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EPI-SET Study Updates

Highlighting progress in several study areas, from implementation, to participant recruitment, to advisory committees, and more!

Milestones
  • Our Prescriber ECHO Sessions have officially launched! These sessions offer an opportunity for prescribers to share information, inform best practices, discuss lessons learnt, and provide recommendations and expertise through specific case reviews. Read below for more details.
  • Over 700 clients have received NAVIGATE across all 6 sites!
Upcoming
  • Fidelity reviews will be taking place throughout the first quarter of 2022. Scheduling details can be found below. 
  • CFIR Qualitative Interviews for Wave 2 sites are projected to take place throughout January 2022. 
  • Family and Youth Qualitative Interviews are projected to start at the end of the first quarter of 2022.
Implementation and Fidelity
The community of practice continues with great engagement and resource sharing at bi-weekly ECHO sessions!

Cycle 3 Schedule (July 2021 - April 2022)
  • ECHO Cycle 3 is continuing to incorporate feedback received from site clinicians and hub team members to improve session format and delivery.
We are looking forward to these upcoming sessions:
December 17, 2021: Psychosis and Substance Use
January 7, 2022: Emotional Regulation Techniques
January 22, 2022: Peer Support


Prescriber ECHO Sessions (November 2021 - May 2022)
  • Our first official Prescriber ECHO session took place on November 25th, 2021.
  • Cycle 1 sessions will be held on the 4th Thursday of every other month until May 2022.
  • We are looking forward to the next session taking place on January 27th, 2022 on Substance Use Disorders.
Fidelity Assessments 
  • A next round of reviews is planned for early in the new year. This includes the third assessment for the Wave 1 sites and the second assessment for Wave 2 sites (Sudbury and Waterloo Wellington). Thunder Bay’s second assessment is scheduled for later in 2022 as it was the last program to join the study. 
  • An assessment of NAVIGATE delivery is being added to the chart review component of the fidelity assessments. This will allow us to learn about NAVIGATE delivery without adding more data collection burden to the sites.



Readiness Survey

  • Early in the new year, site staff will be invited to complete a survey about their current perceptions of the NAVIGATE model. The same survey was administered early in the study shortly after the initial NAVIGATE training. We are re-administering the survey to see if views about the model have changed now that staff have experience delivering it.  
CFIR Qualitative Interviews
  • The Consolidated Framework for Implementation Research (CFIR) assesses facilitators and barriers associated with effective implementation through qualitative interviews with clinicians.
  • All participating clinicians from Wave 1 sites have completed their interviews.
  • Interviews at Wave 2 sites are projected to take place in January 2022.

Family & Youth Qualitative Interviews
  • The Family and Youth Qualitative Interviews aim to build on experiential knowledge to further evaluate NAVIGATE from the patient and family perspective.
  • The research team is currently recruiting 2 patients and 2 family members from each site to take part in these interviews.
  • The interview guide is in its final stages and will be reviewed by the advisory committees in January 2022. Interviews are projected to begin near the end of the first quarter of 2022.
Patient Measures and Outcomes
Patient Research Recruitment 
72 clients from our 6 participating sites have been enrolled in the research study to date.
Thank you to clinicians for referring your clients! 

*Please note that the variation among sites may represent different case loads and implementation start dates.*

Follow-Up Visits 
Research visits are conducted every 6 months for 2 years (4 follow-ups per participant).
Our first participant to reach their final 2-year follow-up is projected for January 2022. 

So far, our retention rate is 90%!

Sharing Research Assessment Scores with Sites
  • Clients that participate in the research study complete clinically relevant measures of symptoms and functioning. These scores can be compared along 6-month time-points for participants that complete follow-up visits.
  • Client scores are sent to sites on a month-by-month basis, further integrating research with clinical care. Clients are given the option to consent for this information to be shared with their care team.
Youth and Family Engagement
Advisory Committees
  • The Youth and Family Advisory Committees held a joint meeting to discuss potential areas and opportunities for collaboration. Members of both committees are interested in developing strategies to communicate findings from this project to stakeholders and broader audiences beyond the clinical community.
  • All advisors continue to offer meaningful suggestions and feedback to enhance and improve several components of the EPI-SET study.
  • Youth advisors are busy working on videos to share their lived experiences! If you still haven't had a chance, check out Tallan's video here: https://www.youtube.com/watch?v=3jNBbFp6P0Q
  • Family advisors continue to increase their direct engagement with clinic teams by attending site meetings and bi-weekly ECHO sessions. Committee members actively offer valuable insight and recommendations to support these teams.
Many advisors work on related projects and are happy to contribute.
Please reach out if you have any opportunities!
e-NAVIGATE

Evaluating the Virtual Delivery of NAVIGATE at CAMH

With our team, including youth and family advisors, we have been working on:

  • Completing Qualitative Interviews with patients and family members to learn more about their experiences of receiving care virtually, as well as a Focus Group with clinicians to understand their experiences of delivering virtual care. We have completed six patient interviews, six family interviews and the focus group with seven clinicians and will begin coding the data in the upcoming weeks. We are hoping to recruit at least two more patients and two more family members for these interviews.
     
  • Finalizing our Fidelity Assessments which examine whether the delivery of NAVIGATE met the Early Psychosis Intervention standards pre-pandemic as well as post-March 2020. We are also beginning the fidelity assessment that will assess how the care that was provided pre- and post-March 2020 aligns with the NAVIGATE model standards.
     
  •  Analyzing data from the Virtual Client Experience Surveys and the Virtual Provider Experience Surveys to understand the facilitators and barriers to receiving and delivering care virtually as well as overall satisfaction with virtual care. These results will additionally provide insight into health equity factors in order to determine how care can be optimized for particular populations and intersections between populations. We will be sharing these findings at an upcoming symposium.
     
  • Planning how to best disseminate the study’s findings via Data Integration and Knowledge Translation. We have already shared our study Protocol through publication in the Journal of Medical Internet Research (JMIR) Research Protocols, and have shared early findings and resources with the EPI-SET sites at EPI-SET ECHO sessions. Additional knowledge translation ideas include conference presentations, informational webinars for patients, families, and providers, and a manual outlining how to deliver NAVIGATE virtually.

The “e-NAVIGATE” team continues to look forward to learning from and sharing knowledge with the EPI-SET sites!

Thanks for reading!
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EPI-SET · 250 College St. · Toronto, Ontario M5T1R8 · Canada

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