NAV-FS: A first episode psychosis services fidelity scale adapted for the NAVIGATE model

Coordinated Specialty Care (CSC) programs were developed to address the most common needs of people who develop a first episode of psychosis. The First Episode Psychosis Services Fidelity Scale (FEPS-FS) was designed to assess the implementation of individual evidence-based treatment components for FEP programs based on a comprehensive literature review rather than a specific treatment model (Addington et al., 2016). Since the development of the FEPS-FS, there has been a significant increase in CSC programs and in CSC treatment models delivered across the US. The FEPS-FS currently focuses more on global fidelity rather than providing specific implementation feedback aimed at quality improvement. This paper describes the development and pilot of an adapted FEP-FS scale for the NAVIGATE model (NAV-FS) to address the limitations of a nonspecific model fidelity scale. The NAV-FS retains the structure and scoring of the original FEPS-FS, but original items were modified based on NAVIGATE interventions. New items were added to more specifically assess the implementation of the NAVIGATE interventions. We compared three FEP programs using the FEPS-FS and the NAV-FS and found that the NAV-FS was feasible. Compared to the FEPS-FS, the NAV-FS provided programs with more specific suggestions for improvements in both the supported employment and education and Individual Resiliency Training interventions. The results identify the benefits of a model-specific fidelity scale aimed at increasing intervention success and improving client outcomes.