Abstract
BackgroundEffective interventions for young adults with severe, multiple problems – such as psychosocial and psychiatric problems, delinquency, unemployment and substance use – are scarce but urgently needed in order to support an adequate transition to adulthood. A multimodal day treatment program called “New Opportunities” (in Dutch: “De Nieuwe Kans”; DNK) was specifically developed to target multi-problem young adults in The Netherlands. The aim of this study protocol is to describe the design of a randomized controlled trial (RCT) in clinical practice to examine the effectiveness of DNK in comparison with care as usual (CAU).Methods/designMulti-problem young adults in Rotterdam, The Netherlands, will be assigned randomly to DNK (expected N = 150) and CAU (expected N = 150). Primary outcome measures are recidivism and self-sufficiency. Secondary outcome measures include quality of life, attending school/work, psychological functioning, cognitive distortions and substance use. Participant and program characteristics will be examined as potential moderators of effectiveness. Additionally, cost-effectiveness will be measured. During 14 months, data from multiple resources will be collected at four time points.DiscussionThis study is one of the first RCTs on the effectiveness of interventions developed for multi-problem young adults. The results will contribute to the currently scant knowledge about what works for various multi-problem young adults in their transition to adulthood. In addition, the study protocol will provide insight into implementing an RCT in a dynamic setting of clinical practice.Trial registrationDutch Trial Register, identifier: NTR5163. Registered on 17 April 2015; retrospectively registered during the recruitment phase.
Highlights
Effective interventions for young adults with severe, multiple problems – such as psychosocial and psychiatric problems, delinquency, unemployment and substance use – are scarce but urgently needed in order to support an adequate transition to adulthood
This study is one of the first randomized controlled trial (RCT) on the effectiveness of interventions developed for multi-problem young adults
Aims of the study The first aim of this study is to examine the effectiveness of the multimodal day treatment program De Nieuwe Kans (DNK) compared to care as usual (CAU) in terms of official and self-reported delinquency and self-sufficiency
Summary
This article describes the design of the effect study on New Opportunities (in Dutch: De Nieuwe Kans; DNK), a multimodal day treatment program in The Netherlands for multi-problem young adults (aged 18–27 years). As it could be difficult to trace them for follow-up measurements – because of many changes in telephone numbers, addresses and social network [80] – we will put much effort in maintaining contact with the respondents (e.g., by making contact via calls, Whatsapp, Short Message Service (SMS), e-mail and Facebook; by contacting their families and third parties; and by visiting them at home) Another possible threat to the value of our study is the risk of nonadherence to interventions (i.e., risk of dropout of treatment) due to the combination of multiple problems in the lives of these young adults, the difficult referral path from intake at the social welfare agency to start at the interventions, and the early moment of randomization [79, 80].
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