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Trial registered on ANZCTR
Registration number
ACTRN12624000634572
Ethics application status
Approved
Date submitted
23/04/2024
Date registered
16/05/2024
Date last updated
21/07/2024
Date data sharing statement initially provided
16/05/2024
Type of registration
Prospectively registered
Titles & IDs
Public title
Contextualising and evaluating the preliminary effectiveness, feasibility, and acceptability of a Suicide Prevention Program for Secondary School Students in Nepal
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Scientific title
Contextualising and evaluating the preliminary effectiveness, feasibility, and acceptability of a Suicide Prevention Program for Secondary School Students in Nepal
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Secondary ID [1]
312014
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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
NA
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Health condition
Health condition(s) or problem(s) studied:
Suicidal thoughts
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Condition category
Condition code
Mental Health
330313
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0
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Suicide
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
SafeTALK is a community-wide awareness program about suicide, its core concepts are Safety and Connectedness (Turley, 2018).
To implement the SafeTALK program in Nepal two training programs will need to be completed. The first program is the LivingWorks Applied Suicide Intervention Skills Training (ASIST) - two days (15 Hours) of in-person training. After completing ASIST, a two-day in-person workshop in the Suicide alertness SafeTALK Training for Trainers (T4T) course should also be completed. For this study, the candidate and supervisors will participate in two days of ASIST training (15 hours) in a group of 15 participants, and the PhD candidate will complete the 2 days T4T workshop before implementation of the program. Both ASIST and T4T trainings will be provided by registered trainers of LivingWorks Australia.
ASIST means applied suicide intervention skills training, which is two days' workshop containing recognising suicide invitaions, suicide risk assessment assessment and connecting to appropriate service and care to keep the person safe. It is pre-requisite for SafeTALK training for trainers T4T. Training for trainers' is a workshop, which enables the trainer to deliver the SafeTALK.
Phase I
Focus groups will be conducted to contextualise the SafeTALK program in Nepalese context. (qualitative study).
Students studying in grade nine and/or ten in Sunsari districts, parents, teachers, school nurses, mental health professionals, and representative health policymakers will be eligible to participate. The sample size will be 5 to 8 adolescents, 1 to 2 parents, 1 to 2 teachers, 1 school nurse, 1 psychiatric nurse, and 1 policymaker from the epidemiology and disease control division. They will be interviewed in two focus groups (one adolescent group and one stakeholder group). Each focus group will take 1-2 hours depending on the robustness of discussion. A package will be developed outlining the main elements of the existing program (SafeTALK) to facilitate the focus group discussion. This package will be sent to the participants as pre-reading and preparation (two weeks in advance). A guide for the topics to be discussed in the focus group discussion will be provided to participants.
Phase II (Intervention/exposure phase)
The contextualised SafeTALK program will be delivered by a LivingWorks (Australia) trained researcher (the Ph.D. candidate) who will implement the program across the classroom after having informed consent. The class will be divided into small class sizes (maximum of 30 in each group), up to four groups to deliver the program. One group will receive the intervention one time for approximately 3 hours SafeTALK training; the standard training designed by LivingWorks. containing classroom activities, short videos and discussion. While delivering the program to one group, other students who are not receiving the program at that moment, will be engaged by schoolteachers in other rooms. Maximum of two groups will be trained in one day, training will be completed in 2-3 days. Two support persons will be in the room throughout the intervention to provide mental health support to the participants if required. Session attendance will be marked by roll number of the students.
Phase III (qualitative study)
Feasibility and acceptability will be assessed by interview method using pre-developed interview schedule. The interviews will be taken by PhD candidate and audio recordings will be obtained with prior consent. Each interview will be conducted for 15-20 minutes. The sample size will be 5 adolescents,3 parents, 3 teachers, 3 nurses, and 3 policymakers from the epidemiology and disease control division (total 15-17). The study population will be selected purposively.
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Intervention code [1]
328470
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Prevention
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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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Contextualisation of SafeTALK suicide prevention program
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Assessment method [1]
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Focus group discussion. Students studying in grade nine and or ten in Sunsari districts, parents, teachers, school nurses, mental health professionals, and representative health policymakers will be eligible to participate. The sample size will be 5 to 8 adolescents, 1 to 2 parents, 1 to 2 teachers, 1 school nurse, 1 psychiatric nurse, and 1 policymaker from the epidemiology and disease control division. They will be interviewed in two focus groups (one adolescent group and one stakeholder group). However, individual interviews can be organised if someone is not available at the scheduled time for the focus group. A purposive, convenience, and snowball sampling technique will be used to recruit participants for the focus group interviews. Students will be recruited using purposive sampling, other stakeholders can be recruited as per convenience or referral by the previous participants. Support from the school under study and the candidate’s professional contacts will be crucial to promote the overall study to adolescents, parents, teachers, healthcare providers, and policy makers. To reach the community, a flyer detailing the overall project will be created that can be distributed widely, placed on school noticeboards, and emailed to stakeholders. Students will be provided with the flyer, Participant Information Sheet (PIS) and consent form to take home for parents to review and return to the candidate should the parent and the child be interested in taking part in this phase of the study. Focus group interviews will be held on Zoom/Google Meet, conducted by PhD Candidate. Audio-recordings of the discussions will be recorded with consent. Focus group interviews may take 1-2 hours depending on the robustness of discussions.
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Timepoint [1]
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Once after obtaining ethical clearance.
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Primary outcome [2]
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Effectiveness of a Suicide prevention program on Suicidal behaviour will be assessed
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Assessment method [2]
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Survey, self-administered questionnaire using Suicidal Ideation Attributes Scale (SIDAS) scale.
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Timepoint [2]
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After obtaining informed consent from the parents and adolescents, baseline data will be collected among 110 adolescents studying in grade 9 and/or 10 in a public school of Koshi Province of Nepal using Socio-demographic proforma, SIDAS and GHSQ. Then, the contextualised safeTALK program will be delivered by a trained researcher (PhD Candidate) and pos-test data will be collected six weeks after completion of the intervention to assess the effectiveness of the Program. It will take 15-20 minutes to fill out the survey form, and 2-3 hours for participating in intervention program.
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Primary outcome [3]
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Effectiveness of a Suicide prevention program on help-seeking, will be assessed.
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Assessment method [3]
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survey, self- administered questionnaire using General Help Seeking Questionnaire (GHSQ).
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Timepoint [3]
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After obtaining informed consent from the parents and adolescents, baseline data will be collected among 110 adolescents studying in grade 9 and/or 10 in a public school of Koshi Province of Nepal using Socio-demographic proforma, SIDAS and GHSQ. Then, the contextualised safeTALK program will be delivered by a trained researcher (PhD Candidate) and pos-test data will be collected six weeks after completion of the intervention to assess the effectiveness of the Program. It will take 15-20 minutes to fill out the survey form, and 2-3 hours for participating in intervention program.
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Secondary outcome [1]
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Feasibility and acceptability will be assessed as a composite outcome.
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Assessment method [1]
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Interview will be taken from 15-17 participants belonging to diverse group (adolescents, parents, teachers, heath workers and policymakers). Pre-developed interview schedule will be used to take interview from 15-20 minutes and audio will be recorded. Separate interview schedule will be used for adolescents and adult participants. one-on-one interview will be conducted by PhD Candidate. Purposive and convenience sampling will be done to recruit the participants. A letter of invitation for parents and students along with a consent form will be sent home with students with the support of the school administration. The consent forms will be collected in the class and students will be interviewed in person, in a private room at the school. For health professionals, teachers, and policy makers, the candidate will email or provide in person a letter of invitation along with a consent form to these stakeholders inviting them to participate in this phase, and they will be recruited only after obtaining informed consent.
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Timepoint [1]
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On completion of intervention.
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Eligibility
Key inclusion criteria
Adolescents aged 15 and above studying in year nine and/or 10 of a government school of Nepal.
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Minimum age
15
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?
Yes
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Key exclusion criteria
Not providing informed consent from the parents and adolescents.
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Study design
Purpose of the study
Prevention
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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
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
The sample size was calculated using G* Power following a t-test matched pair two-tailed priori analysis with 0.5 effect size and 99% power. The total calculated sample size was 100 and adding 10% attrition, the sample size will be 110 for the quantitative phase. Descriptive statistics, mean median, standard deviation, Interquartile range etc. will be calculated and inferential statistics paired t-test will be used to compare pre and post intervention scores.
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
1/08/2024
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Actual
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Date of last participant enrolment
Anticipated
19/09/2024
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Actual
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Date of last data collection
Anticipated
31/10/2024
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Actual
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Sample size
Target
110
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
26279
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Nepal
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State/province [1]
26279
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Koshi
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Funding & Sponsors
Funding source category [1]
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University
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Name [1]
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Western Sydney University- Research Training Program Stipend Scholarship.
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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
Western Sydney University- Research Training Program Stipend Scholarship.
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Address
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
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Country [1]
318549
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
315169
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University of Western Sydney Human Research Ethics Committee
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Ethics committee address [1]
315169
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https://www.westernsydney.edu.au/research/research_ethics_and_integrity/human_ethics/apply_for_human_research_ethics_review
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Ethics committee country [1]
315169
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Australia
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Date submitted for ethics approval [1]
315169
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25/03/2024
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Approval date [1]
315169
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01/07/2024
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Ethics approval number [1]
315169
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H15955
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Ethics committee name [2]
315181
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Nepal Health Research Council
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Ethics committee address [2]
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https://nhrc.gov.np/ethics/
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Ethics committee country [2]
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Nepal
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Date submitted for ethics approval [2]
315181
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24/05/2024
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Approval date [2]
315181
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Ethics approval number [2]
315181
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Summary
Brief summary
This study aims to contextualise and evaluate the preliminary effectiveness, feasibility, and acceptability of a suicide prevention program for secondary school students in Nepal. Phase 1 will be a qualitative study to contextualise an existing suicide prevention program–SafeTalk developed by LivingWorks Australia. Following contextualisation, the program will be implemented across the classes of year nine and/or ten students and will evaluate the preliminary effectiveness of the program in Phase 2. Finally, this study will assess the feasibility and acceptability of the program among a smaller group of participants in Phase 3.
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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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Mrs Rita Pokharel Poudel
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Address
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Western Sydney University, School of Nursing and Midwifery, Parramatta south campus, Locked Bag 1797 Penrith NSW 2751
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Country
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Australia
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Phone
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+61 492885195
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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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Rita Pokharel Poudel
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Address
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Western Sydney University, School of Nursing and Midwifery, Parramatta south campus, Locked Bag 1797 Penrith NSW 2751
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Country
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Australia
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Phone
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+61 492885195
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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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Rita Pokharel Poudel
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Address
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Western Sydney University, School of Nursing and Midwifery, Parramatta south campus, Locked Bag 1797 Penrith NSW 2751
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Country
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Australia
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Phone
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+61 492885195
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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
For confidentiality
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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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