Implementation and fidelity assessment of the NAVIGATE treatment program for first episode psychosis in a multi-site study

Kim T Mueser; Piper S Meyer-Kalos; Shirley M Glynn; David W Lynde; Delbert G Robinson; Susan Gingerich; David L Penn; Corrine Cather; Jennifer D Gottlieb; Patricia Marcy; Jennifer L Wiseman; Sheena Potretzke; Mary F Brunette; Nina R Schooler; Jean Addington; Robert A Rosenheck; Sue E Estroff; John M Kane

doi:10.1016/j.schres.2018.08.015

Implementation and fidelity assessment of the NAVIGATE treatment program for first episode psychosis in a multi-site study

Schizophr Res. 2019 Feb:204:271-281. doi: 10.1016/j.schres.2018.08.015. Epub 2018 Aug 20.

Authors

Kim T Mueser¹, Piper S Meyer-Kalos², Shirley M Glynn³, David W Lynde⁴, Delbert G Robinson⁵, Susan Gingerich⁶, David L Penn⁷, Corrine Cather⁸, Jennifer D Gottlieb⁹, Patricia Marcy¹⁰, Jennifer L Wiseman¹¹, Sheena Potretzke¹², Mary F Brunette¹³, Nina R Schooler¹⁴, Jean Addington¹⁵, Robert A Rosenheck¹⁶, Sue E Estroff¹⁷, John M Kane⁵

Affiliations

¹ Boston University, Center for Psychiatric Rehabilitation, Departments of Occupational Therapy, Psychiatry, and Psychology, Boston, MA, USA. Electronic address: mueser@bu.edu.
² University of Minnesota, School of Social Work, Minnesota Center for Chemical and Mental Health, St. Paul, MN, USA. Electronic address: psmeyer@umn.edu.
³ Semel Institute of Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA.
⁴ Geisel School of Medicine at Dartmouth, Department of Psychiatry, Lebanon, NH, USA.
⁵ Zucker Hillside Hospital, Psychiatry Research, North Shore - Long Island Jewish Medical Center, Glen Oaks, NY, USA; The Feinstein Institute for Medical Research, Manhasset, NY, USA; Hofstra North Shore LIJ School of Medicine, Departments of Psychiatry and Molecular Medicine, Hempstead, NY, USA; Albert Einstein College of Medicine, Department of Psychiatry and Behavioral Sciences, Bronx, NY, USA.
⁶ Independent Consultant and Trainer, Narberth, PA, USA.
⁷ University of North Carolina-Chapel Hill, Department of Psychology, Chapel Hill, NC, USA; Australian Catholic University, School of Psychology, Melbourne, VIC, Australia.
⁸ Massachusetts General Hospital, Boston, MA, USA.
⁹ Boston University, Center for Psychiatric Rehabilitation, Departments of Occupational Therapy, Psychiatry, and Psychology, Boston, MA, USA.
¹⁰ Vanguard Research Group, Glen Oaks, NY, USA.
¹¹ University of Minnesota, Minnesota Center for Chemical and Mental Health, St. Paul, MN, USA.
¹² Oregon Health and Science University, Department of Behavioral Neuroscience, Portland, OR, USA.
¹³ Geisel School of Medicine at Dartmouth, Lebanon, NH, USA; Bureau of Mental Health Services, Department of Health and Human Services, Concord, NH, USA.
¹⁴ Zucker Hillside Hospital, Psychiatry Research, North Shore - Long Island Jewish Medical Center, Glen Oaks, NY, USA; SUNY Downstate Medical Center, Department of Psychiatry, Brooklyn, NY, USA.
¹⁵ Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, Calgary, Canada.
¹⁶ Yale Medical School, New Haven, CT, USA.
¹⁷ Department of Social Medicine, University of North Carolina, Chapel Hill, NC, USA.

Abstract

The NAVIGATE program was developed for the Recovery After Initial Schizophrenia Episode-Early Treatment Program (RAISE-ETP) study, which compared NAVIGATE to usual Community Care in a cluster randomized design involving 34 sites and 404 patients. This article describes the approach to training and implementing the NAVIGATE program at the 17 sites (including 134 practitioners) randomized to provide it, and to evaluating the fidelity of service delivery to the NAVIGATE model. Fidelity was evaluated to five different components of the program, all of which were standardized in manuals in advance of implementation. The components included four interventions (Individualized Resiliency Training, Family Education Program, Supported Employment and Education, Personalized Medication Management) and the overall organization (staffing and structure) of the NAVIGATE team. Most of the sites demonstrated acceptable or higher levels of fidelity in their implementation of the four interventions and the organization of the program, with all 17 sites demonstrating at least acceptable overall fidelity to the NAVIGATE program. The results indicate that the NAVIGATE program can be implemented with good fidelity to the treatment model in a diverse array of community mental health care settings serving persons with a first episode psychosis.

Trial registration: ClinicalTrials.gov NCT01321177.

Keywords: Coordinated specialty care; Fidelity; Implementation; Training.

Publication types

Multicenter Study
Randomized Controlled Trial
Research Support, N.I.H., Extramural

MeSH terms

Adolescent
Adult
Antipsychotic Agents / therapeutic use
Community Mental Health Centers
Community Mental Health Services* / organization & administration
Employment, Supported*
Family
Female
Health Personnel / education*
Humans
Implementation Science
Male
Patient Care Team*
Patient Education as Topic* / organization & administration
Process Assessment, Health Care*
Program Development*
Program Evaluation
Psychotic Disorders / drug therapy
Psychotic Disorders / rehabilitation
Psychotic Disorders / therapy*
Young Adult

Implementation and fidelity assessment of the NAVIGATE treatment program for first episode psychosis in a multi-site study

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