133 Effectiveness of a social network intervention 5 intervention by tailoring social network-related goals to the needs of participants. Furthermore, an RCT design was used comparing the effectiveness of TAU with the addition of FNC to TAU alone, to clearly distinguish the benefits of the informal social network intervention. To our knowledge, this is the first RCT to examine the effectiveness of an additive informal social network intervention among forensic psychiatric outpatients, therefore, treatment effects of multiple outcome domains were explored. The aim of this RCT was to examine whether the addition of FNC to TAU was more effective in improving mental wellbeing (i.e., primary outcome) compared to TAU alone. Furthermore, we explored the effectiveness of FNC plus TAU compared to TAU alone on general psychiatric functioning, hospitalization, criminal behavior, and incarceration (i.e., key secondary outcomes), as well as on other secondary treatment outcomes (i.e., social network, substance use, quality of life, and self-sufficiency). In addition, as engagement to the intervention was expected to vary between patients, we explored the treatment effects of primary and key secondary outcomes across patients with different levels of compliance to the FNC intervention (i.e., no, low, and high compliance). Lastly, potential moderators of treatment effects of primary and key secondary outcomes were explored to optimize knowledge regarding personalized social network interventions. METHODS Study design This study, a mono-center, open-label RCT with two parallel groups, was conducted at Inforsa, the forensic outpatient care department of Arkin Mental Health Institute in Amsterdam, the Netherlands, between April 2018 and December 2022. All participants were recruited at three sites of Inforsa: (1) forensic flexible assertive community treatment (forensic FACT) teams for adults, (2) a forensic FACT team for youth and young adults, and (3) a forensic outpatient clinic. The main goal of these forensic outpatient treatment teams is twofold: (1) reducing patients’ risk of criminal recidivism, contributing to enhanced safety in the society, and (2) enhancing patients’ mental health and wellbeing. We compared the effectiveness of treatment as usual with an additive informal social network intervention – forensic network coaching (FNC) – to treatment as usual (TAU) alone. After screening for eligibility, participants were allocated to one of the two intervention groups using simple 1:1 randomization with random varied block lengths (i.e., 4 and 6), stratified by forensic outpatient care site. The randomization tool in Castor EDC, an online platform for clinical trials, was used for this procedure (Castor Electronic Data Capture, 2019).
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