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Trial registered on ANZCTR
Registration number
ACTRN12624000826549
Ethics application status
Approved
Date submitted
19/06/2024
Date registered
4/07/2024
Date last updated
4/07/2024
Date data sharing statement initially provided
4/07/2024
Type of registration
Prospectively registered
Titles & IDs
Public title
Evaluation of an online program for youth anxiety.
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Scientific title
Randomised controlled trial testing the effect of imagery-based motivation enhancement on youth engagement with an online anxiety program.
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Secondary ID [1]
305818
0
Nil known
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Universal Trial Number (UTN)
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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:
Anxiety
326548
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Condition category
Condition code
Mental Health
321825
321825
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0
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Anxiety
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
This study aims to test the effectiveness of an online session delivering imagery-based motivation enhancement to improve youth engagement with an internet-based Cognitive Behavioural Therapy (CBT) intervention for anxiety.
The motivation enhancement session is based on Functional Imagery Training (FIT), which is a treatment approach developed to enhance motivation for positive behaviour change. FIT is based on Elaborated Intrusion Theory of desire which posits that desire is driven by a process of cognitive elaboration of which mental imagery is a key component. The more vivid an image about a target is, the stronger the desire will be. FIT combines training in mental imagery with the client-centred counselling style of Motivational Interviewing (MI) to engage people in conversations about the positive benefits of change, building self-efficacy and goal-directed planning. FIT involves supplementing these verbal discussions with guided mental imagery, strengthening desire for the imagined goal.
This imagery-based session will deliver a brief, self-guided form of FIT which aims to enhance motivation to engage with the program and to complete homework tasks. This online session will provide imagery psychoeducation, explore benefits of change and of completing the program, build self-efficacy for change, goal setting and planning. Throughout the session, participants are invited to create mental images relating to the different areas of discussion. The imagery session is expected to take participants approximately 30 minutes to complete.
This imagery session will precede the 7-session online anxiety program. This is delivered on the Momentum platform (www.momentumhub.org.au). The Momentum Anxiety program is an individual, interactive, self-guided, internet-based CBT program for young people experiencing elevated levels of anxiety. The program is comprised of 7 sessions focusing on psychoeducation, the maintaining role of avoidance in anxiety, and a variety of graded-exposure and cognitive restructuring strategies as well as relapse prevention.
Participants can input responses directly into the online platform but will be informed and reminded throughout the program that the content is not monitored or reviewed. At the end of each session participants are assigned homework tasks to complete before their next login. It is expected that homework tasks will take participants an average of 30 minutes to complete each week, though this will vary across participants depending how much time they are able/choose to spend on the practise activities. Homework completion is recorded as a binary yes/no response based on whether they attempted their homework activities.
Session completion times will also vary across participants, but on average it is expected that completing each session will take approximately 30-60 minutes. Participants are welcome to log in at times that are convenient to them and to complete the program at a pace that suits them, though it is suggested that they try to log in and complete at least one session per week. Participants can complete the online sessions alone or with support of a parent or caregiver, depending on their age. The platform records the date of completed sessions. A session is considered completed if every page has been clicked through until the final screen.
The content is based on other evidence-based CBT interventions and was developed by a group of experienced researchers and clinical psychologists with significant experience in developing innovative solutions for child and adolescent mental health concerns.
The intervention arm where participants receive the imagery-based motivation enhancement session followed by the standard 7-session Momentum Anxiety program is called the AnxietyPlus arm.
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Intervention code [1]
322212
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Treatment: Other
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Intervention code [2]
322382
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Behaviour
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Comparator / control treatment
The control treatment consists of the Momentum Anxiety program alone (Anxiety), which is compared against the Momentum Anxiety program preceded by the imagery-based motivation enhancement session (AnxietyPlus).
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Control group
Active
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Outcomes
Primary outcome [1]
329826
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Young people’s engagement with the online platform measured as the total number of Momentum Anxiety program sessions completed. This is recorded by the platform and all screens must be clicked through until the final screen of the session for a session to be recorded as completed.
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Assessment method [1]
329826
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Timepoint [1]
329826
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3 months post baseline.
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Primary outcome [2]
329827
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Young people’s engagement with homework tasks measured as the total number of self-reported homework tasks completed between each session.
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Assessment method [2]
329827
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Timepoint [2]
329827
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3 months post baseline.
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Secondary outcome [1]
410396
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Changes in anxiety symptom severity measured using the Spence Children's Scale for Anxiety
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Assessment method [1]
410396
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Timepoint [1]
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3 months and 6 months post Baseline
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Secondary outcome [2]
410399
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Cost effectiveness of the Anxiety treatment arm relative to costs of current standard treatments (i.e. face to face treatment) measured using the Child Health Utility Instrument 9 Dimensions and self-reported health service usage data. Costs of current standard treatment will be determined from existing literature and datasets, e.g., MBS data.
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Assessment method [2]
410399
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Timepoint [2]
410399
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3 months and 6 months post Baseline
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Secondary outcome [3]
410400
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Cost effectiveness of the Anxiety treatment arm relative to the AnxietyPlus treatment arm measured using the Child Health Utility Instrument 9 Dimensions and self-reported health service usage data.
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Assessment method [3]
410400
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Timepoint [3]
410400
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3 months and 6 months post Baseline
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Eligibility
Key inclusion criteria
For inclusion participants must be aged from 7 to 17 years and be experiencing elevated levels of anxiety as measured on the Spence Children’s Anxiety Scale.
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Minimum age
7
Years
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Maximum age
17
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Participants will be excluded if they score in the elevated or clinical range on the Centre for Epidemiological Studies Depression Scale for Children or if they report presence of an Autism Spectrum Disorder (ASD) or Psychotic Disorder.
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Study design
Purpose of the study
Treatment
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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)
Allocation is concealed as the randomisation is allocated by the Momentum platform once the Baseline has been completed.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Participants are randomised to one of the two treatment conditions by the Momentum platform. Randomisations are stratified by age (7 to 12 vs 13 to 17) and gender (male, female, other).
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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
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
Sample size was determined using G*Power 3.1.9.7 based on the effect observed by Titov et al (2010) when they compared an Internet delivered CBT program for social anxiety with a version preceded by MI modules designed to build motivation for program engagement. MomentumPlus is expected to be at least as effective as non-imagery-based motivation enhancement. Based on an effect on program drop-out equivalent to d=0.41, a total sample of 188 is needed to achieve a power of 0.80 to detect group differences on adherence at a .05 alpha level.
Data will be collected in online format and downloaded into excel or SPSS spreadsheets for analysis. Data will be analysed using SPSS Statistics 27. A mix of univariate and multivariate tests will be employed to examine the primary and secondary hypotheses.
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
5/07/2024
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Actual
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Date of last participant enrolment
Anticipated
23/06/2025
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Actual
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Date of last data collection
Anticipated
31/12/2025
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Actual
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Sample size
Target
188
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Accrual to date
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Final
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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]
310165
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Government body
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Name [1]
310165
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Medical Research Future Fund Research Support Scheme, Department of Health and Aged Care
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Address [1]
310165
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Department of HealthLevel 15, 160 Ann StreetBrisbane QLD 4000
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Country [1]
310165
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Australia
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Primary sponsor type
Individual
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Name
Dr Melanie White
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Address
Centre for Children's Health Research62 Graham StSouth Brisbane, QLD 4101
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Country
Australia
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Secondary sponsor category [1]
311452
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Individual
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Name [1]
311452
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Dr Jennifer Connolly
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Address [1]
311452
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School of Psychology and Counselling Queensland University of TechnologyKelvin Grove, QLD 4059
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Country [1]
311452
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Australia
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Secondary sponsor category [2]
313003
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Individual
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Name [2]
313003
0
A/Prof Sanjeewa Kularatna
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Address [2]
313003
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AusHSIQueensland University of TechnologyKelvin Grove, QLD 4059
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Country [2]
313003
0
Australia
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Secondary sponsor category [3]
313004
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Individual
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Name [3]
313004
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Mr Christopher Cahill
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Address [3]
313004
0
School of Psychology and CounsellingQueensland University of TechnologyKelvin Grove, QLD 4059
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Country [3]
313004
0
Australia
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Secondary sponsor category [4]
313005
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Individual
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Name [4]
313005
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Dr Shelley Appleton
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Address [4]
313005
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Centre for Children's Health Research62 Graham StSouth Brisbane, QLD 4101
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Country [4]
313005
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Australia
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Secondary sponsor category [5]
313006
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Individual
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Name [5]
313006
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Emer Prof David Kavanagh
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Address [5]
313006
0
Centre for Children's Health Research62 Graham StSouth Brisbane, QLD 4101
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Country [5]
313006
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Australia
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Secondary sponsor category [6]
313009
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Individual
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Name [6]
313009
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Prof Sonja March
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Address [6]
313009
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University of Southern QueenslandSpringfield campusSpringfield, QLD 4300
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Country [6]
313009
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Australia
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Secondary sponsor category [7]
313010
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Individual
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Name [7]
313010
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Prof Caroline Donovan
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Address [7]
313010
0
School of Applied PsychologyGriffith University 176 Messines Ridge RdMount Gravatt, QLD 4122
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Country [7]
313010
0
Australia
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Secondary sponsor category [8]
313011
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Individual
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Name [8]
313011
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A/Prof Vanessa Cobham
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Address [8]
313011
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School of PsychologyThe University of QueenslandSt Lucia, QLD 4072
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Country [8]
313011
0
Australia
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Secondary sponsor category [9]
313012
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Individual
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Name [9]
313012
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Prof Leanne Hides
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Address [9]
313012
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School of PsychologyThe University of QueenslandSt Lucia, QLD 407
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Country [9]
313012
0
Australia
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Secondary sponsor category [10]
313013
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Individual
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Name [10]
313013
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Prof Lara Farrell
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Address [10]
313013
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School of Applied PsychologyGold Coast campusGriffith UniversityParklands DrSouthport, QLD 4222
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Country [10]
313013
0
Australia
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Secondary sponsor category [11]
313014
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Individual
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Name [11]
313014
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Prof Alison Calear
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Address [11]
313014
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College of Health and MedicineCentre for Mental Health ResearchBuilding 63The Australian National UniversityCanberra, ACT 2601
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Country [11]
313014
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Australia
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Secondary sponsor category [12]
313015
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Individual
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Name [12]
313015
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Emer Prof Sue Spence
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Address [12]
313015
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School of Applied PsychologyGriffith University 176 Messines Ridge RdMount Gravatt, QLD 4122
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Country [12]
313015
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Australia
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Secondary sponsor category [13]
313016
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Individual
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Name [13]
313016
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Prof Britt Klein
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Address [13]
313016
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School of ScienceSMB campusFederation University107 Lydiard StBallarat Central, VIC 3350
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Country [13]
313016
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
309854
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Queensland University of Technology University Human Research Ethics Committee
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Ethics committee address [1]
309854
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https://www.qut.edu.au/research/why-qut/ethics-and-integrity
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Ethics committee country [1]
309854
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Australia
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Date submitted for ethics approval [1]
309854
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07/09/2021
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Approval date [1]
309854
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09/02/2024
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Ethics approval number [1]
309854
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4518
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Summary
Brief summary
It is well documented that rates of drop out from youth digital mental health programs are high, with on average only half of modules being completed. Greater adherence and engagement with programs has been found to be associated with better outcomes. Finding ways to encourage greater program completion may enhance the benefits that users derive. The current study aims to assess the effectiveness of an imagery-based motivation enhancement component embedded within an online program for youth anxiety. The study examines whether the motivational component improves young people’s engagement with the platform, and the subsequent effect on outcomes following treatment.
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Trial website
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Trial related presentations / publications
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Public notes
https://momentumhub.org.au
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Contacts
Principal investigator
Name
115618
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Dr Melanie White
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Address
115618
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Queensland University of Technology, School of Psychology and Counselling, O Block, Kelvin Grove, QLD, 4059
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Country
115618
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Australia
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Phone
115618
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+61 07 3138 4714
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Fax
115618
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Email
115618
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[email protected]
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Contact person for public queries
Name
115619
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Dr Jennifer Connolly
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Address
115619
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Queensland University of Technology, Centre for Children's Health Research, 62 Graham Street, South Brisbane, Queensland 4101
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Country
115619
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Australia
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Phone
115619
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+61 07 3169 7543
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Fax
115619
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Email
115619
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[email protected]
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Contact person for scientific queries
Name
115620
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Jennifer Connolly
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Address
115620
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Queensland University of Technology, Centre for Children's Health Research, 62 Graham Street, South Brisbane, Queensland 4101
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Country
115620
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Australia
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Phone
115620
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+61 07 3169 7543
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Fax
115620
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Email
115620
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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)?
Yes
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What data in particular will be shared?
At this stage there are no plans to make de-identified individual participant data available. However, all de-identified individual participant data from this trial will be made available if requested.
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When will data be available (start and end dates)?
The data will be available once publication occurs for a period of 5 years.
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Available to whom?
Data obtained from the Momentum platform will be made available in non-identifiable format for future research purposes to researchers who obtain ethical approval and at the discretion of the principal researcher.
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Available for what types of analyses?
The data will be made available for any purpose, subject to ethics approval and approval by the principal investigator.
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How or where can data be obtained?
Access will be subject to ethics approval and prior approval being obtained from the principal researcher. Data can be obtained on request from Dr Jennifer Connolly at
[email protected]
.
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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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