Building a Sexual and Reproductive Health Module for Implementation in Early Psychosis Programs: A Co-creation Process: Création d’un module sur la santé sexuelle et reproductive à mettre en œuvre dans les programmes d’intervention précoce en cas de psychose : un processus de création conjointe

BackgroundIndividuals with psychosis are at risk for adverse sexual and reproductive health (SRH) experiences, and for receiving suboptimal SRH care. Early psychosis intervention (EPI) programs offer an opportunity to address SRH early in the illness course, yet SRH is not currently part of routine EPI care. This project sought to develop a SRH module for women, transgender, and gender-diverse individuals for delivery within EPI care.MethodsTo develop the SRH module, an integrated knowledge translation frame was used, informed by a community-based participatory action research approach. A working group was formed of diverse Youth Advisors (n = 3) and a Youth Engagement Specialist (n = 1) with lived experience with early psychosis, SRH experts (n = 3), mental health experts (n = 3), and research staff (n = 1). The working group met approximately biweekly to co-develop the module (January-October 2023). The module was formatted based on the NAVIGATE model of coordinated specialty care, and was informed by prior research on SRH and working group members' lived and clinical experiences.ResultsThe working group developed an interactive module covering five topics: (1) relationships, (2) sexual health, (3) reproductive health, (4) sexual orientation and gender identity, and (5) interpersonal violence. For each topic, client-facing materials (check-in questions, potential topics, worksheets) and clinician-facing materials (goals, handouts, suggested agendas, teaching strategies, tips for common challenges, evaluating gains and therapeutic goals, specific techniques, probes) were developed. SRH and mental health experts brought evidence-based content, and youth brought an affirming and youth-friendly lens to language and content.ConclusionThe developed module covers a broad array of SRH topics important to youth. If implementation is successful, the module could improve SRH-related well-being and outcomes for women, transgender, and gender-diverse youth with psychosis. Including youth with lived experience as collaborators enhanced inclusivity and relevance.