Early Psychosis Intervention-Spreading Evidence-based Treatment (EPI-SET): protocol for an effectiveness-implementation study of a structured model of care for psychosis in youth and emerging adults
Sophie Soklaridis,
Paul Kurdyak,
Claire de Oliveira,
Simone Dahrouge,
Joanna Henderson,
Aristotle N Voineskos,
Kelly K Anderson,
Nicole Kozloff,
George Foussias,
Janet Durbin,
Sanjeev Sockalingam,
Jean Addington,
Donald Addington,
Augustina Ampofo,
Melanie Barwick,
Sarah Bromley,
Jasmyn E A Cunningham,
Lillian Duda,
Catherine Ford,
Sheila Gallagher,
John D Haltigan,
Alexia Jaouich,
Dielle Miranda,
Patrick Mitchell,
Josette Morin,
Valerie Primeau,
Eva Serhal,
Diana Urajnik,
Krista Whittard,
Juveria Zaheer
Affiliations
Sophie Soklaridis
The Centre for Addiction and Mental Health, Toronto, Ontario, Canada
Paul Kurdyak
Psychiatry, University of Toronto, Toronto, Ontario, Canada
Claire de Oliveira
Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
Simone Dahrouge
7 C.T. Lamont Primary Health Care Research Centre, Elisabeth Bruyère Research Institute, Ottawa, Ontario, Canada
Joanna Henderson
Psychiatry, University of Toronto, Toronto, Ontario, Canada
Aristotle N Voineskos
Slaight Family Centre for Youth in Transition, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
Kelly K Anderson
Epidemiology & Biostatistics, Western University, London, Ontario, Canada
Nicole Kozloff
Slaight Family Centre for Youth in Transition, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
George Foussias
Slaight Family Centre for Youth in Transition, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
Janet Durbin
Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
Sanjeev Sockalingam
Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
Jean Addington
Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
Donald Addington
Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
Augustina Ampofo
Centre for Addiction and Mental Health, Toronto, Ontario, Canada
Melanie Barwick
Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
Sarah Bromley
Slaight Family Centre for Youth in Transition, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
Jasmyn E A Cunningham
Slaight Family Centre for Youth in Transition, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
Lillian Duda
Centre for Addiction and Mental Health, Toronto, Ontario, Canada
Catherine Ford
Ontario Ministry of Health, Toronto, Ontario, Canada
Introduction While early psychosis intervention (EPI) has proliferated in recent years amid evidence of its effectiveness, programmes often struggle to deliver consistent, recovery-based care. NAVIGATE is a manualised model of EPI with demonstrated effectiveness consisting of four components: individualised medication management, individual resiliency training, supported employment and education and family education. We aim to implement NAVIGATE in geographically diverse EPI programmes in Ontario, Canada, evaluating implementation and its effect on fidelity to the EPI model, as well as individual-level outcomes (patient/family member-reported and interviewer-rated), system-level outcomes (captured in provincial administrative databases) and engagement of participants with lived experience.Methods and analysis This is a multisite, non-randomised pragmatic hybrid effectiveness-implementation type III mixed methods study coordinated at the Centre for Addiction and Mental Health (CAMH) in Toronto. Implementation is supported by the Provincial System Support Program, a CAMH-based programme with provincial offices across Ontario, and Extension of Community Healthcare Outcomes Ontario Mental Health at CAMH and the University of Toronto. The primary outcome is fidelity to the EPI model as measured using the First Episode Psychosis Services—Fidelity Scale. Four hundred participants in the EPI programmes will be recruited and followed using both individual-level assessments and health administrative data for 2 years following NAVIGATE initiation. People with lived experience will be engaged in all aspects of the project, including through youth and family advisory committees.Ethics and dissemination Research ethics board approval has been obtained from CAMH and institutions overseeing the local EPI programmes. Study findings will be reported in scientific journal articles and shared with key stakeholders including youth, family members, programme staff and policymakers.Trial registration number NCT03919760; Pre-results.
