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Published Online: 4 June 2019

Using Fidelity Measurement to Assess Quality of Early Psychosis Intervention Services in Ontario

Janet Durbin, Ph.D. [email protected], Avra Selick, M.A., Gordon Langill, M.S.W., R.S.W., Chiachen Cheng, M.D., F.R.C.P.(C), Suzanne Archie, M.D., F.R.C.P.(C), Shannel Butt, M.S.W., R.S.W., and Donald E. Addington, M.B.B.S.Authors Info & Affiliations
Publication: Psychiatric Services
Volume 70, Number 9
https://doi.org/10.1176/appi.ps.201800581
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Abstract

Objectives:

The First Episode Psychosis Services Fidelity Scale (FEPS-FS) is a validated measure of program delivery in relation to international standards. This study assessed fidelity in Ontario programs and the utility of the FEPS-FS for program improvement.

Methods:

Assessments were conducted in a volunteer sample of nine early psychosis intervention (EPI) programs. Thirty components of care were each rated on a 5-point scale; a rating of 4 indicates satisfactory performance. Trained assessor teams conducted site visits, and ratings were made by consensus.

Results:

Program mean fidelity ratings ranged from 3.1 to 4.4 and exceeded 4 in five programs. Across the programs, item mean fidelity ratings ranged from 2.1 to 5 and exceeded 4 for 14 of 30 items.

Conclusions:

The FEPS-FS captured variation in program implementation and provided a baseline for measuring change. Additions to the scale are planned to address components of the Ontario EPI standards not covered by the FEPS-FS.

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Information & Authors

Information

Published In

Go to Psychiatric Services
Go to Psychiatric Services
Psychiatric Services
Volume 70 • Number 9 • September 01, 2019
Pages: 840 - 844
PubMed: 31159664

History

Received: 21 December 2018
Revision received: 11 March 2019
Accepted: 4 April 2019
Published online: 4 June 2019
Published in print: September 01, 2019

Keywords

  1. Fidelity
  2. standardized assessment
  3. Quality of care
  4. first episode psychosis

Authors

Details

Janet Durbin, Ph.D. [email protected]
Centre for Addiction and Mental Health, Toronto (Durbin, Selick); Department of Psychiatry, University of Toronto, Toronto (Durbin); Haliburton Kawartha Pine Ridge Branch, Canadian Mental Health Association, Peterborough, Ontario (Langill); Psychiatry Section, Clinical Sciences, Northern Ontario School of Medicine, Thunder Bay, Ontario (Cheng); Department of Psychiatry and Behavioural Neuroscience, McMaster University, Hamilton, Ontario (Archie); Elgin Branch, Canadian Mental Health Association, St. Thomas, Ontario (Butt); Department of Psychiatry, University of Calgary, Calgary, Alberta (Addington).
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Avra Selick, M.A.
Centre for Addiction and Mental Health, Toronto (Durbin, Selick); Department of Psychiatry, University of Toronto, Toronto (Durbin); Haliburton Kawartha Pine Ridge Branch, Canadian Mental Health Association, Peterborough, Ontario (Langill); Psychiatry Section, Clinical Sciences, Northern Ontario School of Medicine, Thunder Bay, Ontario (Cheng); Department of Psychiatry and Behavioural Neuroscience, McMaster University, Hamilton, Ontario (Archie); Elgin Branch, Canadian Mental Health Association, St. Thomas, Ontario (Butt); Department of Psychiatry, University of Calgary, Calgary, Alberta (Addington).
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Gordon Langill, M.S.W., R.S.W.
Centre for Addiction and Mental Health, Toronto (Durbin, Selick); Department of Psychiatry, University of Toronto, Toronto (Durbin); Haliburton Kawartha Pine Ridge Branch, Canadian Mental Health Association, Peterborough, Ontario (Langill); Psychiatry Section, Clinical Sciences, Northern Ontario School of Medicine, Thunder Bay, Ontario (Cheng); Department of Psychiatry and Behavioural Neuroscience, McMaster University, Hamilton, Ontario (Archie); Elgin Branch, Canadian Mental Health Association, St. Thomas, Ontario (Butt); Department of Psychiatry, University of Calgary, Calgary, Alberta (Addington).
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Chiachen Cheng, M.D., F.R.C.P.(C)
Centre for Addiction and Mental Health, Toronto (Durbin, Selick); Department of Psychiatry, University of Toronto, Toronto (Durbin); Haliburton Kawartha Pine Ridge Branch, Canadian Mental Health Association, Peterborough, Ontario (Langill); Psychiatry Section, Clinical Sciences, Northern Ontario School of Medicine, Thunder Bay, Ontario (Cheng); Department of Psychiatry and Behavioural Neuroscience, McMaster University, Hamilton, Ontario (Archie); Elgin Branch, Canadian Mental Health Association, St. Thomas, Ontario (Butt); Department of Psychiatry, University of Calgary, Calgary, Alberta (Addington).
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Suzanne Archie, M.D., F.R.C.P.(C)
Centre for Addiction and Mental Health, Toronto (Durbin, Selick); Department of Psychiatry, University of Toronto, Toronto (Durbin); Haliburton Kawartha Pine Ridge Branch, Canadian Mental Health Association, Peterborough, Ontario (Langill); Psychiatry Section, Clinical Sciences, Northern Ontario School of Medicine, Thunder Bay, Ontario (Cheng); Department of Psychiatry and Behavioural Neuroscience, McMaster University, Hamilton, Ontario (Archie); Elgin Branch, Canadian Mental Health Association, St. Thomas, Ontario (Butt); Department of Psychiatry, University of Calgary, Calgary, Alberta (Addington).
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Shannel Butt, M.S.W., R.S.W.
Centre for Addiction and Mental Health, Toronto (Durbin, Selick); Department of Psychiatry, University of Toronto, Toronto (Durbin); Haliburton Kawartha Pine Ridge Branch, Canadian Mental Health Association, Peterborough, Ontario (Langill); Psychiatry Section, Clinical Sciences, Northern Ontario School of Medicine, Thunder Bay, Ontario (Cheng); Department of Psychiatry and Behavioural Neuroscience, McMaster University, Hamilton, Ontario (Archie); Elgin Branch, Canadian Mental Health Association, St. Thomas, Ontario (Butt); Department of Psychiatry, University of Calgary, Calgary, Alberta (Addington).
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Donald E. Addington, M.B.B.S.
Centre for Addiction and Mental Health, Toronto (Durbin, Selick); Department of Psychiatry, University of Toronto, Toronto (Durbin); Haliburton Kawartha Pine Ridge Branch, Canadian Mental Health Association, Peterborough, Ontario (Langill); Psychiatry Section, Clinical Sciences, Northern Ontario School of Medicine, Thunder Bay, Ontario (Cheng); Department of Psychiatry and Behavioural Neuroscience, McMaster University, Hamilton, Ontario (Archie); Elgin Branch, Canadian Mental Health Association, St. Thomas, Ontario (Butt); Department of Psychiatry, University of Calgary, Calgary, Alberta (Addington).
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Notes

Send correspondence to Dr. Durbin ([email protected]).

Competing Interests

The authors report no financial relationships with commercial interests.

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