CHOICES-HI: Hospital-Initiated Social Prescribing for Children and Young People

Background – Children and young people diagnosed with Type 1 Diabetes (T1D) are at increased risk of developing psychosocial difficulties, particularly within the first year of diagnosis, due largely to disruptions in social development and daily functioning. While access to mental health professionals is routinely available, current support is largely treatment-focused on presenting mental health difficulties, offering limited preventive or early intervention options. Hospital-initiated social prescribing may offer a promising early intervention to mitigate the psychosocial impact of T1D in this population. Aims and objectives - This project will undertake development work in preparation for a trial of hospital-initiated social prescribing for CYP with T1D. The four workstreams will seek to: (1) understand treatment as usual and potential drivers of variation across paediatric diabetes units; (2) confirm the form and implementation of a hospital-based link worker intervention (including the cost); (3) identify outcomes of relevance for the range of stakeholders involved, including CYP, families, clinicians, and commissioners; and (4) determine the optimal trial design and methodology. Methods – A 12-month, multi-site, mixed-methods development study will be undertaken to develop critical collaborations and address key uncertainties in designing a definitive randomised controlled trial and economic evaluation. The study will involve two collaborating sites and a wider network of NHS Trusts engaged across all four workstreams. In particular, we will collect information from teams across England and Wales who are currently delivering hospital-initiated social prescribing as well as those who may be interested to do so in future. Service user and stakeholder engagement – A youth engagement lead will coordinate involvement of an advisory group of CYP with long-term conditions, and their families/carers. This group has shaped the current study design and will continue to inform delivery. A stakeholder engagement lead will oversee co-production of an engagement strategy involving clinicians, link workers, commissioners and third-sector partners, with the aim of building a sustainable stakeholder network to inform the future programme grant application. Impact and dissemination – This study will reduce uncertainty in key areas necessary for a full-scale trial and economic evaluation of hospital-initiated social prescribing for CYP with T1D. Findings will inform intervention design and implementation strategies, supporting national relevance and impact. Dissemination will include peer-reviewed publications, practitioner-facing outputs, and contributions to academic and policy discussions through conferences and knowledge exchange events. The project takes an inclusive approach to co-production and knowledge mobilisation to ensure the relevance and uptake of findings in health and care systems.