Individuals with first-episode psychosis (FEP) are at high-risk for several poor functional and clinical outcomes, including suicide. Coordinated Specialty Care (CSC) is a multidisciplinary, team-based intervention known to improve such outcomes, including suicide risk. However, 30-50% of patients disengage from CSC, thereby limiting its impact. This pilot study will develop and test feasibility of a behavioral change program that uses moderate financial incentives to encourage treatment engagement in 2 CSC programs. A single-arm of 80 patient-participants at these two clinics will be recruited to assess feasibility and acceptability from patient perspectives. Additionally,15 clinicians at these two clinics will be recruited to assess feasibility and acceptability from clinician perspectives, and 50 clinicians from peer clinics not involved in the intervention will be recruited to assess scalability of the intervention. The trial will feature an three-month period for recruitment and baseline data collection and will subsequently feature three intervention periods (3 months each) where modifications to the interventions will be tested (each informed by the feasibility and acceptability findings of the prior period) with the aim of sequentially improving it.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
145
Patient-participants will receive modest financial incentive for attending therapy or medication management appointments combined with text messages to encourage attendance at these appointments. Text messages will be informed by principles of behavioral economics. Maximum incentive = $50/month if all appointments attended. Incentives will be pro-rated by percentage of appointments attended. Pro-rating strategies (e.g., uniform amount per appointment, escalating \[aka, 'back-loaded'\], or decreasing \[aka 'frontloaded'\] will be sequentially changed based on acceptability and other intervention-related data gathered from participants during the trial. Clinician-participants will not receive any intervention, but will receive surveys and interviews to assess their perceptions about the optimization, acceptability, scalability, and other implementation barriers/facilitators for the intervention.
University of North Carolina at Chapel Hill (ENCOMPASS Program)
Raleigh, North Carolina, United States
PEACE Program, Horizon House, Inc.
Philadelphia, Pennsylvania, United States
University of Pennsylvania
Philadephia, Pennsylvania, United States
Acceptability of intervention measure (AIM)
The AIM is a 4-item scale measuring acceptability. Each item is scored 1-5 with 5 indicating greater acceptability. Minimum score is 4; maximum is 20.
Time frame: Change at 8 months
Acceptability of intervention measure (AIM)
The AIM is a 4-item scale measuring acceptability. Each item is scored 1-5 with 5 indicating greater acceptability. Minimum score is 4; maximum is 20.
Time frame: Change at 6 months
Acceptability of intervention measure (AIM)
The AIM is a 4-item scale measuring acceptability. Each item is scored 1-5 with 5 indicating greater acceptability. Minimum score is 4; maximum is 20.
Time frame: Change at 4 months
Feasibility of intervention measure (FIM)
The FIM is a 4-item scale measuring feasibility. Each item is scored 1-5 with 5 indicating greater feasibility. Minimum score is 4; maximum is 20.
Time frame: Change at 8 months
Feasibility of intervention measure (FIM)
The FIM is a 4-item scale measuring feasibility. Each item is scored 1-5 with 5 indicating greater feasibility. Minimum score is 4; maximum is 20.
Time frame: Change at 6 months
Feasibility of intervention measure (FIM)
The FIM is a 4-item scale measuring feasibility. Each item is scored 1-5 with 5 indicating greater feasibility. Minimum score is 4; maximum is 20.
Time frame: Change at 4 months
Implementation Survey Response
Implementation survey. Results will be used to optimize intervention from implementation perspective.
Time frame: Change at 8 months
Implementation Survey Response
Implementation survey. Results will be used to optimize intervention from implementation perspective.
Time frame: Change at 6 months
Implementation Survey Response
Implementation survey. Results will be used to optimize intervention from implementation perspective.
Time frame: Change at 4 months
Motivation Survey Response
Motivation survey. Results will be used to optimize intervention from motivation perspective.
Time frame: Change at 8 months
Motivation Survey Response
Motivation survey. Results will be used to optimize intervention from motivation perspective.
Time frame: Change at 6 months
Motivation Survey Response
Motivation survey. Results will be used to optimize intervention from motivation perspective.
Time frame: Change at 4 months
Ethical Concern Survey Response
Ethical concern survey. Results will be used to optimize intervention from ethical acceptability perspective.
Time frame: Change at 8 months
Ethical Concern Survey Response
Ethical concern survey. Results will be used to optimize intervention from ethical acceptability perspective.
Time frame: Change at 6 months
Ethical Concern Survey Response
Ethical concern survey. Results will be used to optimize intervention from ethical acceptability perspective.
Time frame: Change at 4 months
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