24/12 Improving Outcomes for Children and Young People in Care Using Interventions that Combine Mentoring with Skills Training

Introduction

The aim of the Health Technology Assessment (HTA) Programme is to ensure that high quality research information on the clinical effectiveness, cost-effectiveness and broader impact of healthcare treatments and tests are produced in the most efficient way for those who plan, provide or receive care from NHS and social care services. The commissioned workstream invites applications in response to calls for research on specific questions which have been identified and prioritised for their importance to the NHS, patients and social care.

Research question

Do interventions involving a combination of mentoring and skills training improve outcomes for children or young people in care, do they improve mental health/mental resilience, prevent adolescent risk behaviours and improve inter-personal relationships when compared to current standard of care?

1. Intervention: One of the following programmes, or similar defined programme where a clear justification, with a previous signal of efficacy, is provided:
   
   • Fostering Healthy Futures (FHF)
   • Take Charge (TC)
     • This brief invites applicants to define and justify the age brackets used for each programme and how a programme if previously trialled outside of the UK can be adapted to a UK setting.
2. Patient group: Children and young people (ages 9-17) who are currently residing in kinship care, foster care, residential care or who remain at home but with statutory intervention that transfers legal parental rights to Local Authorities. Applications are encouraged which include recruitment from geographic populations with high burden which have been historically underserved by research activity in this field.
3. Setting: Community setting
4. Comparator: Current standard of care for a child or young people of their age (Applicants to define and justify).
5. Study design: A randomised controlled trial with an internal pilot phase to test key trial processes such as recruitment and adherence. Clear stop/go criteria should be provided to inform progression from pilot to full trial. Applicants should have clear monitoring arrangements with the use of a Trials Unit with safeguarding mechanisms in place from the start. Applicants should consider whether an economic evaluation could be included alongside the main trial design.
6. Important outcomes: Child subjective well-being and mental health, Quality of relationships with peers, Quality of relationships with carers and other significant adults, Suicide-related outcomes (applicants to define and justify qualitative methodology to be used to measure these outcomes). Other outcomes: Development of mental, behavioral and neurodevelopmental disorders, Reports of disorderly or criminal activity post-intervention, Level of academic success post-intervention. Existing Core Outcomes should be included amongst the list of outcomes unless a good rationale is provided to do otherwise. Applicants are encouraged to report recruitment and findings disaggregated by sex (and other demographic factors where relevant).
7. Minimum duration of follow-up: Follow ups should be at 3, 6 and 12 months.
   Longer-term follow up: If appropriate, researchers should consider obtaining consent to allow potential future follow up through efficient means (such as routine data) as part of a separately funded study.

Rationale

Care-experienced young people are young people who have resided or are currently residing in kinship care, foster care, residential care or who remain at home but with statutory intervention that transfers legal parental rights to Local Authorities. A government report in 2016 identified the needs of these children as a government priority as they are “one of the most vulnerable and disadvantaged groups in our society”. Recent guidance published in 2022 by the National Institute for Health and Care Excellence recommended that further development and evaluation of mentoring and parenting interventions to address the mental health and wellbeing of care-experienced young people is required.

A review by the National Institute for Health and Care Research called the “Care-experienced children and young people’s Interventions to improve Mental health and wellbeing outcomes: Systematic review” or CHIMES review, examined several interventions addressing the mental health and wellbeing of care-experience children and young people. The review combined an examination of previous studies with consultations with young people in foster care, care professionals and policy maker to make its conclusions.

The review concluded that interventions addressing the interpersonal relationships between the care-experienced children and young people and either their peers or significant adults are a priority for research. Two interventions were identified by the review as potentially fitting this need, “Fostering Healthy Futures” and “Take Charge”.

“Fostering Healthy Futures” involves both mentoring and skills groups; the mentoring schemes provide one-on-one mentoring with social work students, which is predicted to reduce risk factors and promote resilience. “Take Charge” involves youth-directed coaching and near-peer mentoring with the aim of increasing self-determination and goal achievement.

Studies have shown a level of effectiveness with both these interventions but studies have a bias towards being carried out in the US, requiring a UK trial to ensure that the results can be replicated when transposed to a country with a different culture and residential/foster care system, such as the UK.

Additional commissioning brief background information

A background document is available that provides further information to support applicants for this call. It is intended to summarise what prompted the call and the existing evidence base, including relevant work from the HTA and wider NIHR research portfolio. It was researched and written on the basis of information from a search of relevant sources and databases, and in consultation with a number of experts in the field. If you would like a copy please email htaresearchers@nihr.ac.uk.

Making an application

If you would like to apply for this funding opportunity, you can begin your application via the Funding opportunities page.

Your application must be submitted online no later than 1pm, 24 July 2024. Applications will be considered by the HTA Funding Committee at its meeting in September 2024.

Guidance notes and supporting information for HTA Programme applications are available.

Shortlisted Stage 1 applicants will be given 8 weeks to submit a Stage 2 application. The Stage 2 application will be considered at the Funding Committee in January 2025.

Applications received electronically after 1pm on the due date will not be considered.

For commissioned topics, the Programme strongly discourages the practice of the same co-applicant joining more than one competing team. There may be unusual circumstances where the same person could be included on more than on application eg a lead from a named charity or a unique national expert in a condition.

For such exceptions, each application needs to state the case as to why the same person is included. The shared co-applicant should not divulge application details between teams, and both teams should acknowledge in their application that they are aware of the situation, and that study details have not been shared.

Should you have any queries please contact us via email: htacommissioning@nihr.ac.uk.