Nottinghamshire Healthcare is the first site nationwide to recruit 200 participants to the STADIA trial, with the Research Delivery Team well on their way to reaching the target of 242.
STADIA, commissioned and funded by the National Institute for Health Research (NIHR), focuses on children and young people with emotional difficulties who have been referred to Child and Adolescent Mental Health Services (CAMHS). Despite the well documented rise in mental health difficulties in young people, access to services can be challenging, and has been further complicated by COVID-19.
The study is led by Chief Investigator and Nottinghamshire Healthcare Consultant Psychiatrist Professor Kapil Sayal, who is based at the Institute of Mental Health, along with local lead Research Delivery Psychologist Paula Brown. It is investigating whether the use of an additional assessment, as an aid to usual clinical support, helps with the identification of emotional disorders and the referral process.
Recruitment to the STADIA trial commenced in September 2019 and, despite Covid, has remained open to recruitment throughout, recruiting 849 children and families nationally. The Health Technology Authority, who are supporting the study, commended Nottinghamshire Healthcare’s achievements during the last year. Paula puts the success of STADIA down to several factors:
Teamwork
“It’s been a truly collaborative effort, with teamwork and communication at the heart of its success.”
STADIA is comprised of several teams, all working together to improve access to CAMHS. The national study team, the local research delivery team, the CAMHS Single Point of Access (SPA) team, and children and their families all contribute to the successful running of the trial.
At the beginning of the pandemic, the research delivery team were asked to switch focus and support urgent public health studies, beyond their usual remit of mental health. Paula credits their flexibility, supportive team-working and ‘can-do’ attitude to the continued success of the study during a pandemic, along with the support of colleagues at the University of Nottingham.
In addition, Paula highlights the involvement of the local CAMHS service:
“Mark Kennedy and the SPA team have been very supportive of the study right from the beginning. Not only have they promptly responded to our many queries to help with screening, they have supported us with parents/carers who have, on occasions, contacted the research delivery team in distress. This has ensured participants have a good experience of taking part in research and, I believe, improved follow-up and retention.”
Throughout the trial, the team have been guided by Patient and Public Involvement (PPI) Advisory Panels, one for young people and one for parents. This collaboration has guided how best to support recruitment and engage participants and, according to Professor Kapil Sayal, has been vital to the study’s success.
Communication
When everyone began working remotely, the study team recognised that staying connected was essential to the continued success of the trial. Through regular and more frequent teleconferences they were able to support one another and share good practice. Clinical supervision was maintained, giving staff the opportunity to reflect on challenges and strengths, as well as promoting team cohesion at a time when colleagues may have felt isolated.
Keeping the channels of communication open between the study team, CAMHS and families was essential, particularly as the referral process can be a stressful time for young people and their parents and carers. Newsletters were sent to participants to keep them up to date with the progress of the study and support their involvement.
Online
While many studies had to be paused, the online nature of STADIA has enabled it to continue safely, even with staff working remotely. Remote working has also made it easier to bring in additional researchers to cover absence, relocation to Covid-19 urgent public health research and ultimately maintain capacity. Not only has this shift to online working been helpful for keeping the trial going, it’s demonstrated a major benefit going forwards:
“The focus of the trial, on remote assessment in CAMHS, is also now especially timely as clinical services have had to adopt new ways of working due to the pandemic.”
Find out more about STADIA here.