xml: <clinical_study>
    <!-- This xml conforms to an XML Schema at:
      https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
    <required_header>
      <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
      <link_text>Link to the current ClinicalTrials.gov record.</link_text>
      <url>https://clinicaltrials.gov/ct2/show/NCT06002958</url>
    </required_header>
    <id_info>
      <org_study_id>23-0672</org_study_id>
      <nct_id>NCT06002958</nct_id>
    </id_info>
    <brief_title>Horyzons: Implementation and Integration in Clinical Practice</brief_title>
    <official_title>Horyzons: Implementation and Integration in Clinical Practice</official_title>
    <sponsors>
      <lead_sponsor>
        <agency>University of North Carolina, Chapel Hill</agency>
        <agency_class>Other</agency_class>
      </lead_sponsor>
      <collaborator>
        <agency>North Carolina Department of Health and Human Services</agency>
        <agency_class>Other</agency_class>
      </collaborator>
    </sponsors>
    <source>University of North Carolina, Chapel Hill</source>
    <oversight_info>
      <has_dmc>No</has_dmc>
      <is_fda_regulated_drug>No</is_fda_regulated_drug>
      <is_fda_regulated_device>Yes</is_fda_regulated_device>
      <is_unapproved_device>Yes</is_unapproved_device>
      <is_us_export>No</is_us_export>
    </oversight_info>
    <brief_summary>
      <textblock>
        The primary aim of this trial is evaluating the barriers and enablers of implementing a&#xD;
        digital intervention with both therapeutic content and social networking, Horyzons, as part&#xD;
        of clinical care in first episode psychosis (FEP) clinics in North Carolina. Providers&#xD;
        (clinicians and peers support specialists) will be recruited from FEP clinics to assess&#xD;
        Horyzons implementation and integration within clinical care at three time points (baseline,&#xD;
        6 months, and 12 months). Further, individuals experiencing FEP between the ages of 16 and 35&#xD;
        receiving services from the FEP clinics will be recruited to engage with the platform over&#xD;
        the course of 12 months. Due to the nature of the digital intervention being implemented&#xD;
        across the state of North Carolina, all research visits will be conducted remotely via&#xD;
        videoconferencing.&#xD;
      </textblock>
    </brief_summary>
    <detailed_description>
      <textblock>
        Purpose: The primary objective is to assess the barriers and facilitators of integrating&#xD;
        Horyzons, an evidence-based digital intervention, in outpatient mental health clinics in&#xD;
        North Carolina that provide care to individuals with schizophrenia spectrum and other&#xD;
        unspecified psychotic disorders. The primary aim is to evaluate and identify the unique&#xD;
        barriers and facilitators in implementing Horyzons at each first episode psychosis (FEP)&#xD;
        clinic as part of standard care and distinct implementation strategies. The secondary and&#xD;
        tertiary aims are to evaluate client engagement with Horyzons and attrition as part of&#xD;
        clinical care and assess the change in clients' psychological measures across in addition to&#xD;
        their use of state-funded services (e.g., emergency department and social services) across&#xD;
        the 12-month intervention.&#xD;
  &#xD;
        Participants: To assess the first aim, the investigators will recruit 20 clinicians and/or&#xD;
        peer specialists from the FEP clinics. To assess the first and second aim, the investigators&#xD;
        will recruit 50 individuals with FEP (i.e., first episode of a schizophrenia spectrum and&#xD;
        other unspecified psychotic disorders).&#xD;
  &#xD;
        Procedures (methods): Service provider participants will be recruited over a 4-6 week period&#xD;
        at their respective clinics. They will be asked to complete an adapted measure, the Cancer&#xD;
        Prevention and Control Research Network (CPCRN) Federally Qualified Health Center (FQHC)&#xD;
        Survey, assessing clinical readiness, leadership, acceptance, adoption, and perspective on&#xD;
        evidence-based practices. Service providers will then participate in implementing and&#xD;
        integrating Horyzons within clinical practice including preferred implementation strategy&#xD;
        that is distinct for each clinic (e.g., Horyzons training, access to the platform by&#xD;
        clinicians, ongoing technical support, attendance and update at monthly team meetings, etc.).&#xD;
        Service providers will meet with research staff at approximately the 6-month timepoint (+/- 4&#xD;
        weeks) to complete the CPCRN FQHC Survey then upon completion of the effectiveness trial with&#xD;
        clients, service providers will complete this measure once again in addition to participating&#xD;
        in a qualitative interview based on the Consolidated Framework for Implementation Research&#xD;
        (CFIR) around their experience with integrating the platform and identification of barriers&#xD;
        and facilitators to Horyzons' implementation. Service providers will be compensated for the&#xD;
        completion feedback, including the questionnaire and qualitative interviews.&#xD;
  &#xD;
        Client participants will be recruited over a 16- to 20-week period at their respective&#xD;
        clinic. Participants will participate in a baseline visit to provide informed consent and&#xD;
        complete a brief battery of measures (Demographics and Characteristics, University of&#xD;
        California, Los Angeles (UCLA) Loneliness Scale, MOS Social Supports Survey). Participants&#xD;
        will then meet with a research assistant, peer support specialist, or clinician to be given&#xD;
        guidance and instruction for using the site (i.e., Horyzons onboarding). Clients will then&#xD;
        engage in the platform, where site usage information as well as experience will be collected&#xD;
        from participants through the Horyzons platform. Site usage (e.g., number of posts/comments&#xD;
        made on the online platform, number and type of 'Journeys' or 'Tracks', self-guided&#xD;
        therapeutic content, completed during time on the platform) will automatically be collected&#xD;
        via the platform. Participants will have access and engage in this platform for approximately&#xD;
        12 months, depending on when recruited into trial. During this 12 month engagement period&#xD;
        with the platform, client participants will meet with research staff at their midway point to&#xD;
        complete the brief battery of measures assessing loneliness and social support and feedback&#xD;
        on Horyzons. Upon completion of their engagement with the platform, client participants will&#xD;
        additionally participate two additional research visits to complete the battery of measures&#xD;
        at 12-months and at a 3-month follow-up. research visits to complete the battery of measures&#xD;
        at 12-months and at a 3-month follow-up. As Horyzons involves therapeutic content and is&#xD;
        designed to improve psychological outcomes, such as loneliness and social support, this&#xD;
        platform is considered part of clinical care provided to individuals by their respective&#xD;
        clinic. For this reason, participants will not be compensated for their usage and engagement&#xD;
        with the platform, but rather, they will receive compensation for completion of assessment&#xD;
        batteries at baseline, midway, final, and follow-up research study visits.&#xD;
  &#xD;
        Horyzons will be monitored daily (two hours per weekday and one hour per weekend day) by&#xD;
        trained peer support specialists, master's level clinicians, and/or graduate students with&#xD;
        relevant clinical/research experience with individuals with psychosis. Drs. David Penn and&#xD;
        Kelsey Ludwig, who are clinical psychologists, lead weekly supervision calls to ensure&#xD;
        appropriate care and support of clients involved in the trial, to discuss case&#xD;
        conceptualization and suggestions for engaging clients in the platform.&#xD;
      </textblock>
    </detailed_description>
    <overall_status>Not yet recruiting</overall_status>
    <start_date type="Anticipated">September 5, 2023</start_date>
    <completion_date type="Anticipated">February 28, 2025</completion_date>
    <primary_completion_date type="Anticipated">February 28, 2025</primary_completion_date>
    <phase>N/A</phase>
    <study_type>Interventional</study_type>
    <has_expanded_access>No</has_expanded_access>
    <study_design_info>
      <allocation>Non-Randomized</allocation>
      <intervention_model>Parallel Assignment</intervention_model>
      <primary_purpose>Treatment</primary_purpose>
      <masking>None (Open Label)</masking>
    </study_design_info>
    <primary_outcome>
      <measure>Qualitative Summaries of Provider and Peer support specialists (PSSs) Participant Feedback in Post-Treatment Interview</measure>
      <time_frame>Up to 12 months</time_frame>
      <description>This qualitative data will be collected post-treatment from providers and PSSs. Individual interviews will discuss the utility and usage of Horyzons within their clinical care in addition to barriers and facilitators on numerous levels (individual, inner setting, and outer setting) of its implementation within their clinic. Feedback will be analyzed using grounded theory and summarized to include common themes regarding implementation, barriers, and enablers within the clinical setting and ideas for future implementation.</description>
    </primary_outcome>
    <primary_outcome>
      <measure>Quantitative Summaries of Provider and PSS Participant Experience in Post-Treatment Feedback</measure>
      <time_frame>Up to 12 months</time_frame>
      <description>This quantitative data will be collected pre-, mid-, and post-intervention from providers and PSSs. Feedback forms will prompt providers to answer questions regarding their experience and perspectives with barriers and facilitators in implementing an evidence-based practice (in this case Horyzons) in various settings (outer, inner, and individual). The survey will be analyzed regarding changes or lack thereof in the various settings and climate.</description>
    </primary_outcome>
    <secondary_outcome>
      <measure>Change in Engagement with the Horyzons Platform and Attrition over time</measure>
      <time_frame>Baseline, up to Month 12</time_frame>
      <description>Changes in engagement with Horyzons will be passively collected for client participants via the platform. Data evaluated will include number of logins, number of journeys, tracks, and activities completed, and number engagements on the community page.</description>
    </secondary_outcome>
    <secondary_outcome>
      <measure>Change in use of emergency and social services</measure>
      <time_frame>Baseline, Month 12 following intervention completion, a total of up to 24 months</time_frame>
      <description>Collection of use of emergency and social services one year pre-initiation and one year post-initiation of the Horyzons intervention will be assessed using medical records to determine change in use of such services.</description>
    </secondary_outcome>
    <other_outcome>
      <measure>Mean Change in UCLA Loneliness Scale Score</measure>
      <time_frame>Up to 15 months</time_frame>
      <description>The UCLA Loneliness scale is a 20-item scale. Answers are on a 4-point scale with options &quot;I often feel this way,&quot; &quot;I sometimes feel this way,&quot; &quot;I rarely feel this way,&quot; and &quot;I never feel this way.&quot; Possible scores range from 20 to 80. Higher scores reflect worse outcomes (greater feelings of loneliness). The UCLA Loneliness Scale is a part of the PhenX Toolkit.</description>
    </other_outcome>
    <other_outcome>
      <measure>Mean Change in Medical Outcomes Study (MOS) Social Support Survey - total score</measure>
      <time_frame>Up to 15 months</time_frame>
      <description>The MOS Social Support Survey is a 19-item scale. Answers are on a 5-point scale with options &quot;none of the time&quot;, &quot;a little of the time&quot;, &quot;some of the time&quot;, &quot;most of the time&quot;, and &quot;all of the time&quot;. Possible scores range from 19 to 95. Higher scores reflect higher feelings of social support (more perceived social support). The MOS Social Support Survey is a part of the PhenX Toolkit.</description>
    </other_outcome>
    <other_outcome>
      <measure>Quantitative Summaries of Participant Experience in Post-Treatment Feedback</measure>
      <time_frame>Up to 15 months</time_frame>
      <description>This quantitative data will be collected post-treatment from clients and clinicians. Feedback forms will prompt participants to answer questions regarding their experience with the platform on a scale of 1 to 5, with higher scores reflecting a more positive experience. Frequency counts will be included here.</description>
    </other_outcome>
    <number_of_arms>2</number_of_arms>
    <enrollment type="Anticipated">70</enrollment>
    <condition>Schizophrenia</condition>
    <condition>Schizophreniform Disorders</condition>
    <condition>Schizoaffective Disorder</condition>
    <condition>Unspecified or Other Psychotic Disorders</condition>
    <arm_group>
      <arm_group_label>FEP Providers</arm_group_label>
      <arm_group_type>No Intervention</arm_group_type>
      <description>Approximately 20 FEP providers (clinicians and peer support specialists) affiliated with first episode psychosis (FEP) clinics in North Carolina (OASIS, SHORE, Encompass, Eagle, AEGIS) will be recruited to share their perspectives of barriers and facilitators in implementing and integrating a digital intervention in clinical practice. They will be asked to complete a survey examining their perspective and beliefs at three time points (baseline, 6 months, and 12 months) as well as a qualitative interview based on the Consolidated Framework for Implementation Science at 12 months.</description>
    </arm_group>
    <arm_group>
      <arm_group_label>FEP Clients</arm_group_label>
      <arm_group_type>Experimental</arm_group_type>
      <description>Approximately 50 individuals experiencing FEP and receiving services from FEP clinics (OASIS, SHORE, Encompass, Eagle, AEGIS) or their step down care clinics (STEP and TIDES) will be recruited to participate in a digital platform, Horyzons, for 12 months as part of their clinical care. Participants will have access to and encouraged to use the therapeutic content as well as the moderated online community network during their time engaging with the platform. They will be asked to complete a small battery of measures at baseline, 6-months, 12 months, and 3 month follow-up.</description>
    </arm_group>
    <intervention>
      <intervention_type>Device</intervention_type>
      <intervention_name>Horyzons USA</intervention_name>
      <description>Client participants will be onboarded to the digital platform, including the different spaces and how to use the site. The site includes therapeutic content that is tailored to each individual and their current needs and experiences, including social anxiety, generalized anxiety, mood, and social functioning, and distress intolerance. Further, the platform includes a moderated social media function, where individuals and peer support specialists can post text, images, videos, and comments to connect and share their experiences. The site is monitored by graduated students and trained clinicians.</description>
      <arm_group_label>FEP Clients</arm_group_label>
    </intervention>
    <eligibility>
      <criteria>
        <textblock>
          CLIENT PARTICIPANTS&#xD;
  &#xD;
          Inclusion Criteria:&#xD;
  &#xD;
            -  Clients must be between the ages of 16 and 35&#xD;
  &#xD;
            -  Clients must have a diagnosis of schizophrenia, schizoaffective disorder,&#xD;
               schizophreniform disorder, or Unspecified Schizophrenia Spectrum or Other Psychotic&#xD;
               disorder&#xD;
  &#xD;
            -  Clients must be receiving services at one of the five FEP clinics in North Carolina&#xD;
               (OASIS, Encompass, Eagle, SHORE, or AEGIS) or one of their stepdown outpatient clinics&#xD;
               (STEP and TIDES)&#xD;
  &#xD;
            -  Clients must not have had thoughts of harming themselves in the month before&#xD;
               enrollment&#xD;
  &#xD;
            -  Clients must not have been hospitalized for psychiatric reasons in the three months&#xD;
               before enrollment&#xD;
  &#xD;
            -  Clients must actively be engaging with medication management through their clinic&#xD;
  &#xD;
            -  Clients must have access to the internet through a phone, tablet, or computer&#xD;
  &#xD;
          Exclusion Criteria:&#xD;
  &#xD;
            -  Clients who do not speak English will not be considered for enrollment&#xD;
  &#xD;
            -  Clients with legal guardians (LARs) will not be considered for the study&#xD;
  &#xD;
          PROVIDER PARTICIPANTS&#xD;
  &#xD;
          Inclusion Criteria:&#xD;
  &#xD;
            -  Provider &amp;/or PSS must be 18 years or older&#xD;
  &#xD;
            -  Provider &amp;/or PSS must be currently serving clients within their FEP clinic&#xD;
  &#xD;
            -  Provider &amp;/or PSS must be able to speak and read English&#xD;
  &#xD;
          Exclusion Criteria:&#xD;
  &#xD;
            -  Provider &amp;/or PSS under the age of 18&#xD;
  &#xD;
            -  Provider &amp;/or PSS not currently serving clients in their FEP clinic&#xD;
  &#xD;
            -  Provider &amp;/or PSS not able to speak or understand English&#xD;
        </textblock>
      </criteria>
      <gender>All</gender>
      <minimum_age>16 Years</minimum_age>
      <maximum_age>35 Years</maximum_age>
      <healthy_volunteers>No</healthy_volunteers>
    </eligibility>
    <overall_official>
      <last_name>David Penn, PhD</last_name>
      <role>Principal Investigator</role>
      <affiliation>University of North Carolina, Chapel Hill</affiliation>
    </overall_official>
    <overall_official>
      <last_name>Diana Perkins, MD, MPH</last_name>
      <role>Principal Investigator</role>
      <affiliation>Univeristy of North Carolina, School of Medicine</affiliation>
    </overall_official>
    <overall_official>
      <last_name>Felice Reddy, PhD</last_name>
      <role>Principal Investigator</role>
      <affiliation>University of North Carolina, Chapel Hill</affiliation>
    </overall_official>
    <overall_contact>
      <last_name>Elizabeth R Fraser, MS</last_name>
      <phone>208-967-3976</phone>
      <email>erfraser@unc.edu</email>
    </overall_contact>
    <location>
      <facility>
        <name>University of North Carolina at Chapel Hill</name>
        <address>
          <city>Chapel Hill</city>
          <state>North Carolina</state>
          <zip>27599</zip>
          <country>United States</country>
        </address>
      </facility>
      <contact>
        <last_name>Elizabeth R Fraser, MS</last_name>
        <phone>208-967-3976</phone>
        <email>erfraser@unc.edu</email>
      </contact>
    </location>
    <location_countries>
      <country>United States</country>
    </location_countries>
    <verification_date>August 2023</verification_date>
    <study_first_submitted>August 14, 2023</study_first_submitted>
    <study_first_submitted_qc>August 14, 2023</study_first_submitted_qc>
    <study_first_posted type="Actual">August 21, 2023</study_first_posted>
    <last_update_submitted>August 14, 2023</last_update_submitted>
    <last_update_submitted_qc>August 14, 2023</last_update_submitted_qc>
    <last_update_posted type="Actual">August 21, 2023</last_update_posted>
    <responsible_party>
      <responsible_party_type>Sponsor</responsible_party_type>
    </responsible_party>
    <keyword>Digital Intervention</keyword>
    <keyword>Social Media</keyword>
    <keyword>Virtual Therapeutic Content</keyword>
    <keyword>First Episode Psychosis</keyword>
    <keyword>Implementation</keyword>
    <condition_browse>
      <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
      <mesh_term>Schizophrenia</mesh_term>
      <mesh_term>Psychotic Disorders</mesh_term>
    </condition_browse>
    <patient_data>
      <sharing_ipd>Yes</sharing_ipd>
      <ipd_description>Deidentified individual data that supports the results will be shared beginning 9 to 36 months following publication and provided the investigator who proposes to use the data has approval from an Institutional Review Board (IRB), Independent Ethics Committee (IEC), or Research Ethics Board (REB), as applicable, and executes a data use/sharing agreement with UNC.</ipd_description>
      <ipd_info_type>Study Protocol</ipd_info_type>
      <ipd_info_type>Statistical Analysis Plan (SAP)</ipd_info_type>
      <ipd_info_type>Informed Consent Form (ICF)</ipd_info_type>
      <ipd_time_frame>beginning 9 and continuing for 36 months following publication</ipd_time_frame>
      <ipd_access_criteria>Requesting investigator has appropriate approval (see above) and an executed data use/sharing agreement with UNC.</ipd_access_criteria>
    </patient_data>
    <!-- Results have not yet been posted for this study                                          -->
  </clinical_study>
  
  
text: download date: ClinicalTrials.gov processed this data on September 20, 2023
  link text: Link to the current ClinicalTrials.gov record.
  url: https://clinicaltrials.gov/ct2/show/NCT06002958
  org study id: 23-0672
  nct id: NCT06002958
  lead sponsor: 
  collaborator: 
  has dmc: No
  is fda regulated drug: No
  is fda regulated device: Yes
  is unapproved device: Yes
  is us export: No
  The primary aim of this trial is evaluating the barriers and enablers of implementing a
        digital intervention with both therapeutic content and social networking, Horyzons, as part
        of clinical care in first episode psychosis (FEP) clinics in North Carolina. Providers
        (clinicians and peers support specialists) will be recruited from FEP clinics to assess
        Horyzons implementation and integration within clinical care at three time points (baseline,
        6 months, and 12 months). Further, individuals experiencing FEP between the ages of 16 and 35
        receiving services from the FEP clinics will be recruited to engage with the platform over
        the course of 12 months. Due to the nature of the digital intervention being implemented
        across the state of North Carolina, all research visits will be conducted remotely via
        videoconferencing.
  Purpose: The primary objective is to assess the barriers and facilitators of integrating
        Horyzons, an evidence-based digital intervention, in outpatient mental health clinics in
        North Carolina that provide care to individuals with schizophrenia spectrum and other
        unspecified psychotic disorders. The primary aim is to evaluate and identify the unique
        barriers and facilitators in implementing Horyzons at each first episode psychosis (FEP)
        clinic as part of standard care and distinct implementation strategies. The secondary and
        tertiary aims are to evaluate client engagement with Horyzons and attrition as part of
        clinical care and assess the change in clients' psychological measures across in addition to
        their use of state-funded services (e.g., emergency department and social services) across
        the 12-month intervention.
  
        Participants: To assess the first aim, the investigators will recruit 20 clinicians and/or
        peer specialists from the FEP clinics. To assess the first and second aim, the investigators
        will recruit 50 individuals with FEP (i.e., first episode of a schizophrenia spectrum and
        other unspecified psychotic disorders).
  
        Procedures (methods): Service provider participants will be recruited over a 4-6 week period
        at their respective clinics. They will be asked to complete an adapted measure, the Cancer
        Prevention and Control Research Network (CPCRN) Federally Qualified Health Center (FQHC)
        Survey, assessing clinical readiness, leadership, acceptance, adoption, and perspective on
        evidence-based practices. Service providers will then participate in implementing and
        integrating Horyzons within clinical practice including preferred implementation strategy
        that is distinct for each clinic (e.g., Horyzons training, access to the platform by
        clinicians, ongoing technical support, attendance and update at monthly team meetings, etc.).
        Service providers will meet with research staff at approximately the 6-month timepoint (+/- 4
        weeks) to complete the CPCRN FQHC Survey then upon completion of the effectiveness trial with
        clients, service providers will complete this measure once again in addition to participating
        in a qualitative interview based on the Consolidated Framework for Implementation Research
        (CFIR) around their experience with integrating the platform and identification of barriers
        and facilitators to Horyzons' implementation. Service providers will be compensated for the
        completion feedback, including the questionnaire and qualitative interviews.
  
        Client participants will be recruited over a 16- to 20-week period at their respective
        clinic. Participants will participate in a baseline visit to provide informed consent and
        complete a brief battery of measures (Demographics and Characteristics, University of
        California, Los Angeles (UCLA) Loneliness Scale, MOS Social Supports Survey). Participants
        will then meet with a research assistant, peer support specialist, or clinician to be given
        guidance and instruction for using the site (i.e., Horyzons onboarding). Clients will then
        engage in the platform, where site usage information as well as experience will be collected
        from participants through the Horyzons platform. Site usage (e.g., number of posts/comments
        made on the online platform, number and type of 'Journeys' or 'Tracks', self-guided
        therapeutic content, completed during time on the platform) will automatically be collected
        via the platform. Participants will have access and engage in this platform for approximately
        12 months, depending on when recruited into trial. During this 12 month engagement period
        with the platform, client participants will meet with research staff at their midway point to
        complete the brief battery of measures assessing loneliness and social support and feedback
        on Horyzons. Upon completion of their engagement with the platform, client participants will
        additionally participate two additional research visits to complete the battery of measures
        at 12-months and at a 3-month follow-up. research visits to complete the battery of measures
        at 12-months and at a 3-month follow-up. As Horyzons involves therapeutic content and is
        designed to improve psychological outcomes, such as loneliness and social support, this
        platform is considered part of clinical care provided to individuals by their respective
        clinic. For this reason, participants will not be compensated for their usage and engagement
        with the platform, but rather, they will receive compensation for completion of assessment
        batteries at baseline, midway, final, and follow-up research study visits.
  
        Horyzons will be monitored daily (two hours per weekday and one hour per weekend day) by
        trained peer support specialists, master's level clinicians, and/or graduate students with
        relevant clinical/research experience with individuals with psychosis. Drs. David Penn and
        Kelsey Ludwig, who are clinical psychologists, lead weekly supervision calls to ensure
        appropriate care and support of clients involved in the trial, to discuss case
        conceptualization and suggestions for engaging clients in the platform.
  allocation: Non-Randomized
  intervention model: Parallel Assignment
  primary purpose: Treatment
  masking: None (Open Label)
  measure: Qualitative Summaries of Provider and Peer support specialists (PSSs) Participant Feedback in Post-Treatment Interview
  time frame: Up to 12 months
  description: This qualitative data will be collected post-treatment from providers and PSSs. Individual interviews will discuss the utility and usage of Horyzons within their clinical care in addition to barriers and facilitators on numerous levels (individual, inner setting, and outer setting) of its implementation within their clinic. Feedback will be analyzed using grounded theory and summarized to include common themes regarding implementation, barriers, and enablers within the clinical setting and ideas for future implementation.
  measure: Quantitative Summaries of Provider and PSS Participant Experience in Post-Treatment Feedback
  time frame: Up to 12 months
  description: This quantitative data will be collected pre-, mid-, and post-intervention from providers and PSSs. Feedback forms will prompt providers to answer questions regarding their experience and perspectives with barriers and facilitators in implementing an evidence-based practice (in this case Horyzons) in various settings (outer, inner, and individual). The survey will be analyzed regarding changes or lack thereof in the various settings and climate.
  measure: Change in Engagement with the Horyzons Platform and Attrition over time
  time frame: Baseline, up to Month 12
  description: Changes in engagement with Horyzons will be passively collected for client participants via the platform. Data evaluated will include number of logins, number of journeys, tracks, and activities completed, and number engagements on the community page.
  measure: Change in use of emergency and social services
  time frame: Baseline, Month 12 following intervention completion, a total of up to 24 months
  description: Collection of use of emergency and social services one year pre-initiation and one year post-initiation of the Horyzons intervention will be assessed using medical records to determine change in use of such services.
  measure: Mean Change in UCLA Loneliness Scale Score
  time frame: Up to 15 months
  description: The UCLA Loneliness scale is a 20-item scale. Answers are on a 4-point scale with options "I often feel this way," "I sometimes feel this way," "I rarely feel this way," and "I never feel this way." Possible scores range from 20 to 80. Higher scores reflect worse outcomes (greater feelings of loneliness). The UCLA Loneliness Scale is a part of the PhenX Toolkit.
  measure: Mean Change in Medical Outcomes Study (MOS) Social Support Survey - total score
  time frame: Up to 15 months
  description: The MOS Social Support Survey is a 19-item scale. Answers are on a 5-point scale with options "none of the time", "a little of the time", "some of the time", "most of the time", and "all of the time". Possible scores range from 19 to 95. Higher scores reflect higher feelings of social support (more perceived social support). The MOS Social Support Survey is a part of the PhenX Toolkit.
  measure: Quantitative Summaries of Participant Experience in Post-Treatment Feedback
  time frame: Up to 15 months
  description: This quantitative data will be collected post-treatment from clients and clinicians. Feedback forms will prompt participants to answer questions regarding their experience with the platform on a scale of 1 to 5, with higher scores reflecting a more positive experience. Frequency counts will be included here.
  arm group label: FEP Providers
  arm group type: No Intervention
  description: Approximately 20 FEP providers (clinicians and peer support specialists) affiliated with first episode psychosis (FEP) clinics in North Carolina (OASIS, SHORE, Encompass, Eagle, AEGIS) will be recruited to share their perspectives of barriers and facilitators in implementing and integrating a digital intervention in clinical practice. They will be asked to complete a survey examining their perspective and beliefs at three time points (baseline, 6 months, and 12 months) as well as a qualitative interview based on the Consolidated Framework for Implementation Science at 12 months.
  arm group label: FEP Clients
  arm group type: Experimental
  description: Approximately 50 individuals experiencing FEP and receiving services from FEP clinics (OASIS, SHORE, Encompass, Eagle, AEGIS) or their step down care clinics (STEP and TIDES) will be recruited to participate in a digital platform, Horyzons, for 12 months as part of their clinical care. Participants will have access to and encouraged to use the therapeutic content as well as the moderated online community network during their time engaging with the platform. They will be asked to complete a small battery of measures at baseline, 6-months, 12 months, and 3 month follow-up.
  intervention type: Device
  intervention name: Horyzons USA
  description: Client participants will be onboarded to the digital platform, including the different spaces and how to use the site. The site includes therapeutic content that is tailored to each individual and their current needs and experiences, including social anxiety, generalized anxiety, mood, and social functioning, and distress intolerance. Further, the platform includes a moderated social media function, where individuals and peer support specialists can post text, images, videos, and comments to connect and share their experiences. The site is monitored by graduated students and trained clinicians.
  arm group label: FEP Clients
  criteria: 
  gender: All
  minimum age: 16 Years
  maximum age: 35 Years
  healthy volunteers: No
  last name: David Penn, PhD
  role: Principal Investigator
  affiliation: University of North Carolina, Chapel Hill
  last name: Diana Perkins, MD, MPH
  role: Principal Investigator
  affiliation: Univeristy of North Carolina, School of Medicine
  last name: Felice Reddy, PhD
  role: Principal Investigator
  affiliation: University of North Carolina, Chapel Hill
  last name: Elizabeth R Fraser, MS
  phone: 208-967-3976
  email: erfraser@unc.edu
  facility: 
  contact: 
  country: United States
  responsible party type: Sponsor
  mesh term: Schizophrenia
  mesh term: Psychotic Disorders
  sharing ipd: Yes
  ipd description: Deidentified individual data that supports the results will be shared beginning 9 to 36 months following publication and provided the investigator who proposes to use the data has approval from an Institutional Review Board (IRB), Independent Ethics Committee (IEC), or Research Ethics Board (REB), as applicable, and executes a data use/sharing agreement with UNC.
  ipd info type: Study Protocol
  ipd info type: Statistical Analysis Plan (SAP)
  ipd info type: Informed Consent Form (ICF)
  ipd time frame: beginning 9 and continuing for 36 months following publication
  ipd access criteria: Requesting investigator has appropriate approval (see above) and an executed data use/sharing agreement with UNC.