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Standardizing Fidelity to Evidence-Based Practice in the Early Psychosis Intervention Network

Donald Addington¹, Tina Marshall¹, Abram Rosenblatt¹

¹Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada (Addington); Westat, Rockville, Maryland (Marshall, Rosenblatt, Bond, Goldman); Department of Psychiatry, University of Maryland School of Medicine, Baltimore (Goldman).

Psychiatric Services (Washington, D.C.)

|May 21, 2024

Abstract

Objective:

This study investigated variations in the measurement of fidelity to coordinated specialty care (CSC) within the Early Psychosis Intervention Network (EPINET), a learning health system that consists of 101 CSC programs within eight hubs. The study investigated the degree to which five fidelity scales could be mapped onto a standard scale.

Methods:

The investigators identified six fidelity scales in use by EPINET participants; examined their item content, scoring, and data sources; and mapped five scales onto the First Episode Psychosis Services Fidelity Scale (FEPS-FS), which is the most widely used scale.

Results:

Mapping five fidelity scales onto the FEPS-FS showed that the percentage of FEPS-FS components successfully mapped ranged from 42% to 81%.

Conclusions:

Mapping five scales onto one that uses dichotomous scoring identified the degree of variation in measures and reduced the amount and quality of usable fidelity data. Identifying variations in fidelity measurement is a core function of a learning health system.

Keywords:

Learning health system process assessment health care program evaluation health services research psychotic disorders quality of health care

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