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.
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 Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
50
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).
Participants will receive usual services and family-based treatment offered
New Journeys: Coordinated specialty care
Yakima, Washington, United States
Client Satisfaction Questionnaire-8 (CSQ-8)
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.
Time frame: Baseline through study completion, an average of 1 year; repeated measure to assess change through study completion
Youth Services Survey-Families (YSS-F)
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.
Time frame: Baseline through study completion, an average of 1 year; repeated measure to assess change through study completion
Qualitative interviews
Interviews with providers and family member participants to assess acceptability and of FAMES
Time frame: Month 1 of treatment period and month 1 follow-up period; repeated measure to assess change in acceptability and feasibility
Level of Engagement to measure effectiveness of FAMES
Provider reported service utilization. Total number of contact hours between provider and family member to measure engagement
Time frame: Baseline through study completion, an average of 1 year; repeated measure to assess change through study completion
Rate of Retention to measure effectiveness of FAMES
Provider reported service utilization. Percentage of families that dropout (family member declined or missed three consecutive appointments).
Time frame: Baseline through study completion, an average of 1 year; repeated measure to assess change through study completion
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Burden Assessment Scale (BAS)
Self-report measure to assess family functioning. Total possible scores range from 10 to 171 (higher scores indicating greater burden)
Time frame: Baseline through study completion, an average of 1 year; repeated measure to assess change through study completion
Iowa Cultural Understanding Assessment
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)
Time frame: Baseline through study completion, an average of 1 year; repeated measure to assess change through study completion
Treatment Self-Regulation Questionnaire (TSRQ)
Self-report measure to assess motivation. Scale ranges from 1=not at all true to 7=very true.
Time frame: Baseline through study completion, an average of 1 year; repeated measure to assess change through study completion