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Trial registered on ANZCTR
Registration number
ACTRN12624001462572
Ethics application status
Approved
Date submitted
18/11/2024
Date registered
16/12/2024
Date last updated
16/02/2025
Date data sharing statement initially provided
16/12/2024
Type of registration
Prospectively registered
Titles & IDs
Public title
Sexual and Reproductive Health Screening in a Child and Youth Mental Health Service
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Scientific title
Implementing Routine Sexual and Reproductive Health Screening into a Child and Youth Mental Health Service: A Cluster Randomised Controlled Trial
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Secondary ID [1]
312960
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n/a
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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:
Sexual health
335487
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Reproductive health
335872
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Condition category
Condition code
Public Health
332456
332456
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0
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Health service research
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Reproductive Health and Childbirth
332046
332046
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0
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Contraception
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
The intervention is to be developed as a part of the study. The sexual and reproductive health education and training module (intervention) will be developed by the study team in consultation with clinicians and young people. The consultation process will involve a half-day workshop with the study investigators and experts in SRH, as well as external input via group meetings with the child and youth mental health service (CYMHS) clinicians consumers and parents/guardians.
The final draft of the intervention will be trialed by the study investigator with volunteer child and youth mental health clinicians and the wider study team.
Once the intervention has been finalised, the education intervention will be delivered to clinicians in Cluster 1 (three randomly selected community CYMHS sites; intervention cluster/arm) first, along with nursing staff at each community site in both Clusters 1 and 2, and the Forensic CYMHS site. Clinical staff in Cluster 2 (remaining three randomly selected community CYMHS sites; control cluster/arm) will continue as care as usual without receiving the intervention.
Once sufficient numbers of clinicians in Cluster 1 have received the training, completed pre- and post-intervention surveys, and the intervention has been in practice for approximately 6 months, clinicians and nurses in Cluster 2 will be invited to participate in the study.
The intervention will take form as a one hour, face to face education and training session delivered to clinical staff working within a CYMHS community clinic setting. Participants will receive the intervention as a one-time dose. The intervention will be delivered by two study PIs with extensive experience in sexual and reproductive health and child and youth psychiatry and will cover aspects of sexual and reproductive health such as sexually transmitted diseases, sexual dysfunction (related to mental health medication side effects), consent, healthy relationships and contraception.
The intervention aims to increase clinician knowledge, confidence and skills to engage in brief conversations with young people with mental health problems to screen for sexual and reproductive health issues. Nursing staff (1 to 2 per clinic) will receive an extended version of this intervention comprising additional training to support the nurse-led intervention and will address areas such as STI testing and referral pathways for specialised and/or ongoing care. This extended version of the training for nurses will be delivered around the same time that clinicians receive the standard one-hour education module. Nursing staff across both Cluster 1 and Cluster 2 will receive the intervention (nursing education and training) at baseline.
Clinical staff working with adolescent clients across the community clinics will be provided with resources to implement the intervention immediately following the delivery by way of conducting screening with their adolescent clients who attend these clinics attend weekly to fortnightly appointments on average, although this varies depending on individual need.
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Intervention code [1]
329769
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Early detection / Screening
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Comparator / control treatment
The control arm of this study will be 'Cluster 2', which will comprise three community sites whose staff will not receive the education session intervention and will continue with care as usual for an initial 6-month period. Care as usual will entail standard mental health care in which clinicians may also ask about sexual and reproductive health, however, currently this is infrequently and inconsistently addressed.
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Control group
Active
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Outcomes
Primary outcome [1]
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Comparison of staff knowledge, skills and confidence of SRH screening of young people (composite measure)
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Assessment method [1]
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A bespoke questionnaire completed by participants (clinical staff) electronically via REDCap pre- and post intervention
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Timepoint [1]
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Within one week pre-intervention (Baseline), Post intervention (up to one-week post intervention) and at 3-months post intervention completion.
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Primary outcome [2]
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Comparison between intervention and control sites in the number of referrals for a nurse led consultation
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Assessment method [2]
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Referral numbers, captured by nursing staff.
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Timepoint [2]
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Six-months post-intervention commencement
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Secondary outcome [1]
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The level of adolescent (14-17-years) acceptability of SRH screening in a mental health setting.
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Assessment method [1]
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Qualitative in person, telephone or video conferencing interviews with adolescent clients of the service.
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Timepoint [1]
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Continuously throughout the study from the three-month post intervention time-point until target numbers are reached or data saturation is achieved, whichever comes first.
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Secondary outcome [2]
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The level of staff acceptability of SRH screening in a mental health setting.
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Assessment method [2]
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Qualitative in person, telephone or video conferencing interviews with parents/caregivers with staff who received the intervention (SRH education and training)
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Timepoint [2]
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Continuously throughout the study from the three-month post intervention time-point until target numbers are reached or data saturation is achieved, whichever comes first.
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Secondary outcome [3]
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The level of parent/caregiver acceptability of SRH screening in a mental health setting.
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Assessment method [3]
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Qualitative in person, telephone or video conferencing interviews with parents/caregivers with an adolescent child who is a client of the service.
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Timepoint [3]
442248
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Continuously throughout the study from the three-month post intervention time-point until target numbers are reached or data saturation is achieved, whichever comes first.
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Eligibility
Key inclusion criteria
CYMHS Staff
Surveys: All clinicians at CHQHHS CYMHS community clinics and Forensics CYMHS will be eligible to participate in the intervention. We will seek to recruit these staff to participate in the pre- and post-intervention surveys, with consent being sought prior to participation.
Qualitative interviews: Any clinician from the above sample who consented to a qualitative interview and completed both pre- and post-intervention surveys, and who received the intervention in full (SRH education session).
Adolescent clients, and parents/caregivers of adolescent clients
Qualitative interviews:
a. Adolescent CYMHS clients aged 14-years and over who attended a CYMHS clinic and received mental health care will be eligible to participate in a qualitative interview.
b. Parents or guardians of adolescent CYMHS clients who attended a CYMHS clinic and received mental health care will be eligible to participate in a qualitative interview.
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Minimum age
14
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
Qualitative interviews:
1. Adolescent clients of CYMHS younger than 14 years of age.
2. Insufficient understanding of the English language.
3. Clinicians who are not employed by CHQ CYMHS.
4. Adolescent clients, or parents/caregivers of adolescent clients who are not a patient of CHQHHS.
5. CYMHS clinicians who did not complete all study components; the pre- and post-intervention surveys, and completion of the SRH education session.
4. Any staff, consumers or parents of consumers who are not a patient of CHQHHS.
5. Any consumer who is in state care (foster, residential care etc.).
6. Staff who did not complete all three components of the study; the pre-survey, training and post-survey.
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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)
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 procedures like coin-tossing and dice-rolling
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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
Other
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Other design features
Cluster 2 will act as a comparator for cluster 1, and the clusters will receive the same intervention in a step-wise fashion. For the first 6 months, cluster 2 is usual care and cluster 1 receives the intervention, and outcomes will be compared between the two clusters. Following this, cluster 2 will receive the intervention.
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Phase
Not Applicable
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
3/03/2025
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Actual
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Date of last participant enrolment
Anticipated
5/01/2026
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Actual
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Date of last data collection
Anticipated
27/03/2026
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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 in Australia
Recruitment state(s)
QLD
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Funding & Sponsors
Funding source category [1]
317395
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Other
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Name [1]
317395
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Sexual Health Research Fund. The Sexual Health Research Fund is administered by the Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM).
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Address [1]
317395
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Country [1]
317395
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Australia
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Primary sponsor type
Hospital
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Name
Children's Health Queensland CYMHS service
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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]
319683
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Address [1]
319683
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Country [1]
319683
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
316120
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Children’s Health Queensland Hospital and Health Service Human Research Ethics Committee
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Ethics committee address [1]
316120
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http://www.childrens.health.qld.gov.au/research/human-research-ethics-committee
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Ethics committee country [1]
316120
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Australia
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Date submitted for ethics approval [1]
316120
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18/11/2024
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Approval date [1]
316120
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16/12/2024
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Ethics approval number [1]
316120
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HREC/24/QCHQ/112051
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Summary
Brief summary
This study aims to implement standardised sexual and reproductive health (SRH) screening into the Children’s Health Queensland (CHQ) Child and Youth Mental Health Service (CYMHS). CYMHS provides specialist outpatient mental health services to those up to 18 years of age with complex mental health needs. The intervention involves development and delivery of a brief training and education module designed to equip clinicians with the knowledge and confidence required to engage young people aged 12-17-years in consultations around their SRH and facilitate referrals for nurse-led SRH consultations where indicated, through which further SRH information, more advanced screening, and/or other care can be provided.
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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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Prof James Scott
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Address
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Centre for Children's Health Research (Children's Health QLD), 62 Graham St, South Brisbane QLD 4101
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Country
136854
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Australia
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Phone
136854
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+617 3069 7398
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Fax
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Email
136854
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[email protected]
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Contact person for public queries
Name
136855
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James Scott
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Address
136855
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Centre for Children's Health Research (Children's Health QLD), 62 Graham St, South Brisbane QLD 4101
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Country
136855
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Australia
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Phone
136855
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+617 3069 7000
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Fax
136855
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Email
136855
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[email protected]
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Contact person for scientific queries
Name
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James Scott
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Address
136856
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Centre for Children's Health Research (Children's Health QLD), 62 Graham St, South Brisbane QLD 4101
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Country
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Australia
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Phone
136856
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+617 3069 7398
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Fax
136856
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Email
136856
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[email protected]
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Data sharing statement
Will the study consider sharing individual participant data?
No
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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