Redthread 'Youth Violence Intervention Programme' evaluation 1.0
Research type
Research Study
Full title
Redthread 'Youth Violence Intervention Programme' evaluation
IRAS ID
313341
Contact name
Paul Montgomery
Contact email
Sponsor organisation
The University of Birmingham
Clinicaltrials.gov Identifier
1185413, YEF Charity Number
Duration of Study in the UK
1 years, 2 months, 4 days
Research summary
Research Summary
The research aims to understand whether the Youth Violence Intervention Programme (YVIP) provided by Redthread (a charity) leads to a reduction in violence/abuse related hospital readmissions for children and young people (CYP) aged 10-17 in the following year.During 2020/21 there were 4,091 attendances to an emergency department (ED) due to assault by a sharp object; 17% were aged 18 and under.
Historically in the UK, prevention of youth violence has been the responsibility of community and police services. Interventions where youth workers work in EDs are emerging, however there is a lack of robust evidence in the UK to see if they work.
We are conducting a mixed methods study of whether the Redthread service works. The service is based in EDs and works with CYP who are at risk / victims of violence, exploitation or gang involvement. CYP are referred by clinical staff. The intervention is short-term and intensive (up to 12 weeks on average).
In the first year the study will take place in four hospital sites in Birmingham and London. This will act as pilot study.We aim to undertake:
1) interviews with key stakeholder groups to see how the service works and if there are barriers to use.
2) Analysis of data from CYP who have undergone the service compared to similar CYP who did not.Summary of results
Redthread’s (RT) Youth Violence Intervention Programme (YVIP) works with 11- to 25-year-olds who present to hospital emergency departments (EDs) following a violent incident or an incident that puts them at risk of involvement in violence. It aims to keep them safe from involvement in violence in the future. Eligible children and young people are identified by NHS staff or RT youth workers. An RT youth worker then makes contact with the child or young person to establish whether they are at risk of involvement in violence and assess their needs, risks and support network. This contact will usually occur in the hospital but can also occur outside if the young person has been discharged. If the young person is at lower risk, they will receive short-term one-to-one support from the RT youth worker; this is likely to last around four weeks, but the length of support varies. For children and young people who are more vulnerable, RT offers a longer intervention that lasts up to three months (and longer for those with particularly high needs). Support offered to children and young people may include 1:1 meetings to discuss healthy relationships or managing difficult emotions, support to engage with education, help to secure alternative accommodation, signposting to mental health or substance misuse support, and access to financial support. The content and dosage of support will vary depending on the needs and choice of individuals. Some will receive weekly 1:1 support; others will be offered more sporadic interaction.
ED navigator programmes like YVIP are associated with a large estimated impact on reducing further violence.
However, the evidence that underpins this estimate is severely limited, and we lack a robust estimate of impact in a UK context. YEF, therefore, funded a pilot evaluation of YVIP to establish whether it is feasible to robustly evaluate the programme in an impact evaluation in England and Wales. The evaluation also sought to develop a theory of change for YVIP; understand how the intervention is experienced by children, RT staff, NHS referral staff and partner organisations; establish the feasibility of collecting outcome data (such as the Strengths and Difficulties Questionnaire [SDQ]); and suggest a research design and data collection methods for a future impact evaluation.
The evaluation faced significant challenges, which resulted in substantial amendments to the design. The evaluator attempted to pilot a quasi-experimental study that compared data from all referred 10–17-year-olds across five hospitals with children in the same hospitals who did not receive YVIP. However, this required children to agree to join the study, and obtaining this consent proved extremely difficult for the RT youth workers:
only one child signed up. Consequently, the evaluator redesigned the study to compare the data of two groups:
children who RT had previously supported and a comparison group of children who presented to hospitals before RT worked in those hospitals. Across three hospitals, 1,054 children were identified for the treatment group and 337 for the control. The matching process to ensure that the comparison group was similar enough to the treatment group and to ensure valid findings was severely limited by the unavailability of high-quality hospital-level data. Therefore, the findings relating to quantitative outcomes are severely limited. Without the consent for children’s involvement in the study, the evaluator could not test the feasibility of collecting the SDQ from children or conducting qualitative interviews with them. Instead, the evaluators interviewed 22 RT staff members and 13 NHS and community partnership staff members. They also examined RT delivery data across five hospitals using RT case management data. The evaluation ran from January 2022 to December 2023.
Interviews with RT youth workers, NHS clinicians and community partners reveal that the cohort of children and activities undertaken differed substantially between major trauma centres (MTCs) and local hospitals. Children in MTCs tend to have more serious injuries and spend longer in hospital, which provided more opportunities for RT youth workers to build trusted relationships.
Interviews suggested that NHS staff are essential in facilitating effective referrals. Improving the visibility and physical presence of RT youth workers in EDs and informing NHS clinicians of their work are perceived to be important in facilitating delivery.
Improved recruitment, consent and data-sharing agreements need to be established between RT, hospitals and research partners to enable a future impact evaluation.REC name
London - Bromley Research Ethics Committee
REC reference
22/PR/1243
Date of REC Opinion
17 Nov 2022
REC opinion
Further Information Favourable Opinion