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Trial registered on ANZCTR
Registration number
ACTRN12622000260729
Ethics application status
Approved
Date submitted
15/12/2021
Date registered
14/02/2022
Date last updated
17/11/2022
Date data sharing statement initially provided
14/02/2022
Type of registration
Prospectively registered
Titles & IDs
Public title
The effect of health coaching on the burden of low back pain within the chiropractic setting
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Scientific title
Feasibility and efficacy of health coaching for management of low back pain within the chiropractic setting
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Secondary ID [1]
306053
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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:
Low back pain
324696
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Condition category
Condition code
Musculoskeletal
322148
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0
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Other muscular and skeletal disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
The health intervention of 3 months duration, includes chiropractic patient participants receiving a patient-centred physical activity plan developed with the advice of a certified health coach/accredited allied health professional. This physical activity plan will specifically suit patient needs and preferences, encouraging them to develop goals to suit and gradually increase their physical activity. Health coaching will involve an initial individual online / virtual session, which can take up to 1 hour and it will be held over Zoom or similar platform. Subsequent health coaching sessions will be 10-15 minutes duration.
Specifically, the health coaching sessions will comprise:
1. Increasing physical activity through an individually developed plan that meets patient lifestyle preferences. Guided by The World Health Organisation (WHO), physical activities will relate (but not limited to) sports, other leisure activities, work and transport activity.
2. Decreasing sedentary behaviour by encouraging an increase in incidental physical activity throughout the day. Opportunities may include (but not limited to) public transportation to work, walking to shops, carrying out a home exercise program, standing at work and spending less time sitting while at home.
3. Setting goals that are to the individual, realistic, can be monitored, and receives positive encouragement. The health coach will work with each participant to set short-term physical activity goals to be achieved fortnightly. The participants’ individual goals will be set taking into consideration the nature of their chronic low back pain.
After the first individual virtual coaching session, the health coach will contact each participant 2 week later, and each phone call will be approximately each fortnightly (5 phone calls over a 3-month period for each participant). Calls will comprise of patient progress, updating goals and assist in overcoming barriers. Within the phone call, patients will be asked about their adherence to the intervention.
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Intervention code [1]
322458
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Behaviour
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Comparator / control treatment
No control group.
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Proportion of eligible patients who participate (recruitment) will be assessed by an audit of study database.
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Assessment method [1]
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Timepoint [1]
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Baseline, 3 months (after intervention commencement)
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Primary outcome [2]
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Effectiveness: pre and post study patient outcome measures collected, will be assessed by an audit of study database. This outcome will be assessing the completeness of data, i.e., proportion of outcome measures collected for each participant assessed by an audit of study database.
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Assessment method [2]
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Timepoint [2]
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Baseline, 3 month (post intervention commencement)
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Primary outcome [3]
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Adoption: proportion of clinics who promoted the program, will be assessed by an audit of study database. Information will be added to the study database following a telephone interview and/or email to check promotion with relevant clinic staff.
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Assessment method [3]
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Timepoint [3]
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Baseline, 3 month (post intervention commencement)
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Secondary outcome [1]
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Physical function, assessed using the Patient Specific Functional Scale
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Assessment method [1]
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Timepoint [1]
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Baseline, 3 months post intervention commencement
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Secondary outcome [2]
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Self-reported physical activity levels, assessed with Global Physical Activity Questionnaire (GPAQ)
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Assessment method [2]
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Timepoint [2]
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Baseline, 3 months post intervention commencement
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Secondary outcome [3]
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Pain intensity, assessed fortnightly with the Numerical Rating Scale (NRS).
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Assessment method [3]
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Timepoint [3]
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Baseline, and fortnightly for up to 3 months post intervention commencement.
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Secondary outcome [4]
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Disability, assessed via the Roland– Morris Disability Questionnaire (0-24)
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Assessment method [4]
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Timepoint [4]
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Baseline, 3 months post intervention commencement
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Secondary outcome [5]
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Quality of life, assessed using the Assessment of Quality of Life questionnaire (AQoL-8D)
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Assessment method [5]
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Timepoint [5]
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Baseline, 3 month post intervention commencement.
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Secondary outcome [6]
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Sleep quality, assessed with the Pittsburgh Sleep Quality Index
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Assessment method [6]
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Timepoint [6]
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Baseline, 3 months post intervention commencement.
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Secondary outcome [7]
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Beliefs about back pain, assessed with the Back Beliefs Questionnaire
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Assessment method [7]
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Timepoint [7]
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Baselines, 3 months post intervention commencement
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Secondary outcome [8]
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Attitudes regarding use of pain medications, assessed using the short-form Pain Medication Attitudes Questionnaire (PMAQ-14)
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Assessment method [8]
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Timepoint [8]
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Baseline, 3 months post intervention commencement
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Secondary outcome [9]
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Medication use. Data on the use of medications for managing low back pain, including type (i.e., paracetamol, non-steroidal anti-inflammatory drugs, opioids), dosage, and whether the medication was prescribed by a medical or health professional, will be collected by participant self report.
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Assessment method [9]
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Timepoint [9]
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Baseline, 3 months post intervention commencement.
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Secondary outcome [10]
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This is a primary outcome:
Proportion of patients who undertook health coaching, will be assessed by an audit of health coaches patient notes and study database.
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Assessment method [10]
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Timepoint [10]
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Baseline, 3 months post intervention commencement.
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Eligibility
Key inclusion criteria
Patients who are 18 years and over with chronic low back pain (persisting for over 12 weeks).
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Minimum age
18
Years
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Maximum age
No limit
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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
Acute (<6 weeks) low back pain;
Planned surgery
Currently participating in a supervised exercise program
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised 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
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Single group
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Other design features
There is no control group / no randiomisation.
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Phase
Not Applicable
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
Descriptive statistics will describe all quantitative data collected. As a feasibility study, we will employ the Wilcoxon signed rank test to evaluate the change in participants’ measures at baseline and at 3-month follow up post intervention.
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
30/11/2022
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Actual
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Date of last participant enrolment
Anticipated
28/02/2023
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Actual
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Date of last data collection
Anticipated
31/08/2023
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Actual
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Sample size
Target
20
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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]
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Other
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Name [1]
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The Australasian Institute of Chiropractic Education (AICE)
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Address [1]
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Level 1, 75 George Street, Parramatta NSW 2150
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Country [1]
310390
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Australia
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Primary sponsor type
Individual
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Name
Matthew Fernandez
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Address
CQUniversity
60 Ann Street, Brisbane QLD 4000
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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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Not applicable
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Address [1]
311535
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Not applicable
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Country [1]
311535
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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CQUniversity Australia Ethics Committee
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Ethics committee address [1]
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Building 32, Bruce Highway Rockhampton, Queensland 4702
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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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22/12/2021
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Approval date [1]
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15/02/2022
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Ethics approval number [1]
310039
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Summary
Brief summary
Evidence suggests that health coaching is an effective approach to encourage healthy lifestyle habits, including physical activity engagement. These healthy lifestyle changes have been shown to improve patient outcomes and reduce personal healthcare expenditure and care-seeking. Telephone-based health coaching is a promising and emerging intervention for chronic low back pain and has shown to improve physical activity and enhance expectation of recovery in physiotherapy patients. In chiropractic settings, this approach is novel and has the potential to optimise the effectiveness of chiropractic care and encourage patients to take up healthy lifestyle habits through a telephone-based mechanism of support alongside their chiropractic care. Chiropractic patients will participate in a health coaching feasibility study, which will inform the potential for a larger interventional study to explore effectiveness and offer long-term patient engagement with healthy lifestyle habits, such as physical activity. The health coaching intervention includes chiropractic patient participants receiving a patient-centred physical activity plan developed with the advice of the health coach. This physical activity plan will specifically suit patient needs and preferences. Participants will be encouraged to develop goals to suit and gradually increase their physical activity. Health coaching will involve up to 5 individual online / virtual session. We hypothesise that participants in the health coaching program in addition to receiving concurrent usual chiropractic care, will demonstrate improved levels of physical activity, function and reduced levels of pain and rate of careseeking for low back pain. We also hypothesise that participants will build healthy lifestyle habits, and potential to positively impacting physical and mental health, quality of life and healthy ageing.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Matthew Fernandez
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Address
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CQUniversity Australia, Level 20, 160 Ann St, Brisbane QLD 4000
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Country
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Australia
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Phone
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+61 07 3023 4279
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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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Matthew Fernandez
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Address
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CQUniversity Australia, Level 20, 160 Ann St, Brisbane QLD 4000
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Country
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Australia
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Phone
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+61 07 3023 4279
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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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Matthew Fernandez
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Address
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CQUniversity Australia, Level 20, 160 Ann St, Brisbane QLD 4000
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Country
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Australia
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Phone
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+61 07 3023 4279
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Fax
116280
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Email
116280
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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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