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支持受照料儿童和离开照料机构的青少年减少药物和酒精使用(SOLID):一项针对12至20岁受照料儿童和离开照料机构的青少年开展的减少危险物质使用(药物和酒精)并改善其心理健康干预措施的试点可行性随机对照试验方案

Supporting Looked After Children and Care Leavers In Decreasing Drugs, and alcohol (SOLID): protocol for a pilot feasibility randomised controlled trial of interventions to decrease risky substance use (drugs and alcohol) and improve mental health of looked after children and care leavers aged 12-20 years.

作者信息

Alderson Hayley, McGovern Ruth, Brown Rebecca, Howel Denise, Becker Frauke, Carr Louise, Copello Alex, Fouweather Tony, Kaner Eileen, McArdle Paul, McColl Elaine, Shucksmith Janet, Steele Alison, Vale Luke, Lingam Raghu

机构信息

Institute of Health and Society, Newcastle University, Baddiley Clarke Building, Richardson Road, Newcastle, NE2 4AX UK.

School of Psychology, University of Birmingham, Edgbaston, Birmingham, B15 2TT UK.

出版信息

Pilot Feasibility Stud. 2017 May 22;3:25. doi: 10.1186/s40814-017-0138-7. eCollection 2017.

Abstract

BACKGROUND

Looked after children (LAC) and care leavers are young people who have been placed under the legal care of local authorities, in many instances due to a history of abuse and/or neglect. These young people have a significantly increased risk of substance use and mental disorder compared to their peers. The aim of the SOLID study is to assess the feasibility and acceptability of a definitive three-arm multi-centre randomised controlled trial (RCT) that compares the effectiveness of two interventions that aim to reduce risky drug and alcohol use and improve mental health among LAC aged 12 to 20 years with usual care.

METHODS

All LAC aged 12 to 20 years residing in four local authorities in North East England will be screened by their social worker for risky drug and alcohol use using the CRAFFT (Car, Relax, Alone, Forget, Friends and Trouble) screening tool. Those who score ≥2 will be invited to take part in the trial after further eligibility checks. Informed consent will be taken and baseline data collected. Participants will then be randomised into either (i) Motivational Enhancement Therapy, (ii) Social Behaviour and Network Therapy, or (iii) control-usual care. Follow-up data will be collected 12 months post-baseline. The baseline and follow-up questionnaires will measure self-reported drug and alcohol use, mental health and well-being and health-related quality of life. The follow-up will also collect data on placement stability and self-reported sexual, antisocial and criminal behaviour. Participants will also be asked about the use of health and social services. A detailed process evaluation, using both qualitative and quantitative methods, will be conducted and involve LAC, their carers, social workers and drug and alcohol practitioners.

DISCUSSION

Despite having an increased likelihood of risky substance misuse, there is a lack of evidence outlining specific interventions to decrease drug and alcohol use targeting LAC. This feasibility study will provide the information needed to develop a definitive trial. LAC will benefit from the results of this study and the further development of the interventions.

TRIAL REGISTRATION

ISRCTN80786829.

摘要

背景

受照管儿童和离开照管机构的青少年是指那些被地方当局依法照管的年轻人,在很多情况下是由于曾遭受虐待和/或忽视。与同龄人相比,这些年轻人使用毒品和患精神障碍的风险显著增加。SOLID研究的目的是评估一项确定性三臂多中心随机对照试验(RCT)的可行性和可接受性,该试验比较两种干预措施与常规照护的效果,这两种干预措施旨在减少12至20岁受照管儿童的危险药物和酒精使用并改善其心理健康。

方法

居住在英格兰东北部四个地方当局辖区内的所有12至20岁受照管儿童将由其社会工作者使用CRAFFT(汽车、放松、独处、遗忘、朋友和麻烦)筛查工具对危险药物和酒精使用情况进行筛查。得分≥2分的儿童在经过进一步的资格检查后将被邀请参加试验。将获取知情同意并收集基线数据。然后,参与者将被随机分为以下三组:(i)动机增强疗法,(ii)社会行为与网络疗法,或(iii)对照——常规照护。将在基线后12个月收集随访数据。基线和随访问卷将测量自我报告的药物和酒精使用情况、心理健康和幸福感以及与健康相关的生活质量。随访还将收集关于安置稳定性以及自我报告的性、反社会和犯罪行为的数据。参与者还将被问及健康和社会服务的使用情况。将使用定性和定量方法进行详细的过程评估,评估对象包括受照管儿童、他们的照料者、社会工作者以及毒品和酒精从业者。

讨论

尽管受照管儿童滥用危险物质的可能性增加,但缺乏针对减少其药物和酒精使用的具体干预措施的证据。这项可行性研究将为开展确定性试验提供所需信息。受照管儿童将从本研究结果以及干预措施的进一步发展中受益。

试验注册

ISRCTN80786829。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b0ea/5439153/bff9d76ca0e1/40814_2017_138_Fig1_HTML.jpg

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