Intervention

Navigators will be trained using a training program developed for the study and will have support from an existing patient navigator organisation (CanCare). The navigator will work with patients, caregivers, and health professionals to achieve better care and health for patients through involvement in their social, community and health organisational networks. It is a complex and individualised intervention that will be tailored to the needs of the patients and their families [12]. The navigator will follow a four-by-five matrix of tasks (identification of task categories, facilitation tasks, identification of networks, document and review) and networks (patient, provider, non-clinical staff, supportive services, medical records/electronic medical records). [13] Domains of tasks in this study are further described below:

1. Identification of task categories for a specific patient and family: navigating tasks may consist of identifying and mitigating barriers with patients and healthcare professionals. They may include telling (explaining where and when a renal biopsy will be done), inquiring (asking about the potential barriers, such as language barriers to attend the next appointment after the biopsy), supporting (listening to the fears about the interventions) and coaching (discussing the potential questions the patients and families may wish to ask in the next appointment).

2. Facilitation for a specific patient and family: the navigator may coordinate communication, seek advice from non-medical and medical staff and help to bring patients in for the appointments.

3. Identification of networks: the navigators will identify all potential network interactions that are relevant to the patients and their families. These may include: the health service providers, the non-clinical staff (administrators and receptionist), and other social support services such as social workers, community-based services, transportation, and the maintenance of activities and system tasks for patients.

4. Document and review: the navigator will record their own actions (for example: steps taken with or on behalf of the patients) and record other activities that are relevant to the navigator role.

Participants who do not speak English will be paired with a navigator who speaks a language they are comfortable speaking in or will have access to a phone interpreter service to translate their communications with the navigator.