Adapting coordinated specialty care in the post-COVID-19 era: study protocol for an integrative mixed-methods study

Area of Science:

• Mental Health Services Research
• Psychiatry
• Public Health

Background:

• Coordinated Specialty Care (CSC) programs offer evidence-based treatment for young people experiencing recent-onset psychotic disorders.
• OnTrackNY, a leading CSC model in New York, is part of the Early Psychosis Intervention Network (EPINET) learning health care system (LHS).
• The COVID-19 crisis prompted an examination of service delivery modifications within the OnTrackNY LHS.

Purpose of the Study:

• To investigate the impact of service delivery modifications in OnTrackNY's CSC programs during and after the COVID-19 crisis.
• To systematically classify and analyze adaptations made to CSC services using the Framework for Reporting Adaptations and Modification-Enhanced (FRAME) framework.
• To understand stakeholder decision-making processes and the effects of these modifications on service utilization and participant outcomes.

Main Methods:

• Integrative mixed-methods approach combining qualitative interviews and quantitative program data analysis.
• Qualitative interviews with diverse stakeholders including program participants, families, providers, and administrators.
• Analysis of OnTrackNY program data to track trends in staffing, functioning, service utilization, and participant outcomes.

Main Results:

• The study will identify specific modifications made to CSC services during the COVID-19 pandemic.
• Analysis will differentiate between modifications that maintained fidelity to the CSC model and those that did not.
• The impact of these modifications on service utilization and participant outcomes will be assessed.

Conclusions:

• A CSC Model Adaptation Guide will be developed to inform CSC programs and mental health authorities about effective service modifications.
• The guide will highlight the impact of adaptations on care processes, service utilization, and participant outcomes.
• Findings will support tailored technical assistance for CSC programs within OnTrackNY, EPINET, and nationally.