Sustainability of a rural volunteer program (Nav-CARE): a case study

Area of Science:

• Health Services Research
• Rural Health
• Implementation Science

Background:

• Nav-CARE (Navigation: Connecting, Accessing, Resourcing and Engaging) is an evidence-based program providing navigation and social support to older adults with serious illnesses in rural western Canada.
• The program demonstrated feasibility, acceptability, and positive outcomes during its initial year.
• Nav-CARE was successfully integrated into a local hospice society, achieving sustainability for over two years.

Purpose of the Study:

• To explore the key factors facilitating the long-term sustainability of the Nav-CARE program within a rural hospice society setting.

Main Methods:

• A qualitative single case study design was employed, collecting data over multiple time points from pre-implementation to two years post-implementation.
• Data sources included interviews with community stakeholders, the volunteer coordinator, hospice society coordinator, and Nav-CARE volunteers.
• The i-PARIHS framework and Yin's qualitative case study approach were used for data organization and analysis.

Main Results:

• Facilitating sustainability hinged on the organizational context, including program fit with priorities, organizational capacity, and integration mechanisms.
• The role and processes of facilitation, encompassing volunteer training, ongoing support, and stakeholder planning, were crucial.
• A skilled facilitator with mentorship and formal sustainability planning meetings were identified as key components.

Conclusions:

• The organizational context, facilitator role, and facilitation processes are critical for sustaining rural community interventions like Nav-CARE.
• Further research is needed to assess and enhance organizational sustainability capacity and the impact of facilitator training.
• This study offers a foundation for understanding the sustainability of evidence-based interventions in rural settings.