Digital mental health intervention for schizophrenia spectrum and psychotic disorders: Protocol for a pragmatic feasibility study of Horyzons-Canada

Shalini Lal; John F Gleeson; Simon D'Alfonso; Martin Lepage; Ridha Joober; Hajin Lee; Amal Abdel-Baki; Tania Lecomte; Mario Alvarez-Jimenez

doi:10.1177/20552076241282231

Digital mental health intervention for schizophrenia spectrum and psychotic disorders: Protocol for a pragmatic feasibility study of Horyzons-Canada

Digit Health. 2024 Oct 3:10:20552076241282231. doi: 10.1177/20552076241282231. eCollection 2024 Jan-Dec.

Authors

Shalini Lal^{1

2

3}, John F Gleeson⁴, Simon D'Alfonso⁵, Martin Lepage^{3

6}, Ridha Joober^{3

6}, Hajin Lee^{1

2}, Amal Abdel-Baki^{7

8

9}, Tania Lecomte¹⁰, Mario Alvarez-Jimenez^{11

12}

Affiliations

¹ School of Rehabilitation, Faculty of Medicine, University of Montréal, Montréal, QC, Canada.
² Youth Mental Health and Technology Lab, Health Innovation and Evaluation Hub, University of Montréal Hospital Research Centre, Montréal, QC, Canada.
³ Prevention and Early Intervention Program for Psychosis, Douglas Mental Health University Institute, Montréal, QC, Canada.
⁴ Healthy Brain and Mind Research Centre and School of Behavioural and Health Sciences, Australian Catholic University, Fitzroy, Australia.
⁵ School of Computing and Information Systems, University of Melbourne, Parkville, Australia.
⁶ Department of Psychiatry, McGill University, Montréal, QC, Canada.
⁷ Department of Psychiatry, Centre Hospitalier Université de Montréal (CHUM), Montréal, QC, Canada.
⁸ Axe Neurosciences, University of Montreal Hospital Research Centre (CRCHUM), Montréal, QC, Canada.
⁹ Department of Psychiatry, University of Montréal, Montréal, QC, Canada.
¹⁰ Department of Psychology, University of Montréal, Montréal, QC, Canada.
¹¹ Centre for Youth Mental Health, University of Melbourne, Parkville, Australia.
¹² Orygen Digital, Orygen, Parkville, Australia.

Abstract

Background: Schizophrenia spectrum and other psychotic disorders (SSPD) are among the most debilitating of all mental disorders. While the evidence for psychosocial interventions such as cognitive behavioral therapy and peer support has significantly improved, access to these services remains limited. This paper describes a protocol for a pragmatic feasibility study of a digital mental health intervention (HoryzonsCa) that provides access to evidence-based psychosocial interventions, social networking, and clinical and peer support services through a secured, web-based platform for adults diagnosed with SSPD.

Objective: The objectives are: (1) Adapt and translate HoryzonsCa for implementation in English and French; (2) Develop an implementation and training strategy; (3) Assess the acceptability, safety, and demand of HoryzonsCa; (4) Assess clinical outcomes and perceived impacts; (5) Examine the experiences and process of adapting and implementing HoryzonsCa; (6) Explore the role of sociocultural and demographic factors on HoryzonsCa outcomes and implementation.

Methods: This feasibility study will use a single-group, pre-post, mixed-methods (QUAN-QUAL convergent) research design, with assessments at baseline and 12 weeks. The study aims to recruit 100 individuals (ages 18-50) diagnosed with SSPD from two healthcare settings in Canada. Data collection includes interview-based psychometric measures, self-reports, focus groups, and interviews with participants. The study will also collect qualitative data from moderators and the research team, and will be conducted entirely remotely.

Conclusions: This study has been prospectively registered and is underway. It will provide timely information on the feasibility and potential impacts of using digital mental health services for individuals with chronic mental health conditions.

Trial registration: ISRCTN12561259; https://doi.org/10.1186/ISRCTN12561259 (250/max 250 words).

Keywords: Schizophrenia spectrum; e-mental health; peer support; psychiatry; psychology; psychotic disorders; social support; telemedicine; therapy; virtual care.