Last updated on October 2018

Recovery Roadmap Phase II Small Business Innovation Research Grant


Brief description of study

Recovery Roadmap: A Collaborative Multimedia Tool for Person-Centered Recovery Planning is a highly interactive web-based tool that provides guidance for providers and people in recovery, and promotes widespread implementation of Person-Centered Recovery Planning (PCRP). The Recovery Roadmap prototype was developed and tested by the Center for Social Innovation (C4), in partnership with Yale University's Program for Recovery and Community Health (PRCH), under a Phase I Small Business Innovative Research (SBIR) grant funded by the National Institute of Mental Health (NIMH) (1R43MH100712). Phase II will refine the prototype Roadmap to streamline content, provide additional handouts and exercises for providers and clients to complete together, expand the audio/video vignettes and case studies, and add interactive online coaching and support for providers. Phase II also involves a robust evaluation of the Roadmap, using a quasi-experimental design in a fully powered trial. Approximately 26 community-based mental health programs will be randomized into Recovery Roadmap (RR) or Illness Management and Recovery (IMR) conditions [in New York study sites, this practice is referred to as Wellness Self-Management (WSM)]. Participants will include both providers and clients, and data will include one pre-test and three post-tests with providers and clients, interviews with providers and administrators, network analytics, and administrative client data. This phase will culminate with the dissemination of findings and preparation for Phase III commercialization.

Detailed Study Description

Person-Centered Recovery Planning (PCRP; also referred to as Patient-Centered Care Planning) is a field-tested intervention designed to maximize consumer choice and ownership of the treatment and recovery process. In Phase I of Recovery Roadmap: A Collaborative Multimedia Tool for Person-Centered Recovery Planning, the research team developed a prototype online tool to train providers and persons in recovery to understand and implement PCRP. The tool provided in-depth information and included interactive components (e.g., videos, fillable forms, case studies) to prepare users to partner effectively. The tool was pilot tested in two sites (one received the Recovery Roadmap only; the other received the tool plus a two-day in-person training) to obtain feedback about the Roadmap and determine its impact. The purpose of this Phase II SBIR study is to expand the Recovery Roadmap and conduct a fully powered study to determine the tool's effectiveness in training providers and supporting people in recovery in the PCRP process.

This Phase II study has three specific aims:

Aim 1: Expand the development of the Recovery Roadmap tool. During Phase II, the research team will refine the Roadmap to improve user experience (e.g., include additional videos, case studies. and interactive features; add audio; make changes to how content is presented). In addition, an online coaching component will be added for providers.

Aim 2: Evaluate Roadmap using a quasi-experimental design. Phase II of this study will include a fully powered trial. Investigators will recruit from approximately 26 programs within large community mental health organizations from the state of New York. To control for the internal validity threat of contamination (providers often share clients and resources), programs will be randomized into one of two conditions: 1) Recovery Roadmap, or 2) Illness Management and Recovery (IMR) conditions. IMR is an evidence-based practice that promotes skill development and goal-setting and is implemented regularly in the northeastern U.S., making it an informative comparator.

A total of 230 providers will be recruited (RR n=115; IMR n=115), for a target of 200, oversampling due to attrition. Each provider will recruit two clients to participate (RR n=230; IMR n=230), for a target of 400 total, oversampling due to attrition. Investigators will use mixed methods to assess provider knowledge, behaviors, and relationships related to PCRP via surveys, standardized instruments, interviews, and a Social Network Analysis. Client PCRP knowledge, recovery outcomes, treatment engagement, and provider/client relationship will be assessed via surveys, standardized instruments, and client administrative data. Investigators will also conduct administrator interviews.

Aim 3: Disseminate findings and prepare for commercialization. Findings will be disseminated through conference presentations, peer-reviewed journal articles, and issue briefs. The research team will also lay the groundwork for Phase III by developing a plan to distribute the Recovery Roadmap through C4's online learning platform, t3, which has a large national and international audience and has developed the technology and staffing infrastructure to support the use of this tool.

Hypotheses (for Aims 1 and 2):

H1: Providers in the RR condition will show statistically significant improvements in PCRP knowledge, skills, and provider-client relationships, compared to those in the Illness Management and Recovery (IMR) condition.

H2: Clients served by providers in the RR condition will show statistically significant improvements in treatment engagement and progress toward goals, compared to those served by providers in the IMR condition.

H3: Providers with higher levels of connectivity with their peers online will report sustained PCRP practices, compared with those with lower connectivity.

Clinical Study Identifier: NCT02707367

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