Social care via in-person navigation or signposting? Evidence from a new randomized trial points toward intensity

This paper is an invited commentary on research published by Dahrouge, et al. The original study described how a comprehensive, in-person social needs navigation program (ARC) outperformed simple referral signposting in improving access to resources, particularly for patients with multiple or complex social needs. The published study's findings suggest that in-person encounters and language concordance are critical for program effectiveness: access to resources increased monotonically with additional in-person visits and access to language-appropriate services also improved significantly in the ARC arm. The commentary authors describe the contributions the new research makes to the literature as well as key limitations of the study, including that the study focused narrowly on the proximal measure of self-reported access to services; used a single-navigator design that limited the generalizability of findings; and was underpowered to detect differences in outcomes for subgroups. The commentary underscores that as social care research matures, the field is moving beyond the question of whether to implement navigation services and towards the question of how both to implement them at scale and maximize health benefits.