Development and Pilot Testing of a Novel Fidelity Instrument for Early Intervention for Psychosis (EIP) Services

Poster C88, Wednesday, October 10, 11:30 am - 1:00 pm, Essex Ballroom

Miriam Kinkaid1, Rebecca Fuhrer1, Ashok Malla1, Stephen McGowan2,3; 1McGill University, 2South West Yorkshire Partnership NHS Trust, 3IRIS Early Intervention for Psychosis Network

‘Fidelity’ refers to the degree to which a program is implemented as intended. If fidelity is not considered, studies on complex interventions, such as EIP services, can show inaccurate null results when tested in large population-level evaluations. A short, survey-based fidelity instrument that can be completed by EIP team-members would be useful for such research and program management. We report on the development and pilot testing of such a novel fidelity instrument. The instrument was developed using a literature review and expert opinion generated from a Delphi procedure. It was pilot tested in an EIP service in Montreal, Canada, to identify needed modifications and unreliable items, and test the feasibility of conducting a validation study. Three instruments completed by two EIP team-members, and one using data from a sample of patient records, were compared to assess agreement. Interviews with the respondents were conducted to understand discrepancies. Twenty-two experts from Canada and England participated in two Delphi rounds. The majority of the EIP components identified from the literature review were rated as ‘important’ or ‘very important’. Ranking identified the 25 most important items, which then were operationalized into the instrument. The pilot study showed some items had low agreement. The two respondents often had better mutual agreement than with the ‘gold standard’ using patient records. The first version of the fidelity instrument had many strengths and some weaknesses. Modifications were made to improve it. A validation study appears feasible. The newly modified fidelity instrument will be presented.

Topic Area: Service System Development and Reform

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