Improving health, under community supervision, with the support of a Health Trainer: developing and evaluating a pilot randomised controlled trial

Callaghan L, Thompson TP, Creanor S, Quinn C, Senior J, Green C, Hawton A, Byng R, Wallace G, Sinclair J, Kane A, Hazeldine E, Walker S, Crook R, Wainwright V, Enki DG, Jones B, Goodwin E, Cartwright L, Horrell J, Shaw J, Annison J, Taylor AH
Record ID 32016000541
Authors' objectives: People receiving community supervision, and those released from prison, in the UK have greater healthcare needs and lower levels of healthcare access than the general population. Mental health and substance misuse problems are particularly prevalent and co-morbidity (having both) is common. People subject to the criminal justice system are also more likely to face social inequalities, such as homelessness and unemployment, particularly those just released from prison. Harmful health behaviours and social inequalities lead to long term poorer health outcomes. Little is known about the effectiveness of interventions to improve the physical and mental health, and mental well-being of people recently released from prison or serving community sentences when compared with interventions for those in prison. This is due to a lack of routine data collection and the challenges in following people up. Some research has been conducted on the effects of brief counselling interventions to reduce alcohol consumption with people receiving supervision from the Probation service. Health Trainers, with a good understanding of the challenges faced by people receiving community supervision and basic training in effective behaviour change techniques, may be able to support clients on a regular basis by helping to build motivation and confidence to make important changes without telling clients directly what they should or shouldn't do. They can also provide information about other options to receive support and be there to provide encouragement, share successes and support recovery from relapses. Working in partnership with people who have lived experience of the criminal justice system, we propose to conduct a study in which people receiving community supervision are offered a chance to receive support from a Health Trainer for up to 12 sessions, which follow a clear structure but also offer flexibility. When we begin to offer this, people receiving community supervision will probably include all prison leavers, as well as those with community sentences. The aim will be to ensure that clients gain a sense of achievement and competence, a sense of control over choosing which behaviours to change and when and how, and a chance to relate to and receive support from others. People receiving community supervision, who want to do things that make them feel better about themselves and improve their health, through addressing one of four target health behaviours (alcohol reduction, smoking reduction, increased physical activity, improved diet), will be offered ideas on a number of ways to achieve this, based on others experiences, while also developing a shared understanding of how this can impact on health and well-being, and other behaviours. The Health Trainer will help the client to identify personal goals to set and monitor. The proposed research be the first step towards finding out if this additional support leads to improvement towards the target health behaviours and improvements in wellbeing and health related quality of life. To do this, participants entering the study will be assigned (with an equal chance) to either the additional support from a Health Trainer or usual support, and followed up at 3 & 6 months by a researcher. We will also investigate whether the extra costs associated with the Health Trainer and extra support provided offer value for money in terms of improved health behaviours and resultant reduction in health care costs.
Project Status: Completed
Year Published: 2019
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: England
MeSH Terms
  • Criminals
  • Community Health Workers
  • Community Medicine
  • Mental Health Services
  • Health Promotion
  • Health Behavior
  • Social Support
  • Community Mental Health Services
  • Health Education
Organisation Name: NIHR Public Health Research programme
Contact Address: NIHR Journals Library, National Institute for Health Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK
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Copyright: Queen's Printer and Controller of HMSO
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