Redthread

What does this project involve?

Redthread (RT) Youth Violence Intervention Programme (YVIP) works with 11 to 25 year olds who present to hospital A and E departments following a violent incident, or an incident that puts them at risk of involvement in violence. It aims to keep them safe from involvement in violence in the future. Eligible children and young people are identified by NHS staff or RT youth workers. A RT youth worker then makes contact with the child or young person to establish whether they are at risk of involvement in violence, and assess their needs, risks and support network. This contact will usually occur in the hospital but can also occur outside if the young person has been discharged.

If the young person is at lower risk, they will receive short term 1:1 support from the RT youth worker; this is likely to last around four weeks, but the length of support varies. For children and young people who are more vulnerable, RT offer a longer intervention that lasts up to 3 months (and longer for those with particularly high needs).

Support offered to children and young people may include 1:1 meetings to discuss healthy relationships or managing difficult emotions, support to engage with education, help to secure alternative accommodation, signposting to mental health or substance misuse support, and access to financial support. The content and dosage of support will vary depending on the needs and choice of the individual; some will receive weekly 1:1 support, while others will be offered more sporadic interaction.

Why did YEF fund this project?

A and E navigator programmes like YVIP are associated with a large estimated impact on reducing further violence. However, the evidence that underpins this estimate is severely limited, and we lack a robust estimate of impact in a UK context. YEF, therefore, funded a pilot evaluation of YVIP to establish whether it is feasible to robustly evaluate the programme in an impact evaluation in England and Wales. The evaluation also sought to develop a theory of change for YVIP, understand how the intervention is experienced by children, RT staff, NHS referral staff and partner organisations, establish the feasibility of collecting outcome data (such as the Strengths and Difficulties Questionnaire (SDQ)), and suggest a research design and data collection methods for a future impact evaluation.

The evaluation faced significant challenges which resulted in substantial amendments to the design. The evaluator attempted to pilot a quasi-experimental study that compared data from all referred 10-17 year olds across five hospitals, to children in the same hospitals who did not receive YVIP. However, this required children to agree to join the study and obtaining this consent proved extremely difficult for the RT youth workers: only one child signed up. Consequently, the evaluator redesigned the study to compare the data of two groups: children that RT had previously supported and a comparison group of children who presented to hospital before RT worked in those hospitals. Across three hospitals, 1,054 children were identified for the treatment group; 337 for the control. The matching process to ensure that the comparison group was similar enough to the treatment group to ensure valid findings was severely limited by the unavailability of high-quality hospital level data. Therefore, the findings relating to quantitative outcomes are severely limited.

Without the consent for children’s involvement in the study, the evaluator could not test the feasibility of collecting the SDQ from children or conduct qualitative interviews with them. Instead, the evaluators interviewed 22 RT staff members and 13 NHS and Community partnership staff members. They also examined RT delivery data across 5 hospitals using RT case management data. The evaluation ran from January 2022- December 2023.

Key conclusions

What will YEF do next?

YEF is not planning any further evaluation of Redthread at this stage.

Download the report