Overview
Led by health service researchers from Primary Care at the Faculty of Health, and supported by a grant from the National Institute for Health and Care Research (NIHR) Public Health Research Programme, it assessed whether additional support via Health Trainers was effective in improving the health behaviours and wellbeing of people receiving community supervision.
This trial offered the possibility of a new and cost-efficient way of engaging a group of people that are seldom reached and frequently have multiple and complex needs. Building health and wellbeing can have a wide range of additional benefits, including an improved chance of finding work or training, perhaps reduce offending and becoming more integrated into mainstream society.
This research was supported by the National Institute for Health and Care Research (NIHR) Applied Research Collaboration (ARC) South West Peninsula (PenARC).
Health Trainer intervention
Health Trainers were individuals with a good understanding of the health and social challenges faced by people in the target group, with basic training in effective behavioural change techniques to help address health inequality. They supported their clients by helping to build motivation and confidence to make changes. They also provided information about other support options and were there to offer encouragement, share successes and support recovery from relapses.
This research project explored the most effective ways to do this with people receiving community supervision, and attempted to assess what the benefits are. If the research suggests that this additional support is an acceptable and a cost-effective way of improving health and wellbeing, then it may be rolled out across the country.
In developing the Health Trainer service, researchers listened to those who have experience of the criminal justice system to understand things from their perspective. The research team offered potential participants support from a Health Trainer for up to 12 sessions, to support improvements in their wellbeing and changes in health behaviours, such as alcohol and smoking reduction, increased physical activity, and improved diet. The Health Trainer helped participants to identify, set and monitor personal goals and will offer ideas and support on how to achieve these aims. Allowing participants to develop a sense of achievement, control over decisions about behaviours that influence health, and to relate to others, can all contribute to wellbeing.
Methods
The study methods are described in detail in the following Open Access peer reviewed paper: Thompson TP, Callaghan L, et al & Taylor AH. Health trainer-led motivational intervention plus usual care for people under community supervision compared with usual care alone: a study protocol for a parallel-group pilot randomised controlled trial (STRENGTHEN). BMJ Open. 2018 Jun 4;8(6):e023123. doi: 10.1136/bmjopen-2018-023123.
Researching findings
The study findings (including brief summaries) are available in an Open Access peer reviewed NIHR Final Report (see: Callaghan L, Thompson TP, Creanor S, et al, & Taylor AH. Individual health trainers to support health and well-being for people under community supervision in the criminal justice system: the STRENGTHEN pilot RCT. Southampton (UK): NIHR Journals Library; 2019 Dec. PMID: 31869017; DOI: 10.3310/phr07200.
Funding
The STRENGTHEN study was funded by the NIHR Public Health Research programme. The research was sponsored by the University of Plymouth.
The study was led by Adrian Taylor, Professor in Health Services Research at the Faculty of Medicine and Dentistry, with a second research site at the University of Manchester, colleagues in the Universities of Southampton and Exeter, and Plymouth City Council.
