Is it feasible to nest a Trial within a Cohort Study (TwiCS) to evaluate an early years parenting programme? A Born in Bradford’s Better Start study protocol

Kate Mooney, Charlie Welch, Kirsty Crossley, Tracey Jane Bywater, John Wright, Josie Dickerson, Sarah Louise Blower

Research output: Contribution to journalArticlepeer-review

Abstract

Background
Evaluating the effectiveness of early years parenting interventions provides evidence to improve the development and wellbeing of children. This protocol paper describes a study to explore the feasibility of evaluating the Incredible Years Toddler early life intervention programme, which is offered to parents of 1–3-year-olds via the Better Start Bradford programme.

The study aims to use a Trial Within a Cohort Study (TwiCS) design that randomly selects individuals participating in a cohort to be offered an intervention. The TwiCS information and consent process is person-centred and aims to replicate real world practice whereby only those who are offered the intervention are given information about the intervention.

The cohort is the Born in Bradford’s Better Start (BiBBS) cohort, an interventional birth cohort recruiting expectant parents in three areas of Bradford, UK. The study will assess the feasibility of TwiCS procedures, staged consent, and intervention take-up.

Methods
We will conduct a feasibility TwiCS to test study procedures. We aim to establish: (1) whether TWiCS methodology can be implemented to create control and intervention arms, while documenting any incidences of contamination within the cohort; (2) whether satisfactory rates of intervention uptake are achieved among participants allocated to the intervention; and (3) whether satisfactory rates of retention of participants in the intervention can be achieved. A RAG rating system has been applied to support the feasibility assessment of each objective: to be rated red (not achieved), amber (partly achieved) and green (achieved).

Eligible participants in the BiBBS cohort will be individually randomised 1:1 to the intervention or control arms, with stratification by child age (1 or 2-years-old at the time of randomisation) and ethnicity (White British, South Asian, or other). BiBBS researchers will seek consent from participants randomised to the intervention to pass their contact details onto Incredible Years’ delivery agents.

Discussion
This feasibility study will inform the utility of the TwiCs approach within an experimental birth cohort to evaluate interventions for infants, toddlers, and their families.

Trial registration
The study was prospectively registered on ISRCTN (ISRCTN16150114).
Original languageEnglish
Number of pages16
JournalPilot and Feasibility Studies
DOIs
Publication statusPublished - 22 Nov 2023

Keywords

  • Feasibility
  • trial with a cohort study
  • Parenting programme
  • BIRTH COHORT
  • Incredible Years
  • better start bradford
  • Born in Bradford's Better Start

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