Re-Frame: pilot randomised controlled trial of a diversion programme for adolescents in police custody who possess illicit substances
| ISRCTN | ISRCTN13396729 |
|---|---|
| DOI | https://doi.org/10.1186/ISRCTN13396729 |
- Submission date
- 26/01/2022
- Registration date
- 14/02/2022
- Last edited
- 04/03/2025
- Recruitment status
- No longer recruiting
- Overall study status
- Completed
- Condition category
- Other
Plain English Summary
Background and study aims
For young people having a criminal record is associated with a variety of negative life outcomes including poor physical and mental health, unemployment, and substance use. The Re-Frame study is a study of a diversion scheme implemented in four regions of England; Kent, Cornwall, Sefton, and Lancashire.
The actual study is quite small and is called an internal pilot study. This means the results of the study will help us design a larger study that will answer the key questions about how useful the intervention is for young people.
Who can participate?
Young people aged between 10 and 17 years who are found by the police to be in possession of a class B or C illegal substance (cannabis or amphetamines for example)
What does the study involve?
Participants can be referred to a young person substance misuse service for assessment and intervention rather than being arrested and charged, avoiding a criminal record. Once referred those considered eligible have their intervention chosen at random, either a two-step psycho-education and brief intervention or simple education only. After 6 months we assess how effective the intervention was in terms of offending behaviour, substance use, and other health and psychological factors.
What are the possible benefits and risks of participating?
Those who participate in the intervention have the potential to reduce their substance use and any associated risk-taking behaviours. This in turn is likely to lead to a reduction in involvement in criminal activity and a reduction in involvement with the police which is known to lead to improvements in young people’s wellbeing. The interventions are based on similar approaches in other areas and there is no evidence of any risks associated with engaging with the intervention.
Where is the study run from?
University of Kent (UK)
When is the study starting and how long is it expected to run for?
October 2021 to December 2022
Who is funding the study?
Youth Endowment Fund - Another Chance Scheme (UK)
Who is the main contact?
Prof Simon Coulton, s.coulton@kent.ac.uk
Contact information
Principal Investigator
Centre for Health Service Studies
George Allen Wing
University of Kent
Canterbury
CT2 7NZ
United Kingdom
 ORCID ID |
0000-0002-7704-3274 |
|---|---|
| Phone | +44 1227 824535 |
| s.coulton@kent.ac.uk |
Study information
| Study design | Multi-centre parallel prospective internal pilot randomized controlled trial |
|---|---|
| Primary study design | Interventional |
| Secondary study design | Randomised parallel trial |
| Study setting(s) | Community |
| Study type | Treatment |
| Participant information sheet | https://research.kent.ac.uk/re-frame/ |
| Scientific title | Re-Frame: A paralell prospective internal pilot randomised controlled trial of a brief intervention diversion programme compared with treatment as usual to reduce offending and substance use for adolescents, aged 10-17 years, identifed as being in possession of illegal class B or C substances. |
| Study acronym | Re-Frame |
| Study hypothesis | Objectives of the pilot trial 1. To pilot study outcomes and evaluation methods, assess the parameters for conducting an efficacy evaluation and to assess whether operational progression criteria have been met and if so to develop a full protocol for an appropriately powered efficacy study. 2. To assess the acceptability of an ethically appropriate standardised business as usual control. 3. To qualitatively explore the feasibility and acceptability of referral pathways, intervention delivery and study assessments from the perspectives of the police, intervention provider and participants. A key aim is to identify how, when, why and for whom the interventions work. |
| Ethics approval(s) | Approved 10/12/2021, University of Kent Social Science Research Ethics Committee (Professor Karen Jones, Chair Social Research Ethics Committee, LSSJ, University of Kent, Canterbury, Kent, CT2 7NZ, UK; +44 1227 823406; lssjethics@kent.ac.uk), ref: SRC0498 |
| Condition | Reduction of offending among young people who use class B or C illicit substances |
| Intervention | Intervention Group Two sessions of Brief Intervention by skilled youth workers. In session one they will use a Drug Grid to reflect on how their actions have affected their lives, their family and wider community. The child will have the opportunity to recall their arrest experience and explain how this impacted them. The practitioner will assist the young person in critically reflecting on this event and offer support in relation to trauma or consequences felt as a result of it. The Drug Grid is a drug education exercise that enables the child to demonstrate current understanding of substances (including medication, legal highs, and image and performance enhancing drugs). As they go through the exercise they will learn about these substances (eg depressant or hallucinogen), being led by their own experience and building on their knowledge base. The worker can dispel myths and provide information on the effects of each substance, including the risks of poly use and overdose. Brief intervention session two is the Drug Triangle. We Are With You Young People’s substance misuse services will aim to complete this session within two weeks of the original referral. Ideally session one will take place in week one and session two in week two, depending on the child's availability and preferences. Using the Drug Triangle, the child will focus on the substance, mindset and setting that led them to the session. This holistic harm reduction approach ties in with contextual safeguarding, framing the child’s situation within a wider context. They will spend time thinking about how this has affected them, their family, school (if applicable), and community. The child will also be encouraged to reflect on the impact on those people and communities that produce drugs. At the end of the session the participant will be advised around their rights in relation to stop and search procedures should they require it in the future as well as assertion techniques and advice relating to the procedure itself. At the end of the two sessions, the young person will have greater clarity about the risks they have taken, the links between substance use, risk-taking behaviour and violent offending, and the potential of criminal proceedings. The short-term aims are that the child will have a greater understanding of their personal needs, an increase in confidence to reduce substance use, and a positive shift from precontemplation to action and maintenance in the cycle of change. Control Group The child will receive one session of Advice, Information, and Signposting. The child will be offered information about the With You substance service in their local area and encouraged to access the service for support if required. Advice, Information, and Signposting is a tier 1, universal level of support. It is unstructured and is based on a conversation only. Randomisation Randomisation will employ random permuted blocks of variable size stratified by site; Kent, Cornwall, Sefton, Lancashire, and by age group; 10-14 versus 15-17 years. Random strings will be created for each stratification combination and deployed independent of the research team and each participant will have equal probability of being allocated to the intervention or business as usual. Randomisation will be conducted after eligibility has been assessed, informed consent provided and baseline assessment conducted. The researcher will enter necessary details into an encrypted database and after necessary data has been checked an allocation code will be provided. This code will indicate the nature of allocated group. The researcher will not be able to access randomisation codes. The participant will not be blind to the intervention. Participants Participants will be referred by the police to existing We Are With You Young People’s substance misuse services across four geographical areas of England; Kent, Sefton, Cornwall, Lancashire. |
| Intervention type | Behavioural |
| Primary outcome measure | All offences; including arrests, cautions and charges, in the 6-months post randomisation obtained directly from the Police National Computer. |
| Secondary outcome measures | 1. Self-reported delinquency assessed at baseline and month 6 using the Self-Report Delinquency Scale (SRDS; (Smith and McVie, 2003)). 2. Quantity, frequency and type of substance use will be assessed at 6-months using the Time Line Follow Back Method (TLFB; (Levy et al., 2004; Sobell and Sobell, 1995)), 3. Mental health and wellbeing will be assessed using the Warwick-Edinburgh Mental Well-being scale at baseline and month 6 (WEMWBS; (Clarke et al., 2011)). 4. Health-related quality of life will be assessed at baseline and month 6 using the Child Health Utility Questionnaire (CHU-9D; (Stevens, 2012)). 5. Emotional regulation and behaviour will be assessed at baseline and month 6 using the self-completed Strength and Difficulties questionnaire (SDQ; (Goodman, 1997)). 6. Motivation to change will be assessed using the readiness to change ruler at baseline and month 6(RR; (Maisto et al., 2011)). 7. Self-efficacy will be assessed using the short Situational Confidence Questionnaire at baseline and month 6 (SCQ-8;(Breslin et al., 1998)). 8. Positive and Negative Expectancy will be assessed using a four-item expectancy measure at baseline and month 6 (SUE; (Montes et al., 2019)). 9. Family environment will be assessed at baseline using the Brief Family relationship Scale (BFRS; (Fok et al., 2014)). 10. Anxiety assessed at baseline using the General Anxiety Disorder Questionnaire (GAD-7; (Mossman et al., 2017)). 11. Depression assessed at baseline using the Personal Health Questionnaire for adolescents (PHQ-A; (Mansour et al., 2020)). 12 Adverse child experiences assessed at baseline using the Adverse Child Experience Questionnaire (ACEQ; (Dong et al., 2004)). |
| Overall study start date | 01/10/2021 |
| Overall study end date | 31/12/2022 |
Eligibility
| Participant type(s) | Other |
|---|---|
| Age group | Child |
| Lower age limit | 10 Years |
| Upper age limit | 17 Years |
| Sex | Both |
| Target number of participants | 96 |
| Total final enrolment | 76 |
| Participant inclusion criteria | 1. Aged 10-17 years inclusive 2. Considered appropriate for diversion by police 3. In possession of class B or C illicit substances |
| Participant exclusion criteria | 1. Arrested for a sexual or violent offence 2. History of four or more offences 3. Substance use severity that requires specialist clinical intervention such as detoxification or medication assisted maintenance 4. Inability to understand oral English sufficiently to engage in the intervention or the follow-up to the extent the participant requires an interpreter to engage with the intervention or research. Outcomes are validated for English language populations. |
| Recruitment start date | 01/02/2022 |
| Recruitment end date | 28/02/2023 |
Locations
Countries of recruitment
- England
- United Kingdom
Study participating centres
Jubilee Way
Faversham
ME13 8GD
United Kingdom
Bootle
L20 7AP
United Kingdom
Tabernacle Street
Truro
Tr1 2EJ
United Kingdom
Percy Street
Preston
Pr1 1HQ
United Kingdom
Sponsor information
University/education
The Registry
Canterbury
CT 2 7NZ
England
United Kingdom
| Phone | +44 1227 764000 |
|---|---|
| researchculture@kent.ac.uk | |
| Website | http://www.kent.ac.uk/ |
"ROR" |
https://ror.org/00xkeyj56 |
Funders
Funder type
Charity
No information available
Results and Publications
| Intention to publish date | 28/02/2023 |
|---|---|
| Individual participant data (IPD) Intention to share | No |
| IPD sharing plan summary | Data sharing statement to be made available at a later date |
| Publication and dissemination plan | We plan to publish a final report for the funder and plan publications in high impact peer reviewed journals. |
| IPD sharing plan | The current data sharing plans for this study are unknown and will be available at a later date. |
Study outputs
| Output type | Details | Date created | Date added | Peer reviewed? | Patient-facing? |
|---|---|---|---|---|---|
| Funder report results | 01/07/2023 | 02/01/2024 | No | No | |
| Results article | 10/02/2024 | 04/03/2025 | Yes | No |
Editorial Notes
04/03/2025: Publication reference added.
02/01/2024: The following changes have been made:
1. Funder report added.
2. The final enrolment number has been added from the report.
20/11/2023: The sponsor contact email has been changed.
17/10/2022: The following changes were made to the trial record:
1. The overall end date was changed from 31/10/2022 to 31/12/2022.
2. The intention to publish date was changed from 30/04/2022 to 28/02/2023.
3. The plain English summary was updated to reflect these changes.
4. The total final enrolment was added.
08/04/2022: The sponsor contact email has been updated.
10/02/2022: Trial's existence confirmed by University of Kent
