Acceptability of the Cardiff Online Cognitive Assessment for Clinical Screening of Patients With Psychosis: Protocol for a Mixed Methods Study

TL;DR

This study aims to test if an online cognitive assessment tool is acceptable for patients with psychosis and health professionals.

Contribution

The study introduces a protocol to evaluate the acceptability of the Cardiff Online Cognitive Assessment (CONCA) in clinical settings.

Findings

The study will assess the acceptability of CONCA among young people with psychosis and health professionals.

Barriers and facilitators to implementing CONCA in clinical services will be identified.

Results will inform future effectiveness-implementation studies of the tool.

Abstract

The early detection of cognitive impairments in individuals with psychosis offers a means to support clinical and functional recovery. However, there are significant barriers to assessing cognition in clinical services, including lack of staff time, training, and confidence in administering assessments. We have developed the Cardiff Online Cognitive Assessment (CONCA), aiming to address these barriers, and here present the protocol to assess its acceptability as a clinical tool.

The aim of this study is to conduct the early-stage testing of the CONCA as a clinical tool to determine whether it is acceptable to young people with a history of psychosis and to health professionals.

This cross-sectional study will use a mixed methods approach. A total of 100 young people with a history of psychosis will complete the CONCA and an acceptability questionnaire. We will conduct qualitative interviews with a minimum of 20 participants with psychosis and 10 participants with professional experience of working in early intervention in psychosis services to explore opinions on the CONCA as a clinical tool, attitudes toward and barriers or facilitators of implementing the CONCA, and cognitive testing more generally in clinical services. Quantitative data will be analyzed using descriptive statistics and linear or logistic regression. Qualitative interviews will be analyzed using a deductive thematic analysis approach.

The enrollment of study participants started in July 2025 and is expected to end in October 2026. Data analysis is expected to be finalized by March 2027. As of September 15, 2025, we have enrolled 26 participants with psychosis in the quantitative arm of the study, and 4 participants with psychosis and 1 health professional in the qualitative arm.

Our results will provide new data on the acceptability of the CONCA and cognitive testing more generally among patients and clinicians, as well as identify barriers and facilitators to the CONCA’s implementation. This will provide the groundwork for a larger hybrid effectiveness-implementation study.

Figures