Fidelity, Implementation Determinants, and Patient-Level Outcomes Following Initial Implementation of NAVIGATE in the Early Psychosis Intervention—Spreading Evidence-Based Treatment (EPI-SET) Study Article Swipe
Melanie Barwick
,
Janet Durbin
,
George Foussias
,
Emily Panzarella
,
Matilda Saliba
,
Sandy Brooks
,
Elaine Stasiulis
,
Raluca Dubrowski
,
Paul Kurdyak
,
Sanjeev Sockalingam
,
Donald Addington
,
Augustina Ampofo
,
Kelly K. Anderson
,
Sarah Bromley
,
M. D. Choi
,
Simone Dahrouge
,
Lillian Duda
,
Alexia Jaouich
,
Christopher J. Koegl
,
Colleen A. Maxwell
,
Dielle Miranda
,
Claire de Oliveira
,
Alexia Polillo
,
Valerie Primeau
,
John W. Riley
,
Danilo De Rossi
,
Eva Serhal
,
Jill Shakespeare
,
Sophie Soklaridis
,
Diana Urajnik
,
Nicole Kozloff
,
Aristotle N. Voineskos
·
YOU?
·
· 2025
· Open Access
·
· DOI: https://doi.org/10.1093/schbul/sbaf119
YOU?
·
· 2025
· Open Access
·
· DOI: https://doi.org/10.1093/schbul/sbaf119
Background and Hypothesis While early psychosis intervention (EPI) services are effective, care delivery is often inconsistent, particularly in recovery-oriented care. We hypothesized that facilitated implementation of NAVIGATE, an evidence-based, standardized model of coordinated specialty care, would increase fidelity to EPI standards and improve patient functioning in real-world settings. Study Design The Early Psychosis Intervention-Spreading Evidence-based Treatment (EPI-SET) study was a non-randomized effectiveness-implementation hybrid type III trial in 6 Ontario EPI programs. We used the First Episode Psychosis Services—Fidelity Scale-Revised (FEPS-FS-R) to measure fidelity to EPI standards at baseline (T0) and 12 months (T1). Scores ranged from 1 to 5, indicating poor (<3.5), fair (3.5-4), and good (≥4.0) adherence. The Heinrichs–Carpenter Quality of Life Scale (QLS) was used to determine change in functioning from baseline to 12 months (which roughly coincided with the T1 fidelity assessment). Implementation determinants were assessed using the Consolidated Framework of Implementation Research. Study Results FEPS-FS-R scores indicated good adherence for 19/29 items at T0 and 17/29 items at T1. Compared to T0, at T1, more psychosocial treatment items and fewer access and continuity items achieved fair or better adherence. Among the 100 participants who completed a baseline assessment, QLS total scores improved significantly (estimated change = 13.6, 95% CI: 9.6-17.7, P < .001) from T0 to T1. Implementation experiences varied across sites, with 4 of 6 organizations reporting overall positive experiences. Conclusions Implementation of NAVIGATE was associated with improved fidelity to psychosocial components of care, with concomitant improvements in patient functioning. These findings can inform widespread implementation of NAVIGATE.
Related Topics
Concepts
Fidelity
Psychosocial
Intervention (counseling)
Randomized controlled trial
Global Assessment of Functioning
Psychology
Set (abstract data type)
Clinical psychology
Scale (ratio)
Baseline (sea)
Quality of life (healthcare)
Psychosis
Medicine
Psychiatry
Schizophrenia (object-oriented programming)
Psychotherapist
Computer science
Quantum mechanics
Physics
Geology
Surgery
Oceanography
Programming language
Telecommunications
Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1093/schbul/sbaf119
- https://academic.oup.com/schizophreniabulletin/advance-article-pdf/doi/10.1093/schbul/sbaf119/64115136/sbaf119.pdf
- OA Status
- bronze
- References
- 43
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4413505979
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4413505979Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.1093/schbul/sbaf119Digital Object Identifier
- Title
-
Fidelity, Implementation Determinants, and Patient-Level Outcomes Following Initial Implementation of NAVIGATE in the Early Psychosis Intervention—Spreading Evidence-Based Treatment (EPI-SET) StudyWork title
- Type
-
articleOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2025Year of publication
- Publication date
-
2025-07-01Full publication date if available
- Authors
-
Melanie Barwick, Janet Durbin, George Foussias, Emily Panzarella, Matilda Saliba, Sandy Brooks, Elaine Stasiulis, Raluca Dubrowski, Paul Kurdyak, Sanjeev Sockalingam, Donald Addington, Augustina Ampofo, Kelly K. Anderson, Sarah Bromley, M. D. Choi, Simone Dahrouge, Lillian Duda, Alexia Jaouich, Christopher J. Koegl, Colleen A. Maxwell, Dielle Miranda, Claire de Oliveira, Alexia Polillo, Valerie Primeau, John W. Riley, Danilo De Rossi, Eva Serhal, Jill Shakespeare, Sophie Soklaridis, Diana Urajnik, Nicole Kozloff, Aristotle N. VoineskosList of authors in order
- Landing page
-
https://doi.org/10.1093/schbul/sbaf119Publisher landing page
- PDF URL
-
https://academic.oup.com/schizophreniabulletin/advance-article-pdf/doi/10.1093/schbul/sbaf119/64115136/sbaf119.pdfDirect link to full text PDF
- Open access
-
YesWhether a free full text is available
- OA status
-
bronzeOpen access status per OpenAlex
- OA URL
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https://academic.oup.com/schizophreniabulletin/advance-article-pdf/doi/10.1093/schbul/sbaf119/64115136/sbaf119.pdfDirect OA link when available
- Concepts
-
Fidelity, Psychosocial, Intervention (counseling), Randomized controlled trial, Global Assessment of Functioning, Psychology, Set (abstract data type), Clinical psychology, Scale (ratio), Baseline (sea), Quality of life (healthcare), Psychosis, Medicine, Psychiatry, Schizophrenia (object-oriented programming), Psychotherapist, Computer science, Quantum mechanics, Physics, Geology, Surgery, Oceanography, Programming language, TelecommunicationsTop concepts (fields/topics) attached by OpenAlex
- Cited by
-
0Total citation count in OpenAlex
- References (count)
-
43Number of works referenced by this work
- Related works (count)
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10Other works algorithmically related by OpenAlex
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