Condition category
Not Applicable
Date applied
20/04/2018
Date assigned
14/05/2018
Last edited
09/09/2020
Prospective/Retrospective
Prospectively registered
Overall trial status
Ongoing
Recruitment status
Recruiting

Plain English Summary

Current plain English summary as of 09/09/2020:
Background and study aims
The study aims to determine whether a new out of court programme, named Gateway, improves the health and well-being of young adult offenders aged 18-24, and influences their chance of offending again. Young adult offenders commonly have a range of health and social needs, making them vulnerable to mental health problems. If they are aged between 18-24 years old and have committed a crime, they may need to attend court and face convictions such as prison. However, many believe that more should be done to prevent young adults from entering prison in the first place. The Gateway programme has been developed by Hampshire Constabulary and The Hampton Trust, in partnership with local community groups, with an aim to improve the life chances of young adult offenders. In the programme, a mentor assesses the needs of each adult and develops a pathway with referrals to healthcare, housing support and other support services. The young adult then participate in two workshops about empathy and the causes and consequences of their behaviour. Such intervention programmes are believed to improve the health and well-being of young offenders, and reduce criminal behaviour. However, there is currently little information about how well they work.

Who can participate?
Offenders aged 18 to 24 years old, residing within the Hampshire Constabulary Force Area (HCFA) where the Gateway programme is being provided, who have been arrested for a low-level criminal offence and meet the eligibility criteria.

What does the study involve?
Once charged with an offence, the participants are randomly allocated to either take part in the Gateway programme, or be given a court conviction or other conditional caution. To compare whether the Gateway programme is more (or less) effective at improving their outcomes, participants are followed up for one year. Their outcomes are compared at three timepoints. Specifically, differences in mental health and well-being, quality of life, criminal behaviour, access to health and social care and substance abuse are studied. Some may be asked to participate in restorative justice, which is a meeting between the offender and the victim. The offender has the opportunity to discuss and make amends for the crime they committed. To explore how satisfied the victims, and those delivering and receiving the Gateway programme, are with Gateway in general, qualitative interviews are also being held. Furthermore, information about how much the Gateway programme costs to deliver will be considered.

What are the possible benefits and risks of participating?
The main benefit from this study will be in helping to add to the knowledge about this programme, and whether it helps young adults who otherwise would face a court conviction or other conditional caution. Following completion of each interview to collect study data, the University of Southampton will provide participants with a shopping voucher gift to encourage retention in this population. It is possible that some participants may find it upsetting to talk about their individual circumstances and issues. For those allocated to the Gateway programme, analysing own previous behaviour or meeting the victim may be emotionally upsetting. Details of where support can be accessed will be provided

Where is the study run from?
University of Southampton, University of York and Hampshire Constabulary (UK)

When is the study starting and how long is it expected to run for?
March 2018 to July 2021

Who is funding the study?
Public Health Research (PHR) of the National Institute for Health Research (UK)

Who is the main contact?
Ms Ann Cochrane
ann.cochrane@york.ac.uk



Previous plain English summary:
Background and study aims
The study aims to determine whether a new out of court programme, named Gateway, improves the health and well-being of young adult offenders aged 18-24, and influences their chance of offending again. Young adult offenders commonly have a range of health and social needs, making them vulnerable to mental health problems. If they are aged between 18-24 years old and have committed a crime, they may need to attend court and face convictions such as prison. However, many believe that more should be done to prevent young adults from entering prison in the first place. The Gateway programme has been developed by Hampshire Constabulary and the Hampton Trust, in partnership with local community groups, with an aim to improve the life chances of young adult offenders. In the programme, a mentor assesses the needs of each adult and develops a care pathway with referrals to healthcare. The young adult offenders then attend two workshops about empathy, and the causes and consequences of their behaviour. Such programmes are believed to improve the health and well-being of young offenders, and reduce criminal behaviour. However, there is currently little information about how well they work.

Who can participate?
18-24 year-old offenders who have been arrested for at least a second time for a low level criminal offence

What does the study involve?
Once charged with an offence at Southampton police station, the participants are randomly allocated to either take part in the Gateway programme, or to not take part and be given a court conviction. To compare whether the Gateway programme is more (or less) effective at improving their outcomes, participants are followed up for two years. Their outcomes are compared at different time points. Specifically, differences in mental health and well-being, quality of life, criminal behaviour, access to health and social care and substance abuse are studied. Some are asked to participate in restorative justice, which is a meeting between the offender and the victim. The offender has the opportunity to discuss and make amends for the crime they committed. To explore how satisfied the victims are with this, and on Gateway in general, victims are also interviewed. To understand what works, where and for whom, further interviews are undertaken with groups delivering the programme in other counties. Furthermore, to understand how costly the programme is, the costs spent through each group, as well as the associated health improvements, are compared.

What are the possible benefits and risks of participating?
The main benefit from this study will be in helping to add to the knowledge about this programme, and whether it helps young adults who otherwise would face a court conviction. Following completion of each dataset, the University of Southampton will provide participants with a supermarket voucher to encourage retention in this population. It is possible that some participants may find it upsetting to talk about their individual circumstances and issues. For those allocated to the Gateway programme, analysing own previous behaviour or meeting the victim may be emotionally upsetting.

Where is the study run from?
Southampton Central Police Station (UK)

When is the study starting and how long is it expected to run for?
March 2018 to July 2021

Who is funding the study?
National Institute for Health Research (UK)

Who is the main contact?
Mrs Alison Booth
alison.booth@york.ac.uk

Trial website

Contact information

Type

Public

Primary contact

Ms Ann Cochrane

ORCID ID

http://orcid.org/0000-0002-1502-6719

Contact details

Department of Health Sciences
Lower Ground Floor
ARRC Building
Faculty of Science
University of York
Heslington
York
YO10 5DD
United Kingdom
+44 (0)1904 321084
ann.cochrane@york.ac.uk

Additional identifiers

EudraCT number

ClinicalTrials.gov number

Protocol/serial number

NIHR Public Health Research Programme ref: 16/122/20, Protocol version 2.7, 25/06/2020

Study information

Scientific title

Gateway: a randomised controlled trial, economic and qualitative evaluation to examine the effectiveness of an out-of-court community-based Gateway intervention programme aimed at improving health and well-being for young adult offenders; victim satisfaction and reducing recidivism

Acronym

GATEWAY

Study hypothesis

It is hypothesised that the Gateway intervention will have a beneficial effect on the health and well-being (including alcohol and substance use), access to health and social services and quality of life for young adults who re-offend for low level criminal offences.

Ethics approval

1. The Hampshire Constabulary Ethics Department, 16/03/2018
2. University of Southampton Ethics and Research Governance Board - approval pending
The trialists obtained confirmation that ethical review by an NHS REC, HMPPS (NOMS) or The Social Care REC were not necessary

Study design

Multi-site, pragmatic randomized controlled trial with an economic evaluation and qualitative study

Primary study design

Interventional

Secondary study design

Randomised controlled trial

Trial setting

Other

Trial type

Other

Patient information sheet

Not available in web format, please use the contact details to request a participant information sheet

Condition

The study population of interest are 18-24 year-old offenders who have been arrested for a low level criminal offence. According to police statistics, the five main categories are: violence; possession or trafficking of drugs; theft; criminal damage; and public order offences. These young adults represent a vulnerable population with a range of complex needs, such as mental health issues and drug and substance misuse. They are more likely to come into contact with the police both as suspects and victims of crime and are significantly over represented in the formal justice process, accounting for approximately one-third of police, probation and prison caseloads

Intervention

Current interventions as of 09/09/2020:
Once charged with an offence, the consenting participants will be allocated to either the intervention group or the control group using a computer program.

Gateway is an out-of-court community based intervention (OCBI) with three components: assessing health and social care needs (triaging) and mentoring; empathy workshops; and a commitment to not re-offend. Restorative justice conferencing may be an additional requirement. The programme therefore addresses several risk and protective factors, thereby aiming to promote health and well-being for the individual and supporting desistence. The Gateway programme is issued as a 16 week conditional caution.

Participants randomised to the control group will receive routine disposal; that is either a different conditional caution (not Gateway) or they will be discharged from the police station to await a date for their court appearance where they will receive the judgement of the court.

To compare whether the Gateway programme is more (or less) effective at improving their outcomes, as compared to a different caution or court conviction, participants will be followed up for one year. Their outcomes will be compared at different time points. Specifically, differences in mental health and well-being, quality of life, criminal behaviour, access to health and social care and substance abuse will be studied. To explore how satisfied the victims were with this, and on Gateway in general, victims will also be interviewed. To understand what works, where and for whom, further interviews will be undertaken with groups delivering the programme in other counties.

Information about how much the Gateway programme costs to deliver compared to usual care will be considered and take into account any identified benefits of the programme.


Previous interventions:
Once charged with an offence at Southampton police station, the consenting participants will be allocated to either the intervention group or the control group by chance using a computer program.

Gateway is an out-of-court community based intervention (OCBI) with three components: assessing health and social care needs (triaging) and mentoring; empathy workshops; and restorative justice conferencing. The programme therefore addresses several risk and protective factors, thereby aiming to promote health and well-being for the individual and supporting desistence.

Participants randomised to the control group will receive routine disposal; that is they will be discharged from the police station to await a date for their court appearance where they will receive the judgement of the court.

To compare whether the Gateway programme is more (or less) effective at improving their outcomes, as compared to court conviction, participants will be followed up for two years. Their outcomes will be compared at different time points. Specifically, differences in mental health and well-being, quality of life, criminal behaviour, access to health and social care and substance abuse will be studied. To explore how satisfied the victims were with this, and on Gateway in general, victims will also be interviewed. To understand what works, where and for whom, further interviews will be undertaken with groups delivering the programme in other counties. Furthermore, to understand how costly the programme is, the costs spent through each group, as well as the associated health improvements, will be compared.

Intervention type

Behavioural

Phase

Drug names

Primary outcome measure

Mental health and well-being measured using the Warwick-Edinburgh Mental Health and Well-being Scale (WEMWBS) at 4 weeks, 16 weeks and 1 year post randomisation

Secondary outcome measures

The following secondary outcomes will be measured at 4 weeks, 16 weeks and 1 year post randomisation:
1. Mental and physical functioning and overall health-related-quality of life measured using SF-12
2. Risky alcohol use measured using the Alcohol Use Disorders Identification Test (AUDIT)
3. Drug use measured using the Adolescent Drug Involvement Scale (ADIS)
4. Data on resource use, including access to primary and secondary care health services and social care, gathered using the Client Service Receipt Inventory (CSRI), primarily to inform the economic evaluation
5. Re-offending type and frequency from routinely collected police data
6. Mortality and morbidity, from routine data for patient admission statistics (PAS)

In addition:
1. The Adverse Childhood Experiences (ACE) questionnaire administered at 16 weeks only

Overall trial start date

01/03/2018

Overall trial end date

31/07/2021

Reason abandoned (if study stopped)

Eligibility

Participant inclusion criteria

Current participant inclusion criteria as of 09/09/2020:
1. Suspects aged between 18 and 24 years
2. Suspect resides within the Hampshire Constabulary Force Area (HCFA)
3. Anticipated guilty plea (i.e. admitted the offence and said nothing which could be used as a defence or has made no admission but has not denied the offence or otherwise indicated it will be contested)
4. Full code test met (i.e. there is sufficient evidence and it is in the public interest to charge the suspect)


Previous participant inclusion criteria:
1. Offenders within the Southampton district policing area aged 18-24 years who accept responsibility for an offence in accordance with National Police Chiefs’ Council (NPCC) Guidelines for Community Resolution
2. Case where there is sufficient evidence to meet the Crown Prosecution Service Full Code Test 1 (Evidential standard)
3. 18 year olds that have previously been engaged by Southampton Youth Offender Service with community based orders in the last 12 months

Participant type

Other

Age group

Adult

Gender

Both

Target number of participants

334

Participant exclusion criteria

Current participant exclusion criteria as of 09/09/2020:
1. Hate crime according to Crown Prosecution Services (CPS) Policy
2. Domestic violence related crime
3. Sexual offence related crime referred to CPS
4. Knife crimes
5. Where on conviction the court is more likely to impose a custodial sentence (based on sentencing guides)
6. Remand in custody order is sought
7. Breach of court or sexual offences orders
8. Any offence involving serious injury or death of another
9. Offences under terrorism or official secrets legislation
10. Indictable only offences
11. All drink/drive or endorsable traffic offences
12. Offender already has a Gateway programme flag
13. Offender needs an interpreter
14. Any serious previous convictions within the last 2 years (i.e. serious violence, grievous bodily harm (GBH) or worse, serious sexual offences, robbery or indictable only offences)
15. Summary offences more than 4 months old
16. Persons subject to Court bail; Prison Recall, Red IOM (Integrated Offender Management) or currently under Probation


Previous participant exclusion criteria:
1. Hate crime according to Crown Prosecution Services (CPS) Policy
2. Domestic violence related crime dealt with under Project CARA (community intervention)
3. Domestic violence related crime referred to CPS
4. Offenders suitably dealt with by way of Community Caution as an immediate disposal
5. Where on conviction the court is more likely to impose a custodial sentence (based on sentencing guides)
6. Any offenders currently under multi-agency public protection arrangement (MAPPA) case management
7. Breach of court or sexual offences orders
8. Any offence involving a death of another
9. Offences under terrorism or official secrets legislation
10. Indictable only offences
11. All drink drive offences

Recruitment start date

01/10/2019

Recruitment end date

30/06/2021

Locations

Countries of recruitment

United Kingdom

Trial participating centre

Southampton Central Police Station
Hampshire Constabulary Southern Road
Southampton
SO15 1AN
United Kingdom

Trial participating centre

Portsmouth Central Police Station
Winston Churchill Avenue
Portsmouth
PO1 2DG
United Kingdom

Trial participating centre

Northern Police Investigation Centre (Basingstoke)
Jays Close Viables Business Park
Basingstoke
RG22 4BS
United Kingdom

Trial participating centre

Newport Police Station
High Street Newport
Isle of Wight
PO30 1SZ
United Kingdom

Sponsor information

Organisation

University of Southampton

Sponsor details

Highfield
Southampton
SO17 1BJ
United Kingdom

Sponsor type

University/education

Website

https://www.southampton.ac.uk/

Funders

Funder type

Government

Funder name

Public Health Research Programme

Alternative name(s)

NIHR Public Health Research Programme, PHR

Funding Body Type

government organisation

Funding Body Subtype

National government

Location

United Kingdom

Results and Publications

Publication and dissemination plan

The study protocol will be made freely available on the NIHR PHR project page: https://www.journalslibrary.nihr.ac.uk/programmes/phr/1612220/#/. The study results will be written in a formal report as well as a short summary report, which will be written so that it is easily understood by the public. The study findings will also be shared with all groups and partners involved in the study, including the offender and victim groups, the Public Participation Panel, academics and policy-makers locally and nationally.

IPD sharing statement
The trial dataset will be held at York Trials Unit. Access will be considered on a case by case basis following completion of the trial.

Intention to publish date

30/06/2021

Participant level data

Available on request

Basic results (scientific)

Publication list

Publication citations

Additional files

Editorial Notes

09/09/2020: The following changes have been made: 1. The recruitment start date has been changed from 01/06/2018 to 01/10/2019. 2. The recruitment end date has been changed from 31/05/2019 to 30/06/2021. 3. The study design has been changed from "Single-site pragmatic randomised controlled trial with an embedded economic evaluation and qualitative study" to "Multi-site, pragmatic randomized controlled trial with an economic evaluation and qualitative study". 4. The protocol version has been changed from "Protocol version 1.3 16 April 2018" to "NIHR Public Health Research Programme ref: 16/122/20, Protocol version 2.7, 25/06/2020". 5. the condition has been updated from "The study population of interest are 18-24 year-old offenders who have been arrested for at least a second time for a low level criminal offence. According to police statistics, the five main categories are: violence; possession or trafficking of drugs; theft; criminal damage; and public order offences. These young adults represent a vulnerable population with a range of complex needs, such as mental health issues and drug and substance misuse. They are more likely to come into contact with the police both as suspects and victims of crime and are significantly over represented in the formal justice process, accounting for approximately one-third of police, probation and prison caseloads" to "The study population of interest are 18-24 year-old offenders who have been arrested for a low level criminal offence. According to police statistics, the five main categories are: violence; possession or trafficking of drugs; theft; criminal damage; and public order offences. These young adults represent a vulnerable population with a range of complex needs, such as mental health issues and drug and substance misuse. They are more likely to come into contact with the police both as suspects and victims of crime and are significantly over represented in the formal justice process, accounting for approximately one-third of police, probation and prison caseloads". 6. The interventions have been updated. 7. The participant inclusion criteria have been updated. 8 The participant exclusion criteria have been updated. 9. The trial participating centres "Portsmouth Central Police Station", "Northern Police Investigation Centre (Basingstoke)", and "Newport Police Station" have been added. 10. The funder has been updated. 11. The trial contact has been updated. 12. The plain English summary has been updated to reflect the changes above.