INcreasing Adolescent Social and Community SupporT - Full Trial (INACT)

University College London (UCL)

Status: Not yet enrolling

Conditions: Loneliness

Treatments: Behavioral: Signposting; Behavioral: Social Prescribing

Study type: Interventional

Funder types: Other

Identifiers

NCT07154225

1207

Details and patient eligibility

About

Background: Social Prescribing is a mechanism of connecting patients with non-medical forms of support within the community and has been shown to improve loneliness. Yet update from young people has been lower than for adults. This is thought to be due to accessibility issues as young people are less likely to draw on primary care, where social prescribing is based, for wellbeing support. The INACT pilot sought to test the feasibility and acceptability of a Social Prescribing pathway via schools to support young people who are lonely through a randomised controlled trial. Findings suggested that study procedures, including the measures were appropriate and that Social Prescribing was deemed by young people, social prescribers and school staff as feasible, acceptable and suitable and there was evidence of impact in the social prescribing arm when compared to signposting. Given the positive pilot findings, the aim of the INACT full trial is to build upon the pilot work and conduct a clinical and cost effectiveness trial into the impact of Social Prescribing in schools for loneliness and low community connection, compared to signposting.

Methods: A minimum of 215 pupils reporting loneliness will be recruited across 30 mainstream schools in England and be randomly allocated to signposting or Social Prescribing. Pupils in the control group will receive signposting to sources of support from school staff. The co-produced social prescribing intervention includes up to 6 sessions with a Link Worker who will work with individuals to understand 'what matters to them' and connect them with local sources of support. The clinical and cost effectiveness of Social Prescribing for young people with loneliness will be assessed using measures of loneliness, mental health, wellbeing, quality of life, and service use. Data will be collected at baseline and 3, 6, and 12 months later. Qualitative interviews will also be conducted to explore barriers, facilitators, mechanisms of change and impact.

Discussion: INACT will provide evidence of the clinical and cost effectiveness of Social Prescribing in schools for supporting young people experiencing loneliness. It will also establish what types of community and social activities young people engage in and what factors affect participation.

Enrollment: 215 estimated patients

Sex: All

Ages: 9 to 14 years old

Volunteers: No Healthy Volunteers

Inclusion and exclusion criteria

Inclusion Criteria

1. Schools:

   • A primary or secondary school willing to participate in INACT
   • In England
   • Have classes of pupils in eligible year groups to participate (Years 5, 7, 8)

2. Pupils and their parents/guardians:

   • Score 7 or above on the Good Childhood Index (indicating high loneliness)
   • Parents/guardians consent, and pupils assent, to get support

Exclusion Criteria

1. Schools:

   • Private schools or sixth form/colleges
   • Specialist schools
   • Schools only offering alterative provision
   • Outside of England
   • Does not have classes of pupils in eligible year groups to participate (Years 4, 5, 7, 8)

2. Pupils and their parents/guardians:

   • Score below 7 on the Good Childhood Index (indicating low loneliness)
   • Parents/guardians do not consent, or pupils do not assent, to get support
   • Children and young people with severe learning disabilities who are unable to complete questionnaires

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

---

215 participants in 2 patient groups

Social Prescribing

Experimental group

Description:

SP is a person-centred approach to wellbeing involving the co-development of a non-clinical prescription, between an individual (i.e. young person) and Link Workers (LWs), based on the perceived difficulties for the referral and the YPs values, needs and preferences. LWs have a good knowledge of their local areas, via community asset mapping and networking, allowing them to connect individuals with different types of available support and activities. Typically, SP ranges from 6-12 sessions (average 8 sessions: unpublished data from sites) with a LW over an 8-week period. Sessions may take place online, via phone call, or in person. As part of this process, LWs draw on psychological skills such as motivational interviewing and behavioural activation as well as employ problem solving and goal setting. Following the identification of issues and preferences, the LW will discuss with the YP what the available local activities and support structures are that best match their preferences.

Treatment:

Behavioral: Social Prescribing

Signposting

Active Comparator group

Description:

Those in the control group will receive signposting to activities and local sources of support in their communities. This will consist of school pastoral staff meeting with YP identified as lonely and providing them with a leaflet detailing the same local sources of support identified by the LW from asset mapping.

Treatment:

Behavioral: Signposting