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Trial registered on ANZCTR
Registration number
ACTRN12624001074583
Ethics application status
Approved
Date submitted
14/08/2024
Date registered
5/09/2024
Date last updated
5/09/2024
Date data sharing statement initially provided
5/09/2024
Type of registration
Prospectively registered
Titles & IDs
Public title
Clinician training models for HeLP (A Healthy Lifestyle program for Pain) to support older people with musculoskeletal conditions and comorbid chronic disease risks
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Scientific title
Clinician training models for HeLP (A Healthy Lifestyle program for Pain) to support older people with musculoskeletal conditions and comorbid chronic disease risks
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Secondary ID [1]
312753
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None
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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
334789
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Hip pain
334790
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Knee pain
334791
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Condition category
Condition code
Musculoskeletal
331351
331351
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0
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Osteoarthritis
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Musculoskeletal
331352
331352
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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
Eligible and consenting physiotherapists will be provided one of two training models to inform a larger-scale implementation strategy for capacity building of community clinicians. Both models will be completed within four weeks of baseline data collection. The intervention is an Individual self-paced training model (approx duration 2 hours). Participants will be provided with access to an online dashboard/folder containing all the training modules. The modules/resources are currently under development for this study. The individual self-paced training model includes:
- Clinician education about HeLP, which will provide clinicians with theoretical knowledge of the relationship between musculoskeletal conditions, pain, falls, and chronic disease risks.
- Behaviour change communication skills training, based on Healthy Conversation Skills
- Audit and feedback of HeLP delivery for clinicians 2-4 weeks post-training
- Resource- HeLP booklet (for patients)
- Resource- Behaviour change skills infographic
- Access to HeLP mentor for six months. The HeLP mentor is a HeLP-trained clinician (physiotherapist or chiropractor) with over 10 years of clinical experience.
A number of strategies will be used to assess/monitor adherence to the intervention (e.g., fidelity checklists, training completion status), see outcomes for further details.
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Intervention code [1]
329284
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Behaviour
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Comparator / control treatment
Eligible and consenting physiotherapists will be provided one of two training models to inform a larger-scale implementation strategy for capacity building of community clinicians. Both models will be completed within four weeks of baseline data collection. The comparator is a Group Training Model (approx duration 3.5 hours). It will be delivered online OR face-to-face (not hybrid), depending on the preferences of the participants. The Group Training Model includes:
- Clinician education about HeLP
- Behaviour change communication skills training, Healthy Conversation Skills (Lite)
- Audit and feedback of HeLP delivery for clinicians 2-4 weeks post-training
- Resource- HeLP booklet (for patients)
- Resources- Healthy Conversation Skills (HCS) (SMARTER planner, HCS prompt, HCS self-reflection sheet, HCS summary sheet, list of example HCS questions generated by the group during training.
- Access to HeLP mentor for six months
A number of strategies will be used to assess/monitor adherence to the intervention (e.g., fidelity checklists, training attendance), see outcomes for further details.
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Control group
Active
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Outcomes
Primary outcome [1]
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Use
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Assessment method [1]
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Self-reported 'Use' of HeLP with suitable patients (65 years or older) assessed at four-weeks following training. It will be operationalised as a dichotomous variable (Yes/No). To achieve a ‘Yes’, participants must:
- answer ‘Strongly Agree’ or ‘Agree’ on a 5-point Likert scale to the question ‘Do you think you have used the HeLP model of care principles in your practice in the four weeks since your HeLP training?’
- Provide an example of how they used the HeLP model of care principles. E.g., Used open discover questions, set SMARTER goals.
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Timepoint [1]
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4 weeks post-training
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Secondary outcome [1]
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Clinician communication skills
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Assessment method [1]
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Clinician communication self-efficacy questionnaire (SE-12)
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Timepoint [1]
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Pre-training, immediately post-training, 3-month follow-up
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Secondary outcome [2]
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Confidence
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Assessment method [2]
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On a scale of 0-10 how confident do you feel about supporting clients/individuals to make a lifestyle change (or use the HeLP model)?
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Timepoint [2]
438582
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Pre-training, immediately post-training, 3-month follow-up
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Secondary outcome [3]
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Importance
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Assessment method [3]
438583
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On a scale of 0-10, how important is it for you to support clients/individuals to make a behaviour change?
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Timepoint [3]
438583
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Pre-training, immediately post-training, 3-month follow-up
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Secondary outcome [4]
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Usefulness
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Assessment method [4]
438584
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On a scale of 0-10, how useful do you think the skills you learnt as part of the training package are at supporting individuals to make a behaviour change?
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Timepoint [4]
438584
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Immediately post-training, 3-month follow-up
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Secondary outcome [5]
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Ability (Competence)
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Assessment method [5]
438585
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On a scale of 0-10, how would you rate your ability to communicate with clients and support them to make lifestyle changes?
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Timepoint [5]
438585
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Pre-training, immediately post-training, 3-month follow-up
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Secondary outcome [6]
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Ability (Competence) and barriers
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Assessment method [6]
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Open text questions
Below are four things individuals might say. Please write the next thing you might say to support this individual to make a behaviour change.
1. “I need to lose weight, but I don’t like vegetables”
2. “I should cut down on my alcohol intake, but my partner likes to open a bottle of wine after work”
3. “I’ve lost count of the number of times I’ve tried to stop smoking- it’s hopeless”
4. “I just don’t seem to have time to do any exercise”
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Timepoint [6]
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Immediately post-training, 3-month follow-up
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Secondary outcome [7]
438587
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Use
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Assessment method [7]
438587
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Thinking of your last 10 patients (65 years or older) with hip, knee and low back pain, with how many did you use your HeLP training? That is behaviour change techniques (linking healthy lifestyle with pain) or Healthy Conversation Skills
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Timepoint [7]
438587
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Assessed at four weeks post-training
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Secondary outcome [8]
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Self-reported Fidelity (how well clinicians use HeLP principles)
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Assessment method [8]
438588
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Clinician checklist (Yes/No)
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Timepoint [8]
438588
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Post appointment with client with hip, knee or back pain within four weeks of training
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Secondary outcome [9]
438589
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Fidelity (how well clinicians use) assessed during audit and feedback of HeLP delivery
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Assessment method [9]
438589
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Clinician checklist (Yes/No)
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Timepoint [9]
438589
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Post appointment with client with hip, knee or back pain within four weeks of training
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Secondary outcome [10]
438590
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Training feedback
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Assessment method [10]
438590
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In my opinion the planned objectives of the training were met (scale of 0-10)
The length of the training was adequate for the objectives and content (scale of 0-10)
I would recommend this training to others (scale of 0-10)
On a scale of 0-10 how realistic and practical was the training?
Other
1. What part of the training did you find most useful?
2. How could the training program be improved?
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Timepoint [10]
438590
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Immediately post-training
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Secondary outcome [11]
438591
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Acceptability
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Assessment method [11]
438591
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Acceptability of Intervention Measure
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Timepoint [11]
438591
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Immediately post-training, 3-month follow-up
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Secondary outcome [12]
438592
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Appropriateness
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Assessment method [12]
438592
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Intervention Appropriateness Measure
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Timepoint [12]
438592
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Immediately post-training, 3-month follow-up
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Secondary outcome [13]
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Feasibility
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Assessment method [13]
438593
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Feasibility of Intervention Measure
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Timepoint [13]
438593
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Immediately post-training, 3-month follow-up
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Secondary outcome [14]
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Satisfaction
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Assessment method [14]
438594
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In my opinion the training resources were satisfactory (scale of 0-10)
In my opinion the audit and feedback component of the training was satisfactory (scale of 0-10)
In my opinion the HeLP mentor component of the training was satisfactory (scale of 0-10)
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Timepoint [14]
438594
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3-month follow-up
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Secondary outcome [15]
438595
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Carbon footprinting
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Assessment method [15]
438595
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Data will be collected from participants regarding travel to and from training, as well as other ‘costs’ that will be translated into carbon dioxide equivalents (CO2eq).
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Timepoint [15]
438595
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Immediately post-training, 3-month follow-up
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Eligibility
Key inclusion criteria
- Clinicians from public or private physiotherapy services that agree to undertake HeLP training
- Able to participate in clinician training sessions
- Regularly see clients (at least two per week) with musculoskeletal conditions (hip, knee or low back pain).
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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?
Yes
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Key exclusion criteria
- No specific exclusion criteria
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Study design
Purpose of the study
Educational / counselling / training
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Central randomisation
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Simple randomisation- computerised sequence generation)
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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
The primary analysis will use logistic regression to compare the ‘Use’ of HeLP with suitable patients in the four-week period following training between the ISP and GT groups. The estimate from this model summarising the intervention effect will be the odds ratio and corresponding 95% confidence interval of ISP vs GT. Secondary outcomes will also be analysed using generalised linear models (GLMs). For each outcome, an appropriate distribution and link function will be selected. We will obtain estimates of the effect of the intervention and 95% confidence intervals by constructing linear contrasts to compare the adjusted mean change (continuous variables) or difference in proportions (dichotomous variables) in outcomes from baseline to each time point between the groups.
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
1/02/2025
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
100
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
NSW
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Funding & Sponsors
Funding source category [1]
317183
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Charities/Societies/Foundations
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Name [1]
317183
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HCF Research Foundation
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Address [1]
317183
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Country [1]
317183
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Australia
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Primary sponsor type
Government body
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Name
Hunter New England Local Health District Population Health
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Address
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Country
Australia
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Secondary sponsor category [1]
319452
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University
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Name [1]
319452
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University of Sydney
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Address [1]
319452
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Country [1]
319452
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
315927
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Hunter New England Human Research Ethics Committee
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Ethics committee address [1]
315927
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https://www.hnehealth.nsw.gov.au/research-office/research_ethics
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Ethics committee country [1]
315927
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Australia
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Date submitted for ethics approval [1]
315927
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28/06/2024
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Approval date [1]
315927
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22/07/2024
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Ethics approval number [1]
315927
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2024/ETH01214
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Summary
Brief summary
Thousands of older Australians with hip, knee and low back pain are referred for surgical consultation, wait extended periods without alternative evidence-based care, and 75% have three or more chronic disease risks (e.g., overweight, smoker). We previously found a Healthy Lifestyle program for Pain (HeLP) reduced disability and improved quality of life. Now we seek to test the best method to scale up the program. We will test if an Individual Self-Paced training model is as effective as a Group Training model on the use of HeLP in physiotherapy settings. We expect to find similar results between groups.
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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 Simon Davidson
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Address
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Population Health, Hunter New England Local Health District, Longworth Ave, Wallsend NSW 2287
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Country
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Australia
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Phone
136246
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+61 02 9351 9923
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Fax
136246
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Email
136246
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[email protected]
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Contact person for public queries
Name
136247
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Simon Davidson
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Address
136247
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Population Health, Hunter New England Local Health District, Longworth Ave, Wallsend NSW 2287
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Country
136247
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Australia
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Phone
136247
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+61 02 9351 9923
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Fax
136247
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Email
136247
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[email protected]
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Contact person for scientific queries
Name
136248
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Simon Davidson
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Address
136248
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Population Health, Hunter New England Local Health District, Longworth Ave, Wallsend NSW 2287
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Country
136248
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Australia
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Phone
136248
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+61 02 9351 9923
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Fax
136248
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Email
136248
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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?
De-identified individual participant data collected during the trial
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When will data be available (start and end dates)?
Start- Immediately following publication
End- 5 years following main results publication
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Available to whom?
Researchers who provide a methodologically sound proposal that is approved by the Principal Investigator (
[email protected]
)
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Available for what types of analyses?
Only to achieve the aims in the approved proposal
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How or where can data be obtained?
Access subject to approvals by Principal Investigator (
[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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