Abstract
BackgroundYoung people who engage in multiple risk behaviour (high-risk young people) such as substance abuse, antisocial behaviour, low engagement in education and employment, self-harm or suicide ideation are more likely to experience serious harms later in life including homelessness, incarceration, violence and premature death. In addition to personal disadvantage, these harms represent an avoidable social and economic cost to society. Despite these harms, there is insufficient evidence about how to improve outcomes for high-risk young people. A key reason for this is a lack of standardisation in the way in which programs provided by services are defined and evaluated.MethodsThis paper describes the development of a standardised intervention model for high-risk young people. The model can be used by service providers to achieve greater standardisation across their programs, outcomes and outcome measures. To demonstrate its feasibility, the model is applied to an existing program for high-risk young people.ConclusionsThe development and uptake of a standardised intervention model for these programs will help to more rapidly develop a larger and more rigorous evidence-base to improve outcomes for high-risk young people.
Highlights
Young people who engage in multiple risk behaviour such as substance abuse, antisocial behaviour, low engagement in education and employment, self-harm or suicide ideation are more likely to experience serious harms later in life including homelessness, incarceration, violence and premature death
This paper describes the development of a standardised intervention model that could be used to achieve greater standardisation across programs, outcomes, and outcome measures delivered by different services for high-risk young people
The second additional component, Diversionary Activities, was included after staff highlighted the importance of needing to divert high-risk young people from high-risk activities and peers during high-risk times, in order to achieve both reduced short-term exposure to high-risk situations and sustained behaviour change. Further to identifying these additional two core program components, the workshops with the service providers was used to articulate the mechanism of change for each core component: i) effective engagement ensures participants are exposed to a sufficient number of intervention components; ii) case management ensures participants’ most immediate problems are prioritised; iii) diversionary activities reduce participants’ exposure to high-risk situations at high-risk times; iv) personal development, identity, and team identity improve participants’ capacity to manage when they are in high-risk situations and create a sense of belonging and acceptance; and v) learning and skills development increase the opportunities for active participation in employment and greater engagement with their communities
Summary
The development of a standardised intervention model As delineated, the proposed standardised intervention model adapts a program logic framework to ensure clarity about the proposed program components (part b), why they are likely to effective (part c – mechanisms of change), and to ensure the program components are strongly aligned with the specific problems being targeted (part a), the outcomes and outcome measures - Emerging or established involvement in criminal incidents and the criminal justice system - Tenuous engagement with the education system and/or un-, under-employment - Risky drug and alcohol use - Low self-efficacy and/or emerging mental health issues
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