A co-created randomised controlled feasibility trial of a peer-led complex oral health intervention in UK secondary schools: the RAISED In Yorkshire RiY study protocol

BACKGROUND: Tooth decay in secondary school children is one of the most prevalent non-communicable diseases in the UK and globally. Whilst almost entirely preventable, oral health inequalities remain a significant public health problem to reach and manage those most vulnerable. School-based prevention strategies targeted to localities with oral health inequality, and incorporating peer-to-peer interventions warrant further evaluation. These peer-to-peer interventions have a bidirectional benefit and are proposed to positively influence both the 'peer leader' and 'peer recipient'; they rely on shared cultural backgrounds and relatability to reach students that may be missed by typical healthcare professional-led interventions. This protocol describes a feasibility trial which aims to establish RAISED in Yorkshire with its peer-to-peer delivery model within the secondary school setting supported by newly qualified dentists as an effective and sustainable approach to improve oral health awareness, skills (toothbrushing) and behaviours in adolescents from underserved at-risk communities. METHODS: This is a UK school-based, assessor-blinded, parallel two-arm randomised controlled feasibility trial with a preliminary interim assessment in advance of progression to a larger scale trial in the future. The trial aims to recruit n = ~240 11-13-year-old participants and n = ~50 16-18-year-old peer leaders across five schools/colleges in West Yorkshire. The primary outcomes are related to feasibility in terms of recruitment and retention of participants, and the ability to deliver the intervention. The secondary outcomes include the oral health of participants (knowledge, attitudes and behaviour, plaque and gingival index) and process evaluation. DISCUSSION: The findings of the feasibility trial will dictate whether the project is scalable and can be delivered to multiple schools regionally and nationally. The findings will also show whether it is an effective method to provide oral health education for 11-13-year-old adolescents when delivered collaboratively by trained 16-18-year-old peer leaders. TRIAL REGISTRATION: ISRCTN registry, ISRCTN83511912. Registered on 8 August 2024, https://www.isrctn.com/ISRCTN83511912.