# Optimizing Engagement in Services for First-Episode Psychosis (FEP) in the Community Mental Health Setting

> **NIH NIH K23** · CALIFORNIA STATE UNIV SAN BERNARDINO · 2023 · $54,000

## Abstract

Abstract
Disengagement from services is a major public health problem for individuals with first-episode psychosis
(FEP) as up to 40% of individuals prematurely terminate early care. Individuals with FEP are consequently at
increased risk of persistent symptomatic and functional impairment and poor long-term outcomes. Engagement
can be improved by (1) identifying pragmatic and effective evidence-based interventions, (2) pinpointing the
mechanisms through which change in engagement is achieved, and (3) enhancing the literature on
engagement, such as by developing a nuanced and dynamic conceptualization of engagement to guide future
research. In the U.S., effective interventions for engagement are particularly needed for community mental
health services, which deliver most mental health care and encounter major engagement issues, and for hard-
to-reach communities, such as those comprised by Latinos. Research conducted with individuals with
psychosis has shown that Behavioral Activation (BA) may effectively target engagement and also symptomatic
and functional outcomes. This study will develop 12-session BA for FEP and compare it to treatment-as-usual
over six months with a sample of 58 (29 per condition) Latinos and their family caregivers in a longitudinal
randomized controlled trial. Dyads will also participate in comparable family support groups delivered
separately by condition. To examine mechanisms of change, the association between intervention mediators
and engagement will be examined to determine whether changes in mediators precede changes in
engagement over time. Using mixed-methods, the relationship between local/cultural factors and engagement
will be explored. Qualitative methods will be used to explore how local/cultural factors impact engagement for
future quantitative analysis, how specific characteristics of robust predictors (e.g., family support) influence
engagement, discover other critical influences, consider BA specific factors, and generate a model of
engagement in FEP care with attention to stages of development, illness, and treatment. The project provides
training in service engagement and intervention for FEP, developing and applying BA for FEP, addressing
engagement during FEP in hard-to-reach communities with cultural responsivity, and relevant research
methods with primary mentor, Alex Kopelowicz, M.D, co-mentors Steven R. Lopez, Ph.D., Lisa B. Dixon, M.D.,
M.P.H., and Sona Dimidjian, Ph.D., and consultants Hilary Mairs, Ph.D., Anahi Collado, Ph.D., Mark Lai, Ph.D.,
Jodie Ullman, Ph.D., Lawrence Palinkas, Ph.D., and Ethel Nicdao, Ph.D. Activities will be sustained through
regular communication with and between trainers and resources at California State University San Bernardino,
University of Southern California, and relevant institutions/sites. Training supports Dr. Santos’s long-term goal
of advancing the field of service engagement for persons with FEP from hard-to-reach communities. The
project will enhance the ...

## Key facts

- **NIH application ID:** 10819929
- **Project number:** 3K23MH119313-04S1
- **Recipient organization:** CALIFORNIA STATE UNIV SAN BERNARDINO
- **Principal Investigator:** Maria M Santos
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2023
- **Award amount:** $54,000
- **Award type:** 3
- **Project period:** 2020-04-09 → 2025-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10819929

## Citation

> US National Institutes of Health, RePORTER application 10819929, Optimizing Engagement in Services for First-Episode Psychosis (FEP) in the Community Mental Health Setting (3K23MH119313-04S1). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10819929. Licensed CC0.

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