-structured interviews or focus groups were conducted with patients (n= 44) and care providers (n=23), including case managers, clinic managers and primary care providers. Data analysis: Analysis of interview data was conducted using inductive thematic analysis to identify factors which facilitated or hindered implementation and outcomes. Results: Facilitators of the implementation included a holistic collaborative team-based clinic, an engaged and supportive clinic manager, the active involvement of care providers, dedicated and protected time for NCMs to complete CM tasks, and patient readiness. The implementation was hindered at clinics where staff were not engaged, leading to low recruitment numbers and difficulties carrying out the intervention. NCMs who did not have set time in their schedules or did not integrate the CM duties into their regular role struggled to carry out the program. Difficulty coordinating with specialists and external services also acted as a barrier. A final barrier to implementation was lack of access to appropriate services for patients with complex mental health needs. Outcomes included improved patient health and wellbeing, enhanced professional collaboration, expanded professional practice, more appropriate and efficient use of health services, and increased patient satisfaction. Learnings: CM is increasingly being used internationally as a way to better integrate people centered care for patients with complex care needs. The findings from this study provide insight into what worked well in implementing a 12-month CM intervention, as well as areas for improvement. Next steps: The findings from this study will be used to spread and scale CM in primary care within various provinces and First Nations, Métis, and Inuit communities in Canada over the next five years

Individuals with complex care needs (CCNs) require more health and social care services than the average population. These individuals have better outcomes if they have access to integrated services across settings and sectors. Although promising research on integrated care is underway, efforts are typically not coordinated and occur without patient partner involvement. The critical need for collaboration among stakeholders in this field prompted the establishment of the Centre for Research in Integrated Care (CRIC) in 2018. CRIC is a living laboratory that develops and evaluates integrated care models that are patient-centred and based on the needs of individuals with CCNs. We engage with various stakeholder groups across Canada, including clinicians, decision makers, researchers, trainees, and patient partners in a setting where innovative ideas are explored and modified as needed throughout the research process. We use a patient-oriented research approach, which engages patient partners throughout the entire research process. Together we identify research priorities; design, implement, and evaluate programs; and share our findings. Our team conducts needs assessments on gaps and barriers to care and then develops, implements, and evaluates integrated care models to address these gaps and barriers. One example is a navigation centre we created for children with CCNs and their families. This was implemented in partnership with a patient and family advisory council and based on a needs assessment that involved over 120 interviews with children, their families, and care providers. In this model, patient navigators worked with clients to proactively guide and support them, matching unmet needs to appropriate resources. We have since spread this innovation to support people with dementia and their care partners. Our research demonstrates that navigation programs are effective in decreasing fragmentation, improving access, and promoting the integration of care. Our team also conducts research in close collaboration with the PriCARE Team led by Dr. Catherine Hudon on case management, one of the most studied and recommended models of integrated care. In this model, a case manager is assigned to patients, and they work collaboratively with the care team and patient to assess, plan, facilitate, and coordinate care. Patient partners have been actively engaged in all aspects of this research for 6+ years. We have found this intervention to be successful in improving patient outcomes, such as improved self-management, and also health system outcomes, such as decreased emergency room visits. In this poster presentation, we will share how CRIC creates an ecosystem where diverse stakeholders can co-create knowledge and solutions to contemporary health problems through the implementation of innovative and integrated health services across settings and sectors. We will also share how we apply our patient-oriented research approach to ensure that our studies are focused on meeting the needs of patients and improving their outcomes. Ultimately, our goal is to broaden our national scope and create new international partnerships so that we can expand the reach and impact of our research. The sustainability of healthcare systems worldwide is dependent on finding new ways to meet the needs of individuals who experience CCNs.

Dementia care is often fragmented and difficult to navigate. Patient navigation (PN) is one solution to address the care needs of people with dementia (PWD) and their care partners. Navigating Dementia NB/ Naviguer la démence NB was a research project that piloted a patient navigation (PN) program in a small semi-rural province in Canada for PWD, their care partners, and the care team. The intervention was co-designed with multiple stakeholders, including clinicians, researchers, patient partners, and representatives from Regional Health Authorities. For example, the research team collaborated with representatives from the Regional Health Authorities (e.g., directors, clinic managers) to select the most appropriate clinical sites for this intervention and to manage day-to-day operations of the intervention. A Patient and Family Advisory Committee (PFAC) assisted with program oversight and a member of PFAC also sat on the project organizational committee. The PN program aimed to guide and support patients and their families through health and social care systems, matching client needs to appropriate services/resources. Six patient navigators (4 anglophone and 2 francophone) were embedded in preexisting primary care clinics/health centres in urban and rural settings across the province. The role of the patient navigator was to increase participants’ knowledge of health and social services/resources related to dementia care, to improve access to these services/resources through in person and online patient navigation, and to improve communication pathways that promote the integration and coordination of care. A mixed methods approach was used to evaluate the program, which was piloted for 12 months (July 2022-July 2023). Data for this evaluation was collected from patient navigator charts, satisfaction surveys, and semi-structured interviews with participants and stakeholders involved in creating and implementing the program. Across sites, 150 participants took part in the study. Reasons for contacting the navigators included: connecting with social services, dementia specific information and resources, advance care planning, community resources, and home health care. Fifty-six participants returned post-intervention satisfaction surveys. The survey data indicated that 85% of participants were generally satisfied with services from the program. Seventy-eight percent of participants reported having greater knowledge of health and/or social services and resources because of the patient navigator and 76% of participants reported having greater access to health and/or social services and resources. Thirty-seven participants completed post-intervention interviews about their experiences with the program, and qualitative content analysis of this data is underway. Preliminary analysis identified the following themes: overall satisfaction with the program, supportive tasks, systemic barriers, and recommendations for program improvement. These results suggest that PN, embedded in existing primary care clinics/health centers, is beneficial for PWD and their care partners. Furthermore, patient navigation is a flexible model of care and can be easily adapted to different populations and regions. These findings support our aim to promote positive experiences with health and social care systems for this population and promote person-centred, integrated care.

BackgroundSome health care conversational agents (HCCAs) are designed to simulate health professionals in terms of their presentation or appearance. Research suggests that the public has favorable views toward the depiction of HCCAs as health professionals, but the views of health professionals are less clear. We conducted a qualitative descriptive study to learn more about health professionals' views on this topic.MethodsPhysicians, nurses, and regulated mental health professionals were recruited using web-based methods. Participants were interviewed individually using the Zoom videoconferencing platform. They were asked to discuss potential benefits and drawbacks surrounding the depiction of HCCAs as health professionals. Interviews were transcribed verbatim and uploaded to NVivo (version 12; QSR International, Inc) for thematic analysis.ResultsTwenty-four health professionals participated in the study (19 women, five men; M age = 42.75 years, SD = 10.71). Three themes were developed from their interview data. Participants said that portraying HCCAs as health professionals is a form of misrepresentation and may mislead program users. Participants were also concerned that these depictions could draw from stereotypes regarding the appearance of health professionals, which might affect people's expectations surrounding these programs or their willingness to use them. Despite these concerns, some participants thought that there may be benefits to depicting HCCAs as health professionals, particularly in terms of providing a sense of reassurance to people seeking health support.ConclusionsThe health professionals in this study expressed mixed views toward the depiction of HCCAs as health professionals. Their insights may prompt further discussion on the appropriate depiction of HCCAs among developers and other stakeholders.

BACKGROUND:Health research in Canada is progressively moving towards engaging patients and their caregivers in projects where they can positively contribute to the improvement of healthcare systems and practices. One aspect of patient-oriented research (POR) focuses on identifying patient priorities for health research. Relative to their population size, patients with complex care needs (CCN) account for disproportionately high health services usage. Therefore, these patients and their caregivers are well-positioned to offer informed perspectives on health service delivery improvements. METHODS:Using a cross-sectional qualitative descriptive design, we explored health service delivery research priorities for two patient populations: children/youth with CCN and older adults with CCN, in New Brunswick, Canada. Despite concerted efforts to recruit patients directly, only caregivers responded to the recruitment materials. Qualitative data was collected using semi-structured interviews, focus groups, and self-report surveys. Data were analyzed using qualitative content analysis. RESULTS:Thirty-seven caregivers of children/youth and 35 caregivers of older adults took part in the study. While the study initially aimed to identify research priorities, participants primarily emphasized service gaps and made concrete recommendations for health system improvements. The top five priority areas for improving health service delivery for caregivers of children/youth with CCN were: (1) access to appropriate health care supports and services; (2) care continuity and coordination; (3) transitions to adulthood; (4) school and daycare system barriers; and (5) caregiver support. The top five priority areas for improving health service delivery for older adults with CCN according to their caregivers were: (1) access to appropriate health care supports and services; (2) home care issues and barriers; (3) care navigation and coordination; (4) impact of COVID-19 on care; and (5) caregiver support. CONCLUSION:This study highlights the multifaceted nature of caring for individuals with CCN. Our findings provide direction for future health research projects and offer practical guidance for health system decision-makers in the effort to improve health service delivery, particularly for our most vulnerable populations.

Background and Objective To date, there has been limited research on people's attitudes and design preferences with respect to conversational agents (CAs) that are used for healthcare. Individual differences in attitudes and design preferences have received particularly little attention. The purpose of this study was to gain greater insight into this topic. Methods We recruited American and Canadian residents through the online research platform Prolific. Participants completed a cross-sectional survey assessing demographic, personality, and health factors, as well as attitudes and design preferences with respect to healthcare CAs. Hierarchical regressions were used to determine demographic, personality, and health predictors of attitudes and design preferences. Results A total of 227 participants (116 women; M age = 39.92 years, SD = 12.94) were included in the analysis. Participants tended to report slightly positive attitudes toward healthcare CAs, with more positive attitudes among American residents and people with lower income, lower education levels, and higher levels of the personality factor conscientiousness. In general, participants preferred CAs that use text communication, have unrestricted language input, are disembodied, and simulate health professionals in their presentation. CAs that use text communication were preferred to a greater degree among people with higher levels of digital health literacy, and disembodied CAs were preferred to a greater degree among people with lower levels of conscientiousness. Conclusion The results of this study provide insight into people's attitudes and design preferences with respect to healthcare CAs. This information will help guide developers on how to better design and market CAs for the health sector, which may increase people's adoption and use of these programs.

Background: The process of transitioning from pediatric to adult healthcare is a pivotal juncture in the overall life course of young adults (YAs) with complex care needs (CCN) and their families. As service demands increase for this population, healthcare providers must determine the best ways to meet their needs. Following the transition to adult healthcare, YAs are vulnerable to poor outcomes, such as increased stress and repeated ER visits. Studies that explore how to address their needs often do not reflect the perspectives of YAs. As such, seeking their input about health services is a crucial step towards improving service delivery. Objective: This study aimed to explore the experiences and recommendations of YAs with CCN to improve the transition process from pediatric to adult healthcare across settings and sectors. Methods: A qualitative descriptive design was used. Semi-structured interviews were conducted with 23 young adults aged 19–29 with CCN from a small Canadian province. Maximum variation sampling was used to capture diverse perspectives from individuals with an array of CCN. Data was managed using NVivo software and analyzed using inductive thematic analysis. Results: The following themes were identified in the data, highlighting the importance of: 1) continuity of care, 2) improved access to care and supports, 3) transition readiness, and 4) a patient-centred care team. Conclusion: Results from this study can inform practice, policy, and research by guiding the development of service delivery improvement strategies for YAs and their families involved in the transition from pediatric to adult healthcare.

Abstract Introduction Navigating dementia care is challenging, but patient navigation (PN) offers valuable support for this population. The ‘Navigating Dementia NB/Naviguer la démence NB’ program piloted a PN program in New Brunswick, Canada, targeting people living with dementia (PLWD) and their carers. The program aimed to assist participants in navigating health and social care systems, matching their needs with available services. Methods Navigating Dementia NB was co-developed by researchers, patient partners, and clinicians. This pilot program embedded six PNs in primary care clinics/centres across the province between July 2022 and July 2023. Using a mixed methods approach, participant surveys and interviews were used to explore program benefits and recommendations for improvement. Focus groups were used to explore facilitators and barriers to program development and implementation. Results There were 150 participants (PLWD and carer dyads) enrolled in the PN program who provided informed consent. Interviews were conducted with 36 PLWD and their carers. Focus groups were conducted with nine members of the research team and five patient navigators. Program benefits included: emotional support from navigators, provision of relevant information, and facilitating connections to appropriate services. Recommendations for improvement included: the need for PLWD and their carers to have access earlier in the patient journey and the need to reassess provincial policies related to home care support. Facilitators for implementing a PN program included: providing appropriate staff training and leveraging established connections within the health and social systems. Barriers included a compressed timeline and existing systemic issues to service access. Conclusions The findings suggest that embedding PN for PLWD in community based primary care can be done. The program was beneficial for PWLD and their caregivers/care partners. Future plans involve partnering with government to support the implementation and evaluation of a province-wide scale-up of the PN program for this population.

Background: Individuals with complex care needs (CCNs) require more health and social care services than the average population. These individuals have better outcomes if they have access to integrated services across settings and sectors. One solution to address the multifaceted care needs of this population is patient navigation (PN). This model is increasingly being used across North America and abroad and is defined as a patient-centred approach intended to proactively guide, support, and orient patients through health and social care systems, matching patientsunmet needs to appropriate resources. Our research team at the Centre for Research in Integrated Care (CRIC) has developed, implemented, and evaluated PN programs in New Brunswick (NB) for two populations commonly experiencing complex care needs: children/youth with chronic and/or complex conditions and older adults living with dementia. Approach: At CRIC, we use a patient-oriented research approach, which engages patient partners throughout the entire research process. For example, when implementing and evaluating our PN programs, we did so in partnership with patient and family advisory councils. NaviCare/SoinsNavi was a research-based PN program for children/youth with complex care needs (CCNs), their families, and the care team. One bilingual navigator and one lay navigator were housed at an academic institution and provided in-person and virtual navigation services to participants across NB. Navigating Dementia NB/Naviguer la dmence NB was a research project that piloted a PN program for people with dementia (PWD), their care partners, and the care team. Six patient navigators (4 anglophone and 2 francophone) were embedded in preexisting primary care clinics/health centres in urban and rural settings across NB. Results: NaviCare/SoinsNavi served 62 families and 42 care providers between January 207 and May 2020. Navigating Dementia NB/ Naviguer la dmence NB served 50 participants between July 2022 and July 2023. Interviews with caregiver clients from both PN programs highlighted that caregivers frequently reported feeling overwhelmed and isolated. However, patient navigation offered a solution to meet patient and caregiver needs by promoting more convenient and integrated care and enhancing access to education, support, and resources. Additionally, patient navigators delivered crucial emotional support to both patients and caregivers. These results support that PN is a flexible model of care and can be easily adapted to different populations and settings to promote positive experiences with health and social care systems and promote person-centred, integrated care. Implications: Next steps involve developing, implementing, and evaluating a PN program specifically tailored for youth with addictions and mental health needs, identified as a priority population in New Brunswick. CRIC ultimate goal is to enhance the experiences of individuals with complex care needs (CCN), along with their care partners and providers, within health and social care systems. By improving communication pathways and fostering better integration of care, we aim to create more cohesive and supportive care environments, thereby promoting more positive health outcomes for this vulnerable group.