Empowered Together (coordinated social care in prison): A feasibility and definitive randomised controlled trial, with embedded realist informed process evaluation.

Background

Social care relates to activities of daily living, social interaction, independence and activity in society. Men in prison in
the UK have much higher levels of social care needs than men living in the community. As prison populations
increase and age, this burden will increase. Prisons are difficult environments in which to meet social care needs.
Many of these needs are not met despite a legal responsibility on Local Authorities to do so. This leaves men with
poor quality of life and health and social outcomes.

There is no evidence-based social care intervention in prison. We have co-produced a social care intervention
named Empowered Together which aims to ensure men’s social care needs are met in prison.
Empowered Together involves trauma-informed, integrated, and person-centred care. It includes screening,
assessment and care coordination across the complex systems in local authorities, prisons, healthcare, and third
sector organisations.

Key Research Questions

1.Does Empowered Together improve the number of met social care needs of adult men in prison, who are at high risk of having unmet needs, after six weeks and six months, in comparison with care as usual?
2. Is it feasible to conduct a randomised controlled trial (RCT) (to answer research question 1)?
3. Is Empowered Together cost-effective?
4. What aspects of Empowered Together work well, in what contexts and why?

Overarching Aims and Objectives
1. Assess the feasibility of conducting a RCT of Empowered Together
2. Evaluate the effectiveness and cost effectiveness of Empowered Together in reducing the unmet social care
needs of men in prison
3. Explore what aspects of Empowered Together work, in what circumstances and why.

Methods
As part of a previous programme delivery grant (PDG) we conducted:
1. A realist synthesis to develop the initial programme theory, logic model and intervention delivery platform for
2. A systematic review of suitable outcome measures
3. Development of patient, public involvement and engagement (PPIE)

The proposed study builds on the work conducted in the PDG. It contains three work packages:
WP1: Development of:
1. training manual
2. bespoke outcome measure
3. fidelity scale
4. immersive film, audio, blog, event and webpage

WP2: Feasibility study/embedded formative process evaluation
1. Feasibility RCT
2. Cost-effectiveness feasibility
3. Realist-informed formative process evaluation (including implementation fidelity)
4. Review of progression criteria

WP3: Definitive RCT and embedded summative process evaluation
3.1 Definitive RCT
3.2 Cost-effectiveness analysis
3.3 Realist-informed summative process evaluation (including implementation fidelity)
3.4 Development of future funding application to adapt Empowered Together for women