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Steering Committee: October 31, 2018

In attendance: Aristotle, Lillian, Sanjeev, Eva, Sarah, George, Alexia, Janet, Chelsi, Dielle, Nadia

Action Items:

Follow-up items from the Launch:

1. Steering Committee Members

  • Contact Patrick Mitchell regarding policy member as representative in steering committee – Aristotle

  • Invite Augustina to be potential lead youth representative on the Steering Committee – Dielle

2. Governance

  • Invite Sara Traore to Youth Advisory Committee – Dielle

  • Follow-up with Family Group members – Sarah

  • Follow-up with Caroline about potential SCEIS family member - Dielle

  • Formulate operations sub-committees/working groups for each aim/outcome. Assign members to committees. Send draft of committees and members for next week - Chelsi/Dielle

3. Measures

  • Follow-up with Eddy Nason regarding goal attainment as a quality of life measure – George

  • Measure DUP with SCID → clarify with Jean if this is based on onset of symptoms or onset of diagnosis? – George

  • Use ADDIS for alcohol and drug use scale (cross-reference with PSSX study) → to be added as REB amendments after initial approval

4. Find out more about evidence-network advisement for SPOR from Vasanthi – Dielle/Aristotle


1. Steering Committee members to respond to questions form Lakeridge REB by Thursday Afternoon (Nov. 1st) – Dielle/SC

2. Assign questions from Niagara REB response to SC members on Monday- Dielle

3. Send contracts to all sites on Monday (except Durham) – Dielle

4. Meeting around site readiness assessment and implementation landscape – Alexia, George, & Sarah

  • Identify site members for pre-training calls, in-person training break-out sessions and post-training calls


  • Email sites informing that anyone providing case management should be on pre-training calls – Chelsi (done)

  • Send pre-training call options to implementation specialists – Chelsi

  • Send pre-training confirmed time by Friday to Janaki (to inform Piper) – Chelsi

  • Get feedback from Piper about materials for pre-training calls (full modules or clinician guide and condensed handout) – Sarah/Janaki

  • Look into community resources for different NAVIGATE roles – PSSP

  • Decide if in-person training session will be recorded – Sarah/George

  • Contact education specialist to formulate NAVIGATE sustainability training/as potential auditors for in-person training – Sanjeev


Meeting Minutes:

Follow-Up on Main Points from Launch:

1. Reach out to Patrick Mitchell to find suitable delegate who can regularly attend SC meetings for policy representation (Catherine Ford)

2. We will use the ADDIS to measure alcohol and drug use as part of patient assessments → this will overlap with Miner’s Lamp study at Slaight and can be incorporated into the protocol as a future amendment after initial approval

3. Measuring duration of untreated psychosis (DPU)

  • RAISE study used the SCID

  • Unclear if this is based on onset of symptoms or onset of diagnosis → follow-up with Jean

4. Governance Structure

  • Develop operations sub-committees/working groups for measurement of each aim and outcome (e.g., ICES, patient-level, implementation and engagement) instead of a research/administrative operations committee. PIs and Co-Is would represent each of the outcomes.

  • Youth/Family Advisory Committees will address patient/family engagement outcomes

  • Steering Committee represents the intersection of various committees and executes high level operations

  • Site managers/leads should be involved in the implementation committees

  • ECHO will also interact with site managers/leads for organizational readiness

  • Clinical needs assessment will help build the curriculum within ECHO

  • Clinical pieces around needs assessment to build the curriculum within ECHO

5. Aristotle to follow-up with Vasanthi at OSSU meeting in 4 weeks to explore evidence-network advisements for SPOR

Recruitment of Youth/Family Members

  • 2 potential candidates → both referrals form the TECC-Y study → 1 no longer has the time/travel barrier → teleconference could be an option

  • We need someone with lived experience and from central hospital → Sarah Traore is an option

  • Karleigh has identified three potential candidates → one responded to the NAVIGATE flyer, but has issues with commitment. She will call national advisory council to look for other candidates.

  • Augustina to be invited to Steering Committee as Youth Committee Lead Representative

  • Caroline → family member from SCEIS might be interested in joining

  • Need to populate committees with patients/family members with lived experiences from the sites. Other Sites: 4 Potential from Sudbury; 1 Potential from North Bay

REB Updates:

  • North Bay REB Call on Oct. 30 2018 → they did not have the full protocol during the discussion. We are waiting to hear back about their written questions.

  • Lakeridge REB: Additional responses from Lakeridge were received this morning → we need get our responses by mid-Friday to submit our responses for November 5th deadline. If we miss this deadline, we will have to wait another month to submit to their REB.

  • Received comments from Niagara site clinicians

  • Consent forms do not need to be equivalent across sites → focus should be on lay language

Site Readiness & Pre-Training:

  • Alexia has updated Implementation landscape document → look through site readiness excel sheet with Sarah and George to determine how breakdown of interventions will work for each site.

  • PSSP might need to look into community resources for different NAVIGATE roles

  • Some clinicians might have to do half IRT and half family components, others doing full IRT to maximize efficiency

  • Advanced practice clinician from sites should be on pre-training calls. Anyone providing case management (not those solely doing family work) should be part of pre-training calls

  • We are moving forward with pre-training regardless of REB approval → performed outside of research activities

  • Calls will begin the week of November 19th with Sarah and George

  • IRT modules to be sent out weekly → need to determine if they receive full module or condensed handouts

Training & Post-Training:

  • Sites don’t have enough staff to accommodate all NAVIGATE roles

  • Alexia and Sarah meet to determine who will be assigned to NAVIGATE components at each site

  • Decide if we can record the entire in-person training session → have not asked NAVIGATE trainers about this

  • Received responses that videotaping the sessions is not appropriate for adult learning → how can we support training → role playing and immersive exercises would be an option

  • Sanjeev → NAVIGATE training is not developed to train new staff after turnover → sustainability issue. They currently currently send new staff to a full 2.5 day training at another site, no virtual module. ECHO is similar, but trying to train regional staff – “train the trainer model”

  • We could apply train the trainer approach to NAVIGATE as they do not support this as much

  • Not sustainable for us to rely on US trainers only

  • NAVIGATE competent vs. NAVIGATE brand → need to train people on navigate competencies, move away from NAVIGATE proper, our training would be based on the model

  • How to make 2.5 day training accessible after the actual training

  • Eva – build into core competency online training

  • ECHO would take over on-going training to maintain level of knowledge

  • ECHO – didactic session + case based learning to solidify the learning

  • Create foundation learning session and immersive experiences based on in-person 2.5 day training (edit video recording)

  • Content is not conducive to purely remote learning → will need continuous feedback loops for individuals in their respective roles (Step Care model for education)

  • Also applies to Slaight Centre training – consider a regular foundational training session every 6 months → single training session for CAMH and site staff (similar to Temerity brain stimulation annual session) with ECHO involvement

  • Find out core competencies from the 2.5 day training

  • Sanjeev – education consultants could audit the 2.5 day training to determine how to build the appropriate education model

Additional Minutes from October 24, 2018

ALL TEAM MEMBERS – if you have any questions you would like to add to site readiness assessments (e.g., CBT training), forward all of your questions in one email to the respective leads at PSSP, ECHO & Fidelity so they can be incorporated into the interview guides

  • Fidelity – send to Mary Hanna (Janet)

  • PSSP – send to Derek (Alexia)

  • ECHO – send to Christine Mitchell or Eva


INTRODUCTORY EMAIL - Send out email introducing all sites to point persons at Fidelity, PSSP, ECHO for their respective readiness assessments and to provide pre-training call options from Janaki/Piper.

RMT – after in-person training ?

Timeline for all support Calls


1. Post training call map (visual) not sure if we need a visual as well as a chart (this will include trainer calls and other echo capacity building calls with us and the implementation team)– Sarah

2. Establish call ins for all sites (ie. Tuesday at 10am) –are these support calls? -- Sarah

  • Determine if additional time slots are needed for ECHO

3. For IRT non-trainer consultation calls (post training) – what is the framework of these for ongoing capacity building – module specific with patient examples? – these need to be created with CAMH clinician experts

4. Structure, frequency of calls – trainer and non-trainer/peer-to-peer learning/echo

Main Points from Launch:

1. Policy decision-maker regularly on Steering committee

2. Connect with Andrea Tricco/Sharon Straus – Evidence-Network advisement for SPOR – knowledge translation support provided by CIHR

3. Consider including an addiction scale because of high rates of drug-induced psychosis at some sites - incorporate as patient-outcome measure and make necessary amendments

4. Eddy Nason suggested looking at goal attainment as a quality of life measure

5. Look at how to measure the duration of untreated psychosis (DUP) - not currently addressed by the protocol

6. Differentiate ECHO and PSSP involvement in operations and implementation

7. Need to identify one leader from each site to be part of Implementation Committee (look for local champions)

8. Sara Traore - could join Steering Committee as a representative

9. Set up central training process for youth/service user and family advisory committee.

10. Diana suggested an operations subcommittee focused on measurement of outcomes

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