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Early-phase Schizophrenia: Practice-based Research to Improve Treatment Outcomes (ESPRITO)

Award Number: R01MH120594
ORGANIZATION: NATIONAL INSTITUTE OF MENTAL HEALTH
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 08/22/2019
PERIOD OF PERFORMANCE END DATE: 05/31/2025

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Early-phase Schizophrenia: Practice-based Research to Improve Treatment Outcomes (ESPRITO) - PROJECT SUMMARY/ABSTRACT For the RAISE initiative, we developed the NAVIGATE model of coordinated specialty care (CSC) for first episode psychosis which supports the EPINET goal of furthering measurement-based care and shared treatment decisions. To meet the EPINET goal of improving treatment, having all sites providing treatment using the same model has distinct advantages. Therefore, we have engaged 11 NAVIGATE sites in 4 states, enabling us to address challenges in different regions and find solutions that are not dependent on the environment and support of a single state. Based on our experience training NAVIGATE sites and analyses of RAISE-ETP data, we have identified targets for improvement of services. Our specific targets for improvement divide into two categories. First, initial approaches added to NAVIGATE care for all participants to provide an enhanced version of NAVIGATE (E-NAVIGATE). Second, three research projects target critical junctures in CSC care. Study 1 aims to reduce duration of untreated psychosis (DUP). In RAISE-ETP median DUP was 74 weeks and had a significant impact on quality of life and symptoms. We will study the effect of targeted ads that appear in response to specific terms when someone searches the internet. We expect that this will increase the number of young people who will come to our clinics with shorter DUP. Study 2 addresses further reduction of hospitalization. Even with CSC, approximately one third will be hospitalized within 2 years and poor adherence to medication can lead to hospitalization. Direct observation of treatment can substantially improve adherence and reduce hospitalization. We will study a unique suite of methods for direct observation delivered as an app on a smart phone to support adherence. In a randomized trial we will compare this intervention to usual E-NAVIGATE to improve adherence and reduce hospitalization. Study 3 is designed to identify E-NAVIGATE participants who are at high risk for disengagement, and to intervene in order to prevent/delay disengagement because even with CSC, 30-50% of participants will disengage from treatment within 2 years. We will compare an internet delivered version of E-NAVIGATE that reduces treatment burden to usual clinical strategies to prevent disengagement. We will build upon our RAISE-ETP and post-ETP experience to build a unique network that will deliver an evolving CSC that changes based upon feedback from experience and a dedicated informatics platform. Research, designed to be generalizable not only to our network but to CSC practice more broadly, will set the stage for the next generation of CSC deployment.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = -$98,113 )
2026	2023	THE FEINSTEIN INSTITUTES FOR MEDICAL RESEARCH	350 COMMUNITY DR	MANHASSET	NY	11030	NASSAU	USA	Mental Health Research Grants	000	5	11/20/2025	NON-COMPETING CONTINUATION	-$98,113
														Subtotal = -$98,113

Issue Date FY: 2023 ( Subtotal = $1,483,303 )
2023	2023	FEINSTEIN INSTITUTES FOR MEDICAL RESEARCH, THE	350 COMMUNITY DR	MANHASSET	NY	11030	NASSAU	USA	Mental Health Research Grants	000	5	7/11/2023	NON-COMPETING CONTINUATION	$1,483,303
														Subtotal = $1,483,303

Issue Date FY: 2022 ( Subtotal = $1,480,860 )
2022	2022	FEINSTEIN INSTITUTES FOR MEDICAL RESEARCH, THE	350 COMMUNITY DR	MANHASSET	NY	11030	NASSAU	USA	Mental Health Research Grants	000	4	5/19/2022	NON-COMPETING CONTINUATION	$1,480,860
														Subtotal = $1,480,860

Issue Date FY: 2021 ( Subtotal = $1,485,095 )
2021	2021	FEINSTEIN INSTITUTES FOR MEDICAL RESEARCH, THE	350 COMMUNITY DR	MANHASSET	NY	11030	NASSAU	USA	Mental Health Research Grants	000	3	5/17/2021	NON-COMPETING CONTINUATION	$1,485,095
														Subtotal = $1,485,095

Issue Date FY: 2020 ( Subtotal = $1,504,444 )
2020	2020	FEINSTEIN INSTITUTE FOR MEDICAL RESEARCH, THE	350 COMMUNITY DR	MANHASSET	NY	11030	NASSAU	USA	Mental Health Research Grants	002	2	5/26/2020	NON-COMPETING CONTINUATION	$1,504,444
2020	2019	FEINSTEIN INSTITUTE FOR MEDICAL RESEARCH, THE	350 COMMUNITY DR	MANHASSET	NY	11030	NASSAU	USA	Mental Health Research Grants	000	1	11/5/2019	NEW	$0
2020	2019	FEINSTEIN INSTITUTE FOR MEDICAL RESEARCH, THE	350 COMMUNITY DR	MANHASSET	NY	11030	NASSAU	USA	Mental Health Research Grants	001	1	11/5/2019	SUPPLEMENT FOR EXPANSION	$0
														Subtotal = $1,504,444

Issue Date FY: 2019 ( Subtotal = $1,706,495 )
2019	2019	FEINSTEIN INSTITUTE FOR MEDICAL RESEARCH, THE	350 COMMUNITY DR	MANHASSET	NY	11030	NASSAU	USA	Mental Health Research Grants	001	1	8/23/2019	NEW	$0
2019	2019	FEINSTEIN INSTITUTE FOR MEDICAL RESEARCH, THE	350 COMMUNITY DR	MANHASSET	NY	11030	NASSAU	USA	Mental Health Research Grants	000	1	8/22/2019	NEW	$1,620,699
2019	2019	FEINSTEIN INSTITUTE FOR MEDICAL RESEARCH, THE	350 COMMUNITY DR	MANHASSET	NY	11030	NASSAU	USA	Mental Health Research Grants	002	1	9/12/2019	SUPPLEMENT FOR EXPANSION	$85,796
														Subtotal = $1,706,495

Grand Total All Awards = $7,562,084

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Early-phase Schizophrenia: Practice-based Research to Improve Treatment Outcomes (ESPRITO)

Award Number: R01MH120594

ORGANIZATION: NATIONAL INSTITUTE OF MENTAL HEALTH

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 08/22/2019

PERIOD OF PERFORMANCE END DATE: 05/31/2025

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