Implementation and fidelity assessment of the NAVIGATE treatment program for first episode psychosis in a multi-site study

Kim T. Mueser, Piper S. Meyer-Kalos, Shirley M. Glynn, David W. Lynde, Delbert G. Robinson, Susan Gingerich, David L. Penn, Corrine Cather, Jennifer D. Gottlieb, Patricia Marcy, Jennifer L. Wiseman, Sheena Potretzke, Mary F. Brunette, Nina R. Schooler, Jean Addington, Robert A. Rosenheck, Sue E. Estroff, John M. Kane

Research output: Contribution to journalArticlepeer-review

13 Scopus citations

Abstract

The NAVIGATE program was developed for the Recovery After Initial Schizophrenia Episode-Early Treatment Program (RAISE-ETP) study, which compared NAVIGATE to usual Community Care in a cluster randomized design involving 34 sites and 404 patients. This article describes the approach to training and implementing the NAVIGATE program at the 17 sites (including 134 practitioners) randomized to provide it, and to evaluating the fidelity of service delivery to the NAVIGATE model. Fidelity was evaluated to five different components of the program, all of which were standardized in manuals in advance of implementation. The components included four interventions (Individualized Resiliency Training, Family Education Program, Supported Employment and Education, Personalized Medication Management) and the overall organization (staffing and structure) of the NAVIGATE team. Most of the sites demonstrated acceptable or higher levels of fidelity in their implementation of the four interventions and the organization of the program, with all 17 sites demonstrating at least acceptable overall fidelity to the NAVIGATE program. The results indicate that the NAVIGATE program can be implemented with good fidelity to the treatment model in a diverse array of community mental health care settings serving persons with a first episode psychosis.

Original languageEnglish (US)
Pages (from-to)271-281
Number of pages11
JournalSchizophrenia Research
Volume204
DOIs
StatePublished - Feb 2019

Bibliographical note

Funding Information:
Ms. Marcy owns shares of Pfizer, Inc. stock in addition to receiving research funding from Janssen and Otsuka.

Funding Information:
This work has been funded in whole or in part with funds from the American Recovery and Reinvestment Act and from NIMH under contract HHSN271200900019C. Additional support for these analyses was provided by an NIMH Advanced Centers for Intervention and/or Services Research award (P30MH090590) to Dr. Kane.

Publisher Copyright:
© 2018 Elsevier B.V.

Keywords

  • Coordinated specialty care
  • Fidelity
  • Implementation
  • Training

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