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为老年犯罪受害者开展务实随机对照试验时的跨部门合作:我们的经验与教训

Cross-agency working when conducting a pragmatic RCT for older victims of crime: our experiences and lessons learned.

作者信息

Serfaty Marc, Satchell Jessica, Laycock Gloria K, Brewin Chris R, Buszewicz Marta, Leavey Gerard, Drennan Vari M, Cooke Jonathan, Kessel Anthony

机构信息

Division of Psychiatry, Department of Epidemiology and Applied Clinical Research, University College London, 6th Floor, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK.

Priory Hospital North London, London, UK.

出版信息

Trials. 2025 Jan 15;26(1):17. doi: 10.1186/s13063-024-08680-y.

Abstract

BACKGROUND

With the population ageing, more victims of community crime are likely to be older adults. The psychological impact of crime on older victims is significant and sustained, but only feasibility trials have been published regarding potential interventions. The integration of public health and care services and cross-agency working is recommended, but there is little information on how this should be undertaken. Our recent Victim Improvement Package (VIP) randomised controlled trial (RCT) involved cross-agency collaboration between our university, a police service and a mental health charity. However, as the VIP trial only managed to recruit 131 out of 226 participants, we hope our reflections will help those wishing to conduct research in this population.

METHODS

The trial management group (authors) and partners organisations identified the challenges and lessons learned from conducting the VIP trial in which the police identified and screened victims of reported community crime, aged 65 years or over, for distress. In the VIP trial, three screening methods were used: (1) visits by safer neighbourhood teams (SNTs), (2) police telephone screening and (3) employment of a university researcher embedded within the police service. Staff from the mental health charity were trained to deliver a manualised cognitive-behaviourally informed Victim Improvement Package (VIP) to be compared against treatment as usual (TAU).

LESSONS LEARNED

Factors promoting successful screening included simple IT systems, building rapport with the police and maintaining contact with participants. However, policy and staff changes within the police service and altered public confidence in the police compromised screening. The delivery of therapy was impaired by waiting times, therapist availability and the quality of therapy. Conducting research within an existing busy clinical service was challenging, but the COVID-19 pandemic demonstrated the acceptability and feasibility of offering online therapy to older victims.

CONCLUSION

SNT screening was an effective way to identify distressed victims, but service demands question whether it is viable for working police staff and the delivery of the therapy proved challenging in the context of a traditional RCT. Ways in which to strengthen research in this pioneering area of work are discussed.

摘要

背景

随着人口老龄化,社区犯罪的受害者中老年人可能会增多。犯罪对老年受害者的心理影响重大且持续存在,但关于潜在干预措施仅有可行性试验发表。建议整合公共卫生和护理服务以及跨机构合作,但对于如何开展这方面工作的信息却很少。我们最近的受害者改善方案(VIP)随机对照试验(RCT)涉及我们大学、警察局和一家心理健康慈善机构之间的跨机构合作。然而,由于VIP试验仅成功招募了226名参与者中的131名,我们希望我们的反思能帮助那些希望在这一人群中开展研究的人。

方法

试验管理小组(作者)和合作组织确定了在进行VIP试验过程中遇到的挑战和吸取的经验教训,在该试验中,警方识别并筛查65岁及以上报告的社区犯罪受害者的痛苦情况。在VIP试验中,使用了三种筛查方法:(1)邻里安全小组(SNTs)上门走访,(2)警方电话筛查,以及(3)聘用一名驻警察局的大学研究人员。来自心理健康慈善机构的工作人员接受培训,以提供一份以认知行为为依据的手册化受害者改善方案(VIP),并与常规治疗(TAU)进行比较。

经验教训

促进成功筛查的因素包括简单的信息技术系统、与警方建立融洽关系以及与参与者保持联系。然而,警察局内部的政策和人员变动以及公众对警方信心的改变损害了筛查工作。治疗的提供受到等待时间、治疗师可用性和治疗质量的影响。在现有的繁忙临床服务中开展研究具有挑战性,但新冠疫情证明了为老年受害者提供在线治疗的可接受性和可行性。

结论

邻里安全小组筛查是识别痛苦受害者的有效方法,但服务需求使人质疑这对在职警察工作人员是否可行,并且在传统随机对照试验的背景下,治疗的提供被证明具有挑战性。本文讨论了在这一开创性工作领域加强研究的方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1ae5/11734491/8f547c726ee3/13063_2024_8680_Fig1_HTML.jpg

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