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Trial registered on ANZCTR
Registration number
ACTRN12625000332426
Ethics application status
Approved
Date submitted
4/04/2025
Date registered
17/04/2025
Date last updated
17/04/2025
Date data sharing statement initially provided
17/04/2025
Type of registration
Retrospectively registered
Titles & IDs
Public title
Testing the Body Blocks Program: Helping Early Childhood Educators Support Children's Positive Body Image
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Scientific title
Impact of the Body Blocks Program on Early Childhood Educators’ Knowledge and Competency for Promoting Positive Body Image: A Randomised Controlled Trial
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Secondary ID [1]
314133
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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:
Body dissatisfaction
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mental health
336942
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Eating Disorders
336944
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Condition category
Condition code
Mental Health
333414
333414
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0
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Eating disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Body Blocks by The Embrace Collective (https://theembracehub.com/body-blocks-by-embrace-kids/) is a universal prevention program for early childhood educators that aims to prevent body image issues in young people by getting in early with messages of body appreciation. The program aims to provide knowledge and strategies for early learning educators to support young children to develop positive relationships with food, movement and their bodies. The program targets educators working with children aged zero to eight years of age and consists of 7 x 5-minute online evidence-based and inspirational modules, which can be completed in their entirety or in a self-paced manner. The modules include practical strategies designed to be easily implemented. The program was intentionally designed be succinct, to be completed in short work breaks, allowing for reflection and integration into practice.
The seven modules cover the following topics:
1. Body Talk: Avoiding negative body talk; using non-appearance-based compliments; treating movement as fun; reframing diet talk
2. Body Talk & Kids: Helping kids develop a positive body image; talking about what bodies can do and focusing on functionality; avoiding praising appearance. Activities to support educators to help kids develop positive body image focusing on unique body strengths and non-physical features.
3. Playtime: Aiming to teach children: (1) we appreciate their positive skills and qualities (and they can too); (2) what’s on the inside is more important than what is on the outside; (3) lots of people look different and can-do different things; (4) we accept them just as they are.
4. Food Talk: Importance of avoiding labelling food (as either good or bad, junk food); focusing on the joy of food and its function; ideas on how to update food-based activities (i.e., food collages, food I spy; food Bingo).
5. Mealtimes: Supporting children to build positive relationships with food and eating by: (1) getting curious during mealtimes; (2) bringing all five senses into meals; (3) encouraging kids to listen to their bodies; (4) remembering: “I provide, they decide!”; (5) speaking about all foods in a positive way.
6. Home time: How to support parents and family to build their children’s body image; Body Blocks guide for parents’ information sheet; communicating to parents the information educators’ have learnt through the program and what positive messages they are implementing.
7. Me time: How to support educators to build their own self-compassion and self-care practices and practice being kinder to themselves instead of self-critical.
Participants had 1-week after randomization to complete the 7x5 minute modules. To assess adherence to the intervention, participants were asked qualitative questions such as "What were the key takeaway messages from the Body Blocks program?"
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Intervention code [1]
330794
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Behaviour
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Intervention code [2]
330726
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Prevention
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Comparator / control treatment
Waitlist control. The waitlist group were provided with access to the Body Blocks materials upon completion of their 4-week follow-up survey.
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Control group
Active
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Outcomes
Primary outcome [1]
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Competence and Awareness of positive body image (composite primary outcome)
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Assessment method [1]
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To assess educators’ competence and awareness of positive body image, a 10-item scale was developed for the current study based on the learning outcomes from the Body Blocks modules
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Timepoint [1]
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baseline, 1-week post randomization (primary endpoint)
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Primary outcome [2]
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Body Image Knowledge
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Assessment method [2]
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The Knowledge Test for Body Image and Eating patterns in Childhood (Knowledge Test BEC; Damiano et al., 2015)
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Timepoint [2]
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baseline, 1-week post randomization (primary endpoint) and 4 weeks post randomization
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Secondary outcome [1]
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Functionality appreciation
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Assessment method [1]
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Functionality appreciation was assessed using Alleva et al. (2017) Functionality Appreciation Scale (FAS).
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Timepoint [1]
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baseline, 1-week post randomization and 4 weeks post randomization
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Secondary outcome [2]
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Body image self-efficacy
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Assessment method [2]
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Body image self-efficacy was assessed at baseline, 1-week and 4-week follow up using a modified version of the 7-item disengagement subscale from the Coach Self-Efficacy Body Image Scale (CSEBIS; Silva-Breen et al., 2022)
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Timepoint [2]
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baseline, 1-week post randomization and 4 weeks post randomization
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Secondary outcome [3]
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Body positive work setting
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Assessment method [3]
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To assess early learning educators’ work setting’s attitudes and culture towards body positivity, 10-items were developed for the present study based on recommendations from Neumark-Sztainer et al. (2018). Items assess whether their work setting promotes, encourages and/or celebrates body diversity, functionality, appreciation, and self-compassion. Together, all items provide an overall work setting's attitudes and culture towards body-positivity score (composite secondary outcome).
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Timepoint [3]
445731
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baseline, 1-week post randomization and 4 weeks post randomization
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Secondary outcome [4]
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Fat attitudes
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Assessment method [4]
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Early learning educators’ fat attitudes were assessed at all time points using the 6-item size acceptance and the 5-item critical health subscales from the Fat Attitudes Assessment Toolkit (FAAT; Cain et al., 2022).
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Timepoint [4]
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baseline, 1-week post randomization and 4 weeks post randomization
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Secondary outcome [5]
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Body appreciation
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Assessment method [5]
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Body appreciation was assessed using the 3-item short-form version of the Body Appreciation Scale-2 (Tylka et al., 2022).
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Timepoint [5]
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baseline, 1-week post randomization and 4 weeks post randomization
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Eligibility
Key inclusion criteria
Eligibility criteria included consent from ELC director and minimum of two or more staff members expressing interest in participating in the research trial.
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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 exclusion criteria.
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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 was not concealed.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Randomisation was conducted in a 1:1 ratio using the RAND formula list procedure in Excel.
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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
Parallel
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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
Linear Mixed Model (LMM) analyses were performed to evaluate between group changes in knowledge and attitudes over time with fixed effects of group, time and interaction between group and time. LMM analyses are robust in handling missing data and unbalanced designs in repeated measures research (Nich et al., 1997), using estimation maximization (EM) for observed and missing data based on maximizing likelihood for population parameters as a function of observed data (Norusis, 2007). Thus, all participants who completed the baseline survey (regardless of missing data at follow-up) are included in the data analyses which is not possible with traditional ANOVA techniques (Gueorguieva et al., 2004).
Moderator analyses additionally included fixed effects for moderator, group × moderator, time × moderator and group × time × moderator. Potential moderators of change in knowledge and awareness included: age category (0 = below 40; 1 = above 40), years worked in the profession (0 = less than 15 years; 1 = more than 15 years), SEIFA category (0 = SEIFA score below 1000; 1 = SEIFA score above 1000), educators’ body appreciation (0 = below sample mean of 3.41; 1 = above sample mean of 3.41), educators’ functionality appreciation (0 = below sample mean of 4.13; 1 = above sample mean of 4.13) and lastly educators’ positive fat attitudes as measured by the size acceptance (0 = below sample mean of 5.8; 1 = above sample mean of 5.8) and critical health subscales (0 = below mean of 5.7; 1 = above mean of 5.7).
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
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Actual
24/05/2024
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Date of last participant enrolment
Anticipated
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Actual
29/10/2024
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Date of last data collection
Anticipated
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Actual
6/12/2024
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Sample size
Target
170
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Accrual to date
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Final
221
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Recruitment in Australia
Recruitment state(s)
QLD,SA
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Funding & Sponsors
Funding source category [1]
318642
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Government body
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Name [1]
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The Australian Federal Government Department of Health and Aged Care
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Address [1]
318642
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Country [1]
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Australia
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Primary sponsor type
Charities/Societies/Foundations
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Name
The Embrace Collective
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Address
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Country
Australia
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Secondary sponsor category [1]
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University
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Name [1]
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Flinders University
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Address [1]
321070
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Country [1]
321070
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
317252
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Flinders University Human Research Ethics Committee
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Ethics committee address [1]
317252
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https://staff-projects.flinders.edu.au/research-support/integrity/human-ethics
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Ethics committee country [1]
317252
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Australia
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Date submitted for ethics approval [1]
317252
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05/04/2024
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Approval date [1]
317252
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03/05/2024
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Ethics approval number [1]
317252
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HREC6484
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Summary
Brief summary
The present study aimed to evaluate the impact of the Body Blocks program on early learning educators’ knowledge, attitudes, and teaching practices by conducting a randomised controlled trial, with participants randomised to either an intervention group or waitlist control. We anticipated that participants randomised to the intervention group would report higher educator knowledge and attitudes about body image compared to educators in the waitlist control group, as well as greater confidence and capabilities in promoting positive body image. In addition, we explored the moderating role of demographic variables (i.e., age, years in the profession, socio-economic-status), as well as educators’ own body and functionality appreciation and fat attitudes on our main outcome of interest (i.e., knowledge and awareness).
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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 Ivanka Prichard
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Address
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Flinders University, Sturt Road, Bedford Park, SA 5042
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Country
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Australia
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Phone
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+61 8 82013713
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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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Ivanka Prichard
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Address
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Flinders University, Sturt Road, Bedford Park, SA 5042
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Country
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Australia
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Phone
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+61 8 82013713
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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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Ivanka Prichard
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Address
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Flinders University, Sturt Road, Bedford Park, SA 5042
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Country
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Australia
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Phone
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+61 8 82013713
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Fax
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Email
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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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