iCogCA to Promote Cognitive Health Through Digital Group Interventions for Individuals Living With a Schizophrenia Spectrum Disorder: Protocol for a Nonrandomized Concurrent Controlled Trial

BackgroundCognitive impairments are a key aspect of schizophrenia spectrum disorders (SSDs), significantly affecting clinical and functional outcomes. The COVID-19 pandemic has heightened concerns about mental health services and cognitive stimulation opportunities. Despite e...

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Main Authors: Christy Au-Yeung, Helen Thai, Michael Best, Christopher R Bowie, Synthia Guimond, Katie M Lavigne, Mahesh Menon, Steffen Moritz, Myra Piat, Geneviève Sauvé, Ana Elisa Sousa, Elisabeth Thibaudeau, Todd S Woodward, Martin Lepage, Delphine Raucher-Chéné
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Language:English
Published: JMIR Publications 2025-04-01
Series:JMIR Research Protocols
Online Access:https://www.researchprotocols.org/2025/1/e63269
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author Christy Au-Yeung
Helen Thai
Michael Best
Christopher R Bowie
Synthia Guimond
Katie M Lavigne
Mahesh Menon
Steffen Moritz
Myra Piat
Geneviève Sauvé
Ana Elisa Sousa
Elisabeth Thibaudeau
Todd S Woodward
Martin Lepage
Delphine Raucher-Chéné
author_facet Christy Au-Yeung
Helen Thai
Michael Best
Christopher R Bowie
Synthia Guimond
Katie M Lavigne
Mahesh Menon
Steffen Moritz
Myra Piat
Geneviève Sauvé
Ana Elisa Sousa
Elisabeth Thibaudeau
Todd S Woodward
Martin Lepage
Delphine Raucher-Chéné
author_sort Christy Au-Yeung
collection DOAJ
description BackgroundCognitive impairments are a key aspect of schizophrenia spectrum disorders (SSDs), significantly affecting clinical and functional outcomes. The COVID-19 pandemic has heightened concerns about mental health services and cognitive stimulation opportunities. Despite evidence-based interventions like action-based cognitive remediation (ABCR) and metacognitive training (MCT), a research-to-practice gap exists in their application across mental health settings. ObjectiveThe iCogCA study aims to address this gap by implementing digital ABCR and MCT through a national Canadian collaborative effort using digital psychological interventions to enhance cognitive health in SSDs. MethodsThe study involves 5 Canadian sites, with mental health care practitioners trained digitally through the E-Cog platform, which was developed by our research group. Over 2.5 years, participants with SSDs will undergo pre- and postintervention assessments for clinical symptoms, cognition, and functioning. Each site will run groups annually for both ABCR and MCT, totaling ~390 participants. A nonrandomized concurrent controlled design will assess effectiveness design, in which one intervention (eg, ABCR) acts as the active control for the other (eg, MCT) and vice versa, comparing cognitive and clinical outcomes between the interventions using generalized linear mixed effect modeling. Implementation strategy evaluation will consider the digital platform’s efficacy for mental health care practitioners’ training, contextual factors influencing implementation, and sustainability, using descriptive statistics for quantitative data and thematic analysis for qualitative data. ResultsA pilot pragmatic trial has been conducted previously at the Montreal site, evaluating 3 early implementation outcomes: acceptability, feasibility, and engagement. Patient and therapist acceptability was deemed as high and feasible (21/28, 75% of recruited service users completed therapy, rated feasible by therapists). Technology did not appear to significantly impede program participation. Therapist-rated levels of engagement were also satisfactory. In the ongoing study, recruitment is underway (114 participants recruited as of winter 2024), and intervention groups have been conducted at all sites, with therapists receiving training via the E-Cog learning platform (32 enrolled as of winter 2024). ConclusionsAt least 3 significant innovations will stem from this project. First, this national effort represents a catalyst for the use of digital technologies to increase the adoption of evidence-based interventions and will provide important results on the effectiveness of digitally delivered ABCR and MCT. Second, the results of the implementation component of this study will generate the expertise needed to inform the implementation of similar initiatives. Third, the proposed study will introduce and validate our platform to train and supervise mental health care practitioners to deliver these interventions, which will then be made accessible to the broader mental health community. Trial RegistrationClinicalTrials.gov NCT05661448; https://clinicaltrials.gov/study/NCT05661448 International Registered Report Identifier (IRRID)DERR1-10.2196/63269
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spelling doaj-art-896c05e5b9bc4f3ea097e1ec11b1abe12025-08-20T02:26:33ZengJMIR PublicationsJMIR Research Protocols1929-07482025-04-0114e6326910.2196/63269iCogCA to Promote Cognitive Health Through Digital Group Interventions for Individuals Living With a Schizophrenia Spectrum Disorder: Protocol for a Nonrandomized Concurrent Controlled TrialChristy Au-Yeunghttps://orcid.org/0000-0002-0839-410XHelen Thaihttps://orcid.org/0000-0002-9873-6790Michael Besthttps://orcid.org/0000-0002-4632-5893Christopher R Bowiehttps://orcid.org/0000-0002-1983-8861Synthia Guimondhttps://orcid.org/0000-0002-1582-725XKatie M Lavignehttps://orcid.org/0000-0002-3918-691XMahesh Menonhttps://orcid.org/0000-0002-4007-0922Steffen Moritzhttps://orcid.org/0000-0001-8601-0143Myra Piathttps://orcid.org/0000-0002-5933-0974Geneviève Sauvéhttps://orcid.org/0000-0001-8140-2578Ana Elisa Sousahttps://orcid.org/0000-0002-8189-950XElisabeth Thibaudeauhttps://orcid.org/0000-0001-5603-0856Todd S Woodwardhttps://orcid.org/0000-0001-8083-0079Martin Lepagehttps://orcid.org/0000-0003-4345-6502Delphine Raucher-Chénéhttps://orcid.org/0000-0002-5663-4454 BackgroundCognitive impairments are a key aspect of schizophrenia spectrum disorders (SSDs), significantly affecting clinical and functional outcomes. The COVID-19 pandemic has heightened concerns about mental health services and cognitive stimulation opportunities. Despite evidence-based interventions like action-based cognitive remediation (ABCR) and metacognitive training (MCT), a research-to-practice gap exists in their application across mental health settings. ObjectiveThe iCogCA study aims to address this gap by implementing digital ABCR and MCT through a national Canadian collaborative effort using digital psychological interventions to enhance cognitive health in SSDs. MethodsThe study involves 5 Canadian sites, with mental health care practitioners trained digitally through the E-Cog platform, which was developed by our research group. Over 2.5 years, participants with SSDs will undergo pre- and postintervention assessments for clinical symptoms, cognition, and functioning. Each site will run groups annually for both ABCR and MCT, totaling ~390 participants. A nonrandomized concurrent controlled design will assess effectiveness design, in which one intervention (eg, ABCR) acts as the active control for the other (eg, MCT) and vice versa, comparing cognitive and clinical outcomes between the interventions using generalized linear mixed effect modeling. Implementation strategy evaluation will consider the digital platform’s efficacy for mental health care practitioners’ training, contextual factors influencing implementation, and sustainability, using descriptive statistics for quantitative data and thematic analysis for qualitative data. ResultsA pilot pragmatic trial has been conducted previously at the Montreal site, evaluating 3 early implementation outcomes: acceptability, feasibility, and engagement. Patient and therapist acceptability was deemed as high and feasible (21/28, 75% of recruited service users completed therapy, rated feasible by therapists). Technology did not appear to significantly impede program participation. Therapist-rated levels of engagement were also satisfactory. In the ongoing study, recruitment is underway (114 participants recruited as of winter 2024), and intervention groups have been conducted at all sites, with therapists receiving training via the E-Cog learning platform (32 enrolled as of winter 2024). ConclusionsAt least 3 significant innovations will stem from this project. First, this national effort represents a catalyst for the use of digital technologies to increase the adoption of evidence-based interventions and will provide important results on the effectiveness of digitally delivered ABCR and MCT. Second, the results of the implementation component of this study will generate the expertise needed to inform the implementation of similar initiatives. Third, the proposed study will introduce and validate our platform to train and supervise mental health care practitioners to deliver these interventions, which will then be made accessible to the broader mental health community. Trial RegistrationClinicalTrials.gov NCT05661448; https://clinicaltrials.gov/study/NCT05661448 International Registered Report Identifier (IRRID)DERR1-10.2196/63269https://www.researchprotocols.org/2025/1/e63269
spellingShingle Christy Au-Yeung
Helen Thai
Michael Best
Christopher R Bowie
Synthia Guimond
Katie M Lavigne
Mahesh Menon
Steffen Moritz
Myra Piat
Geneviève Sauvé
Ana Elisa Sousa
Elisabeth Thibaudeau
Todd S Woodward
Martin Lepage
Delphine Raucher-Chéné
iCogCA to Promote Cognitive Health Through Digital Group Interventions for Individuals Living With a Schizophrenia Spectrum Disorder: Protocol for a Nonrandomized Concurrent Controlled Trial
JMIR Research Protocols
title iCogCA to Promote Cognitive Health Through Digital Group Interventions for Individuals Living With a Schizophrenia Spectrum Disorder: Protocol for a Nonrandomized Concurrent Controlled Trial
title_full iCogCA to Promote Cognitive Health Through Digital Group Interventions for Individuals Living With a Schizophrenia Spectrum Disorder: Protocol for a Nonrandomized Concurrent Controlled Trial
title_fullStr iCogCA to Promote Cognitive Health Through Digital Group Interventions for Individuals Living With a Schizophrenia Spectrum Disorder: Protocol for a Nonrandomized Concurrent Controlled Trial
title_full_unstemmed iCogCA to Promote Cognitive Health Through Digital Group Interventions for Individuals Living With a Schizophrenia Spectrum Disorder: Protocol for a Nonrandomized Concurrent Controlled Trial
title_short iCogCA to Promote Cognitive Health Through Digital Group Interventions for Individuals Living With a Schizophrenia Spectrum Disorder: Protocol for a Nonrandomized Concurrent Controlled Trial
title_sort icogca to promote cognitive health through digital group interventions for individuals living with a schizophrenia spectrum disorder protocol for a nonrandomized concurrent controlled trial
url https://www.researchprotocols.org/2025/1/e63269
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