OPAL Pilot Projects

Current Pilot Projects:

Qualitative Assessment of the Transition to Housing Unit (THU)

This pilot study will determine the feasibility of conducting a longitudinal qualitative evaluation of the Transition to Housing Unit.  It will provide early feedback to the OMH about the program and contribute knowledge that can aid any needed modifications.  The project will also demonstrate how OPAL investigators and expertise can inform policy makers in real time.  In addition, the project will provide preliminary data for possible future proposals addressing homelessness among individuals diagnosed with schizophrenia.

Investigators:

  • Lauren Gonzales, PhD, Principal Investigator
  • Ana Stefancic, PhD, Co-Investigator

Hearing Loss in Schizophrenia: Audiologic Characteristics and Association with Cognition and Functioning

Hearing loss (HL)  is highly prevalent in all adults over age 50, and is associated with cognitive decline, social isolation and withdrawal. Given its association with disability, it is striking that HL has not been studied as it relates to the disease trajectory of schizophrenia. This proposal takes the first steps to study hearing loss (HL) in schizophrenia, with the intent to build an investigative path to inform identification and treatment.

Investigators:

  • Alice Saperstein, PhD, Principal Investigator
  • Alice Medalia, PhD, Co-Investigator

Presentations:

  1. Saperstein, A.M., Subhan B.A., Golub, J.S., Stroup T.S., Medalia, A. Hearing Loss in Schizophrenia: The Role of Medical and Psychiatric Factors. Oral presentation at Schizophrenia International Research Society, 2023, Toronto, Ontario, Canada.
  2. Subhan, B.A., Saperstein, A.M., Golub, J.S., Medalia, A. Hearing Loss in Schizophrenia: Feasibility, Reliability, and Clinical Utility of Shoebox Audiometry. Oral presentation at Schizophrenia International Research Society, 2023, Toronto, Ontario, Canada.

Publications:

  1. Alice M. Saperstein, Bibi A. Subhan, Justin S. Golub, Alice Medalia, Hearing Loss in Older People With Schizophrenia: Audiologic Characteristics and Association With Psychosocial Functioning, The American Journal of Geriatric Psychiatry, 2023, ISSN 1064-7481, https://doi.org/10.1016/j.jagp.2023.11.002. (Link)

Completed Pilot Projects:

Anti-Black Racism Shapes Pathways to Recovery among Black Individuals with First-Episode Psychosis

The goal of this pilot project is to identify how anti-Black racism shapes social determinants (social, economic, and environmental conditions) for Black individuals with FEP in ways that hinder recovery. This project is significant because it will be one of the first to provide rich mixed-methods data on social factors in the family, community, and neighborhood that matter most in the recovery of Black individuals with FEP. Results will also inform barriers/promotors to family engagement in care for Black FEP families.

Investigators:

  • Deidre M. Anglin, PhD, Principal Investigator

Publications:

  1. Anglin, D. M. (2023). Racism and social determinants of Psychosis. Annual review of clinical Psychology, Volume 19. (Link)

Presentations:

  1. Anglin, D. M. (2023). From Being Tokenized to Feeling Heard: Improving Intervention by Tackling Anti-Black Racism through Community Engagement and Support. Invited Presenter for Webinar in On Track NY, NY.
  2. Anglin, D. M. (2023). From Being Tokenized to Feeling Heard: Improving Intervention by Tackling Anti-Black Racism through Community Engagement and Support. Invited Presenter at Columbia University’s Optimizing and Personalizing interventions for people with schizophrenia Across the Lifespan (OPAL) Center Seminar Series at Columbia University, NY, NY.
  3. Anglin, D. M. (2023). Racism and Social Determinants of Psychosis Risk. Invited Plenary Presenter for the Schizophrenia International Research Society 2023 Annual Congress, Toronto, Canada.
  4. Anglin, D. M. (2023). The Role of Racism in Diagnosis and Risk for Psychosis. Invited Presenter at Mount Sinai Morningside -West Department of Psychiatry Grand Rounds, NY, NY.
  5. Anglin, D. M. (2023). The Role of Racism in Diagnosis and Risk for Psychosis. Invited Presenter at Lenox Hill Hospital Medical Center Department of Psychiatry Grand Rounds, NY, NY.
  6. Anglin, D. M. (2023). Racism and Psychosis: The Role of Social Determinants. Invited Presenter at Washington University in St Louis Colloquium Series, Department of Psychological and Brain Sciences, St Louis, MO.
  7. Anglin, D. M. (2022). The Role of Racism in Diagnosis and Risk for Psychosis. Invited Presenter at the University of Texas Southwestern Medical Center Department of Psychiatry Grand Rounds, Dallas, TX.
  8. Anglin, D. M. (2022). Infusing the Intersection of DEI Throughout Your Research Program: Examples from a Doctoral Program in a Public University. Invited presenter for DEI symposium for the Society for Research in Psychopathology Annual Meeting, Philadelphia, PA.
  9. Anglin, D. M. (2022). The Social Patterning of Psychosis. Invited Presenter for the Workshop on Early Interventions for Psychosis: First Episodes and High-Risk Populations for The National Academies of Sciences, Engineering, and Medicine. Washington, D.C.

Impact of The Shift To Telehealth During The COVID-19 Pandemic On Services Received By Medicaid Recipients With Serious Mental Illness

This study will investigate patterns of service utilization among NYS Medicaid recipients before and after the telehealth transition to identify characteristics of those who may or may not be well served by telehealth. Little is known regarding how individuals with SMI engage in care in a predominantly telehealth environment. The findings from this study will help characterize those who have participated in care via telehealth and those who have not. Findings will provide preliminary data for future studies exploring whether individuals not adequately served by the transition to telehealth might benefit from outreach and engagement strategies to enable meaningful participation in telehealth.

Investigators:

  • Natalie Bareis, MS, LMSW, PhD, Principal Investigator
  • Thomas Smith, MD, Co-Investigator

Publications:

  1. Bareis N, Tepper MC, Wang R, Tang F, Olfson M, Dixon LB, Kimhy D, Wall MM, Medalia A, Finnerty MT, Anderson A, and Smith TE. Engagement of Individuals with Serious Mental Illness in Outpatient Mental Health Services and Telehealth Use During the COVID-19 Pandemic. Psychiatry Research, In Press, 2023. (Link)

Presentations:

  1. Bareis N., Tepper M., Smith T. Engagement in Outpatient Mental Health Services and Telehealth Use in New York State During COVID, Accepted for Poster presentation at American Psychiatric Association Annual Meeting at the Moscone Center in San Francisco, CA, Saturday, May 20, 2023 – Wednesday, May 24, 2023

Self-stigma among people with severe mental illness: the development of a brief video

The overarching goal of this study is to gather qualitative data to inform the development of short video intervention to reduce self-stigma among people with severe mental illness (e.g., schizophrenia, schizoaffective disorder, or bipolar disorder).

Investigators:

  • Doron Amsalem, MD, Principal Investigator

Publications:

  1. Amsalem D, Jankowski SE, Yanos P, Yang LH, Markowitz JC, Rogers RT, Stroup TS, Dixon LB, Pope LG. Brief Video Intervention to Reduce Self-Stigma of Mental Illness: Randomized Controlled Trial. Journal of Clinical Psychiatry. In press.
  2. Amsalem D, Rogers RT, Stroup S, Dixon L, Pope L. Self-stigma among people with serious mental illnesses: the use of focus groups to inform the development of a brief video intervention. Psychiatr Rehabil J. 2023 May 25. doi: 10.1037/prj0000570. Epub ahead of print. PMID: 37227841. (Link)

Refinement of a Motivational Self-Regulation Intervention for Avolition in Schizophrenia:  Improving Feasibility & Acceptability for Community-Based Deployment

This proposed project, which refines a novel intervention based on stakeholder feedback, is in keeping with this priority. Refinement of MFT will pave the way towards a R34 application to conduct a  full-scale feasibility/efficacy project, and a more adaptable, readily deployable, and recovery-oriented intervention for community settings.

Enhancing Motivation and Executive Functioning in People with Schizophrenia: A Pilot Efficacy & Feasibility Study

This proposed pilot study will gather preliminary data on a new psychotherapeutic intervention, Strategies to Motivate and Execute (SME), which targets motivation and executive functioning deficits in people with psychotic disorders. The proposed naturalistic prospective cohort study of wait listed versus enrolled SME participants will collect data on treatment acceptability, EF, motivation, neurocognition, community functioning, quality of life, and personal goal attainment from a community-based PROs program.

Investigators:

  • Marie Hansen, PhD/Alice Saperstein, PhD, Principal Investigator
  • Alice Medalia, PhD, Co-Investigator

Findings:

Within our sample, the majority of participants (81%) inaccurately saw motivation as unmalleable – as a trait formed in childhood that is “injected” into you. Further, when asked to describe their approach to motivationally challenging situations, they did not demonstrate flexible regulation of motivational strategies to ensure task-motivation fit. Instead, there was overreliance on rewards or a focus on outcome to motivate themselves to do difficult or challenging tasks. While rewards are potential motivators, especially when self-administered so autonomy is maintained, the participants in our sample showed little awareness that other motivational strategies could be applied. They tended to focus on task outcome without the concomitant problem-solving of motivational obstacles, an approach that can deleteriously impact the ability to successfully complete a goal.

Publications:

  1. Hansen MC, Lynch DA, Stefancic A, Medalia A. Metamotivation in people diagnosed with schizophrenia: A conceptual introduction and qualitative study. Schizophr Res. 2022 May;243:317-321. (Link)

Presentations:

  1. Lynch, DA. Metamotivation in schizophrenia. Oral presentation, 23rd Annual Cognitive Remediation in Psychiatry Conference, 2021, New York, NY

Grants:

1R34MH129552

Motivation Skills Training to Enhance Functional Outcomes for People with Schizophrenia

Alice Saperstein, PhD, Principal Investigator

Developing a Health Promotion Program for Young Adults Experiencing First Episode Psychosis

This study seeks to develop a practical and engaging health promotion program, tailored to the needs and preferences of young adults with first episode psychosis (FEP) that can be delivered within a Coordinated Specialty Care (CSC) program for FEP. Using a simultaneous mixed methods study, we will identify the health needs and service use of clients experiencing FEP and the components of a health promotion program that can be implemented within New York State’s OnTrackNY CSC service to address these priority areas.

Investigators:

  • Ana Stefancic, PhD, Principal Investigator

Presentations:

  1. Stefancic, A., Tuda, D., Bochicchio, L., Hau, F., Basaraba, C., & Cabassa, L.J. Developing a Health Promotion Program within Coordinated Specialty Care Clinics for First Episode Psychosis, ALACRITY cross-center presentation, 3.10.2021
  2. Stefancic, A., Tuda, D., Bochicchio, L., Hau, F., Basaraba, C., & Cabassa, L.J. (2021). Developing a Health Promotion Program within Coordinated Specialty Care Clinics for First Episode Psychosis. Oral paper presentation to the Washington Early Recognition Center, virtual, August 19, 2021.
  3. Stephanie Rolin, Ana Stefancic, Natalie Bareis, Scott Stroup. Early-stage investigators and timely support: The OPAL Center and its mission to fund and train the next generation of schizophrenia researchers, panel submitted for 2022 APA meeting.

Machine Learning: Optimizing Individualized Treatments for Schizophrenia with Administrative Data

This pilot study will use “big data” derived from all available Medicaid beneficiary data (e.g., inpatient, outpatient, pharmacy, and other services) for a cohort of all individuals diagnosed with schizophrenia in the U.S. Machine learning methods will be applied to identify optimal intervention strategies tailored to subject specific characteristics. The goal is to guide clinicians and their patients using a new complementary data driven methodology that may more effectively identify precise treatments that work best for each individual.

Investigators:

  • Natalie Bareis, MS, LMSW, PhD, Principal Investigator
  • T. Scott Stroup, MD, MPH, Co-Investigator
  • Yuanjia Wang, PhD, Co-Investigator

Findings:

Prescribing patterns for all types of psychotropic medications varied across states. Clozapine and LAI prescriptions showed the most dramatic differences across states and among patients with different demographic characteristics. Across states, adjusted proportions of prescriptions ranged from 4% to 22% for LAIs and from 1% to 11% for clozapine. Non-Hispanic Blacks and people of other race-ethnicities were more likely than non-Hispanic Whites to fill prescriptions for LAIs, and non-Hispanic Whites were more likely than individuals from other racial-ethnic groups to fill prescriptions for clozapine and all other medications.

Considerable variation in prescribing patterns of LAIs and clozapine by race-ethnicity and across states suggests uneven quality of care for individuals with schizophrenia spectrum disorders in the United States. A better understanding of what causes this variation could inform policy makers to improve treatment for this vulnerable population.

Publications:

  1. Bareis N, Olfson M, Wall M, Stroup TS. Variation in Psychotropic Medication Prescription for Adults With Schizophrenia in the United States. Psychiatr Serv. 2021 Sep 30:appips202000932. doi: 10.1176/appi.ps.202000932. Epub ahead of print. PMID: 34587788. (Link)

Presentations:

  1. Bareis N; Olfson M; Stroup TS, Variation in Psychotropic Medication Treatment of Adults Diagnosed with Schizophrenia in the United States, Poster 4553 at American Psychiatric Association Annual Meeting, May 1-3, 2021
  2. Stephanie Rolin, Ana Stefancic, Natalie Bareis, Scott Stroup. Early-stage investigators and timely support: The OPAL Center and its mission to fund and train the next generation of schizophrenia researchers, panel submitted for 2022 APA meeting.

Grants:

1K23MH129628-01A1

Machine Learning for Precision Treatments in Schizophrenia

Natalie Bareis, MS, LMSW, PhD, Principal Investigator

Using Contingency Management to Achieve Cannabis Abstinence Among Individuals with First Episode Psychosis Attending OnTrackNY: A Proof of Concept Study

The purpose of this pilot study is to show proof of concept for the use of contingency management (CM) as a behavioral intervention to improve abstinence rates among persistent cannabis users in FEP populations and to assess acceptability of the intervention among patients and clinicians.

Investigators:

  • Leslie Marino, MD, MPH, Principal Investigator

Violence risk assessment for young adults with early psychosis

This project aims to assess the feasibility and comparative utility of five different violence risk assessment tools in a population of young adults receiving treatment for early psychosis. This study is a pilot that will assess the feasibility of implementing these tools, along with cross validation of these tools.

Investigators:

  • Stephanie A. Rolin, MD, MPH, Principal Investigator
  • Paul Appelbaum, MD, Co-Investigator
  • Lisa Dixon, MD, MPH, Co-Investigator

Findings:

This study sought to establish the feasibility, acceptability, and clinical utility of different approaches for assessing violence risk for EIS clients. This 12-month longitudinal pilot, spanning November 2019 to February 2021, overlapped with a global pandemic that dramatically changed the nature of this research. In the process, it exposed challenges of conducting research with a vulnerable group susceptible to many of the socioeconomic impacts of the COVID-19 pandemic, including reduced access to health care and housing instability. Despite these challenges, this study demonstrated the feasibility and acceptability of research related to violence at EIS clinics, including the use of structured violence risk assessment. This is important as structured violence risk assessments can help EIS clinics improve the accuracy and transparency of violence risk assessments, compared to unaided clinical judgment which can embed racial bias – either explicitly or implicitly – in ways that are difficult to identify or challenge. In comparison to most other studies on violence related to schizophrenia, this study is unusual in that the data were collected prospectively, exclusively for the purpose of studying violence, utilizing multiple methods of measuring violence (i.e., self-report and arrest records), and focusing specifically on young adults with early psychosis receiving treatment in an EIS setting.

Publications:

  1. Rolin SA, Scodes J, Dambreville R, Nossel IR, Bello I, Wall MM, Stroup TS, Dixon LB, Appelbaum PS. Feasibility and Utility of Different Approaches to Violence Risk Assessment for Young Adults Receiving Treatment for Early Psychosis. Community Ment Health J. 2022 Jan 4:1–11. doi: 10.1007/s10597-021-00922-6. Epub ahead of print. PMID: 34981276; PMCID: PMC8723812. (Link)

Presentations:

  1. Stephanie Rolin, Ana Stefancic, Natalie Bareis, Scott Stroup. Early-stage investigators and timely support: The OPAL Center and its mission to fund and train the next generation of schizophrenia researchers, panel submitted for 2022 APA meeting.

Grants:

1K23MH126312-01A1

Young Adults with Violent Behavior During Early Psychosis: A Mixed Methods Assessment and Intervention Trial

Stephanie Rolin, MD, Principal Investigator

The Role of Early Auditory Information Processing in the Symptoms and Community Functioning of People with First Episode Psychosis

This pilot study will gather preliminary data to inform the potential for scalable Cognitive Remediation (CR) personalization in first-episode psychosis (FEP), with a focus on early auditory processing (EAP) ability as a tailoring variable. 

Investigators:

  • Alice Saperstein, PhD, Principal Investigator
  • Alice Medalia, PhD, Co-Investigator

Presentations:

  1. Saperstein, A.M., Medalia, A. Early auditory processing in people with first episode psychosis. Invited presentation at the Optimizing Personalization and Accessibility across the Lifespan (OPAL) Seminar Series, 2021, New York, NY.