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Trial registered on ANZCTR
Registration number
ACTRN12614000316606
Ethics application status
Approved
Date submitted
17/03/2014
Date registered
25/03/2014
Date last updated
13/04/2021
Date data sharing statement initially provided
13/04/2021
Date results provided
13/04/2021
Type of registration
Prospectively registered
Titles & IDs
Public title
TriPoD: Trial for the Prevention of Depression in final year secondary school students
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Scientific title
A randomised controlled trial to investigate the effects of SPARX, an online cognitive behavioural intervention, on the prevention of depression, anxiety and suicide risk in final year high school students.
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Secondary ID [1]
284278
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Nil known
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Universal Trial Number (UTN)
U1111-1154-5917
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Depression
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Anxiety
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Suicidal ideation and behaviour
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Condition category
Condition code
Mental Health
291774
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0
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Depression
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Mental Health
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0
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Anxiety
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Mental Health
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0
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Suicide
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
The experimental group will participate in the SPARX program, an online, interactive, fantasy game based on principles of cognitive behavioural therapy (CBT), designed to prevent and treat depression in young people. The gaming component allows the participant to choose an avatar and then undertake a number of skill-building challenges in the context of a fantasy world. This component is supplemented by direct instruction, education and activities (or homework) provided by a ‘guide’ avatar. SPARX consists of seven modules (levels) which cover: finding hope, being active, dealing with emotions, problem solving, recognizing and challenging unhelpful thought and bringing it altogether. SPARX is delivered via the internet in school classrooms over the course of 5 weeks. Participants spend approximately 30-40 mins on the program per week.
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Intervention code [1]
288993
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Prevention
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Comparator / control treatment
The control group will be allocated to the lifeSTYLE program, an attention match control condition. This program requires participants to complete online open ended questions that probe health factors, physical and artistic activities, education and hobbies, social, financial, and family roles, work habits and stress, medications, pain and nutrition. Each week it provides an online ‘package’ of educational material with information about health risks, in order to match levels of interactivity. lifeSTYLE is also delivered via the internet in school classrooms over the course of 5 weeks. Participants spend approximately 30-40 mins on the program per week. A previous trial demonstrated no difference in preference for this form of control condition relative to an active website arm.
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Control group
Active
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Outcomes
Primary outcome [1]
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Depressive symptoms, measured by mean score on the Major Depression Inventory (MDI)
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Assessment method [1]
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Timepoint [1]
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Pre- and post-intervention, 6 and 18 month follow-up
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Secondary outcome [1]
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Academic performance measured by an estimate of the Australian Tertiary Admission Rank (based on Higher School Certificate results provided to schools)
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Assessment method [1]
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Timepoint [1]
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HSC results released in December (between 6 and 18 month follow-up)
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Secondary outcome [2]
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Mean score on the Depression Anxiety Stress Scales - Anxiety subscale
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Assessment method [2]
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Timepoint [2]
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Pre- and post-intervention, 6 and 18 month follow-up
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Secondary outcome [3]
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Suicidal ideation and behaviour, as measured by total score on the Youth Risk Behavior Survey (YRBS)
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Assessment method [3]
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Timepoint [3]
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Pre- and post-intervention, 6 and 18 month follow-up
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Secondary outcome [4]
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Stigma measured by the Personal subscale of the Depression Stigma Scale
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Assessment method [4]
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Timepoint [4]
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Pre- and post-intervention and 6 and 18 month follow up
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Eligibility
Key inclusion criteria
Students in their final year of high school at participating schools. Students and their parents must provide consent to participate.
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Minimum age
15
Years
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Maximum age
20
Years
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Sex
Both males and females
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
Nil
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Study design
Purpose of the study
Prevention
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
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Who is / are masked / blinded?
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Intervention assignment
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
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Statistical methods / analysis
A total of 1600 students will be recruited for this trial. In community samples, between 8 and 20% of young people will develop depression over an 18 month period and the rates of conversion to Major Depressive Disorder (MDD) are even higher in individuals who have sub-threshold symptoms. Power will be achieved primarily by recruiting a sample from mid to late adolescence where conversion rates are high (up to 15%), and undertaking the intervention in anticipation of a universal stressor. Calculations of required sample size were based on detecting a post-intervention effect size of 0.20 for the primary outcome measure. This is a small effect but reflects the universal nature of this intervention. Power was set at .80, a = .05 (two-tailed) and correlation of .5 assumed between baseline and endpoint scores. To allow for possible clustering effects (participants from the same school having characteristics and outcomes more alike than between schools) a design effect was calculated assuming an intraclass correlation (ICC) of 0.02 and an average class size of 25. The estimate of the ICC was derived from previous Australian school-based studies that have found non-significant class effects (i.e., non- significant intraclass correlation) and a value of .02. The estimated sample size was 1166. To accommodate an attrition or non-return of endpoint data rate of approximately 20%, (our previous school based trials reported 84%-88% completion at post-test, and 81% at 6 months) we set the target sample size at 1600, or 800 students (approximately 60 classes of 25) per condition. Power calculations for these are sufficient to examine all other secondary outcome effects with the exception of incidence/recurrence of MDD. Analysis of predictors will involve correlations. No mediation or moderation analyses are claimed, so power is also sufficient.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
2/02/2015
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Actual
2/02/2015
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Date of last participant enrolment
Anticipated
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Actual
15/03/2015
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Date of last data collection
Anticipated
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Actual
26/08/2016
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Sample size
Target
1600
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Accrual to date
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Final
540
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Recruitment in Australia
Recruitment state(s)
NSW
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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National Health and Medical Research Council
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Address [1]
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GPO Box 1421
Canberra ACT 2601
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Country [1]
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Australia
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Primary sponsor type
Individual
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Name
Prof Helen Christensen
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Address
Black Dog Institute
University of New South Wales
Hospital Road
Randwick
NSW 2031
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
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Country [1]
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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University of New South Wales Human Research Ethics Committee
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Ethics committee address [1]
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University of New South Wales Sydney NSW 2052
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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28/03/2014
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Approval date [1]
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06/05/2014
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Ethics approval number [1]
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HC14105
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Ethics committee name [2]
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NSW Department of Education, State Education Research Approval Process (SERAP
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Ethics committee address [2]
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Level 1, 1 Oxford Street, Darlinghurst 2010 Locked Bag 53, Darlinghurst NSW 1300
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Ethics committee country [2]
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Australia
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Date submitted for ethics approval [2]
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11/04/2014
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Approval date [2]
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18/06/2014
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Ethics approval number [2]
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SERAP2014001
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Summary
Brief summary
Using Randomised Controlled Trial methodology, this study investigates the effectiveness of a universal prevention intervention for depression in adolescents prior to the Higher School Certificate (HSC). Students in 30 schools across New South Wales (NSW) will be randomly allocated to receive an online, automated, preventative Cognitive Behavioral Therapy (CBT) program or an online control program focused on health and wellbeing. Students will participate in the intervention in February of Year 12, and will complete assessment measures pre- and post-intervention, approximately 6 months later (prior to the Trial HSC) and at 18-month follow-up. The primary outcome measure will be symptom levels of depression. Secondary outcomes include academic performance, incidence/recurrence of depression, suicidal ideation and behaviour. Cost effectiveness, as well as predictors of treatment response and adherence will also be measured. Additionally, the effect of the intervention on parental mental health and wellbeing will be examined.
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Trial website
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Trial related presentations / publications
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Public notes
The manuscript reporting the outcomes from this paper is currently under review and the anticipated publication date is in the latter part of 2017.
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Contacts
Principal investigator
Name
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Prof Helen Christensen
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Address
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Black Dog Institute
Hospital Rd Randwick
NSW 2031
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Country
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Australia
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Phone
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+61 2 9382 4530
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Aliza Werner-Seidler
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Address
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Black Dog Institute
Hospital Rd Randwick
NSW 2031
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Country
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Australia
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Phone
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+61 2 9382 3769
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Aliza Werner-Seidler
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Address
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Black Dog Institute
Hospital Rd Randwick
NSW 2031
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Country
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Australia
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Phone
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+61 2 9382 3769
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Fax
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Email
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
Trial for the Prevention of Depression (TriPoD) in final-year secondary students: Study protocol for a cluster randomised controlled trial.
2015
https://dx.doi.org/10.1186/s13063-015-0929-1
N.B. These documents automatically identified may not have been verified by the study sponsor.
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