Assessing the feasibility of a co-produced peer-group intervention for supporting wellbeing during the transition to adulthood among autistic 16–25-year-olds (ATAG):a randomised controlled feasibility trial

Background: Autistic people, including those without intellectual disability, face challenges during the transition to adulthood, and experience poor adult outcomes. We conducted a feasibility trial of a novel co-produced peer group intervention to support the transition to adulthood in autistic people.<br/><br/>Methods: Autistic 16- to 25-year-olds were recruited to this feasibility randomised controlled trial via autism charities and research databases in England and Wales. Participants needed sufficient literacy abilities to be able to access the intervention materials. Participants were randomly assigned (1:1), via an online randomisation service, stratified by age (16-17 and 18-25 years) to the peer group intervention or care as usual (CAU). Participants in both arms could access CAU, which was the routine care offered to autistic 16-25 year-olds in their region, and so varied by participant. The intervention comprised six hour-long online peer group psychoeducation sessions to improve autism knowledge, autism social identity, and self-advocacy skills. The main outcomes of this feasibility trial were as follows: recruitment and retention rates; the acceptability of randomisation and outcome measurement procedures; CAU accessed by participants; acceptability of the interventions; and clinical outcome measure variances. Clinical outcome measures were collected at baseline, and 8-, 16-, and 24-weeks after randomisation. The primary clinical outcome measure was wellbeing<br/>at 16-weeks, using the Warwick Edinburgh Wellbeing Scale [WEMWBS], and all randomised participants were included in the analyses. A co-produced qualitative study investigated trial experiences. The trial is registered with the International Standard Randomised Controlled Trial Number [ISRCTN] registry, ISRCTN10513626.<br/><br/>Findings: Seventy participants were recruited between 1st November 2023 and 10th June 2024 (n = 35 per arm). At 16-weeks, the primary clinical outcome measure (wellbeing score) was completed by 74% (n = 26) of the intervention group and 91% (n = 32) of the CAU group. In terms of CAU, across both arms, participants were most likely to have used medications and primary and community care. Adverse events were comparable between arms (intervention group: 6, CAU group: 7). Qualitative feedback indicated that both study procedures and the intervention itself were acceptable.<br/><br/>Interpretation: A full trial appears to be feasible. Limitations including retention in the intervention arm and limited sample representativeness would need to be addressed for a full trial.