2016 International Early Psychosis Association (IEPA) 10th Biennial Conference: Milan, Italy. October 2016.
Poster Presentation
CHENG C, NADIN S, KATT M, LEM C, DEWA CS, MINORE B
Acknowledgements: The NorthBEAT Project was funded by the Sick Kids Foundation in partnership with CIHR. Attendance at this conference is supported by St. Joseph’s Care Group Thunder Bay.
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(2016) NorthBEAT: A mixed-method approach to examine the needs of youth in Northern and rural Canada (IEPA Poster C22)
1. A mixed-method approach to examine the needs of youth in Northern and rural Canada
RESULTS
CONCLUSION
Functional Status:
Scores on the psychometric scales suggested participants were functioning relatively well (GAF & PANSS) and had a positive outlook on their recovery (RAS):
Acknowledgements:
The NorthBEAT Project was funded by the Sick Kids Foundation in partnership with CIHR. Attendance at this conference is supported by St. Joseph’s Care Group Thunder Bay.
References:
*: Statistics Canada. 2013. North West (Health Region), Ontario, North East (Health Region), Ontario and Ontario (table). Health Profile. Catalogue no. 82-228-XWE
Statistics Canada. 2007. North East Health Integration Network, Ontario (Code3513) (table) and North West Health Integration Network, Ontario (Code3514) (table). Catalogue no. 92-591-XWE.
Demographics
Ethnicity
Caucasian: 61.5%
Other: 11.5%
Indigenous: 27%
Female 54%, male 46%
Enrolled in school: 85%
Mental health related interuptions to school: 73%
Employed (paid or volunteer): 58%
Living with Family: 77%
Paying Rent: 46%
No physical illness: 99%
Mean age = 17.3 years
All were single
None had children 3
DUPs ranged from < 1 month to 96
months . (Median = 12; IQR = 36).
96
Duration of Untreated Psychosis (DUP)
KT Workshops:
Workshop participants validated they study findings, and suggested
areas for further EPI research and action. Youth and families created a
variety of arts-based KT products.
Barriers & Service Needs:
Unique rural barriers and service
needs were revealed.
There were no statistically significant differences between Indigenous and non-Indigenous youth in DUP or any of the other indices (t-tests, p >.05)
Cheng, C.1,2,3
; Nadin, S.1,3
; Katt, M.3
; Lem, C.1
; Dewa C.S.4
; Minore, B.3 1. 2. 3. 4.
Aims:
• To understand how youth in Northern Ontario
experience early psychosis and services for psychosis;
• To understand what are the barriers to receiving
appropriate EPI;
• To examine Indigenous youth as a significant and
vulnerable population in Northern Ontario.
BACKGROUND
NORTHERN
ONTARIO
Northern Ontario (rural Canada) is an area with a vast geography, scarce
population and many Indigenous communities, and where EPI programs
struggle to understand and meet service needs.*
Research Question:
What are the perceived service needs of Indigenous and
non-Indigenous youth in Northern Ontario who experience
first episode psychosis?
(Barriers to Early Assessment and
Treatment) is a 3-year, descriptive, mixed-method project
that explored the service needs of youth in Northern Ontario.
Population:
786 290
Land mass:
802 396.28 km2
6%
of Ontario’s
population
90%
of Ontario’s
landmass
32%
of Northern Ontario’s
population is rural, vs
14% in Ontario overall
2 out of 50
of Ontario’s EPI programs
service the entire region
6x
the Indigenous population, as
compared to the rest of Ontario
(15% vs 2%)
MIXED-METHODS APPROACH
1. Structured interviews assessed
demographic characteristics, duration of
untreated psychosis (DUP) and functional
status of a subset of rural youth:
- Convenience sample of rural EPI clients aged ≤
21 years (n = 26)
- Domains assessed (measure):
Duration of Untreated Psychosis (NOS)
Psychosis Symptomatology (PANSS)
Global Functioning (GAF)
Hope and Recovery (RAS)
- Analyzed using descriptive & univariate statistics
3. End-of-project data validation & knowledge translation
(KT) workshops validated project findings and resulted in
arts-based KT products and possible KT strategies:
- Workshops were held separately with youth study
participants, family study participants, and a larger group of
project stakeholders.
- Preliminary results were presented to workshop participants
who reacted to our interpretation of the study findings.
- A series of facilitated activities then lead to the co-creation
of arts-based products from the study data to use in KT
activities and ideas about possible KT audiences and
venues.
2. Qualitative interviews
explored the help seeking
experiences of rural youth,
their mental health service
needs, and the barriers
they face to receiving
appropriate EPI.
This project revealed
important EPI barriers
and service needs that
are unique to northern
and rural contexts and
Indigenous youth living in
these contexts.
Bringing together multiple stakeholders
for the end-of-grant workshops
strengthened the project and its results,
and also created innovative arts-based
knowledge translation products that
we have shared to engage decision-
makers with the project findings.
PANSS:
When compared to the normative sample, participants
were experiencing less symptoms and general
psychopathology.
RAS:
Participants generally had high levels of hope and
confidence and goal/success orientation, and
were not dominated by psychosis symptoms.
GAF:
90% of participants were
coded as 60 or higher (i.e.,
mild-moderate symptoms)
Only 23% of participants
had a DUP of < 3 months.
mildsevere
Positive Scale
Negative Scale
General Scale
39.65 (8.54)
32.77 (5.13)
32.77 (7.72)
Mean (SD)PANNS Scale Compared to Norm
Slightly below average
Much below average
Much below average
Personal Confidence & Hope
Goal & Success Orientation
Not Dominated by Symptoms
32.38 (7.28)
19.65 (3.54)
9.42 (3.58)
Mean (SD)RAS Scale Maximum Possible Score
45
25
15
Participant DUP
Recommended: <3 months
<1 month to 96 months
96
View related presentations:
www.slideshare.net/drcheng
View related presentations:
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NorthBEAT’s qualitative methods/results are the
focus of IEPA poster AI36:
View related presentations:
www.slideshare.net/drcheng
View the detailed results as
part of IEPA poster AI36:
View related presentations:
www.slideshare.net/drcheng
View past presentations on
NorthBEAT’s KT Workshops:
Next steps for NorthBEAT include addressing some of
the barriers revealed through this project. This includes
developing, implementing, and evaluating an eLearning
training program that can be accessed online, especially
for people living in rural, remote and northern regions.
For more information, visit: www.chicheng.ca