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Randomized Controlled Trial
. 2024 Apr 30;50(3):705-716.
doi: 10.1093/schbul/sbae018.

Examining the Effectiveness of a Digital Media Campaign at Reducing the Duration of Untreated Psychosis in New York State: Results From a Stepped-wedge Randomized Controlled Trial

Michael L Birnbaum  1   2   3 , Chantel Garrett  4 , Amit Baumel  5 , Nicole T Germano  1 , Danny Sosa  1 , Hong Ngo  6 , Majnu John  1   2 , Lisa Dixon  6 , John M Kane  1   2   3
Affiliations
Randomized Controlled Trial

Examining the Effectiveness of a Digital Media Campaign at Reducing the Duration of Untreated Psychosis in New York State: Results From a Stepped-wedge Randomized Controlled Trial

Michael L Birnbaum et al. Schizophr Bull. .

Abstract

Background and hypothesis: Longer duration of untreated psychosis (DUP) predicts worse outcomes in First Episode Psychosis (FEP). Searching online represents one of the first proactive step toward treatment initiation for many, yet few studies have informed how best to support FEP youth as they engage in early online help-seeking steps to care.

Study design: Using a stepped-wedge randomized design, this project evaluated the effectiveness of a digital marketing campaign at reducing DUP and raising rates of referrals to FEP services by proactively targeting and engaging prospective patients and their adult allies online.

Study results: Throughout the 18-month campaign, 41 372 individuals visited our website, and 371 advanced to remote clinical assessment (median age = 24.4), including 53 allies and 318 youth. Among those assessed (n = 371), 53 individuals (14.3%) reported symptoms consistent with psychotic spectrum disorders (62.2% female, mean age 20.7 years) including 39 (10.5%) reporting symptoms consistent with either Clinical High Risk (ie, attenuated psychotic symptoms; n = 26) or FEP (n = 13). Among those with either suspected CHR or FEP (n = 39), 20 (51.3%) successfully connected with care. The campaign did not result in significant differences in DUP.

Conclusion: This study highlights the potential to leverage digital media to help identify and engage youth with early psychosis online. However, despite its potential, online education and professional support alone are not yet sufficient to expedite treatment initiation and reduce DUP.

Keywords: clinical high risk; digital media; duration of untreated psychosis; early psychosis; first episode psychosis; internet; online services.

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Conflict of interest statement

Dr Birnbaum is a consultant for NorthShore Therapeutics. Dr Kane holds shares with Vanguard Research Group (private), LB Pharmaceuticals, Inc. (private), North Shore Therapeutics (private), Cerevel (public), HealthRhythms (private), Karuna (public), Sage (public), and Talkspace (public). He receives Honoraria and is on the advisory boards of Alkermes, Allergan, Boehringer-Ingelheim, Cerevel, Click Therapeutics, Dainippon Sumitomo, H. Lundbeck, HealthRhythms, HLS, Indivior, Intracellular Therapies, Janssen Pharmaceutical, Johnson & Johnson, Karuna, LB Pharmaceuticals, Merck, Minerva, Neurocrine, Newron, Novartis, NW PharmaTech, Otsuka, Roche, Saladax, Sunovion, and Teva. Mrs Garrett serves as a project consultant for the New York State Psychiatric Institute.

Declaration of Generative AI and AI-assisted technologies in the writing process: None.

Figures

Fig. 1.
Fig. 1.
Overview of the NYWell intervention.
Fig. 2.
Fig. 2.
Stepped-wedge approach.
Fig. 3.
Fig. 3.
Referral pathways for participants reporting psychotic symptoms.
See this image and copyright information in PMC

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