Kinship Connected

The feasibility of a pilot randomised controlled trial investigating outcomes for children in kinship care

Kinship Connected

Highlights

This feasibility study found that it is possible to run a pilot RCT of the Kinship Connected programme.

Report

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Trial Protocol

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Summary

This is a feasibility study of Kinship Connected, a programme developed by Kinship, the leading kinship care charity, conducted by Ecorys, the University of Exeter and Kinship. The programme offers one-to-one support to kinship carers for at least six months via a dedicated project worker, and develops and maintains kinship carers’ support networks through community-based peer support groups.

Research illustrates that Kinship Connected has been positively received by kinship carers. However, the potential of the programme to improve children’s mental health and wellbeing, through support to ensure that kinship carers can meet their needs, has not been established in the evidence so far.

The study aimed to determine whether it is possible to run a pilot randomised controlled trial (RCT) of the Kinship Connected intervention with a focus on children’s mental health and wellbeing, and what the key design features of such a pilot would be.

Aims

The study aimed to determine whether it is possible to run a pilot randomised controlled trial (RCT) of the Kinship Connected intervention with a focus on children’s mental health and wellbeing, and what the key design features of such a pilot would be.

This study aimed to answer the following questions:

  • Is randomisation acceptable to participants in this setting?
  • What are the key barriers and facilitators to potential participants in taking part in this study?
  • What are the key barriers and facilitators for the study’s success more widely?
  • What are the key design components of a proposed pilot study protocol?

 

Method

The feasibility study involved conducting five focus groups with a total of 13 kinship carers and 10 staff from local authorities and the Kinship charity. The focus groups aimed to obtain the participants’ views on the above questions, and so fostered discussions surrounding the ethics of randomisation in this context, ways to increase the likelihood of the study being successful, and which outcome measurements may be most appropriate to consider.

The study also involved refining the Theory of Change and logic model for Kinship Connected, to understand the pathways by which outcomes from the programme could be achieved.

 

Key Findings

The study found that it is possible to run a pilot RCT of the Kinship Connected programme. The aim of the pilot RCT would aim to determine whether a full-scale RCT could be conducted to ultimately answer the question: Does the Kinship Connected intervention improve children’s mental health outcomes?

Based on the findings of the study, this report makes the following key recommendations about how to design the pilot RCT:

  • Restricting the pilot RCT to local authorities that do not currently offer Kinship Connected, so that the control group can receive all business-as-usual services
  • Randomising at the local authority level and using a stepped-wedge design, whereby eventually all local authorities receive Kinship Connected
  • Using the Strengths and Difficulties Questionnaire, completed by the kinship carer, to measure the child’s mental health outcomes.

 

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Cost ratings:

This rating is based on information that programme providers have supplied about the components and requirements of their programme. Based on this information, EIF rates programmes on a scale from 1 to 5, where 1 indicates the least resource-intensive programmes and 5 the most resource-intensive. 

1: A rating of 1 indicates that a programmes has a low cost to set up and deliver, compared with other interventions reviewed by EIF. This is equivalent to an estimated unit cost of less than £100.

2: A rating of 2 indicates that a programme has a medium-low cost to set up and deliver, compared with other interventions reviewed by EIF. This is equivalent to an estimated unit cost of £100–£499.

3: A rating of 3 indicates that a programme has a medium cost to set up and deliver, compared with other interventions reviewed by EIF. This is equivalent to an estimated unit cost of £500–£999.

4: A rating of 4 indicates that a programme has a medium-high cost to set up and deliver, compared with other interventions reviewed by EIF. This is equivalent to an estimated unit cost of £1,000–£2,000.

5: A rating of 5 indicates that a programme has a high cost to set up and deliver, compared with other interventions reviewed by EIF. This is equivalent to an estimated unit cost of more than £2,000.

Child Outcomes:

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Supporting children’s mental health and wellbeing: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.

Preventing child maltreatment: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.

Enhancing school achievement & employment: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.

Preventing crime, violence and antisocial behaviour: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.

Preventing substance abuse: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.

Preventing risky sexual behaviour & teen pregnancy: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.

Preventing obesity and promoting healthy physical development: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.

Evidence ratings:

The evidence ratings distinguish five levels of strength of evidence. This is not a rating of the scale of impact but of the degree to which a programme has been shown to have a positive, causal impact on specific child outcomes.

Level 2: Recognises programmes with preliminary evidence of improving a child outcome, but where an assumption of causal impact cannot be drawn.

Level 2+: The programme will have observed a significant positive child outcome in an evaluation meeting all of the criteria for a level 2 evaluation, but also involving a treatment and comparison group. There is baseline equivalence between the treatment and comparison‐group participants on key demographic variables of interest to the study and baseline measures of outcomes (when feasible).

Level 3: Recognises programmes with evidence of a short-term positive impact from at least one rigorous evaluation – that is, where a judgment about causality can be made.

Level 3+: The programme will have obtained evidence of a significant positive child outcome through an efficacy study, but may also have additional consistent positive evidence from other evaluations (occurring under ideal circumstances or real world settings) that do not meet this criteria, thus keeping it from receiving an assessment of 4 or higher.

Level 4: Recognises programmes with evidence of a long-term positive impact through multiple rigorous evaluations. At least one of these studies must have evidence of improving a child outcome lasting a year or longer.