CSC OnDemand: An Innovative Online Learning Platform for Implementing Coordinated Specialty Care

NCT ID: NCT03465371

Last Updated: 2022-05-02

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

349 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-10-01

Study Completion Date

2022-01-31

Brief Summary

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In response to the growing need for training on interventions to address first episode psychosis, the Center for Social Innovation (C4) partnered with experts in Coordinated Specialty Care (CSC) to develop and test CSC OnDemand: An Innovative Online Learning Platform for Implementing Coordinated Specialty Care. The product builds on the findings of the Recovery After an Initial Schizophrenia Episode (RAISE) studies, funded by the National Institute of Mental Health (NIMH). RAISE examined team-based models of care for people early in the course of schizophrenia. Through a Fast Track Small Business Innovation Research (SBIR) grant, investigators will prototype, test, refine, and evaluate the impact of CSC OnDemand.

Detailed Description

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Building on existing resources and the expertise of our faculty and advisors, the investigators developed CSC OnDemand, a multifaceted online learning product that includes four levels: 1) an online readiness tool and CSC Learning Hub; 2) dynamic multimedia core curriculum on first episode psychosis and CSC; 3) live faculty-led online courses; and 4) ongoing support, including an online community of practice to support peer-to-peer learning.

During Phases I and II of this Fast Track SBIR, the investigators prototyped, pilot tested, built out, and evaluated the product through a cluster randomized study comparing it with InPerson training (and due to the global pandemic, a "virtual" in person training, using Zoom to train with the same curriculum as in-person, creating (unexpectedly) three study arms).

Phase I built a robust prototype of the online platform and tested it with 16 providers from three sites. This phase explored feasibility, acceptability, and preliminary effectiveness of the product, and examined which components of the online platform providers found most useful.

Based on our findings from Phase I, the investigators refined and fully built out the product to test in a larger randomized trial. Phase II used a cluster randomized non-inferiority design to assess if OnDemand training (n = 20 sites) was comparable to InPerson training (n = 10 sites). Using a mixed-methods approach, the investigators examined provider (n enrolled was 239; after attrition 206) outcomes (satisfaction; knowledge gains/retention; attitudes toward shared decision making) and client (n = 110) outcomes (work/school participation; engagement in CSC services; inpatient psychiatric hospitalizations).

The study was guided by the following specific aims:

Phase II AIM 1: To refine, expand, and finalize CSC OnDemand based on Phase I findings.

AIM 2: To examine the differences in outcomes of OnDemand training intervention as compared to the InPerson and Virtual In Person interventions as it related to CSC providers knowledge and shared decision making (SDM). Hypothesis: Providers in the OnDemand condition will achieve increases in knowledge, SDM and satisfaction at post training and nine months that will be no more than .5 standard deviations less than the InPerson or Virtual InPerson condition.

AIM 3: To determine if the OnDemand training intervention is as successful as the InPerson or Virtual InPerson training in increasing participation in work or school, improving engagement in treatment, and decreasing relapse rates for participating clients. Hypothesis: Clients being served by the providers in the OnDemand condition will have work/school participation rates, levels of engagement and rates of hospitalization nine months after admission that are no more than 10 percent higher (hospitalization) or lower (work/school, engagement) than clients served by providers in the InPerson or Virtual InPerson condition.

Conditions

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Psychosis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

A 3-arm randomized controlled trial
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Virtual InPerson Intervention

Participants receiving the Virtual InPerson Intervention (the InPerson training via Zoom)

Group Type ACTIVE_COMPARATOR

Virtual InPerson Intervention

Intervention Type OTHER

Level 1: Readiness

Telephone conversations with program leaders to determine structures, roles, staffing, recruitment

Level 2: Core Knowledge

1 day of virtual (via Zoom) in-person training on FEP basics and CSC components

Level 3: Going Deeper

1.5 days of virtual (via Zoom) in-person training on how the team works, followed by breakout sessions by role

Level 4: Sustainability

9 months of monthly implementation coaching calls with team leads; monthly telephone case conferences; monthly care coordination calls split out by role

OnDemand Training Intervention

Participants receiving the OnDemand Training Intervention

Group Type EXPERIMENTAL

CSC OnDemand Training Intervention

Intervention Type OTHER

Level 1: Readiness

Online readiness tool

Level 2: Core Knowledge

Week 1-self-paced core curriculum, totaling 8 hours of instruction

Level 3: Going Deeper

Week 2-instructor-led, role-specific, and advanced topics, totaling 12 hours of instruction

Level 4: Sustainability

9 months of online community of practice support; a discussion forum; open office hours with experts; multisite case conferencing; access to online materials

InPerson Intervention

Participants receiving the InPerson Intervention

Group Type ACTIVE_COMPARATOR

InPerson Intervention

Intervention Type OTHER

Level 1: Readiness

Telephone conversations with program leaders to determine structures, roles, staffing, recruitment

Level 2: Core Knowledge

1 day of in-person training on FEP basics and CSC components

Level 3: Going Deeper

1.5 days of in-person training on how the team works, followed by breakout sessions by role

Level 4: Sustainability

9 months of monthly implementation coaching calls with team leads; monthly telephone case conferences; monthly care coordination calls split out by role

Interventions

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CSC OnDemand Training Intervention

Level 1: Readiness

Online readiness tool

Level 2: Core Knowledge

Week 1-self-paced core curriculum, totaling 8 hours of instruction

Level 3: Going Deeper

Week 2-instructor-led, role-specific, and advanced topics, totaling 12 hours of instruction

Level 4: Sustainability

9 months of online community of practice support; a discussion forum; open office hours with experts; multisite case conferencing; access to online materials

Intervention Type OTHER

InPerson Intervention

Level 1: Readiness

Telephone conversations with program leaders to determine structures, roles, staffing, recruitment

Level 2: Core Knowledge

1 day of in-person training on FEP basics and CSC components

Level 3: Going Deeper

1.5 days of in-person training on how the team works, followed by breakout sessions by role

Level 4: Sustainability

9 months of monthly implementation coaching calls with team leads; monthly telephone case conferences; monthly care coordination calls split out by role

Intervention Type OTHER

Virtual InPerson Intervention

Level 1: Readiness

Telephone conversations with program leaders to determine structures, roles, staffing, recruitment

Level 2: Core Knowledge

1 day of virtual (via Zoom) in-person training on FEP basics and CSC components

Level 3: Going Deeper

1.5 days of virtual (via Zoom) in-person training on how the team works, followed by breakout sessions by role

Level 4: Sustainability

9 months of monthly implementation coaching calls with team leads; monthly telephone case conferences; monthly care coordination calls split out by role

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

Agencies will need to provide:

* direct care to individuals with early psychosis;
* administrative-level support for training and use of the CSC model;
* an entire treatment team that is willing to participate in this team-based intervention;
* contact information for direct service staff;
* support for the study, including a staff person to serve as a liaison to work with the research team;
* access to the Internet during the intervention period; and
* a willingness to provide data and participate in the evaluation.

Exclusion Criteria

* Teams should not have previously received CSC training.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Dartmouth College

OTHER

Sponsor Role collaborator

University of Maryland

OTHER

Sponsor Role collaborator

New York State Psychiatric Institute

OTHER

Sponsor Role collaborator

Center for Social Innovation, Massachusetts

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Kathleen Ferreira, PhD

Role: PRINCIPAL_INVESTIGATOR

C4 Innovations

Locations

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Center for Social Innovation

Needham, Massachusetts, United States

Site Status

Countries

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United States

Other Identifiers

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4R44MH111283-02

Identifier Type: NIH

Identifier Source: org_study_id

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