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Trial registered on ANZCTR
Registration number
ACTRN12617001390370
Ethics application status
Approved
Date submitted
27/09/2017
Date registered
29/09/2017
Date last updated
22/11/2021
Date data sharing statement initially provided
22/11/2021
Date results provided
22/11/2021
Type of registration
Prospectively registered
Titles & IDs
Public title
Mindtrack: A randomised controlled trial testing different methods of communicating personal mental health risk profiles
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Scientific title
The impact of different methods of communicating personal mental health risk profiles on emotional outcomes and engagement within a smartphone App
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Secondary ID [1]
292986
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None
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Universal Trial Number (UTN)
None
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Trial acronym
None
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Linked study record
None
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Health condition
Health condition(s) or problem(s) studied:
Psychological distress
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Wellbeing
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Condition category
Condition code
Mental Health
304207
304207
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0
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Depression
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Mental Health
304208
304208
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0
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Anxiety
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Mental Health
304209
304209
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0
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Studies of normal psychology, cognitive function and behaviour
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Public Health
304210
304210
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0
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Health promotion/education
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Brief name: MindTrack App
Arm 1: Current personal risk profile; Arm 2: Achievable personal risk profile; Arm 3: (Control) No personal risk profile. The “Mindtrack App” is a software that is NOT being used as a medical device. The purpose of the App is to test different ways of communicating personal risk of future distress. The mode of delivery of the App is via a smartphone, on an individual basis. The Mindtrack App is a mood monitoring App adapted from the “Headgear App” (attention control version) developed by the same team for research purposes (UNSW HREC HC number: HC17021). The University of Sydney hosts the study site. The study is conducted on a smartphone App (Mindtrack), which is available to Apple and Android users in Australia for once-off free-of-charge download. Participants can download and use the App at a time and place convenient to them. The Mindtrack App will be removed from the Apple and Google Play stores after recruitment for the study is closed. The duration of the study is 6 months, with the trial running for 5 weeks. Following baseline assessment participants will be randomly allocated to receive one of 3 risk profiles once only. Following receipt of their allocated condition, all participants will be encouraged to continue engaging with the App for a period of 4 weeks by monitoring their mood once every week (by completing the primary outcome measure (K10) weekly). The application also automatically monitors and records usage and adherence outcomes on a continuous basis, to provide data on level of engagement with the App. At Week 4, participants complete the endpoint measures (K10, SF-12, and ASHQ) via an online wufoo survey. Participants will receive a maximum 3 SMS reminders with a unique link to complete the survey, spaced at least two days apart. At Week 5, participants “unlock” their Mental Fitness Report in the App. After the completion of the study, participants can continue to use the Mindtrack App for as long as they wish. They can remove the App by uninstalling it from their smartphone. The “Mindtrack” App is a mood monitoring App freely available from Apple Store and Google Play. It involves a 4-week challenge to help individuals understand their risk of developing mental health problems through an initial assessment and ongoing mood monitoring. The main features of the MindTrack App are a risk calculator, mood tracking, a weekly quiz (K10), and a Mental Fitness Report, as well as automatically generated weekly reminders and support service resources. Participants are randomised to a study arm after completing of the baseline measures in App. For those in the active arms, each participant receives a personalized risk profile for developing future distress, calculated using the published HILDA risk algorithm for future distress in working adults, based upon their self-report responses to baseline and risk items. This consists of “current” personal risk estimate of developing a common mental health problem within the next 12 months (Arm 1), and additional information of their lowest possible risk if in the “achievable” group (Arm 2). Materials and wording provided to each participant are as follows:
Arm 1:
Current personal mental health risk profile: Participants receive their personal risk estimate of developing a common mental health problem within the next 12 months. They are shown an icon array which displays the numerical risk estimate of that individual, along with a text description “XX out of 100 people with your risk factors are likely to become distressed within the next year”.
Arm 2:
Achievable personal mental health risk profile: Similar to the current risk profile condition, participants first receive their personal risk estimate of developing a common mental health problem within the next 12 months. They are shown an icon array which displays the calculated numerical risk estimate of that individual, along with a text description “XX out of 100 people with your risk factors are likely to become distressed within the next year”. They are then shown on the next screen their “achievable risk”, in which the icon array displays the lowest possible risk estimate for that individual, based on the targets being met for all the modifiable risk factors. The icon array is shown with the accompanying text “Many risk factors are changeable. You could lower your risk to XX out of 100 by improving your mental fitness. Participants will also see a list of their top modifiable risk factors.
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Intervention code [1]
299226
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Lifestyle
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Comparator / control treatment
Control group - Arm 3: No personal risk profile. The control group have access to the same mood monitoring Mindtrack App as Arms 1 and 2 but do not receive a personal risk profile. They have access to the same features within the App’s 4-week challenge to help individuals understand their risk of developing mental health problems through an initial assessment and ongoing monitoring, such as the risk calculator, mood tracking, weekly quiz, and a Mental Fitness Report. However, they receive no information about their level of personal risk, and no personal risk profile, thus serving as the control condition.
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Control group
Active
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Outcomes
Primary outcome [1]
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Psychological distress measured using the 10-item Kessler Psychological Distress Scale (K10) (Kessler et al, 2002).
Kessler, R.C., Andrews, G., Colpe, L.J., Hiripi, E., Mroczek, D.K., Normand, S.L., Walters, E.E. and Zaslavsky, A.M., 2002. Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychological Medicine, 32(6), pp.959-976.
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Assessment method [1]
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Timepoint [1]
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Baseline, weekly (once per week) for 4 weeks, and endpoint (4 weeks post-baseline). The Week 4 K10 value is used as the primary endpoint outcome.
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Secondary outcome [1]
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Wellbeing measured using the 12-item Short Form Health Survey (SF-12) (Sanderson and Andrews, 2002).
Sanderson, K. and G. Andrews, The SF-12 in the Australian population: cross-validation of item selection. Australian and New Zealand Journal of Public Health, 2002. 26(4): p. 343-345
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Assessment method [1]
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Timepoint [1]
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Endpoint (4 weeks post-baseline).
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Secondary outcome [2]
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Help-seeking behaviour in the past month measured using 1 item adapted from the General Help-seeking Questionnaire (GHSQ) (Wilson et al, 2005).
Wilson, C. J., Deane, F. P., Ciarrochi, J., & Rickwood, D. (2005). Measuring help-seeking intentions: Properties of the general help-seeking questionnaire. Canadian Journal of Counselling, 39(1), 15-28.
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Assessment method [2]
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Timepoint [2]
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Endpoint (4 weeks post-baseline).
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Secondary outcome [3]
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App usage (defined as “level of activity within a program”).
The usage measures recorded will be: number of times App opened, number of mood and activities logged, time spent in App per week, total time spent in App.
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Assessment method [3]
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Timepoint [3]
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Data is automatically collected by the software in a continuous manner over the 4-week period of participant engagement with the App.
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Secondary outcome [4]
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App adherence (defined as “the degree the user’s activity within the program matches the pattern of activity that was intended by the program developers”).
The adherence measure recorded will be: number of weekly K10 measures completed.
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Assessment method [4]
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Timepoint [4]
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Data is automatically collected by the software in a continuous manner over the 4-week period of participant engagement with the App.
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Eligibility
Key inclusion criteria
Eligibility criteria are:
• Adult aged between 18 years and 70 years
• An Australian resident
• In employed work
• Fluent in the English language
• Has access to their own smartphone
• Has a valid mobile phone number
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Minimum age
18
Years
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Maximum age
70
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
There are no a priori exclusion criteria.
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Study design
Purpose of the study
Educational / counselling / training
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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)
Non-inferiority randomised controlled trial with 3 arms. Allocation was concealed using central computerised randomisation within the App, and stratified according to level of risk. The participant will be enrolled into the study after the informed consent process has been completed and the participant has met all inclusion criteria within the App. All enrolled participants will complete the baseline measures. Following completion of baseline measures, enrolled participants will then be randomised using the above process through central allocation to one of three groups.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Simple randomisation using a randomisation table created by computer software. An automatic random allocation sequence generated by Math.random() javascript.
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
Not applicable
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
Power calculations were based on a non-inferiority trial design comparing parallel-groups.
The convention is to set the alpha level at half the type 1 error rate of 2-sided tests (2.5%) as only the lower bounds of the confidence intervals are relevant. Test criterion for non-inferiority was that the lower bound of the 95% CI of the mean difference should fall within *. * was defined as 4.6 points on the K10, which was the difference between the normative Australian score (M=14.5, SD=9.4) and the mean score for people with a mental disorder (M=19.1) in the most recent National Survey of Mental Health and Wellbeing. This margin was selected because the intervention would be unacceptably worse than the no personal risk profile group if it caused distress to the level of people with a mental disorder. The intervention would be non-inferior to providing no personal risk profile if the lower bounds of the 95% CI is less than 4.6 points difference. Given the effect sizes from meta-analysis, it is expected that the actual difference between groups at the endpoint is 0.05.
The sample size was estimated on the K10 total score at endpoint for a non-inferiority research of personal risk profile compared to providing no risk profile, using a one-sided Student’s t-test for independent samples at 2.5% type I error. Considering a predefined non-inferiority margin fixed at 4.6 points on the K10, 68 participants per group allow to conclude that the personal risk profile group is non-inferior to providing no risk profile with a power of 80%. To allow for a 40% dropout rate, 340 participants need to be recruited in total.
Independent t-tests and chi-square analyses will be used to estimate between-group differences in demographics and baseline measures. The primary objective is analysed using a mixed ANCOVA to compare the current risk profile group and the achievable risk profile group to the no risk profile group on the primary outcome of distress (K10) at Week 4 (endpoint) for establishing non-inferiority. Mixed ANCOVAs will be used to compare the current risk profile group and the achievable risk profile group to the no risk profile group on the secondary outcome of wellbeing (SF-12). One-way ANOVAs will be used to compare groups on the secondary outcomes of usage and adherence. Two-way between group ANOVAs will test for differences in K10 and engagement among participants with high, average, and low risk, across risk profiling groups.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
23/10/2017
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Actual
4/12/2017
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Date of last participant enrolment
Anticipated
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Actual
20/04/2018
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Date of last data collection
Anticipated
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Actual
31/05/2018
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Sample size
Target
340
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Accrual to date
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Final
355
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Recruitment in Australia
Recruitment state(s)
ACT,NSW,NT,QLD,SA,TAS,WA,VIC
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Funding & Sponsors
Funding source category [1]
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Charities/Societies/Foundations
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Name [1]
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Beyondblue
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Address [1]
297611
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PO Box 6100
Hawthorne
Vic 3122
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Country [1]
297611
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Australia
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Funding source category [2]
297612
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Charities/Societies/Foundations
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Name [2]
297612
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Movember Foundation
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Address [2]
297612
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PO Box 60
East Melbourne
VIC 8002
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Country [2]
297612
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Australia
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Primary sponsor type
University
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Name
University of Sydney
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Address
University of Sydney
Sydney
2000 NSW
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Country
Australia
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Secondary sponsor category [1]
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Other
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Name [1]
296624
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Black Dog Institute
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Address [1]
296624
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Hospital Rd
Randwick
2031 NSW
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Country [1]
296624
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Australia
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Secondary sponsor category [2]
296625
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University
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Name [2]
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University of New South Wales
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Address [2]
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High St
Kensington
NSW 2052
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Country [2]
296625
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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University of Sydney Human Research Ethics Committee (HREC)
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Ethics committee address [1]
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University of Sydney Human Research Ethics Committee Ethics and Research Integrity Margaret Telfer Building (K07) University of Sydney NSW 2006
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Ethics committee country [1]
298703
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Australia
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Date submitted for ethics approval [1]
298703
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21/08/2017
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Approval date [1]
298703
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29/09/2017
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Ethics approval number [1]
298703
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Summary
Brief summary
There is growing research on using risk algorithms to identify individuals at increased risk for future mental ill-health and for prevention interventions. However, there is lack of research on the effects of communicating personal mental health risk profiles on psychological or behavioral outcomes. There is potential that personal risk profiles can cause short term distress but motivate people to modify behavior to reduce their risks. Our research team has developed a risk algorithm to predict the 12-month risk of psychological distress in working Australian adults (Fernandez et al, 2017). This study explores the impact of communicating different types of personal mental health risk profiles on psychological outcomes and engagement with a smartphone App. The aim of this study is to investigate the effect of communicating different personal mental health risk profile on psychological distress and engagement with a smartphone App (Mindtrack). The secondary aim of the study is to explore how level of risk affects the psychological outcomes and engagement. The study’s purpose is to answer three main research questions namely: (1) What is the impact of different methods of communicating personal mental health risk profile on psychological outcomes in the medium term? (2) What is the impact of different methods of communicating personal mental health risk profile on engagement with an App? (3) Is an individual’s current or achievable risk an effect modifier of these outcomes? In order to achieve these objectives, a randomized controlled non-inferiority design will compare the effects of communicating (1) their current personal risk profile or (2) achievable personal risk profile or (3) no personal risk profile on psychological outcomes and engagement in the Mindtrack App. The 3 main study hypotheses are: i) The participants provided with the current risk profile and the achievable risk profile do not have unacceptably worse levels of psychological distress (defined as the lower bounds of the 95% CI is less than 4.6 points difference on the K10 between groups) compared to participants who do not receive personal risk profile at the endpoint (4 weeks). ii) The participants provided with the current risk profile and achievable risk profile will have higher levels of psychological distress (defined as a significant difference in K10) compared to participants who do not receive personal risk profile at 1-week post-test. iii) The participants provided with the current risk profile and the achievable risk profile do not have significantly different levels of wellbeing (defined as a significant difference in SF-12) compared to participants who do not receive personal risk profile at the endpoint (4 weeks). Other hypotheses available on request.
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Trial website
Not applicable
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Trial related presentations / publications
Fernandez, A., Salvador-Carulla, L., Choi, I., Calvo, R., Harvey, S., & Glozier, N. (2017). Development and validation of a prediction algorithm for the onset of common mental disorders in a working population. Australian & New Zealand Journal of Psychiatry, 1-12.
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Public notes
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Contacts
Principal investigator
Name
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Prof Nicholas Glozier
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Address
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Level 5, Professor Marie Bashir Centre
67-73 Missenden Road
Camperdown, NSW 2050
Brain and Mind Centre
University of Sydney
Sydney, NSW 2000.
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Country
77950
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Australia
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Phone
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+61 2 9515 1596
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Fax
77950
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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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Nicholas Glozier
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Address
77951
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Level 5, Professor Marie Bashir Centre
67-73 Missenden Road
Camperdown, NSW 2050
Brain and Mind Centre
University of Sydney
Sydney
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Country
77951
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Australia
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Phone
77951
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+61 2 9515 1596
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Fax
77951
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Email
77951
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[email protected]
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Contact person for scientific queries
Name
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Nicholas Glozier
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Address
77952
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Level 5, Professor Marie Bashir Centre
67-73 Missenden Road
Camperdown, NSW 2050
Brain and Mind Centre
University of Sydney
Sydney
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Country
77952
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Australia
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Phone
77952
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+61 2 9515 1596
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Fax
77952
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Email
77952
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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)?
No
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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
No additional documents have been identified.
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