Improving Health Outcomes for Care Leavers: the Life in Transition (LIFT) cluster-randomised feasibility trial

Background Inequalities in health amongst care-experienced young people span all aspects of health, including mental health and wellbeing. We developed an intervention to better equip Personal Advisors (staff with statutory responsibility for supporting Care Leavers) to address a range of health issues. The study aimed to assess the acceptability of the intervention and the feasibility of conducting a definitive cluster randomised trial. Methods This 24-month study took place in three local authorities (LAs) between 2022 and 2024. Two LAs were in the South West of England, the third was in the East Midlands. Two of the three Personal Advisor teams in each LA were randomised to receive the training, which comprised six online modules and a one-day skills workshop facilitated by health professionals. Study participation was voluntary but all staff in the intervention arm were expected to complete the training. Control teams received no training. Our objectives were to evaluate the feasibility of recruitment and retention of both Personal Advisors (PAs) and Care leavers (CLs), data collection (by peer researcher and research staff), the acceptability and cost of the intervention and the general demands of the study. We conducted qualitative interviews with PAs and CLs. Results We recruited 63 of 76 eligible PAs and 71 CLs. 52 CLs (73%) completed the final follow up interview. CLs were typically female, white with a mean age of 19 years. Just over half were not in education, employment, or training. The intervention was broadly acceptable, but some PAs reported difficulties in finding the time to complete the modules, despite a commitment by managers of protected time to do so. Some PAs said they were already familiar with some module content. The demands of the trial were generally judged to be acceptable to CLs and to PAs. Delays incurred by the REDCap team meant that we had to stagger the recruitment of PAs and CLs. This extended the number of requests to LA staff, which some found irksome. Plans to use peer researchers had to be abandoned for logistical reasons. Conclusions The results demonstrate the feasibility of conducting a cluster randomised trial in children’s social care. Trial registration ISRCTN, ISRCTN11518804. Registered 13 January 2023, https://www.isrctn.com/ISRCTN11518804