Implementation and fidelity assessment of the NAVIGATE treatment program for first episode psychosis in a multi-site study

Schizophr Res. 2019 Feb:204:271-281. doi: 10.1016/j.schres.2018.08.015. Epub 2018 Aug 20.


The NAVIGATE program was developed for the Recovery After Initial Schizophrenia Episode-Early Treatment Program (RAISE-ETP) study, which compared NAVIGATE to usual Community Care in a cluster randomized design involving 34 sites and 404 patients. This article describes the approach to training and implementing the NAVIGATE program at the 17 sites (including 134 practitioners) randomized to provide it, and to evaluating the fidelity of service delivery to the NAVIGATE model. Fidelity was evaluated to five different components of the program, all of which were standardized in manuals in advance of implementation. The components included four interventions (Individualized Resiliency Training, Family Education Program, Supported Employment and Education, Personalized Medication Management) and the overall organization (staffing and structure) of the NAVIGATE team. Most of the sites demonstrated acceptable or higher levels of fidelity in their implementation of the four interventions and the organization of the program, with all 17 sites demonstrating at least acceptable overall fidelity to the NAVIGATE program. The results indicate that the NAVIGATE program can be implemented with good fidelity to the treatment model in a diverse array of community mental health care settings serving persons with a first episode psychosis.

Trial registration: NCT01321177.

Keywords: Coordinated specialty care; Fidelity; Implementation; Training.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Antipsychotic Agents / therapeutic use
  • Community Mental Health Centers
  • Community Mental Health Services* / organization & administration
  • Employment, Supported*
  • Family
  • Female
  • Health Personnel / education*
  • Humans
  • Implementation Science
  • Male
  • Patient Care Team*
  • Patient Education as Topic* / organization & administration
  • Process Assessment, Health Care*
  • Program Development*
  • Program Evaluation
  • Psychotic Disorders / drug therapy
  • Psychotic Disorders / rehabilitation
  • Psychotic Disorders / therapy*
  • Young Adult


  • Antipsychotic Agents

Associated data