Nicole Kozloff, Slaight Family Centre for Youth in Transition, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
George Foussias, Slaight Family Centre for Youth in Transition, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
Janet Durbin, Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Provincial System Support Program, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
Sanjeev Sockalingam, Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Education, Centre for Addiction and Mental Health, 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
Kelly K. Anderson, Epidemiology & Biostatistics, Western University, London, Ontario, Canada
Melanie Barwick, Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Child Health Evaluative Sciences, SickKids Research Institute, 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; Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
Simone Dahrouge, C.T. Lamont Primary Health Care Research Centre, Bruyere Research Institute, Ottawa, Ontario, Canada; Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada
Lillian Duda, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
Catherine Ford, Ontario Ministry of Health, Toronto, Ontario, Canada
Sheila Gallagher, Durham Amaze Early Psychosis Intervention Program, Lakeridge Health, Whitby, Ontario, Canada
John D. Haltigan, Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Child and Youth Psychiatry, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
Joanna Henderson, Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
Alexia Jaouich, Provincial System Support Program, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
Dielle Miranda, Slaight Family Centre for Youth in Transition, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
Patrick Mitchell, Ontario Ministry of Health, Toronto, Ontario, Canada
Josette Morin, Regional Early Intervention in Psychosis Service, North Bay Regional Health Centre, North Bay, Ontario, Canada
Claire de Oliveira, Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
Valeria Primeau, Regional Early Intervention in Psychosis Service, North Bay Regional Health Centre, North Bay, Ontario, Canada
Eva Serhal, Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Telepsychiatry, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
Sophie Soklaridis, Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Education, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
Diana Urajnik, Human Sciences, Social and Population Health, Northern Ontario School of Medicine, Sudbury, Ontario, Canada; Centre for Rural and Northern Health Research, Laurentian University, Sudbury, Ontario, Canada
Krista Whittard, Early Psychosis Intervention, Niagara Region Public Health, Thorold, Ontario, Canada
Juveria Zaheer, Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
Paul Kurdyak, Department of 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; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada

Document Type

Article

Publication Date

2020

Abstract

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.

Comments

http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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