JMIR Publications

ABSTRACT

Background:

The global estimate of number of children in institutions is found to be around 5 million, with around 1 million of these children living in Europe. In Germany, about 75,000 children and adolescents find themselves in the foster care system and about 93,000 additional children and adolescents are living in institutions. Traumatic experiences and neglect in childhood are highly prevalent among these youth-in-care (Y-IC) and are related to severe long-term effects. Childhood maltreatment and abuse increases the risk of future re-victimization. Although Y-IC are at risk of (re)-victimization, no specific evidence-based prevention program has been designed to address these specific needs.

Objective:

To evaluate the efficacy of a newly developed six-module internet-based prevention program for Y-IC against (re-)victimization named EMPOWER YOUTH.

Methods:

In a randomized controlled trial, the intervention group will be compared to a waiting-list control group with an un-blinded 1:1 allocation ratio. Assessments will take place before randomization (baseline) and at follow-up 18 weeks after baseline (i.e. 12 weeks after finishing the last module of the program). The primary endpoint is the number of victimization and (cyber-)bullying (composite score) experiences at the 18-week follow-up. Secondary endpoints are risk-taking behavior, aggressive tendencies, empathy, prosocial behavior, depressiveness, and loneliness at follow-up. The expected outcome requires a sample size of 156 subjects to achieve a power of 80%. Assuming a 30% drop-out at follow-up, we require 225 participants to be allocated to the trial. Participants are Y-IC, i.e., adolescents in foster-care, adopted adolescents or young care-leavers aged 14 to 21 years.

Results:

Recruitment started in September 2021.

Conclusions:

Given the increased likelihood for future victimization experiences in Y-IC, there is a strong need for a low-threshold intervention specifically for this high-risk age-group. So far, there are no existing nation-wide mental health programs exclusively for Y-IC in Germany. Clinical Trial: German Clinical Trial Registration DRKS00024749. Registered on March 17th, 2021.