Pragmatic randomised controlled trial to evaluate the effectiveness and cost effectiveness of a multi-component intervention to reduce substance use and risk-taking behaviour in adolescents involved in the criminal justice system: A trial protocol (RISKIT-CJS)

Abstract

BackgroundAdolescence is a critical developmental stage when young people make lifestyle choices that have the potential to impact on their current and future health and social wellbeing. The relationship between substance use and criminal activity is complex but there is clear evidence that the prevalence of problematic substance use is far higher among adolescent offenders than the general adolescent population. Adolescent offenders are a marginalized and vulnerable population who are significantly more likely to experience health and social inequalities in later life than their non-offending peers.There is a paucity of evidence on effective interventions to address substance use and risk-taking behaviours in adolescent offender populations but it is clear that preventative or abstinence orientated interventions are not effective. RISKIT-CJS is an intervention developed in collaboration with young people taking account of the current best evidence. Feasibility and pilot studies have found the intervention addresses the needs of adolescents, is acceptable and has demonstrated potential in reducing substance use and risk-taking behavior.MethodsThe study is a mixed method, two-armed, prospective, pragmatic randomized controlled trial with individual randomisation to either treatment as usual alone or the RISKIT-CJS intervention in addition to treatment as usual. Adolescents, aged 13 to 17 years inclusive, engaged with the criminal justice system who are identified as having problematic substance use are eligible to participate. The study will be conducted across three geographical areas; South and South East England, London and North East England between March 2017 and February 2019.DiscussionThe study represents an ambitious programme of work to address an area of need for a marginalized and vulnerable population.Trial registration ISRCTN77037777 registered 15/09/2016.

Framing ‘drug prevention’ for young people in contact with the criminal justice system in England: views from practitioners in the field

“…There has been little attention paid to developing bespoke drug-specific interventions which target young people in contact with the criminal justice system and who are engaged in or 'at risk' of problematic substance use. A key exception is the RisKit intervention (Stevens et al, 2014) which has been adapted for adolescents aged 13-17 in the criminal justice system (RisKit-CJS) and is currently being evaluated (see Coulton et al, 2017).…”

The engagement of young people in drug interventions in coercive contexts: findings from a cross-national European study

“…In some cases, the focus for practitioners is merely to attract them into interventions and ensure they complete their orders, rather than developing engagement (Szapocznik et al, 1990). However, Coulton et al (2017) argue that there is a consensus that young people involved in offending are one of the most 'hard to reach' groups as well as being those most in need of pro-active interventions to engage them. For involuntary clients who are legally mandated to participate in interventions, engagement may be more difficult due to the coercion and external pressure from the criminal justice system (Rooney, 2009).…”