It has now been just over a year since ComBAT started in March 2021. To mark our first anniversary we would like to offer a round-up of the progress we have made to date.
Development of the intervention
We have now completed our intervention materials and these include a manual for professionals, young people and their families, and a training package for professionals. We have also developed a Massive Open Online Course (MOOC) “Introduction to Behavioural Activation” that went live on 10th January 2022 and has so far attracted almost 4,000 participants and garnered much positive feedback. As well as being available for free to the public around the world, it is serving as a valuable additional training tool for professionals.
Several key elements went into the development of our Behavioural Activation (BA) materials. Firstly we conducted a systematic literature review of all the relevant Randomised Controlled Trials (RCTs) in BA undertaken to date to review which ingredients and approaches have so far proved the most effective. Secondly we looked at all the existing BA manuals available in the public domain. Thirdly, we held several focus groups and individual discussions with 13 young people, parents and professionals.
Mapping usual care
We have been mapping what usual care means across different settings and services that support young people with depression, recording in a database what this is and where and how it is delivered and by whom.
ComBAT Feasibility Study
We are currently ‘road-testing’ the delivery and acceptability of our intervention with a small feasibility study of 20 young people aged 12-18 years we have recruited with three partner sites: our NHS sponsor trust: Tees Esk and Wear Valleys NHS Foundation Trust, an E-ACT Academy School in West Yorkshire and the Redcar and Cleveland branch of Mind. Following a baseline survey, the young people are undertaking our new version of BA in five modules over five to eight weekly sessions, depending on the needs of the individual. They are each being supported by a therapist or youth worker at one of the partner sites, who has been trained in our intervention and whom we are closely supporting and supervising. After the intervention, we will interview both the young people and the professionals about their experience of undertaking/delivering the BA. This will give us valuable insight into how the delivery format and materials might be further enhanced ahead of the randomised controlled trial.
ComBAT Randomised Controlled Trial (RCT)
We have compiled all the study and consent documents for our full-scale RCT, ready for submission to the Ethics Committee. To date, three NHS Trusts, four schools and three voluntary organisations/charities have confirmed their participation as sites for the RCT and many more have expressed a strong interest. The University of York’s Trials Unit has set up a system for inputting and managing all the data that will emerge from the trial.
We have developed a Resource Utilisation Questionnaire for self-completion by the adolescents. Its purpose is to collect information about the use of healthcare and other resources by each young person over the six months previous to the intervention. This will then go towards our economic evaluation. The questionnaire has been informed by those used in previous studies, including those developed by our own team for other mental health interventions with young people. ComBAT PPI representatives also fed into its development and it is currently being administered as part of our feasibility study.
We have also developed data collection forms to track the resources used during training, intervention delivery and supervision and designed a database to collate and present the information gathered.
We are half-way through the process of developing an innovative and exciting digital interface which will assist the management and delivery of the intervention.
As you can see, we have had a busy year and have managed to make some really exciting progress. We look forward to the coming year and to getting fully underway with our main trial.