Improving Family Engagement in Coordinated Specialty Care for First Episode Psychosis
Study Details
Study Description
Brief Summary
Investigators aim to develop and evaluate a culturally informed family motivational engagement strategy (FAMES) and implementation toolkit for coordinated specialty care (CSC) programs for first episode psychosis. First, 5 family member participants will be recruited into a three-month trial of FAMES and implementation toolkit. The investigators will then conduct a 16-month non-randomized, stepped-wedge trial with 50 family members from 5 CSC programs in community-based mental health clinics.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
N/A |
Detailed Description
FAMES involves three distinct and revolving components - early, continuous, and motivational contact - that incorporate motivational techniques and the Diagnostic and Statistical Manual of Mental Disorders 5TH Edition (DSM-5) Cultural Formulation Interview (CFI).
The overarching objective of this study is to assess the feasibility and acceptability of a brief provider-led FAmily Engagement Motivational Strategy (FAMES) and its accompanying implementation toolkit. The investigators will also preliminary examine whether FAMES improves family engagement and retention in treatment, and motivation.
A total of 50 participants with a loved one enrolled in CSC program for FEP will be recruited from five CSC programs in Washington State to take part in a non-randomized stepped-wedge pilot trial. Each CSC program will represent a cluster and serve as its own control. A two-month implementation transition period will occur at each CSC program and during which providers will be introduced to the intervention using the implementation toolkits and trained to conduct FAMES. A 12-month open cohort design will be utilized to recruit approximately 50 family members during the study period.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Experimental: FAMES Modification 3-month trial of FAMES. Results from modifications will be used to by stakeholders (i.e., family members, client, providers, organizational leadership,) to inform finalization and implementation of FAMES |
Behavioral: FAMES
Participants will receive three distinct and revolving components - early, continuous, and motivational contact - that incorporate motivational techniques and the Diagnostic and Statistical Manual of Mental Disorders 5TH Edition (DSM-5) Cultural Formulation Interview (CFI).
|
| Experimental: FAMES Pilot Trial Pilot testing of FAMES and implementation toolkit |
Behavioral: FAMES
Participants will receive three distinct and revolving components - early, continuous, and motivational contact - that incorporate motivational techniques and the Diagnostic and Statistical Manual of Mental Disorders 5TH Edition (DSM-5) Cultural Formulation Interview (CFI).
Behavioral: Treatment-as-Usual
Participants will receive usual services and family-based treatment offered
|
Outcome Measures
Primary Outcome Measures
- Client Satisfaction Questionnaire-8 (CSQ-8) [Baseline through study completion, an average of 1 year; repeated measure to assess change through study completion]
Self-report measure to assess acceptability, a brief measure for family member participant. Items are scored from 1 to 4. Possible total scores range from 8 to 32, with higher scores (>23) indicating greater satisfaction.
- Youth Services Survey-Families (YSS-F) [Baseline through study completion, an average of 1 year; repeated measure to assess change through study completion]
Self-report measure to assess acceptability in the following domains: appropriateness, participation, cultural sensitivity, social connectedness, and outcomes. Items in a domain are summed and divided by the total number of items, and scores greater than 3.5 are reported in the positive range for the domain.
- Qualitative interviews [Month 1 of treatment period and month 1 follow-up period; repeated measure to assess change in acceptability and feasibility]
Interviews with providers and family member participants to assess acceptability and of FAMES
Secondary Outcome Measures
- Level of Engagement to measure effectiveness of FAMES [Baseline through study completion, an average of 1 year; repeated measure to assess change through study completion]
Provider reported service utilization. Total number of contact hours between provider and family member to measure engagement
- Rate of Retention to measure effectiveness of FAMES [Baseline through study completion, an average of 1 year; repeated measure to assess change through study completion]
Provider reported service utilization. Percentage of families that dropout (family member declined or missed three consecutive appointments).
- Burden Assessment Scale (BAS) [Baseline through study completion, an average of 1 year; repeated measure to assess change through study completion]
Self-report measure to assess family functioning. Total possible scores range from 10 to 171 (higher scores indicating greater burden)
- Iowa Cultural Understanding Assessment [Baseline through study completion, an average of 1 year; repeated measure to assess change through study completion]
Self-report measure to assess provider cultural competence. All items are scored from 1=strongly disagree to 5=strongly agree. Total scores range from 25 to 125 (higher scores indicating great cultural competence)
- Treatment Self-Regulation Questionnaire (TSRQ) [Baseline through study completion, an average of 1 year; repeated measure to assess change through study completion]
Self-report measure to assess motivation. Scale ranges from 1=not at all true to 7=very true.
Other Outcome Measures
- Organizational Readiness to Change Assessment (ORCA) [Baseline through study completion, an average of 1 year; repeated measure to assess change through study completion]
Self-report provider measure to assess assess evidence assessment, contextual readiness and facilitation needs. All items are scored from 1=strongly disagree to 5=strongly agree
Eligibility Criteria
Criteria
Inclusion Criteria:
-
Aged 18 years or older;
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One family member (e.g., parent, guardian, aunt, uncle, spouse, grandparent, sibling, close friend) of an individual enrolled in a Washington State CSC program; and
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Received no more than 6 months of services
Exclusion Criteria:
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | New Journeys: Coordinated specialty care | Yakima | Washington | United States | 98902 |
Sponsors and Collaborators
- Washington State University
- National Institute of Mental Health (NIMH)
Investigators
None specified.Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- 17761-001
- K01MH117457-01A1