Development of a Nigeria-Specific Early Intervention Framework for First-Episode Psychosis Based on Cultural Adaptation Science

Early intervention in psychosis (EIP) has demonstrated robust evidence for improving clinical and functional outcomes, yet no structured EIP framework exists for Nigerian healthcare settings. This study develops a Nigeria-specific EIP framework using cultural adaptation science principles. The development process will span four sequential phases: systematic evidence synthesis through meta-analysis of EIP outcomes in low- and middle-income countries; qualitative stakeholder consultations with patients, families, clinicians, policymakers, and community leaders across six geopolitical zones using participatory action research; iterative framework design incorporating cultural, resource, and systems considerations; and pilot feasibility testing of the framework at three psychiatric hospitals in Lagos, Kano, and Enugu over 12 months. Fidelity, acceptability, and preliminary patient outcomes (DUP, remission rates, caregiver burden) will be measured during the pilot phase. The adaptation process will be guided by Barrera and Castro's heuristic model of cultural adaptation, preserving EIP core components while accommodating Nigerian illness attributions, family structures, and service configurations. This study delivers an original implementation framework with immediate transferability to Nigerian mental health policy and training institutions. Keywords: early intervention, first-episode psychosis, cultural adaptation, Nigeria, framework development