@article{pmid42418951,

title = {An appraisal of practice guidelines for early intervention services for psychosis: Using AGREE II (Appraisal of Guidelines for Research and Evaluation) to enhance the quality and trustworthiness of guidelines in the future},

author = {Manuela Ferrari and Nicole Pawliuk and Jai Shah and Amal Abdel-Baki and Phil Tibbo and Donald Addington and Marc-André Roy and Ridha Joober and Kevin MacDonald and Srividya N Iyer},

doi = {10.1016/j.schres.2026.06.005},

issn = {1573-2509},

year  = {2026},

date = {2026-07-01},

journal = {Schizophr Res},

volume = {295},

pages = {282--291},

abstract = {BACKGROUND: Early intervention services (EIS) for psychosis have expanded internationally. Yet, the quality of the guidelines to support and monitor them has never been evaluated. We therefore aimed to systematically appraise the quality of EIS guidelines.nnSTUDY DESIGN: We conducted a systematic review of grey literature websites, supplemented by guidelines identified in a prior scoping review. Eligible documents were guidelines focused on/with a section on early intervention or first episode psychosis. Two independent reviewers appraised each guideline using the Appraisal of Guidelines for Research and Evaluation (AGREE II).nnSTUDY RESULTS: Thirty-two guidelines were included. Guidelines varied widely on scores for the AGREE II domains. Many scored high (≥70%) on Scope and Purpose (24/32; 75%) and Clarity of Presentation (22/32; 69%). Only 22% (7/32) scored well on Rigour of Development, primarily due to the lack of methods for evidence identification and appraisal. The lowest scoring domain was Applicability; only two guidelines scored ≥70%, while more than half provided no information on barriers or facilitators to implementation. Stakeholder involvement, especially from service users, was limited in developing EIS-specific guidelines. Guidelines performing consistently well were from large guideline development groups and used established evidence-grading methods.nnCONCLUSIONS: This first systematic appraisal shows that while many EIS guidelines clearly articulate aims and recommendations, substantial methodological and implementation gaps remain. Nonetheless, EIS guidelines score like others in psychiatry. Still, limited stakeholder engagement and applicability may impede consistent, evidence-based EIS delivery. Future guidelines should explicitly describe evidence-based review processes, integrate service user input, and use AGREE II-like tools to enhance their usability and impact.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid42054343,

title = {The Readability of Patient-Reported Measures in Early Psychosis},

author = {Maria Abou Farhat and Negin Zamani and Simran Bajaj and Nicole Pawliuk and Navdeep Kaur and Jai Shah and Manuela Ferrari and Srividya N Iyer},

doi = {10.1093/schbul/sbag018},

issn = {1745-1701},

year  = {2026},

date = {2026-04-01},

journal = {Schizophr Bull},

volume = {52},

number = {3},

abstract = {BACKGROUND: Patient-reported measures are increasingly central to early intervention in psychosis. Many persons with psychosis have lower educational attainment than the general population and cognitive difficulties, making the readability of measures salient for this population. However, the readability of patient-reported measures in psychosis has never been investigated. This study assessed the readability levels of patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs) in early intervention in psychosis.nnSTUDY DESIGN: PROMs and PREMs were identified from a scoping review of measures used in early intervention services for psychosis (January 2000-January 2024). Of 111 measures identified, 104 (89 PROMs; 15 PREMs) were assessed using mean grade levels derived from 3 established readability formulas (Flesch-Kincaid Grade Level, Simple Measure of Gobbledygook index, FORCAST formula), applied to instructions, items, and total scales.nnSTUDY RESULTS: Overall, 82.7% of patient-reported measures exceeded the recommended 6th-grade reading level. Instructions were harder to read than items (mean readability: 9.44 vs. 7.95; t(90) = 6.54, P < .001). PREMs demanded higher readability levels than PROMs. Readability scores were different across formulas, with Flesch-Kincaid consistently producing lower scores. Except for one, the strikingly few measures co-developed with patients (n = 14) also exceeded 6th-grade reading level.nnCONCLUSIONS: Most patient-reported measures in early psychosis exceed recommended readability levels, raising concerns about accessibility, validity, and whose experiences are represented in patient-reported data. This creates impetus for integrating readability assessments into measures development. More fundamentally, centering the participation of persons with lived experience can support readable, relevant, and patient-centered assessments reflecting the language, priorities, and realities of people with psychosis, and advance epistemic justice.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid41667176,

title = {Rapid realist review of organisational supports for youth peer support workers},

author = {Julia Hews-Girard and Tanya Halsall and Emma Cullen and Amanda Bellefeuille and Mardi Daley and Charlotte Evans and Vanessa Sandoval and Allison Dunning and Jayden Lee and Brittany Carde and Jennifer Couturier and Manuela Ferrari and Melissa Kimber and Scott B Patten and Srividya Iyer and Gina Dimitropoulos},

doi = {10.1136/bmjopen-2025-111837},

issn = {2044-6055},

year  = {2026},

date = {2026-02-01},

journal = {BMJ Open},

volume = {16},

number = {2},

pages = {e111837},

abstract = {OBJECTIVES: Providing peer support can benefit youth peer support workers (peers)et by supporting self-determination, recovery and resilience to self-stigma. There is a need to clarify the role of the organisation in providing benefits for peers. We aimed to identify the organisational contexts and mechanisms that result in the creation of healthy workplaces for peers.nnDESIGN: Rapid realist review guided by the Realist and Meta-Narrative Evidence Syntheses-Evolving Standards guidelines and Pawson's iterative approach.nnDATA SOURCES: MEDLINE, CINAHL, PsycINFO, ERIC, SocINDEX, Google Scholar and Embase were searched from 1979 to 2025.nnELIGIBILITY CRITERIA: We included qualitative and quantitative peer-reviewed studies and grey literature that captured characteristics of organisational practices and employment considerations in youth peer support programmes.nnDATA EXTRACTION AND SYNTHESIS: Articles were screened independently by multiple reviewers. Inclusion criteria were adjusted to capture literature on organisational practices, and employment considerations for youth peer support programmes. Data were extracted and analysed retroductively to develop Context-Mechanism-Outcome Configurations (CMOCs).nnRESULTS: Five employment-related risks to peer well-being were identified: (1) difficulty entering the job market, (2) lack of role clarity, (3) pressure to live up to ideals, (4) retraumatisation and (5) stigma. Six CMOCs were developed; all focused on the creation of equitable employment and supporting peer development and empowerment were developed.nnCONCLUSIONS: Community-based mental health organisations can facilitate equitable peer employment through strategies that reduce professional stigma, enhance peer resilience and promote professional and personal development. Policy reform that addresses precarious work conditions is needed to support healthy work environments.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid41271418,

title = {Integrating the digital culture of youth in clinical mental health assessments: protocol for the codesign and pilot test of an interview method},

author = {Vincent Paquin and Samantha Aversa and Elizabeth Nickrenz and G Eric Jarvis and Melissa Park and Manuela Ferrari and Jai Shah},

doi = {10.1136/bmjopen-2025-104200},

issn = {2044-6055},

year  = {2025},

date = {2025-11-01},

journal = {BMJ Open},

volume = {15},

number = {11},

pages = {e104200},

abstract = {INTRODUCTION: Digital media practices have varied implications for the mental health of youth, notably as a function of sociocultural and environmental factors. However, there are limited tools available to guide the assessment of digital culture in clinical practice. This study will aim to design and pilot test an interview tool for the assessment of youth digital culture, as a companion to the Cultural Formulation Interview which broadly assesses cultural factors in mental healthcare.nnMETHODS AND ANALYSIS: We will recruit youth aged 16-35 years and receiving mental healthcare in Montreal, Canada, to codesign (n=10) and evaluate (n=20) the interview tool. We will also recruit clinician participants (n=10) to provide feedback on the interview. The tool will be developed with codesign participants using the nominal group technique and subsequently tested with the evaluation participants. We will provide the evaluation participants and clinicians with a written summary of the interview and will assess their perspectives on the feasibility, acceptability and utility of the interview method through surveys and debriefing interviews. We will conduct reflexive thematic analysis of the interview transcripts and descriptive quantitative analyses of the feasibility, acceptability and utility scores.nnETHICS AND DISSEMINATION: The study received ethical approval from the Research Ethics Board of the CIUSSS de l'Ouest-de-l'Île-de-Montréal (MP-18-2025-1164). The results will be interpreted in consultation with codesign participants and will be disseminated through peer-reviewed publications, workshops for clinicians and academic conferences.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid41122899,

title = {Feasibility and acceptability of remote technologies for the treatment of trauma- and stressor-related disorders in adults: mixed-methods systematic review},

author = {Marjolaine Rivest-Beauregard and Justine Fortin and Élyse Gauthier and Michelle Lonergan and Alain Brunet and Manuela Ferrari},

doi = {10.1192/bjo.2025.10832},

issn = {2056-4724},

year  = {2025},

date = {2025-10-01},

journal = {BJPsych Open},

volume = {11},

number = {6},

pages = {e247},

abstract = {BACKGROUND: Trauma- and stressor-related disorders (TSRD) are debilitating mental health conditions. Given the barriers to traditional services, remote and online technologies are increasingly used in treating TSRD.nnAIMS: This mixed-methods systematic review aimed to identify remote technologies and assessed their feasibility and acceptability in treating adults with post-traumatic stress disorder (PTSD), acute stress disorder and adjustment disorder (AjD).nnMETHOD: The databases MEDLINE, CINAHL, Embase, PsycInfo, PubMed and the Cochrane Library were screened to identify studies investigating the feasibility and acceptability of remote interventions for PTSD, acute stress disorder and AjD in adults. Studies that obtained poor-quality ratings on critical appraisal tools were excluded. Results were synthesised using a narrative review approach.nnRESULTS: In total, there were 74 studies evaluating 27 remote interventions for TSRD: online interventions ( = 47, 63.51%), mobile applications ( = 17, 22.97%), video conferencing ( = 9, 12.16%) and message-based systems  = 1, 1.35%). Findings from the review showed higher feasibility and acceptability for interventions with an interactive clinician-patient component. Among self-directed interventions, only two applications and eight online interventions provided a clinician component. Most studies targeted PTSD, with few targeting other diagnoses.nnCONCLUSIONS: Recommendations related to remote interventions for TSRDs should be broadened to include AjD and other underrepresented diagnoses, and tailored to individual patients' profiles, including their ability to sustain engagement and clinical needs, using a stepped-care approach.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid40544541,

title = {Implementation of a digital measurement-based care approach in an early intervention service for psychosis: the PEPP-Montreal electronic data capture protocol and its alignment with learning health system principles},

author = {Elissa Zavaglia and Ridha Joober and Srividya N Iyer and Kevin MacDonald and Martin Lepage and Sherezad Abadi and Jai Shah and Manuela Ferrari},

doi = {10.1016/j.schres.2025.05.021},

issn = {1573-2509},

year  = {2025},

date = {2025-06-01},

journal = {Schizophr Res},

volume = {282},

pages = {141--149},

abstract = {Measurement-based care, crucial for improving outcomes in psychiatric disorders, remains underutilized, particularly during the impactful early treatment phases. Inspired by a learning health system approach, a hybrid paper/electronic data capture platform was developed at PEPP-Montreal, an early psychosis program, gathering data on patient socio-demographics, symptoms, functioning, pathways to care, substance use, and medication monitoring. This article evaluates the year-one deployment of this innovative infrastructure (2022-2023). The novel 2022 hybrid infrastructure was compared with the 2016 paper-based version, using the RE-AIM framework (Reach, Effectiveness, Adoption, Implementation, and Maintenance). Phase 1 identified evidence-based clinical measures including patient-reported, clinician-reported, and evaluator-reported outcomes, while phase 2 further streamlined and implemented the electronic data capture platform. Continuous data collection through the platform was deployed at six time points. Results included: Reach: N = 53/81 patients used paper/electronic data for their year-one service evaluation. Effectiveness: The automated, hybrid paper/electronic protocol optimized data management. Adoption: Rates of electronic patient-reported outcomes were higher in 2022-2023 than 2016-2017 (paper version). Completion rates for clinician-reported outcomes were highest at baseline (year-one). Implementation/maintenance: Barriers and facilitators, essential adaptations, and sustainable impacts were identified. Using electronic, measurement-based data collection accelerates feedback closer to real time and alignment with learning health system principles. Implementing the hybrid data collection platform at PEPP-Montreal provided valuable insights into using measurement-based care to inform quality of services. In the complex transition to a digital protocol within a learning health system, including engagement of key stakeholders, using the hybrid protocol was a necessary first step.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid39983366,

title = {SARPEP, a rapid-learning healthcare system of early intervention services for psychosis in Quebec, Canada: Feasibility, acceptability and early impacts},

author = {Amal Abdel-Baki and Manuela Ferrari and Annie Leblanc and Camille Arbaud and Daniel Rabouin and Marc-André Roy and Srividya N Iyer},

doi = {10.1016/j.schres.2025.02.001},

issn = {1573-2509},

year  = {2025},

date = {2025-03-01},

journal = {Schizophr Res},

volume = {277},

pages = {20--30},

abstract = {INTRODUCTION: Despite growing interest in learning health systems, their application and evaluation in mental health have been scarce. This study aimed to evaluate the feasibility, acceptability and early impacts of SARPEP, a rapid learning healthcare system (RLHS) for early intervention services for psychosis in Quebec, Canada.nnMETHODS: SARPEP comprised technology-supported monitoring of program and patient outcomes, feedback and capacity-building. It involved 11 services (128 professionals, 1700+ patients). We descriptively analyzed quantitative data on the RE-AIM framework (Reach, Effectiveness, Adoption, Implementation, Maintenance) collected in the first two years.nnRESULTS: Reach: Patient and family partners, all programs (clinicians, managers), government representatives and the provincial early psychosis association agreed to co-design and implement all SARPEP components.nnEFFECTIVENESS: Data informed program- and provincial-level decision-making. Some quality indicators (e.g., timely access) improved over time. 80 % of youth were satisfied with services. Adoption: All programs collected data on satisfaction and quality, with data collection improving over time. Eight programs and all stakeholder groups participated in most community-of-practice sessions.nnIMPLEMENTATION: The time required for data collection and providing feedback decreased over time. SARPEP offered rapid, flexible support; tools; and a community of practice that facilitated collecting data, and monitoring and improving practices. Maintenance: All programs remained in SARPEP post study.nnCONCLUSION: Involving all stakeholders, RLHSs can be deployed, adopted, and maintained in mental healthcare and increase the measurement of practices and quality improvement efforts. Strategies are needed to increase the completion of patient-reported measures and to rigorously evaluate the RLHS' effectiveness in improving service quality and outcomes.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid40087675,

title = {Implementing a rapid-learning health system in early intervention services for psychosis: qualitative evaluation of its feasibility and acceptability},

author = {Manuela Ferrari and Marianne-Sarah Saulnier and Srividya N Iyer and Marc-André Roy and Amal Abdel-Baki},

doi = {10.1186/s12961-024-01281-w},

issn = {1478-4505},

year  = {2025},

date = {2025-03-01},

journal = {Health Res Policy Syst},

volume = {23},

number = {1},

pages = {34},

abstract = {BACKGROUND: Heterogeneity in implementing essential evidence-based early intervention for psychosis services (EIS) components persists despite existing fidelity standards/guidelines in many countries. Rapid-learning health systems (RLHS) may remedy these challenges, improving service delivery through systematic data collection, analysis, feedback and capacity-building activities. SARPEP (Système Apprenant Rapide pour les Programmes de Premiers Épisodes Psychotiques) is the first Canadian RLHS for EIS. This paper presents qualitative findings from the mixed-method study that evaluated the feasibility and acceptability of SARPEP.nnMETHODS: We conducted six focus groups on the implementation of SARPEP with 25 participants from all SARPEP stakeholder groups; most were involved from project inception and throughout the 3-year implementation. The Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework (Glasgow, et al., 2019) and Lessard's dimensions for learning health systems guided data collection and deductive analysis.nnRESULTS: Reach: focus group participants reflected SARPEP reach and included all stakeholders involved (six service users, two family members, four psychiatrists, six managers, seven team leaders) who shared their experiences.nnEFFECTIVENESS: participants confirmed that SARPEP improved program capacity for data collection on core indicators and promoted evidence-based practices. Adoption: participants supported the selection of specific indicators and need to improve data-gathering technologies in the RLHS, even while challenges persisted regarding the integration of digital platform use by service users into routine care. Implementation and maintenance: all participants credited the RLHS with enabling mutual learning, self-reflection of programs and shared improvement of practices.nnCONCLUSIONS: SARPEP contributes to promote evidence-based care and a sense of belonging within the Quebec EIS network.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid41127217,

title = {Experiences and socio-environmental contexts in the lead-up to psychosis: a qualitative analysis of the narratives of persons with psychosis from different ethnic, racial and immigrant backgrounds},

author = {Salomé M Xavier and Adrianne Both and Els van der Ven and Manuela Ferrari and Amal Abdel-Baki and Nicole van den Bogerd and Imke Lemmers-Jansen and Srividya N Iyer},

doi = {10.3389/fpsyt.2025.1602468},

issn = {1664-0640},

year  = {2025},

date = {2025-01-01},

journal = {Front Psychiatry},

volume = {16},

pages = {1602468},

abstract = {INTRODUCTION: Previous research, predominantly quantitative, has attributed the excess risk for psychosis among immigrants and ethnic minorities to social adversity, discrimination and structural inequities. Although calls have acknowledged their potential for yielding nuanced insights, qualitative methods focused on first-person narratives have not been used in research into the social determinants of the development of psychosis.nnMETHODS: We explored the experiences and socio-environmental contexts of individuals with psychosis from diverse ethno-racial and immigrant backgrounds. We also gathered their perspectives on the causality of psychosis. We conducted in-depth interviews with 24 participants at early intervention services for psychosis in Montreal, Canada.nnRESULTS: Through thematic analysis, we identified five themes: "Spaces and societies of oppression"; "Nothing to hold on to"; "Mistreated, invisible or seen in the wrong light"; "Places of freedom, connection and safety"; and "Healing and well-being". Spaces described as oppressive fomented experiences of precarity, isolation and mistreatment. Spaces of freedom, connection and inclusivity enabled healing and well-being. Experiences of precarity, mistreatment and exclusion were more frequent for minoritized individuals. Participants attributed psychosis to multiple factors, many pertaining to social contexts.nnDISCUSSION: Our findings shed light on the processes through which social contexts shape the lives and illness development of individuals from diverse backgrounds. By framing them within particular life stories and places, we gain a fuller, more fine-grained understanding of the social-structural determinants that have been identified in quantitative studies. Our work highlights the need to attend closely to patients' social contexts and narratives and advocate for inclusivity, equity, and connection at the societal level.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid39773678,

title = {Promoting Digital Health Data Literacy: The Datum Project},

author = {Daniel Powell and Laiba Asad and Elissa Zavaglia and Manuela Ferrari},

doi = {10.2196/60832},

issn = {2561-326X},

year  = {2025},

date = {2025-01-01},

journal = {JMIR Form Res},

volume = {9},

pages = {e60832},

abstract = {With the increased use of digital health innovations in Canadian health care, educating health care users, professionals, and researchers on the ethical challenges and privacy implications of these tools is essential. The Datum project, funded by the Fondation Barreau du Quebec, was created to help these actors better understand legal and ethical issues regarding the collection, use, and disclosure of digital health data for the purposes of scientific research, thereby enhancing literacy around data privacy. The project consists of a multimedia website divided into legislation and policy documents and narrative-based video content. Users can access the core legislation and policies governing the collection and use of health care data geared toward researchers and health practitioners. Users can also view the narrative-based video content explaining key concepts related to digital health data. The Datum project makes an original contribution to the field of law and ethics in health science research by using novel approaches, such as learning health systems and data banks, to improve equity in health care delivery and by generating multimedia content aimed at encouraging health care users to become better consumers and supporting the collective use of their data. The Datum project also promotes digital literacy as a digital communication tool, which has the significant potential to improve health outcomes, bridge the digital divide, and reduce health inequities.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid39083788,

title = {Examining the experiences of student peer support workers delivering care within post-secondary institutions},

author = {Gina Dimitropoulos and Emma Cullen and Julia C Hews-Girard and Scott B Patten and Pauline MacPherson and Jai Shah and Kevin Friese and Kevin Wiens and Bonny Lipton-Bos and Helen Vallianatos and Andrew C H Szeto and Manuela Ferrari and Srividya Iyer},

doi = {10.1080/07448481.2024.2378291},

issn = {1940-3208},

year  = {2024},

date = {2024-07-01},

journal = {J Am Coll Health},

pages = {1--10},

abstract = { Despite experiencing exacerbation of mental health issues, post-secondary students may not seek help due to perceived stigma, overreliance on the self, or preference for nonprofessional supports - including peer support. This study aimed to understand peer support workers' (PSWs) perspectives regarding providing support for mental health concerns in post-secondary institutions.  41 PSWs were recruited from two post-secondary institutions. 17 semi-structured interviews and three focus groups were conducted. Themes were identified using a qualitative descriptive approach.  Three themes emerged: (1) diverse presentations and approaches to operationalizing peer support for mental health issues on campus exist; (2) peer support has core ingredients; (3) reasons why students access peer support extend beyond mental health crisis.  An inclusive peer support approach to mental health is needed for post-secondary students. Considerations for implementation hinge on providing standardized, foundational training to prepare PSWs for the complex mental health issues that present across services.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid38598210,

title = {Trajectories of Adolescent Media Use and Their Associations With Psychotic Experiences},

author = {Vincent Paquin and Manuela Ferrari and Soham Rej and Michel Boivin and Isabelle Ouellet-Morin and Marie-Claude Geoffroy and Jai L Shah},

doi = {10.1001/jamapsychiatry.2024.0384},

issn = {2168-6238},

year  = {2024},

date = {2024-07-01},

journal = {JAMA Psychiatry},

volume = {81},

number = {7},

pages = {708--716},

abstract = {IMPORTANCE: Adolescent media use is thought to influence mental health, but whether it is associated with psychotic experiences (PEs) is unclear.nnOBJECTIVE: To examine longitudinal trajectories of adolescent media use and their associations with PEs at 23 years of age.nnDESIGN, SETTING, AND PARTICIPANTS: This cohort study included participants from the Québec Longitudinal Study of Child Development (1998-2021): children who were born in Québec, Canada, and followed up annually or biennially from ages 5 months through 23 years. Data were analyzed between January 2023 and January 2024.nnEXPOSURES: Participants reported their weekly amount of television viewing, video gaming, computer use, and reading at ages 12, 13, 15, and 17 years.nnMAIN OUTCOME AND MEASURES: Lifetime occurrence of PEs was measured at 23 years of age. Covariables included sociodemographic, genetic, family, and childhood characteristics between ages 5 months and 12 years.nnRESULTS: A total of 1226 participants were included in the analyses (713 [58.2%] female, 513 [41.8%] male). For each media type, latent class mixed modeling identified 3 group-based trajectories, with subgroups following trajectories of higher use: television viewing, 128 (10.4%); video gaming, 145 (11.8%); computer use, 353 (28.8%); and reading, 140 (11.4%). Relative to lower video gaming, higher video gaming was preceded by higher levels of mental health and interpersonal problems at age 12 years. Adjusting for these risk factors mitigated the association between higher video gaming and PEs at age 23 years. The curved trajectory of computer use (189 [15.4%] participants), characterized by increasing levels of use until age 15 years followed by a decrease, was associated with higher PEs (estimated difference, +5.3%; 95% CI, +1.5% to +9.3%) relative to lower use (684 [55.8%] participants). This association remained statistically significant after covariable adjustment.nnCONCLUSIONS AND RELEVANCE: This study found that longitudinal trajectories of media use during adolescence were modestly associated with PEs at age 23 years, likely reflecting the influence of shared risk factors. Understanding the environmental determinants and psychosocial functions of media use during adolescence may help better integrate digital technologies in the prevention and management of PEs.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid37644511,

title = {Development of a transdiagnostic digital interactive application for eating disorders: psychometric properties, satisfaction, and perceptions on implementation in clinical practice},

author = {Linda Booij and Mimi Israël and Manuela Ferrari and Annie St-Hilaire and Chloé Paquin-Hodge and Melissa Allard and Amélie Blaquière and Julia Dornik and Shiri Freiwald and Shawna A Long and Marika Monarque and William D Pelletier and Lea Thaler and Miriam Yaffe and Howard Steiger},

doi = {10.1186/s40337-023-00871-3},

issn = {2050-2974},

year  = {2023},

date = {2023-08-01},

journal = {J Eat Disord},

volume = {11},

number = {1},

pages = {146},

abstract = {BACKGROUND: Given limited availability of informed treatments for people affected by eating disorders (EDs), there has been increasing interest in developing self-administered, technology-based ED interventions. However, many available interventions are limited to a specific ED diagnosis or assume that participants are ready to change. We developed a digital self-help application (called ASTrA) that was explicitly designed to be transdiagnostic and to help increase motivation for change. The aim of the present study was to describe the development and examine the psychometric properties, user satisfaction and rated potentials for practical use of our application.nnMETHODS: The content of our application was based on concepts derived from self-determination theory, the transtheoretical model of change, and cognitive theory. The application was developed by a multidisciplinary team of clinicians, researchers, staff members and individuals with lived ED experience, each being involved in all steps of the application's development. We tested validity, reliability, satisfaction and perceived feasibility for clinical implementation in an independent sample of 15 patients with an ED and 13 clinicians specialized in ED treatment. Psychometric properties were evaluated using descriptive statistics, correlations, content validity indices and intraclass coefficients. Differences in satisfaction ratings and perceived potential for clinical implementation of the application between clinicians and patients were examined using Mann-Whitney U tests.nnRESULTS: The digital application showed excellent validity (mean i-CVI: .93, range: .86-.96) and internal reliability (all Cronbach alpha's > .88). Patients and clinicians both considered the application acceptable, appropriate, and feasible for use in clinical practice.nnCONCLUSIONS: Findings suggest that our transdiagnostic interactive application has excellent psychometric properties. Furthermore, patients and clinicians alike were positive about the possible use of the application in clinical practice. The next step will be to investigate the application's effectiveness as an intervention to promote autonomous motivation and to facilitate remission in people on the waitlist for specialized ED treatment.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid36321318,

title = {A Scoping Review of Measures Used in Early Intervention Services for Psychosis},

author = {Manuela Ferrari and Nicole Pawliuk and Megan Pope and Kevin MacDonald and Jill Boruff and Jai Shah and Ashok Malla and Srividya N Iyer},

doi = {10.1176/appi.ps.202100506},

issn = {1557-9700},

year  = {2023},

date = {2023-05-01},

journal = {Psychiatr Serv},

volume = {74},

number = {5},

pages = {523--533},

abstract = {OBJECTIVE: The early intervention service (EIS) model for psychosis has been implemented with increasing frequency; yet, improving outcomes across domains for all patients remains challenging. Measurement-based care can strengthen outcomes by optimizing interventions and promoting alignment with standards, but it is still not widely deployed in EIS. The authors conducted a scoping review by systematically identifying and synthesizing measures used in EIS related to purpose (i.e., to assess patients, families, and programs), domains (e.g., symptoms, quality of life), and reporting perspectives (of patients, families, and clinicians).nnMETHODS: EMBASE, MEDLINE, PsycINFO, CINAHL, and Cochrane Library databases were searched for pertinent literature published between 2000 and 2020. Two reviewers independently screened titles, abstracts, and full texts and extracted data. Measures were classified as clinician-reported outcome measures (CROMs), patient-reported outcome or experience measures (PROMs/PREMs), or family-reported outcome or experience measures (FROMs/FREMs).nnRESULTS: In total, 172 measures of 27 domains were identified from 115 articles. Nineteen measures had been used to assess programs on fidelity, service engagement, and satisfaction; 136 to assess patients on duration of untreated psychosis, symptoms, functioning, quality of life, and others; and 17 to assess families on coping and burden, background, and others. Sixty percent were CROMs, 30% were PROMs/PREMs, and 10% were FROMs/FREMs.nnCONCLUSIONS: Greater inclusion of PROMs and FROMs is needed because they align with the EIS philosophy of patient and family engagement and may improve shared decision making and outcomes. A comprehensive, meaningfully synthesized archive of measures can advance measurement-based care, services research, and data harmonization in early psychosis.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid37203146,

title = {Engaging with care in an early intervention for psychosis program: The role of language, communication, and culture},

author = {Anika Maraj and Manuela Ferrari and Kathleen MacDonald and Matthew Peters and Ridha Joober and Jai L Shah and Srividya N Iyer},

doi = {10.1177/13634615231167067},

issn = {1461-7471},

year  = {2023},

date = {2023-05-01},

journal = {Transcult Psychiatry},

pages = {13634615231167067},

abstract = {Language is an important aspect of communication and language status is known to impact healthcare accessibility, its perceived suitability, and outcomes. However, its influence on treatment engagement and/or disengagement is unknown. Our study therefore sought to investigate the impact of language on service disengagement in an early intervention psychosis program in Montreal, Quebec (a province with French as the official language). We aimed to compare service disengagement between a linguistic minority group (i.e., English) vis-à-vis those whose preferred language was French and to explore the role of language in service engagement. Using a mixed methods sequential design, we tested preferred language and several sociodemographic characteristics associated with service disengagement in a time-to-event analysis with Cox proportional hazards regression models ( = 338). We then conducted two focus groups with English (seven patients) and French speakers (five patients) to further explore differences between the two linguistic groups. Overall, 24% ( = 82) disengaged from the service before the two-year mark. Those whose preferred language was English were more likely to disengage ( = 47, 31.5%) than those whose preferred language was French ( = 35, 18.5%; χ2 = 9.11,  < .01). This remained significant in the multivariate regression. In focus groups, participants identified language as one aspect of a complex communication process between patients and clinicians and highlighted the importance of culture in the clinical encounter. Language status of patients plays an important role in their engagement with early psychosis services. Our findings underscore the value of establishing communication and cultural understanding in creating clinical/therapeutic alliance.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid36661284,

title = {Time to Think "Meta": A Critical Viewpoint on the Risks and Benefits of Virtual Worlds for Mental Health},

author = {Vincent Paquin and Manuela Ferrari and Harmehr Sekhon and Soham Rej},

doi = {10.2196/43388},

issn = {2291-9279},

year  = {2023},

date = {2023-02-01},

journal = {JMIR Serious Games},

volume = {11},

pages = {e43388},

abstract = {The metaverse is gaining traction in the general population and has become a priority of the technological industry. Defined as persistent virtual worlds that exist in virtual or augmented reality, the metaverse proposes to afford a range of activities of daily life, from socializing and relaxing to gaming, shopping, and working. Because of its scope, its projected popularity, and its immersivity, the metaverse may pose unique opportunities and risks for mental health. In this viewpoint article, we integrate existing evidence on the mental health impacts of video games, social media, and virtual reality to anticipate how the metaverse could influence mental health. We outline 2 categories of mechanisms related to mental health: experiences or behaviors afforded by the metaverse and experiences or behaviors displaced by it. The metaverse may benefit mental health by affording control (over an avatar and its virtual environment), cognitive activation, physical activity, social connections, and a sense of autonomy and competence. However, repetitive rewarding experiences may lead to addiction-like behaviors, and high engagement in virtual worlds may facilitate and perpetuate the avoidance of challenges in the offline environment. Further, time spent in virtual worlds may displace (reduce) other determinants of mental health, such as sleep rhythms and offline social capital. Importantly, individuals will differ in their uses of and psychological responses to the metaverse, resulting in heterogeneous impacts on their mental health. Their technological motivations, developmental stage, sociodemographic context, and prior mental health problems are some of the factors that may modify and frame the positive and negative effects of the metaverse on their mental health. In conclusion, as the metaverse is being scaffolded by the industry and by its users, there is a window of opportunity for researchers, clinicians, and people with lived experience to coproduce knowledge on its possible impacts on mental health and illness, with the hope of influencing policy-making, technological development, and counseling of patients.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid36805783,

title = {Digital interventions for substance use disorders in young people: rapid review},

author = {Marika Monarque and Judith Sabetti and Manuela Ferrari},

doi = {10.1186/s13011-023-00518-1},

issn = {1747-597X},

year  = {2023},

date = {2023-02-01},

journal = {Subst Abuse Treat Prev Policy},

volume = {18},

number = {1},

pages = {13},

abstract = {BACKGROUND: Young people are disproportionately more likely than other age groups to use substances. The rise in substance use and related harms, including overdose, during the Covid-19 pandemic has created a critical need for more innovative and accessible substance use interventions. Digital interventions have shown effectiveness and can provide more engaging, less stigmatizing, and accessible interventions that meet the needs of young people. This review provides an overview of recent literature on the nature of recently published digital interventions for young people in terms of technologies used, substances targeted, intended outcomes and theoretical or therapeutic models employed.nnMETHODS: Rapid review methodology was used to identify and assess the literature on digital interventions for young people. An initial keyword search was conducted using MEDLINE the Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects (DARE), Health Technology Assessment Database (HTA) and PROSPERO for the years 2015-2020, and later updated to December 2021. Following a title/abstract and full-text screening of articles, and consensus decision on study inclusion, the data extraction process proceeded using an extraction grid developed for the study. Data synthesis relied on an adapted conceptual framework by Stockings, et al. that involved a three-level treatment spectrum for youth substance use (prevention, early intervention, and treatment) for any type of substance.nnRESULTS: In total, the review identified 43 articles describing 39 different digital interventions. Most were early interventions (n = 28), followed by prevention interventions (n = 6) and treatment interventions (n = 5). The identified digital technologies included web-based (n = 14), game-based (n = 10), mobile-based (n = 7), and computer-based (n = 5) technologies, and virtual reality (n = 3). Most interventions targeted alcohol use (n = 20) followed by tobacco/nicotine (n = 5), cannabis (n = 2), opioids (n = 2), ketamine (1) and multiple, or any substances (n = 9). Most interventions used a personalized or normative feedback approach and aimed to effect behaviour change as the intended outcome. Interestingly, a harm reduction approach guided only one of the 39 interventions.nnCONCLUSIONS: While web-based interventions represented the most common type of technology, more recently developed immersive and interactive technologies such as virtual reality and game-based interventions call for further exploration. Digital interventions focused mainly on alcohol use, reflecting less concern for tobacco, cannabis, co-occurring substance use, and illicit drug use. Specifically, the recent exacerbation in the opioid crisis throughout North American underlines the urgent need for more prevention-oriented digital interventions for opioid use. The uptake of digital interventions among youth also depends on the incorporation of harm reduction approaches.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid35773789,

title = {Sleep of Healthcare Workers During the COVID-19 Pandemic and the Role of Atypical Work Schedules: A Scoping Review},

author = {Niamh Power and Michel Perreault and Manuela Ferrari and Philippe Boudreau and Diane B Boivin},

doi = {10.1177/07487304221103376},

issn = {1552-4531},

year  = {2022},

date = {2022-08-01},

journal = {J Biol Rhythms},

volume = {37},

number = {4},

pages = {358--384},

abstract = {The COVID-19 pandemic has negatively impacted the well-being of healthcare workers (HCWs). HCWs are highly exposed to shift work and their work schedules have been subject to increasing unpredictability since the start of the pandemic. This review aims to: (1) map the studies providing information about factors associated with sleep characteristics in HCWs working in the context of the COVID-19 pandemic during the first and second waves and (2) examine the state of the evidence base in terms of the availability of information on the influence of atypical work schedules. A literature search was performed in PubMed. Studies containing information about factors (demographic; psychological; occupational; COVID-19-specific; work schedule; lifestyle; medical; or other) associated with various sleep characteristics among HCWs working in the context of the COVID-19 pandemic were included. Particular attention was paid to the availability of information on the role of atypical work schedules on HCW sleep. Fifty-seven articles met the inclusion criteria. Most studies were reports of quantitative cross-sectional surveys using self-report measures. Associations between female sex, frontline HCW status, psychological factors, and poorer sleep were observed. Six studies included a measure of shift work in their analyses, 5 of which reported an association between shift work status and sleep. A wide range of factors were investigated, with female sex, frontline HCW status, and psychological factors repeatedly demonstrating associations with poorer sleep. Sleep was predominantly measured in terms of self-reported sleep quality or insomnia symptoms. Few studies investigated the influence of atypical work schedules on HCW sleep in the context of the COVID-19 pandemic. Research on this topic is lacking in terms of reliable and consistent measurements of sleep outcomes, longitudinal data, and knowledge about the influence of covariates such atypical work schedules, comorbidity, and medical history on HCW sleep.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}