ACTION ITEMS
Check out how the Thunder Bay EPI site is supporting families virtually
CMHA Thunder Bay’s virtual family groups also got a shoutout in the recent EPION newsletter
Share Waterloo clinician feedback regarding terminology/other challenges in the NAVIGATE manual at ECHO – Kim/team
Follow up with ECHO hub team with survey feedback and coordinate next session materials - Abanti
MINUTES
Intro & Administrative / Study Progress Updates
Protocol amendment: COVID-19 self-assessment measures approved by CAMH REB!
These additional questionnaires incorporated will be incorporated into the participant research visits when approved by site ethics boards
Site submissions are in progress, so far we have submitted to Durham and received approval from North Bay
Implementation - NAVIGATE Delivery and Site Updates
Sheila (Durham):
Participant Research:
Abanti and Dielle continue to attend staff meetings and have found this effective for participant research
10 clients have been referred and interviewed
Clinician feedback: some clinicians want to build rapport with clients before presenting the research opportunity so there is still some difference of opinion about when to ask
As clinicians start to ask clients and this becomes more successful, it is likely that the culture will shift and it will feel easier to ask
Youth Advisory Feedback: from a client perspective, it is always exciting to have the opportunity to give back and so a clinician doesn’t need rapport to present the opportunity
Clinical Operations:
Staff continue to work from home primarily, with clients coming in-person for injections or when new to the clinic
Still receiving lots of referrals, and have over 120 cases
Hired a full-time, permanent mental health clinician, Allison, who is a social worker and will be performing the IRT role for NAVIGATE
Josette (North Bay)
Participant Research:
3 clients are currently enrolled in the research study, with 1 having their 6-month research visit soon
The research staff are trying to reach 1 client who was recently referred, and clinicians have helped facilitate
Having Dielle and Abanti attend weekly calls has been helpful
Feedback from clinicians and YAC indicate that youth tend to prefer emails over phone calls as they can be anxiety inducing
Clinical Operations:
29 clients currently on case load
Clients are coming back for face-to-face visits and have the option of virtual
Kerri (Niagara)
Participant Research:
2 clients referred this week!
Clinical Operations:
Onboarding some new staff
NAVIGATE is now the norm for every client that enters service
Clinic is starting to open up more, but is more virtual than usual
Kim (Waterloo-Wellington)
Participant Research:
As of last Monday, clients entering the program are being asked about research
Clinical Operations:
Have been using NAVIGATE material and are more comfortable with it
Family groups are running virtually
200 clients are in the program
Kim to follow-up with Sandy regarding the baseline Fidelity assessment
Clinician feedback: experiencing some challenges with the language/terminology in the modules (e.g. “Negative Feelings”) and how flexible they can be with the language.
Will be discussing this further at Implementation Committee and suggest this for an ECHO session
Kim’s team has a running log with notes about any variations they use, and the rationales behind them to be used for feedback
Project Team feedback re: this challenge:
♣ NAVIGATE is a framework; when providing info on psychosis, it is helpful to know which pieces to cover/key elements. That said, saying things verbatim will not enhance the therapeutic alliance.
♣ Youth advisor agrees that clinicians should be free to have talent/character and deliver info in an authentic way ♣ The U.S. trainers also want clinicians to know that there is some flexibility
♣ This is one of the central challenges of implementation science - how do you deliver a model as it has been designed/studied and have it work with clinicians/patients? This is a really important theme and also relates to a main aspect of the Fidelity evaluation
♣ This is a great question, and makes us think about how we get to the essence of the model without getting stuck on the words
Would it be possible to revise the NAVIGATE manual to use youth-friendly terms?
♣ We will have the implementation leads attend a YAC and FAC meeting to discuss NAVIGATE and this
♣ From an Evaluation perspective: measuring the delivery of NAVIGATE focuses on whether modules are not delivered, and is not as nuanced as to how. Would it be possible to pick up on things like this that clinicians notice about the model’s expectations/adaptations?
Jen (Thunder Bay)
Participant Research:
Will be joining patient measures; still need to pitch this to the team and will seek feedback on how other site clinicians received this aspect of the project
Clinical Operations:
Youth and Family Advisory Committees
Family Advisory Committee
Meeting this Thursday
Video: Family advisors will be filming a video about what NAVIGATE and having a coordinated care model means to them
The video can be used in both family groups and among clinicians
Feedback from Project Team: the video sounds great and for site leads this will be very helpful for onboarding new staff!
Will also be giving recommendations based on Fidelity results in collaboration with Sandy and Janet
Youth Advisory Committee
We had a great discussion at the last YAC meeting about mental health during the pandemic
We will be giving quality improvement suggestions on the Fidelity results, working with Sandy on this
YAC still looking for representation from sites
Implementation - ECHO
Completed our third summer ECHO session yesterday, presentation on Virtual Groups by Eva Serhal
Discussed tips and processes that the CAMH virtual health service applies to virtual groups/virtual care
Next session on Tuesday July 21st on Behavioral Activation
Good discussion and interaction between sites with 22 site clinicians in attendance
Sites prefer more practical clinical skills based ECHO sessions
Abanti to follow up with hub team with survey feedback and coordinate next session materials
Surveys continue to be done more consistently, and feedback indicates that staff want more practical clinical skills and less formal sessions
Currently working with sites and PSSP to find a better time for ECHO sessions for Sept onwards
Patient Measures and Outcomes
Recruitment Update
24 referrals total, 5 from North Bay and 2 from Niagara (we have reached out to them)
13 baselines completed (10 from Durham, 3 from North Bay)
First 6-month visit completed
Clinicians have been so helpful and we appreciate their hard work!
We have attempted to contact all referrals, and have reached out to clinician when we haven’t been able to contact
Having Abanti and Dielle attend site meetings have been helpful; we will set up with Sudbury and Waterloo-Wellington
Research Orientation meeting completed with Waterloo; Sudbury scheduled for July 16th
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