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Development of the Clinical High Risk for Psychosis Services Fidelity Scale (CHRPS-FS) for Team-Based Care.

Mark Savill1, Lindsay M Banks1, Briana T Sepulveda1

  • 1Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento (Savill, Banks, Sepulveda, Tryon, Nye, Asbun, Ereshefsky, Hayes, Niendam); Weill Institute for Neurosciences, University of California, San Francisco, San Francisco (Ho, Blay, Carlson, LaCross); Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada (Addington).

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Summary

A new scale, the Clinical High Risk for Psychosis Services Fidelity Scale (CHRPS-FS), was developed and piloted. This tool measures service delivery for individuals at clinical high risk for psychosis (CHRP) and is suitable for quality improvement.

Keywords:
community mental health servicespsychosesresearch/service deliveryscales/outcome and clinical measurement

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Area of Science:

  • Psychiatry
  • Mental Health Services Research
  • Clinical Psychology

Background:

  • Individuals at clinical high risk for psychosis (CHRP) require specialized care.
  • Existing fidelity scales may not fully capture the nuances of CHRP services.

Purpose of the Study:

  • To develop and pilot the Clinical High Risk for Psychosis Services Fidelity Scale (CHRPS-FS).
  • To assess the feasibility and validity of the CHRPS-FS for measuring service delivery in CHRP programs.

Main Methods:

  • Literature review to identify evidence-based CHRP treatments and compare with existing fidelity scales.
  • Delphi process with 17 experts to achieve consensus on scale items.
  • Pilot testing of the CHRPS-FS in eight coordinated specialty care (CSC) clinics.

Main Results:

  • The CHRPS-FS incorporated new components and modifications from existing scales.
  • Expert consensus (>80%) was achieved on scale items after two rounds.
  • The scale was successfully piloted, showing a mean rating of 3.96 and 72% of items rated at good to high fidelity.

Conclusions:

  • The CHRPS-FS is feasible, possesses face validity, and can be used independently or with other assessments.
  • The scale effectively measures service delivery and is valuable for clinical trials, learning health care systems, and quality improvement initiatives for CHRP.