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Trial registered on ANZCTR
Registration number
ACTRN12625000654459
Ethics application status
Approved
Date submitted
2/06/2025
Date registered
20/06/2025
Date last updated
20/06/2025
Date data sharing statement initially provided
20/06/2025
Type of registration
Prospectively registered
Titles & IDs
Public title
Evaluating the feasibility, acceptability, and preliminary efficacy of a peer support program for trans people on a waitlist to access gender affirming care (‘Thriving Transitions’): a randomised controlled trial
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Scientific title
Randomised controlled trial evaluation of the feasibility, acceptability, and preliminary efficacy of a peer support program for reducing suicidality, depressive symptoms, and improving quality of life among trans people on a waitlist to access gender affirming care relative to standard care (‘Thriving Transitions’)
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Secondary ID [1]
314579
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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:
Mental health
337685
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Condition category
Condition code
Mental Health
334019
334019
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0
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Depression
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Public Health
334020
334020
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0
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Health promotion/education
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Public Health
334021
334021
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0
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Other public health
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
This study aims to evaluate the feasibility, acceptability, and preliminary efficacy of an online peer support program (‘Thriving Transitions’) for reducing suicidal ideation, depressive symptoms, and improving quality of life, among trans people on a waitlist for initiating gender affirming hormone therapy, compared to standard care as usual.
Participants will be allocated to intervention (‘Thriving Transitions’) or standard care (no intervention). Intervention is a peer support program consisting of 7 x 1.5 hr once weekly sessions over a 7 week period. This will be delivered online via videoconference by two peer facilitators (both trained in providing support to trans people experiencing suicidal thoughts.
The peer support program will cover the following topics:
1. Introductions, group agreement
2. Medical gender affirmation
3. Hoping and coping
4. Coming out or ‘inviting in’
5. Sex, dating, and intimacy
6. Gender embodiment goals
7. Trans futures
Facilitators will be provided with a comprehensive facilitator training and delivery manual which outlines key details about the background and co-development of the Thriving Transitions intervention, in addition to week-by-week aims, learning objectives, key topics to be discussed and explored, and relevant local resources and services as they pertain to the topic. Additionally, this document outlines the schedule of activities (including discussion activities) to be facilitated for each week, including prompts, follow-up questions, implementation considerations to be planned and anticipated. All facilitators will receive a half-day (~4hr equivalent) of training at least 4 weeks prior to the program commencement date delivered by 1-2 independent member(s) of the research team. Training day will involve orientation, introductions and fostering collegiality and familiaritiy, going through content, asking questions, with optional practical (e.g., role-play) activities for targeted training about specific scenarios or anticipated concerns of facilitators. Each week, co-facilitators with debrief together. Facilitators will also have access to a weekly supervision session provided a trans peer.
To monitor adherence and fidelity, facilitators will be required to complete weekly implementation and debrief logbooks within which attendance will be annotated. Within 48 hours following a session, facilitators will send a ‘wrap-up’ style email summarising the previous week and, additionally, an ‘orientation’ style email will send at least 48 hours in advance an ‘orientation’ style email providing an overview of the upcoming session, including notices and reminders of attendance. This logbook will also allow facilitators to reflexively denote any facilitators and barriers to participant engagement and participation among attendees from that week. From participant enrolment stage, to be eligible for this study participants must be able to confirm that they do not foresee any difficulty to regularly attending the 7-week Thriving Transitions program in the event that they are randomly allocated to receive the program.
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Intervention code [1]
331202
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Prevention
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Comparator / control treatment
Participants randomly allocated to the control trial arm will receive standard care as usual (i.e., resumed occupation of waitlist for initiating gender affirming hormone treatment). There are no current plans to offer the intervention to the control group during this study.
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Control group
Active
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Outcomes
Primary outcome [1]
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Preliminary efficacy - suicidal ideation
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Assessment method [1]
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Suicidal ideation Assessment Method: Suicidal Ideation Attributes Scale (SIDAS) Timepoint: Baseline (T0), 7-weeks post-baseline (T1), 3-months post-baseline (T2)
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Timepoint [1]
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Suicidal ideation Assessment Method: Suicidal Ideation Attributes Scale (SIDAS) Timepoint: Baseline (T0), 7-weeks post-baseline (T1), 3-months post-baseline (T2)
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Primary outcome [2]
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Feasibility
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Assessment method [2]
341676
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Facilitator weekly logbooks: Seven assessments weekly over course of 7-week Thriving Transitions program Facilitator experience survey: 7-weeks post-baseline (T1) Participant experience survey: 7-weeks post-baseline (T1)
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Timepoint [2]
341676
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Facilitator weekly logbooks: Seven assessments weekly over course of 7-week Thriving Transitions program Facilitator experience survey: 7-weeks post-baseline (T1) Participant experience survey: 7-weeks post-baseline (T1)
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Primary outcome [3]
341677
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Acceptability
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Assessment method [3]
341677
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Facilitator weekly logbooks: Seven assessments weekly over course of 7-week Thriving Transitions program Facilitator experience survey: 7-weeks post-baseline (T1) Participant experience survey: 7-weeks post-baseline (T1)
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Timepoint [3]
341677
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Facilitator weekly logbooks: Seven assessments weekly over course of 7-week Thriving Transitions program Facilitator experience survey: 7-weeks post-baseline (T1) Participant experience survey: 7-weeks post-baseline (T1)
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Secondary outcome [1]
448726
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Depressive symptoms
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Assessment method [1]
448726
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Patient Health Questionnaire (PHQ-9)
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Timepoint [1]
448726
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Baseline (T0), 7-weeks post-baseline (T1), 3-months post-baseline (T2)
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Secondary outcome [2]
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Nicotine use
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Assessment method [2]
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Derived from US National Survey on Drug Use and Health (NSDUH)
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Timepoint [2]
448312
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Baseline (T0), 7-weeks post-baseline (T1), 3-months post-baseline (T2)
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Secondary outcome [3]
448309
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Hope
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Assessment method [3]
448309
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Adult Hope Scale
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Timepoint [3]
448309
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Baseline (T0), 7-weeks post-baseline (T1), 3-months post-baseline (T2)
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Secondary outcome [4]
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Health-related quality of life
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Assessment method [4]
448727
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Health-related quality of life scale (EQ-5D-5L)
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Timepoint [4]
448727
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Baseline (T0), 7-weeks post-baseline (T1), 3-months post-baseline (T2)
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Secondary outcome [5]
448313
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Vaping use
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Assessment method [5]
448313
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Derived from US National Survey on Drug Use and Health (NSDUH)
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Timepoint [5]
448313
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Baseline (T0), 7-weeks post-baseline (T1), 3-months post-baseline (T2)
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Secondary outcome [6]
448315
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Wellbeing
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Assessment method [6]
448315
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Personal Wellbeing Index - Adults (PWI-A)
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Timepoint [6]
448315
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Baseline (T0), 7-weeks post-baseline (T1), 3-months post-baseline (T2)
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Secondary outcome [7]
448310
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Anxiety symptoms
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Assessment method [7]
448310
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Generalised Anxiety Disorder Screener (GAD-7)
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Timepoint [7]
448310
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Baseline (T0), 7-weeks post-baseline (T1), 3-months post-baseline (T2)
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Secondary outcome [8]
448314
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Cannabis use
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Assessment method [8]
448314
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Derived from US National Survey on Drug Use and Health (NSDUH)
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Timepoint [8]
448314
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Baseline (T0), 7-weeks post-baseline (T1), 3-months post-baseline (T2)
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Secondary outcome [9]
448319
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Service utilisation
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Assessment method [9]
448319
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Adapted version of the Actual Help-Seeking Questionnaire (AHSQ)
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Timepoint [9]
448319
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Baseline (T0), 7-weeks post-baseline (T1), 3-months post-baseline (T2)
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Secondary outcome [10]
448316
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Trans community connectedness
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Assessment method [10]
448316
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Trans community connectedness subscale of the Gender Minority Stress and Resilience Scale (GMSR)
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Timepoint [10]
448316
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Baseline (T0), 7-weeks post-baseline (T1), 3-months post-baseline (T2)
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Secondary outcome [11]
448311
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Social functioning
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Assessment method [11]
448311
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Social functioning subscale of the Short Form Health Survey (SF-36)
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Timepoint [11]
448311
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Baseline (T0), 7-weeks post-baseline (T1), 3-months post-baseline (T2)
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Secondary outcome [12]
448318
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Trans health literacy
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Assessment method [12]
448318
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Bespoke, purpose-built items designed by trans researchers working in the trans health research fields.
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Timepoint [12]
448318
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Baseline (T0), 7-weeks post-baseline (T1), 3-months post-baseline (T2)
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Secondary outcome [13]
448317
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Social isolation
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Assessment method [13]
448317
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UCLA 3-item Loneliness scale
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Timepoint [13]
448317
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Baseline (T0), 7-weeks post-baseline (T1), 3-months post-baseline (T2)
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Secondary outcome [14]
448320
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Resilience
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Assessment method [14]
448320
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Brief Resilience Scale
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Timepoint [14]
448320
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Baseline (T0), 7-weeks post-baseline (T1), 3-months post-baseline (T2)
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Eligibility
Key inclusion criteria
1. have a gender different to the one presumed for them at birth (often termed ‘trans’)
2. aged 18+ years at time of study, and
3. seeking initiation of gender affirming hormone therapy (GAHT) at Austin Health Gender Clinic or North-Eastern Urology
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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
1. has the same gender that was presumed for them at birth (often termed ‘cisgender’)
2. Aged <18 years
3. people who have ever undertaken a regime of GAHT
4. people seeking to re-initiate GAHT (or who have taken GAHT previously)
5. people who foresee difficulty to regularly attend seven weekly sessions of a trans peer support group program and complete health and evaluation surveys over a three month period
6. people who are experiencing mental ill-health difficulties which may make them unable to take care of themselves and keep themselves safe throughout the study duration
7. people who feel that their level of English language proficiency may negatively impact their ability to participate and experience an English language-run trans peer support group program run across six fortnightly sessions over three months
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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 by phone/fax/computer
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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 (i.e. computerised 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
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
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
30/06/2025
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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
40
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
VIC
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Funding & Sponsors
Funding source category [1]
319096
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Charities/Societies/Foundations
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Name [1]
319096
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Suicide Prevention Australia
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Address [1]
319096
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Country [1]
319096
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Australia
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Primary sponsor type
University
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Name
University of Melbourne
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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]
321560
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Address [1]
321560
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Country [1]
321560
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Other collaborator category [1]
283535
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University
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Name [1]
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The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney
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Address [1]
283535
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Country [1]
283535
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
317696
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Austin Health Human Research Ethics Committee
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Ethics committee address [1]
317696
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https://www.austin.org.au/Office-for-Research/
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Ethics committee country [1]
317696
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Australia
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Date submitted for ethics approval [1]
317696
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04/05/2025
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Approval date [1]
317696
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27/05/2025
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Ethics approval number [1]
317696
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Summary
Brief summary
This study will conduct a randomised controlled trial to evaluate the feasibility, acceptability, and preliminary efficacy of the program to reduce suicidality, depressive symptoms, and improve quality of life, among trans people on a waitlist for initiating GAHT. Participants in the intervention condition will attend 7 x 1.5hr weekly sessions of the peer support program over seven weeks, co-facilitated by two trans people. Participants in the control group will remain on the standard care waitlist and will not receive the intervention. Participants in both groups will be required to complete 3 x 20min online health surveys. If proven feasible, acceptable, with preliminary evidence of efficacy, this program may represent an implementation-ready and readily scalable solution to address the mental health support needs of trans people on GAHT waitlists across Australia.
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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 Ada Cheung
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Address
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Austin Health, 145 Studley Road, Heidelberg, VIC, 3084.
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Country
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Australia
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Phone
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+61 03 9496 5000
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Fax
141842
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Email
141842
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[email protected]
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Contact person for public queries
Name
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Dr Sasha Bailey
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Address
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Austin Health, 145 Studley Road, Heidelberg, VIC, 3084.
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Country
141843
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Australia
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Phone
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+61 03 9496 5000
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Fax
141843
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Email
141843
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[email protected]
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Contact person for scientific queries
Name
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Ada Cheung
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Address
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Austin Health, 145 Studley Road, Heidelberg, VIC, 3084.
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Country
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Australia
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Phone
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+61 03 9496 5000
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Fax
141844
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Email
141844
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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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