title: Pragmatic randomised controlled trial to evaluate the effectiveness and cost effectiveness of a multi-component intervention to reduce substance use and risk-taking behaviour in adolescents involved in the criminal justice system: A trial protocol (RISKIT-CJS).
abstract: Adolescence is a critical developmental stage when young people make lifestyle choices that have the potential to impact on their current and future health and social wellbeing. The relationship between substance use and criminal activity is complex but there is clear evidence that the prevalence of problematic substance use is far higher among adolescent offenders than the general adolescent population. Adolescent offenders are a marginalized and vulnerable population who are significantly more likely to experience health and social inequalities in later life than their non-offending peers. There is a paucity of evidence on effective interventions to address substance use and risk-taking behaviours in adolescent offender populations but it is clear that preventative or abstinence orientated interventions are not effective. RISKIT-CJS is an intervention developed in collaboration with young people taking account of the current best evidence. Feasibility and pilot studies have found the intervention addresses the needs of adolescents, is acceptable and has demonstrated potential in reducing substance use and risk-taking behavior.
  
  
  
  The study is a mixed method, two-armed, prospective, pragmatic randomized controlled trial with individual randomisation to either treatment as usual alone or the RISKIT-CJS intervention in addition to treatment as usual. Adolescents, aged 13 to 17 years inclusive, engaged with the criminal justice system who are identified as having problematic substance use are eligible to participate. The study will be conducted across three geographical areas; South and South East England, London and North East England between March 2017 and February 2019.
  
  
  
  The study represents an ambitious programme of work to address an area of need for a marginalized and vulnerable population.
  
  
  
  ISRCTN77037777 registered 15/09/2016.
authors.affiliation: Centre for Health Services Studies, University of Kent, Canterbury, UK. s.coulton@Kent.ac.uk.
authors.forename: Simon
authors.identifier: 0000-0002-7704-3274
authors.initials: S
authors.lastname: Coulton
authors.affiliation: Health and Social Care Institute, Teesside University, Middlesbrough, UK.
authors.forename: Kelly
authors.initials: K
authors.lastname: Stockdale
authors.affiliation: Centre for Health Services Studies, University of Kent, Canterbury, UK.
authors.forename: Catherine
authors.initials: C
authors.lastname: Marchand
authors.affiliation: Centre for Health Services Studies, University of Kent, Canterbury, UK.
authors.forename: Nadine
authors.initials: N
authors.lastname: Hendrie
authors.affiliation: Centre for Health Services Studies, University of Kent, Canterbury, UK.
authors.forename: Jenny
authors.initials: J
authors.lastname: Billings
authors.affiliation: Institute of Psychiatry Psychology and Neurosciences, Kings College, London, UK.
authors.forename: Sadie
authors.initials: S
authors.lastname: Boniface
authors.affiliation: Addaction Young Peoples Service, Canterbury, Kent, UK.
authors.forename: Steve
authors.initials: S
authors.lastname: Butler
authors.affiliation: Institute of Psychiatry Psychology and Neurosciences, Kings College, London, UK.
authors.forename: Paolo
authors.initials: P
authors.lastname: Deluca
authors.affiliation: Institute of Psychiatry Psychology and Neurosciences, Kings College, London, UK.
authors.forename: Colin
authors.initials: C
authors.lastname: Drummond
authors.affiliation: Health and Social Care Institute, Teesside University, Middlesbrough, UK.
authors.forename: Dorothy
authors.initials: D
authors.lastname: Newbury-Birch
authors.affiliation: Centre for Health Services Studies, University of Kent, Canterbury, UK.
authors.forename: Tracy
authors.initials: T
authors.lastname: Pellatt-Higgins
authors.affiliation: School of Sociology, Social Policy and Social Research, University of Kent, Canterbury, Kent, UK.
authors.forename: Alex
authors.initials: A
authors.lastname: Stevens
authors.affiliation: RAND Europe, Cambridge, UK.
authors.forename: Alex
authors.initials: A
authors.lastname: Sutherland
authors.affiliation: Dept. of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
authors.forename: Ed
authors.initials: E
authors.lastname: Wilson
mesh_terms: D000293:Adolescent; D001521:Behavior Therapy / Q000191:economics / Q000379:methods*; D002985:Clinical Protocols; D003362:Cost-Benefit Analysis; D057237:Criminals / Q000523:psychology*; D004739:England; D005260:Female; D006801:Humans; D008297:Male; D015397:Program Evaluation; D011446:Prospective Studies; D012309:Risk-Taking; D019966:Substance-Related Disorders / Q000523:psychology / Q000628:therapy*
keywords: Adolescent; Criminal justice; Health economics; Motivational interviewing; Randomised controlled trial; Risk-taking behaviour; Substance use; Youth offending