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Community engagement (CE) is widely acknowledged as a way to enhance the ethics, rigor, and impact of research. Additionally, CE is a demonstrated way to integrate Indigenous and colonial (western) research systems. For these reasons and others, designers of the Multi‐site Implementation Evaluation of Tribal Home Visiting (MUSE) used a community‐engaged approach to study the implementation of federally funded home‐visiting programs across 17 Indigenous communities throughout the United States. This paper describes MUSE's community‐engaged approach and its practical applications from the perspective of the MUSE study team. The paper highlights key outcomes attributable to CE, addresses barriers to CE, and details responses to these barriers and their impacts. Adding to the rich evidence base demonstrating the value of community‐engaged approaches, MUSE demonstrates that in‐depth CE is feasible and valuable in multisite studies done in partnership with Indigenous communities. [ABSTRACT FROM AUTHOR]

ObjectiveTo test effectiveness of the Early Detection, Intervention, and Prevention of Psychosis Program in preventing the onset of severe psychosis and improving functioning in a national sample of at-risk youth.MethodsIn a risk-based allocation study design, 337 youth (age 12-25) at risk of psychosis were assigned to treatment groups based on severity of positive symptoms. Those at clinically higher risk (CHR) or having an early first episode of psychosis (EFEP) were assigned to receive Family-aided Assertive Community Treatment (FACT); those at clinically lower risk (CLR) were assigned to receive community care. Between-groups differences on outcome variables were adjusted statistically according to regression-discontinuity procedures and evaluated using the Global Test Procedure that combined all symptom and functional measures.ResultsA total of 337 young people (mean age: 16.6) were assigned to the treatment group (CHR + EFEP, n = 250) or comparison group (CLR, n = 87). On the primary variable, positive symptoms, after 2 years FACT, were superior to community care (2 df, p < .0001) for both CHR (p = .0034) and EFEP (p < .0001) subgroups. Rates of conversion (6.3% CHR vs 2.3% CLR) and first negative event (25% CHR vs 22% CLR) were low but did not differ. FACT was superior in the Global Test (p = .0007; p = .024 for CHR and p = .0002 for EFEP, vs CLR) and in improvement in participation in work and school (p = .025).ConclusionFACT is effective in improving positive, negative, disorganized and general symptoms, Global Assessment of Functioning, work and school participation and global outcome in youth at risk for, or experiencing very early, psychosis.

Aim: This qualitative study examined the lived experience of associative stigma for parents of adolescents at clinical high risk for psychosis. A central goal was to empower families to tell their stories and to use the themes that emerge from this narrative data to make recommendations that might support families coping with a loved one being diagnosed with risk for psychosis. Methods: Twelve parents of adolescents diagnosed with the clinical high risk for psychosis syndrome were interviewed using a semi‐structured approach. The qualitative study employed Interpretative Phenomenological Analysis (IPA) to focus on experiences of associative stigma and the way parents make sense of these experiences. Results: From these interviews, the researcher identified themes and subthemes categorized into major domains that represent topics particularly relevant to these 12 parents. Two main domains emerged as particularly salient to parents' experiences with associative stigma: perceptions of stigma and coping with stigma. Conclusions: Participants' insights demonstrated increased experience of stigma associated with psychotic‐like symptoms as compared to other psychiatric symptoms, attempts to balance fighting against stigma with the privacy needs of adolescents, and participation in research as less stigmatizing than non‐specialty care. Stigma impacted treatment‐seeking and participation in family groups that were seen as both potentially supportive and threatening. The interviews provided an opportunity for these families to voice their unique experiences, which expands the literature on the topic of caregivers of adolescents at risk for psychosis as treatment programs for the clinical high risk syndrome expand across the United States. [ABSTRACT FROM AUTHOR]