A Digital Health Innovation to Prevent Relapse and Support Recovery in Youth Receiving Specialized Services for First-Episode Psychosis: Protocol for a Pilot Pre-Post, Mixed Methods Study of Horyzons-Canada (Phase 2).

Shalini Lal,Mario Alvarez-Jimenez,Geraldine Etienne,Martin Lepage,Ridha Joober,Simon D'Alfonso,John F Gleeson,Hajin Lee

doi:10.2196/28141

Abstract

BackgroundPsychotic disorders are among the most disabling of all mental disorders. The first-episode psychosis (FEP) often occurs during adolescence or young adulthood. Young people experiencing FEP often face multiple barriers in accessing a comprehensive range of psychosocial services, which have predominantly been delivered in person. New models of service delivery that are accessible, sustainable, and engaging are needed to support recovery in youth diagnosed with FEP.ObjectiveIn this paper, we describe a protocol to implement and evaluate the acceptability, safety, and potential efficacy of an online psychosocial therapeutic intervention designed to sustain recovery and prevent relapses in young adults diagnosed with FEP. This intervention was originally developed and tested in Australia and has been adapted for implementation and evaluation in Canada and is called Horyzons-Canada (HoryzonsCa).MethodsThis cohort study is implemented in a single-center and applies a pre-post mixed methods (qualitative-quantitative convergent) design. The study involves recruiting 20 participants from a specialized early intervention program for psychosis located in Montreal, Canada and providing them with access to the HoryzonsCa intervention for 8 weeks. Data collection includes interview-based psychometric measures, self-reports, focus groups, and interviews.ResultsThis study received funding from the Brain and Behavior Research Foundation (United States), the Quebec Health Research Funding Agency (Canada), and the Canada Research Chairs Program. The study was approved by the Research Ethics Board of the Centre intégré universitaire de santé et de services sociaux de l'Ouest-de-l'Île-de-Montréal on April 11, 2018 (#IUSMD 17-54). Data were collected from August 16, 2018, to April 29, 2019, and a final sample of 20 individuals participated in the baseline and follow-up interviews, among which 9 participated in the focus groups. Data analysis and reporting are in process. The results of the study will be submitted for publication in 2021.ConclusionsThis study will provide preliminary evidence on the acceptability, safety, and potential efficacy of using a digital health innovation adapted for the Canadian context to deliver specialized mental health services to youth diagnosed with FEP.Trial RegistrationISRCTN Registry ISRCTN43182105; https://www.isrctn.com/ISRCTN43182105International Registered Report Identifier (IRRID)RR1-10.2196/28141

Highlights

BackgroundPsychotic disorders have a lifetime prevalence of 3% [1] and include symptoms such as delusions, hallucinations, disorganized thoughts and behaviors, poverty of thought and affect, apathy, and deficits in verbal memory and executive functioning [2,3]
Data were collected from August 16, 2018, to April 29, 2019, and a final sample of 20 individuals participated in the https://www.researchprotocols.org/2021/12/e28141
This study will provide preliminary evidence on the acceptability, safety, and potential efficacy of using a digital health innovation adapted for the Canadian context to deliver specialized mental health services to youth diagnosed with first-episode psychosis (FEP)

Summary

Introduction

BackgroundPsychotic disorders have a lifetime prevalence of 3% [1] and include symptoms such as delusions, hallucinations, disorganized thoughts and behaviors, poverty of thought and affect, apathy, and deficits in verbal memory and executive functioning [2,3]. Over the past two decades, a specialized early intervention approach has been developed for youth diagnosed with first-episode psychosis (FEP) with the ultimate goal of achieving symptom remission, relapse prevention, and social recovery [7,8]. Many of these programs accept patients with schizophrenia spectrum psychoses and affective psychoses. Randomized controlled trials have confirmed that young people treated in a specialized early intervention service have higher rates of adherence; lower relapse and hospitalization rates; better quality of life; and improved outcomes at 12, 18, and 24 months compared to patients in routine care [11,12,13]. New models of service delivery that are accessible, sustainable, and engaging are needed to support recovery in youth diagnosed with FEP

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