1 - (SYM 32) A Mixed-method Analysis to Explore Barriers to and Facilitators of Implementing a Novel Stepped-care Intervention for Clinical High Risk for Psychosis in Community Settings

Abstract Body
The clinical high-risk for psychosis (CHR-p) syndrome is a pluripotent risk state. Thus, treatments must be able to address current concerns and allow for early identification of and differing interventions for both psychotic and nonpsychotic symptom outcomes (McGorry & Mei, 2018). Stepped-care models allow such an approach but are relatively new in the U.S. healthcare system. Therefore, it is imperative to consider community providers’ perceptions and experiences of adopting a new treatment model to better support implementation efforts. The SCIP-Step Program is an innovative, CBT-based stepped-care intervention implemented at non-specialty community mental health clinics. This study aims to examine potential barriers to and facilitators of implementation, develop strategies to overcome challenges and improve program outcomes.

Participants are community providers partnering with the SCIP-Step Program. Thus far 37 providers have been trained. Eleven providers and 14 clients have begun the intervention. A convergent parallel mixed methods design will be used in the study. Providers who have completed SCIP-Step training will be invited to participate in an online survey. We aim to recruit 70 participants from the ongoing project. The quantitative survey assesses multiple factors identified in previous implementation science research that influence providers’ motivation and desire to learn and adopt a new intervention in their practice (e.g., self-efficacy, organizational support). The survey also includes items assessing perspectives on the CBT-based stepped-care model. Providers who have clients actively in the stepped-care program will be invited to complete a qualitative interview. A semi-structured guide will be used to assess common themes about real-world experiences of delivering this novel intervention. Approximately 30 interview participants are anticipated to allow for saturation of main themes. Survey and interview results will be available and discussed during this presentation.

After data collection, quantitative and qualitative data will be compared for similarities and differences in themes. This approach will help the SCIP-Step Program gain an in-depth understanding of implementation barriers and facilitators from community mental health providers, and results will be used to modify implementation strategies. This community-engaged research will further close the research-to-practice gap by integrating implementation science with quality improvement initiatives within real-world clinics.