RATIONALE: Telehealth navigation programmes have shown potential to improve video visit usage and attendance. However, their effectiveness in safety-net healthcare settings remains uncertain. AIMS AND OBJECTIVES: This project assessed the impact of a volunteer-staffed telehealth navigation programme on video visit usage and attendance at an urban safety-net primary care clinic. METHODS: Volunteers conducted outreach calls to patients with upcoming telehealth appointments to help them prepare for their visits. Outcomes, including video usage (video vs. audio-only visits) and no-show rates, were compared between patients who received outreach and those who did not. RESULTS: Analysis revealed no significant differences in video usage (14.1% for outreach vs. 14.0% for non-outreach) or no-show rates (22.5% for outreach vs. 22.0% for non-outreach). The study included 881 patients who received outreach and 2728 patients who did not. CONCLUSION: Patients unresponsive to outreach had lower portal activation rates and higher non-attendance, suggesting the presence of distinct engagement subgroups within the population. While volunteer-staffed programmes may provide a practical method to reach patients, telephone outreach alone was insufficient to improve video visit usage or attendance rates. Further research is needed to explore alternative or complementary strategies to enhance telehealth engagement in safety-net settings.