Realist Process Evaluation of the implementation and impact of an organisational cultural transformation programme in the Children and Young People's Secure Estate (CYPSE) in England: study protocol

Abstract

IntroductionYoung people in contact with the youth justice system are more likely to present with complex ongoing needs than young people in the general population. To address this, the Framework for Integrated Care (SECURE STAIRS) is being implemented in the Children and Young People's Secure Estate: a ‘whole systems’ approach to support secure settings to develop trauma-informed and relationally based environments, supporting staff to provide consistent, therapeutic care. This paper aims to present the protocol for a national cohort study examining the impact and implementation of this cultural transformation programme.Methods and analysisA mixed-methods realist evaluation will be conducted. Data collection will take place between August 2018 and December 2020. Eighteen sites will collect routine service activity data and questionnaires completed by young people, parents/guardians and staff. Semi-structured interviews and non-participant observations will be conducted across five qualitative focus sites with young people and staff. An economic evaluation will examine value for money. The results will be triangulated at the analysis stage to gain an in-depth understanding of experiences.Ethics and disseminationEthical approval was granted by the Health Research Authority, Her Majesty’s Prison and Probation Service and UCL Ethics Committee. Findings will be disseminated via project reports, site feedback, peer-reviewed journal publications and conference presentations.

The SECURE STAIRS Framework: Preliminary Evaluation of Trauma Informed Training Developments Within the Children and Young People’s Secure Estate

“…The SECURE STAIRS framework highlights the importance of whole system approaches to integrated care within the Children and Young People’s Secure Estate (Taylor et al, 2018 ; D’Souza et al, 2021 ). The framework can be considered a fundamental component in promoting the development of trauma informed care among multidisciplinary staff within SCHs.…”

“…Almost a third of children and young people are reportedly exposed to trauma by the age of 18 years in the United Kingdom (UK; Lewis et al, 2019 ). Prevalence rates of childhood adversity and trauma within the Children and Young People’s Secure Estate (CYPSE) are known to be higher than within the general population (Baetz et al, 2019 ; D’Souza et al, 2021 ). The CYPSE in England and Wales includes Young Offender Institutions (YOIs), Secure Training Centres (STCs) and Secure Children’s Homes (SCHs).…”

“…The SECURE STAIRS framework is intended to ensure that children and young people receive the same care and support, irrespective of location in England, built on a consistent evidence-informed approach (Twitchett, 2016 ). The aim of the framework is to influence and support organisational culture change to better support trauma informed and formulation-driven, evidence-based approaches to create positive changes for children and young people (D’Souza et al, 2021 ). As part of this, the framework promotes trauma informed understanding and training across the workforce to inform work with children and young people and to support staff well-being.…”

A Neuroecosocial Perspective on Adolescent Development

“…An example of youth engagement in mental health research is an innovative study examining the impact of different threads of cultural connection, that is, the effect of different dimensions of individuals' identity-including one's worldview, religion, sociocultural background, collective histories, and language-on youth mental health (D'Souza et al 2021). Conducted in Canada and supported by the Wellcome Trust, this study resulted in the creation of a cross-Canada Youth Advisory Council (YAC) composed of youth with lived experience of depression and anxiety.…”