My long-term career objective is to become an independent clinical scientist conducting research to facilitate treatment decision-making and engagement in evidence-based practices among emerging adults with early psychosis through peer-delivered services. My training objectives include: 1) develop new knowledge of service engagement frameworks and treatment decision-making models, and apply this knowledge to understand and address emerging adult disengagement in coordinated specialty care (CSC); 2) further expand knowledge of implementation of peer support services in general, and as applied to early intervention in psychosis; 3) train in intervention development and clinical trials methodology; 4) train in mixed methodology; and 5) hone communication, writing, and leadership skills needed to effectively communicate research findings, secure external funding to continue my program of research, and manage my own research lab. I will accomplish these objectives through didactic and applied training activities and regular meetings with mentors. The research project's specific aims are: 1) to understand decision-making needs pertinent to early CSC engagement in order to develop a peer-delivered decision support intervention (Study 1), and 2) to perform a preliminary evaluation of the peer-delivered decision support intervention in order to inform and support an R01 study (Study 2). Study 1 is a qualitative study to identify decision points and related decision-making needs pertaining to the first six months of engagement in a CSC program, followed by an intervention development phase with my mentorship team, a key stakeholder steering committee, and other consultants. Based on an experimental therapeutics approach, Study 2 is a mixed methods, pilot trial to assess feasibility, acceptability, and the intervention's potential impact on key decision-making targets. The focus of the project is highly responsive to NIMH's goal to ??maximize recovery among persons in the earliest stages of psychotic illness.? The environment at the College of Public Health (CPH) at Temple University is well-equipped to support my training and research objectives. CPH will afford me the opportunity to receive in-house mentorship from internationally recognized researchers in areas relevant to my training and research plan [Mark Salzer, Ph.D. (Professor and Chair of the Department of Rehabilitation Sciences; primary mentor), Laura Siminoff, Ph.D. (Dean of CPH; co-mentor)], and offers didactics that will fill critical gaps in my current training. CPH will also provide space, equipment, and technical assistance needed to successfully implement the research procedures. Additionally, I will benefit from Dr. Salzer's longstanding collaboration with Horizon House, Inc., whose Psychosis Education, Assessment, Care and Empowerment (PEACE) program will provide the infrastructure and target population needed to conduct the research project. Together, support and protected time from the K08 mechanism and the mentorship, training, and research-related resources available to me will enable me to establish an independent program of research and accomplish my long-term career objective.
Despite a proliferation of evidence-based, coordinated specialty care (CSC) programs for early psychosis in the United States, many emerging adults never derive clinical benefit due to high rates of service disengagement during the first several months of treatment. The purpose of this project is to develop and pilot test a peer-delivered decision support intervention to address this issue. The resulting knowledge and tools are anticipated to provide the basis for a competitive R01 study that will test our hypothesis that the intervention will promote early service engagement by addressing key treatment decision-making targets.
