Recovery Roadmap Phase II Small Business Innovation Research Grant

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.

Inclusion Criteria:

Clients:

- Age of majority

- Receipt of mental health services within the participating program;

- Directly work with a provider participating in the study

- The ability to participate in the activities as determined by the client's clinical
team

- Willing and able to engage in a six month PCRP intervention and participate in
follow-up research activities (24 months total including follow up assessments).

Providers: Providers must meet the following inclusion criteria:

- Age of majority

- Directly work with clients willing to participate in the study;

- Have access to and basic navigation skills for using the Internet (for online coaching

- Work for a participating program

- Have a willingness to engage in a six-month PCRP intervention and participate in
follow-up research activities (24 months total).

Administrators: Inclusion criteria for administrators participating in key informant
semi-structured interviews include:

- Age of majority

- Being administrator of a program participating in the study or umbrella organization

- Have access to a computer to view tool components

- Knowledge about the market for this type of product for use in adult mental health.
The team will develop a screening tool for administrators to ensure they meet basic
criteria for the study.

Exclusion Criteria:

Clients:

- Non-English speakers

- Clients who are unable to participate in study activities (per clinical team
determination) and individuals who are unable to understand the informed consent
process (per the Quiz of Understanding for Informed Consent) will be excluded from the
study.

Providers:

- Non-English speakers

- Providers who have prior experience with RR tools will be excluded from the study.

Administrators:

• Non-English speakers