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Published Online: 27 October 2020

Reliability and Feasibility of the First-Episode Psychosis Services Fidelity Scale–Revised for Remote Assessment

Abstract

Objective:

The authors sought to evaluate the interrater reliability and feasibility of the First-Episode Psychosis Services Fidelity Scale–Revised (FEPS-FS-R) for remote assessment of first-episode psychosis programs according to the coordinated specialty care model.

Methods:

The authors used the FEPS-FS-R to assess the fidelity of 36 first-episode psychosis program sites in the United States with information from three sources: administrative data, health record review, and phone interviews with staff. Four raters independently conducted fidelity assessments of five program sites by listening to each of the staff interviews and independently rating the two other data sources from each site. To calculate interrater reliability, the authors used intraclass correlation coefficients (ICCs) for each of the five sites and across the total scores for each site.

Results:

Total interrater reliability was in the good to excellent range, with a mean ICC of 0.91 (95% confidence interval = 0.72–0.99, p<0.001). Two first-episode psychosis program sites (6%) achieved excellent fidelity, 25 (69%) good fidelity, and nine (25%) fair fidelity. Of the 32 distinct items on the FEPS-FS-R, 23 (72%) were used with good or excellent fidelity. Most sites achieved high fidelity on most items, but five items received ratings indicating low-fidelity use at most sites. The fidelity assessment proved feasible, and sites required on average 10.5 hours for preparing and conducting the fidelity review.

Conclusions:

The FEPS-FS-R has high interrater reliability and can differentiate high-, moderate-, and low-fidelity sites. Most sites had good overall fidelity, but the FEPS-FS-R identified some services that were challenging to implement at many sites.

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Information & Authors

Information

Published In

Go to Psychiatric Services
Go to Psychiatric Services
Psychiatric Services
Pages: 1245 - 1251
PubMed: 33106096

History

Received: 2 February 2020
Revision received: 21 May 2020
Accepted: 27 May 2020
Published online: 27 October 2020
Published in print: December 01, 2020

Keywords

  1. Early intervention
  2. Psychotic disorders
  3. Implementation science
  4. Quality of care
  5. Health services accessibility
  6. Community mental health services

Authors

Details

Donald Addington, M.B.B.S. [email protected]
Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada (Addington); Douglas Research Centre, Douglas Mental Health University Institute, Montreal (Noel); Sanford School of Public Policy, Duke University, Durham, North Carolina (Landers); Westat Corporation, Lebanon, New Hampshire (Bond).
Valerie Noel, Ph.D.
Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada (Addington); Douglas Research Centre, Douglas Mental Health University Institute, Montreal (Noel); Sanford School of Public Policy, Duke University, Durham, North Carolina (Landers); Westat Corporation, Lebanon, New Hampshire (Bond).
Matthew Landers, M.Sc.
Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada (Addington); Douglas Research Centre, Douglas Mental Health University Institute, Montreal (Noel); Sanford School of Public Policy, Duke University, Durham, North Carolina (Landers); Westat Corporation, Lebanon, New Hampshire (Bond).
Gary R. Bond, Ph.D.
Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada (Addington); Douglas Research Centre, Douglas Mental Health University Institute, Montreal (Noel); Sanford School of Public Policy, Duke University, Durham, North Carolina (Landers); Westat Corporation, Lebanon, New Hampshire (Bond).

Notes

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

Competing Interests

The authors report no financial relationships with commercial interests.

Funding Information

This study was funded by a grant from the Substance Abuse and Mental Health Services Administration, in collaboration with the National Institute of Mental Health and the Office of the Assistant Secretary for Planning and Evaluation (Mental Health Block Grant 10% set-aside evaluation HHSS283201200011I/HHSS28342008T, RFTOP No. 280-16-0482).

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