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Trial registered on ANZCTR
Registration number
ACTRN12624001159549
Ethics application status
Approved
Date submitted
8/07/2024
Date registered
24/09/2024
Date last updated
24/09/2024
Date data sharing statement initially provided
24/09/2024
Type of registration
Retrospectively registered
Titles & IDs
Public title
TransformUs Wellbeing: Feasibility of a multicomponent school-based systems intervention within Victorian primary schools.
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Scientific title
A cluster-randomised controlled trial examining the effectiveness of a multicomponent school-based systems intervention (TransformUs Wellbeing) on determinants of childhood obesity within Victorian primary schools.
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Secondary ID [1]
311641
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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
This study is an extension of ACTRN12617000204347 and ACTRN12618001986268. The TransformUs Wellbeing study is incorporating systems science and co-design approach used in RESPOND and embedding in the existing TransformUs intervention and further including diet, sleep and wellbeing.
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Health condition
Health condition(s) or problem(s) studied:
Obesity
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Poor nutrition
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Physical inactivity
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Sleep insufficiency
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Mental wellbeing
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Condition category
Condition code
Public Health
329781
329781
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0
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Health promotion/education
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Diet and Nutrition
329782
329782
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0
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Obesity
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Mental Health
329783
329783
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0
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Studies of normal psychology, cognitive function and behaviour
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
TransformUs Wellbeing builds on the successfully scaled-up primary school physical activity and sedentary behaviour intervention in Victoria (TransformUs) which currently reaches over 500 schools and the whole of community systems intervention called RESPOND (Reflexive Evidence and Systems interventions to Prevent Obesity and Non-communicable Disease (RESPOND). TransformUs Wellbeing will expand and optimise the existing interventions to further to include diet quality, sleep sufficiency and wellbeing and incorporate systems approach within the primary school setting.
It is best described as an educational intervention, whereby, school and community leaders participate in workshops designed to understand the problem (e.g. childhood wellbeing) and then design and implement intervention actions to improve behaviours that can improve wellbeing (e.g. physical activity, sedentary behaviour, diet quality and sleep sufficiency). TransformUs Wellbeing is a cluster RCT involving 8 intervention and 8 control primary schools across three regional Victoria [Warrnambool, Moyne and Corangamite] local government areas (LGAs). There are 3 phases of the intervention which are described below.
Stage 1 - Monitoring (Intervention and control schools): Data provides the first and critical step in the school engagement process. At baseline in Term 2 2024, we will conduct a census styled (e.g. all primary schools invited (n =35) health behaviour monitoring system across the 3 LGAs to examine current estimates of physical activity, sedentary behaviour, diet quality, sleep sufficiency and wellbeing among students in Grade 2, 3, 4 and 5. We will again conduct these measurements post-intervention in Term 2, 2025 among intervention schools-only. E.g. All n= 35 primary schools will be invited in 2024 and only 16 intervention/control schools in 2025.
Children in Year 2, Year 3, Year 4 and Year 5 (as well as Year 6 in 2025) will be invited to participate in this research study using an opt-out approach. At each participating school, a 3–5-minute presentation about the study and what participation involves will be made to all students (in Year 2 - Year 5) in a language that is appropriate for their age level. At the conclusion of this presentation, the Plain Language Statement and Opt-Out form will be distributed to students. A newsletter item about the study will also be offered to participating schools to put in their school communication platforms, in addition, schools will be offered the opportunity to email the Plain Language Statement and Opt-Out form to parents/guardians or via their electronic communication platforms.
Students in Year 2, Year 3, Year 4 and Year 5 will be invited to wear a wrist-worn activity monitor (ActiGraph wGT3X-BT) (like a Fitbit) for 24-hours a day over the proceeding 7-days. Students in Year 4 and Year 5 will be invited to complete a self-report electronic questionnaire on their physical activity, sedentary behaviours, diet intake, sleep and health-related quality of life (approx. 30 mins) in class-time. Students will be informed that their participation is voluntary, and they can participate in as much (e.g. just questionnaire) or as little (e.g. not participate at all) in the study as they wish. Their verbal assent will be sought at all stages of data collection.
Stage 2 - Community engagement (Intervention Schools): Working with key leaders within intervention schools [e.g. students, school leadership (Principal, Leading Teachers), health service staff, local council, parents/guardians etc.] the research team will lead the workshops to develop a visual understanding of the drivers of childhood obesity/wellbeing within the community by developing a causal loop diagram (CLD) or systems map. This will be completed in 2x2hr online/face-to-face workshops with key leaders (workshop session one and workshop session two). The 8 intervention primary schools after randomisation are likely to be grouped into clusters of (2-3 schools) based on geographic and/or school-size (e.g. small, medium, large schools). Schools will nominate how they would like to be grouped after randomisation in 2024. Each cluster group is likely to involve 10-20 key leaders for workshop session one and workshop session two (e.g. 20 x 4 = 80 persons).
As part of workshop session two, the CLD will be finalised and priority actions for each theme area (e.g. physical activity, sedentary time, sleep, wellbeing, diet quality) will be developed. TransformUs evidence informed actions will be used around physical activity and sedentary behaviour (e.g. Active breaks, Active lessons, Active homework, Active environments) and current literature on sleep (e.g. stress management and sleep education), dietary (e.g. food literacy classes, food tasting, school gardens) and wellbeing (e.g. social and emotional learning) interventions for workshop participants to select. Working groups around each priority theme will be developed to enhance implementation of identified actions for each school cluster group. These working groups will be supported in Stage 3 to implement these actions (see below).
Workshops will be held at a public community venue (e.g. school, community hall, public library) if held in person, and via zoom or teams if held online (they will not be audio/video recorded). As part of the group model building (GMB) process, there is a designated facilitator who takes notes on the conversations held, to ensure critical information is not missed. The time period between workshops is yet to be determined, however, it is anticipated that workshop session two would occur no more than one month after workshop session one.
Stage 3 - Implementation of actions: This will occur immediately after Stage 2, with an overall duration of 9 months. Intervention experience will vary depending on the types/number of bespoke activities implemented by each school (e.g., health lessons, extra-curricular activities, policy development etc.).
The intervention will be administered by teachers/school staff with the support of researchers. Ongoing support sessions with key leaders and working groups with each cluster group will be conducted every 1-2 months online (frequency decided by key leaders/cluster group) to discuss barriers and facilitators to implementation and support implementation efforts. The research team will lead these peer mentoring/implementation support sessions to enable mutual learning and sharing of case studies and processes. It is envisaged that these sessions will last 1-2 hrs every 1-2 months per cluster group (e.g. 6x 2hrs = 8 hrs over 9 months). These sessions will occur via Zoom/Teams and will not be audio or video recorded.
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Intervention code [1]
328104
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Prevention
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Comparator / control treatment
At the conclusion of baseline monitoring, 16 schools will be randomised 1:1 intervention to control. The control schools will not receive any additional activities or support, however, specifically designed resources on how to implement intervention actions will be made available to control schools at the conclusion of the intervention.
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Control group
Active
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Outcomes
Primary outcome [1]
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Wellbeing
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Assessment method [1]
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The 23-item Paediatric Quality of Life Inventory 4.0 (PedsQL)TM questionnaire will be used to examine perceived health-related quality of life among participants.
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Timepoint [1]
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Grade 4 and Grade 5 at baseline, and immediately post-intervention (approx. 9-months after baseline).
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Secondary outcome [1]
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Moderate-to-vigorous physical activity
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Assessment method [1]
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Self-reported behavioural questionnaire: Two questionnaire items examining self-reported duration spent in moderate-to-vigorous physical activity and screen-time from the Core Indicators and Measures of Youth Health survey on each of the last 7 days. One further question examining usual active transportation to and/or from school.
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Timepoint [1]
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Grade 4 and Grade 5 at baseline, and immediately post-intervention (approx. 9-months after baseline).
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Secondary outcome [2]
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Sedentary behaviour
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Assessment method [2]
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Self-reported behavioural questionnaire. Two questionnaire items examining self-reported duration spent in moderate-to-vigorous physical activity and screen-time from the Core Indicators and Measures of Youth Health survey on each of the last 7 days. One further question examining usual active transportation to and/or from school.
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Timepoint [2]
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Grade 4 and Grade 5 at baseline, and immediately post-intervention (approx. 9-months after baseline).
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Secondary outcome [3]
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Sleep duration
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Assessment method [3]
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Self-reported behavioural questionnaire: (a bespoke sleep question item based on Berentzen et al (2014) in which students report the time they usually went to bed and woke up on school days).
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Timepoint [3]
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Grade 4 and Grade 5 at baseline, and immediately post-intervention (approx. 9-months after baseline).
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Secondary outcome [4]
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Diet quality - Fruit intake
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Assessment method [4]
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Self-reported fruit intake will be examined using a modified single item from the Child Nutrition Questionnaire (CNQ) (Wilson, 2008) to examine adherence to the Australian Dietary Guidelines of 2 serves of fruit per day for girls and boys aged 9 to 13 years will be examined.
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Timepoint [4]
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Grade 4 and Grade 5 at baseline, and immediately post-intervention (approx. 9-months after baseline).
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Secondary outcome [5]
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Moderate-to-vigorous physical activity
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Assessment method [5]
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Accelerometry
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Timepoint [5]
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Grade 2, 3, 4, 5 at baseline, and immediately post-intervention (approx. 9-months after baseline).
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Secondary outcome [6]
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Sedentary behaviour
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Assessment method [6]
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Accelerometry
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Timepoint [6]
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Grade 2, 3, 4, 5 at baseline, and immediately post-intervention (approx. 9-months after baseline).
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Secondary outcome [7]
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Sleep duration
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Assessment method [7]
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Accelerometry
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Timepoint [7]
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Grade 2, 3, 4, 5 at baseline, and immediately post-intervention (approx. 9-months after baseline).
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Secondary outcome [8]
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Diet quality- vegetable intake
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Assessment method [8]
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Self-reported vegetable intake will be examined using a modified single item from the Child Nutrition Questionnaire (CNQ) (Wilson, 2008) to examine adherence to the Australian Dietary Guidelines of =5 serves of vegetables per day for girls aged 9 to 13 years and boys aged 9 to 11 years, =5.5 serves of vegetables per day for boys aged 12 to 13 years.
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Timepoint [8]
440000
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Grade 4 and Grade 5 at baseline, and immediately post-intervention (approx. 9-months after baseline).
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Eligibility
Key inclusion criteria
All children in Grade 2, 3, 4 and 5 in participating primary schools in the Warrnambool, Corangamite and Moyne LGAs of South-West Victoria will be invited to participate in the monitoring component (n=35 schools).
This trial is conducted in the real-world school setting. Entire schools are randomised to intervention or control and individual participants are not singled out.
Inclusion criteria for the group model building workshop sessions will be based on facilitators judgement of the best placed school/community leaders/stakeholders who can generate community interest and buy-in for a community-led obesity prevention effort.
There are no school-based inclusion criteria.
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Minimum age
7
Years
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Maximum age
13
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 exclusion criteria for the monitoring component. All children in Grade 2, Grade 3, Grade 4 and Grade 5 at participating schools will be invited to participate.
There are no exclusion criteria set for the group model building workshop sessions and or intervention school enrolment.
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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)
Allocation is not concealed.
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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.
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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
Statistical analyses of primary (HRQol) and secondary outcomes (physical activity, sedentary behaviour, sleep, and diet quality) will be examined using an intention to treat analyses.
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Recruitment
Recruitment status
Active, not recruiting
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Date of first participant enrolment
Anticipated
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Actual
15/04/2024
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Date of last participant enrolment
Anticipated
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Actual
28/06/2024
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Date of last data collection
Anticipated
19/09/2025
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Actual
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Sample size
Target
640
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Accrual to date
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Final
759
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Recruitment in Australia
Recruitment state(s)
VIC
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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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VicHealth
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Address [1]
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Country [1]
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Australia
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Primary sponsor type
University
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Name
Deakin University
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Address
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Country
Australia
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Secondary sponsor category [1]
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Government body
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Name [1]
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VicHealth
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Address [1]
318237
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Country [1]
318237
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
314791
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Deakin University Human Research Ethics Committee (DUHREC)
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Ethics committee address [1]
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Human Research Ethics Office Deakin University, 221 Burwood Hwy Burwood, VIC 3125
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Ethics committee country [1]
314791
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Australia
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Date submitted for ethics approval [1]
314791
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27/10/2023
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Approval date [1]
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31/01/2024
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Ethics approval number [1]
314791
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DU-HREC 2023- 361
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Ethics committee name [2]
314891
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Research in Schools and Early Childhood Settings (RISEC)
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Ethics committee address [2]
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Department of Education, Performance and Evaluation Division, research@education.vic.gov.au
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Ethics committee country [2]
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Australia
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Date submitted for ethics approval [2]
314891
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06/02/2024
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Approval date [2]
314891
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01/05/2024
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Ethics approval number [2]
314891
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24-01-238
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Summary
Brief summary
This research will develop, test, and disseminate a multicomponent childhood obesity intervention for primary schools in South-West Victoria. The innovative TransformUs Wellbeing intervention builds on the successfully scaled-up primary school physical activity behaviour intervention in Victoria (TransformUs) and multi-component WHO STOPS community-based childhood obesity intervention. We hypothesise that by embedding capacity in systems thinking and mapping within primary school settings, and extending on the risk behaviours (e.g. diet quality, physical activity, sedentary behaviour, and sleep sufficiency and mental wellbeing) will lead to greater impacts and sustained changes in key behavioural drivers of childhood obesity. Our aim is test the effectiveness of TransformUs Wellbeing on health-related quality of life through a 9-month cluster-RCT among 8 intervention and 8 control primary schools in South-West Victoria in 2024.
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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 Claudia Strugnell
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Address
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Deakin University, Insitute of Physical Activity and Nutrition, 221 Burwood Hwy, Burwood, VIC 3125
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Country
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Australia
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Phone
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+61 3 5227 8483
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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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Claudia Strugnell
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Address
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Deakin University, Insitute of Physical Activity and Nutrition, 221 Burwood Hwy, Burwood, VIC 3125
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Country
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Australia
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Phone
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+61 3 5227 8483
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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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Claudia Strugnell
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Address
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Deakin University, Insitute of Physical Activity and Nutrition, 221 Burwood Hwy, Burwood, VIC 3125
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Country
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Australia
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Phone
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+61 3 5227 8483
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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)?
No
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No/undecided IPD sharing reason/comment
No individual participant data will be shared due to the privacy and confidentiality as per ethics application
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What supporting documents are/will be available?
No Supporting Document Provided
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
23966
Ethical approval
[email protected]
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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