Abstract
BackgroundEmerging adults with early psychosis demonstrate high rates of service disengagement from critical early intervention services. Decision support interventions and peer support have both been shown to enhance service engagement but are understudied in this population. The purposes of this article are to describe the development of a novel peer-delivered decision coaching intervention for this population and to report plans for a pilot study designed to gather preliminary data about its feasibility, acceptability, and potential impact.MethodsThe intervention was developed based on formative qualitative data and in collaboration with a diverse team of researchers, key stakeholders, and expert consultants. The pilot trial will utilize a single-group (N = 20), pre-post, convergent mixed-methods design to explore whether and how the intervention addresses decision-making needs (the primary intervention target). The impact of the intervention on secondary outcomes (e.g., engagement in the program) will also be assessed. Additionally, through observation and feedback from the peer decision coach and study participants, we will evaluate the feasibility of research and intervention procedures, and the acceptability of information and support from the peer decision coach.DiscussionThe peer-delivered decision coaching intervention holds promise for assisting young people with making informed and values-consistent decisions about their care, and potentially enhancing service engagement within this traditionally difficult-to-engage population. If the intervention demonstrates feasibility and acceptability, and pilot data show its potential for improving treatment decision-making, our work will also lay the foundation for a new evidence base regarding roles for peer specialists on early intervention teams.Trial registrationThis trial was registered with ClinicalTrials.gov (Identifier: NCT04532034) on 28 August 2020 as Temple University Protocol Record 261047, Facilitating Engagement in Evidence-Based Treatment for Early Psychosis.
Highlights
The long-term occupational, social, and economic outcomes associated with psychosis make it an urgent public health problem [1, 2]
Consistent with their areas of expertise, each investigator was responsible for ensuring that the intervention met specific requirements: (a) incorporated principles of peer support (MSS); (b) responded to results from our qualitative analysis of emerging adults’ decisionmaking needs (AL); (c) built upon lessons learned from development of other engagement/adherence interventions (LBD); (d) incorporated an appropriate treatment decision-making model and conformed to best practices for decision support (LAS); (e) could be feasibly implemented within the study site (IH); and (f ) was appropriate for emerging adults with early psychosis (DLP)
Dissemination policy In accordance with study sponsor guidelines, this study will be registered and de-identified results information will be submitted to ClinicalTrials.gov. This pilot and feasibility study is subject to limitations common to other pilot trials
Summary
The long-term occupational, social, and economic outcomes associated with psychosis make it an urgent public health problem [1, 2]. A shorter period between psychosis onset and receipt of appropriate care is associated with better outcomes decades later [4, 5], and moderates the effect of early treatment [6]. Service disengagement among emerging adults with early psychosis (i.e., premature treatment drop-out) is a prevalent problem, with recent estimates between 20 and 40% [13]. This is concerning given that service disengagement during early psychosis is a risk factor for relapse, persistent symptoms, and poorer prognosis [14]. The purposes of this article are to describe the development of a novel peer-delivered decision coaching intervention for this population and to report plans for a pilot study designed to gather preliminary data about its feasibility, acceptability, and potential impact
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