{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T20:26:27Z","timestamp":1790972787506,"version":"4.1.0"},"reference-count":27,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2021,4,7]],"date-time":"2021-04-07T00:00:00Z","timestamp":1617753600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The Cleft Palate Craniofacial Journal"],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To evaluate the impact of a Cleft Nurse Navigator (CNN) program on care for patients with cleft lip and cleft palate and assess the programs efficacy to reduce existing socioeconomic disparities in care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Retrospective review and outcomes analysis (n = 739).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting:<\/jats:title>\n                    <jats:p>Academic tertiary care center.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients:<\/jats:title>\n                    <jats:p>All patients presenting with cleft lip and\/or cleft palate (CL\/P) born between May 2009 and November 2019 with exclusions for atypical clefts, submucous cleft palates, international adoption, and very late presentation (after 250 days of life).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions:<\/jats:title>\n                    <jats:p>Multidisciplinary care coordination program facilitated by the CNN.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measures:<\/jats:title>\n                    <jats:p>Patient age at first outpatient appointment and age at surgery, reported feeding issues, weight gain, and patient-cleft team communications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>After CNN implementation, median age at outpatient appointment decreased from 20 to 16 days ( P = .021), volume of patient-cleft team communications increased from 1.5 to 2.8 ( P &lt; .001), and frequency of reported feeding concerns decreased (50% to 35%; P &lt; .001). In the pre-CNN cohort, nonwhite and publicly insured patients experienced delays in first outpatient appointment ( P &lt; .001), cleft lip repair ( P &lt; .011), and cleft palate repair ( P &lt; .019) compared to white and privately insured patients, respectively. In the post-CNN cohort, there were no significant differences in first appointment timing by race nor surgical timing on the basis of racial identity nor insurance type.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>A variety of factors lead to delays in cleft care for marginalized patient populations. These findings suggest that a CNN can reduce disparities of access and communication and improve early feeding in at-risk cohorts.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10556656211005646","type":"journal-article","created":{"date-parts":[[2021,4,7]],"date-time":"2021-04-07T04:15:18Z","timestamp":1617768918000},"page":"320-329","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":39,"title":["Reduced Socioeconomic Disparities in Cleft Care After Implementing a Cleft Nurse Navigator Program"],"prefix":"10.1177","volume":"59","author":[{"given":"Connor","family":"Wagner","sequence":"first","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Children\u2019s Hospital of Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carrie E.","family":"Zimmerman","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Children\u2019s Hospital of Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4408-2071","authenticated-orcid":false,"given":"Carlos","family":"Barrero","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Children\u2019s Hospital of Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher L.","family":"Kalmar","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, University of Pennsylvania, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paris","family":"Butler","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, University of Pennsylvania, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Guevara","sequence":"additional","affiliation":[{"name":"Division of 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