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Development and Testing of the First-Episode Psychosis Services Fidelity Scale
Donald Emile Addington1, Ross Norman1, Gary R Bond1
1Dr. Addington, Ms. McKenzie, and Dr. Wang are with the Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada (e-mail: addingto@ucalgary.ca ). Dr. Norman is with the Department of Health Outcomes and Health Services Research, London Health Sciences Centre, London, Ontario, Canada. Dr. Bond is with the Dartmouth Psychiatric Research Center, Lebanon, New Hampshire. Ms. Sale and Dr. Melton are with the EASA Center for Excellence, Regional Research Institute, Graduate School of Social Work, Portland State University, Portland, Oregon.
Objective:
The purpose of this study was to test the reliability and validity of the First-Episode Psychosis Services Fidelity Scale (FEPS-FS) and compare it with similar scales.
Methods:
A fidelity scale was developed from previously identified essential components of first-episode psychosis services. The scale was tested in six programs in two countries and compared with three existing scales.
Results:
Program data collection from multiple sources indicated the feasibility and reliability of the FEPS-FS (intraclass correlation coefficient for interrater reliability=.842; 95% confidence interval=.795-.882). Satisfactory programs scored an average of 86% of the maximum total score; the single unsatisfactory program scored 70%. Compared with the other scales, the FEPS-FS has fewer items, but it has the highest proportion of items common to all scales.
Conclusions:
The FEPS-FS is a feasible, compact, reliable, and valid measure of adherence to evidence-based practices for first-episode psychosis services that can be applied to any first-episode psychosis service.
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