COVID-19 studies are our top priority. For all other trials, there is a 4-week delay in processing a trial submitted to the ANZCTR and additional delays for updates of registered trials. We appreciate your patience.

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been endorsed by the ANZCTR. Before participating in a study, talk to your health care provider and refer to this information for consumers
Trial registered on ANZCTR


Registration number
ACTRN12613000723785
Ethics application status
Approved
Date submitted
28/06/2013
Date registered
1/07/2013
Date last updated
2/10/2019
Date data sharing statement initially provided
11/07/2019
Date results information initially provided
11/07/2019
Type of registration
Prospectively registered

Titles & IDs
Public title
The CSC intervention: A comprehensive universal internet-based intervention to prevent anxiety, depression, substance use, and related harms in Australian adolescents aged 13 to 16 years.
Scientific title
The CSC intervention: A comprehensive universal internet-based intervention to prevent anxiety, depression, substance use, and related harms in Australian adolescents aged 13 to 16 years.
Secondary ID [1] 282761 0
Nil
Universal Trial Number (UTN)
U1111-1141-6746
Trial acronym
CSC Study
Linked study record

Health condition
Health condition(s) or problem(s) studied:
Substance use prevention

289501 0
Prevention of substance use related harms
289518 0
Depression prevention
289519 0
Anxiety prevention 289520 0
Condition category
Condition code
Mental Health 289827 289827 0 0
Addiction
Mental Health 289828 289828 0 0
Depression
Mental Health 289829 289829 0 0
Anxiety

Intervention/exposure
Study type
Interventional
Description of intervention(s) / exposure
Participating secondary schools will be randomly allocated to one of four groups.

Group 1:
The Control condition: One group will serve as the control group and receive their usual school drug and mental health education. The following groups will receive one of the following three study interventions:

Group 2:
The Climate Schools-Substance Use (CS-SU) intervention aims to reduce the use of Australia’s most commonly used licit and illicit drugs: alcohol and cannabis, and prevent related harms. The program consists of twelve 40-minute lessons delivered as part of the Year 8 (Year 9 in QLD) Health and Physical Education syllabus. The first six lessons will be delivered in Term 1, 2014 during consecutive Health and Physical education classes (approximately 1 lesson per week). The remaining six lessons will be delivered in Term 3, 2014 in consecutive Health and Physical education classes (approximately 1 lesson per week).

The first part of each lesson is completed individually over the internet. During this part of the lesson students are engaged through cartoon story lines that impart information about the short and long term effects of alcohol and cannabis, normative alcohol and cannabis use, refusal skills, and first aid. The second part of each lesson is a group or class activity delivered by the teacher, and reinforces the information in the cartoons, while allowing interactive communication between students. Teachers are provided with a manual containing the activities, implementation guidelines, links to the education syllabus and summaries for each lesson. The first six lessons focus specifically on alcohol and are delivered approximately six months prior to the remaining six lessons which focus on cannabis.

Group 3:
The Climate Schools-Mental Health (CS-MH) intervention aims to reduce anxiety and depression symptoms, and to prevent the development of associated disorders later in life. The program consists of six 40-minute lessons delivered as part of the Year 9 (Year 10 in QLD) Health and Physical Education syllabus. The six lessons will be delivered in Term 1,2015 in consecutive Health and Physical education classes (approximately 1 lesson per week). The lessons are structured in the same way as the Climate Schools-Substance Use intervention. The content of the lessons focuses on identifying and effectively dealing with anxiety and depression symptoms. The six lessons are designed to be run consecutively within one school Term.

Group 4:
The Climate Schools Combined (CSC) Intervention will deliver both the Climate Schools-Substance Use and the Climate Schools-Mental Health interventions consecutively, as described above. The CSC intervention simultaneously targets mental health and substance use, as it is known that the two commonly co-occur and share common risk factors.

For those groups receiving an intervention, teachers will be asked to complete a log book at the end of the intervention to document adherence to the intervention and record which activities they implemented in the classroom. As students are required to log in to complete the study intervention online records will indicate student completion rates.

Regardless of group, teachers will be asked at the end of each year during the study period to record any other drug, alcohol or mental health education that was delivered to students participating in the trial, that was in addition to the Climate Schools courses.

CSC LONG TERM FOLLOW UP 2018-2022
The CSC long-term follow up is an opportunistic extension of the landmark CSC study, whereby follow up of this cohort will extend beyond the completion of secondary school and into the critical transition period of early adulthood. The investigators will extend longitudinal follow-up for a further 5 years, inviting the participants to take part in two additional online surveys assessing demographic information, drinking and drug use habits, mental health systems, health service use and behavioural and personality inventories. Consent will also be sought to link to participants MBS and PBS data. A cost-effectiveness analysis will also examine the cost-effectiveness of the prevention program. This extended follow-up component was added after initial recruitment for Phase 1 of the CSC trial, run between 2014 – 2017.
Intervention code [1] 287426 0
Prevention
Comparator / control treatment
The Climate Schools Combined (CSC) Intervention will be compared to:

a) A "standard treatment" control group - Students will not receive the Climate Schools-Substance Use or Mental Health interventions. Participants will complete their standard Year 8 and Year 9 (Year 9 & 10 in QLD) Health and Physical Education classes, delivered by their usual teacher.

b) The Climate Schools-Substance Use only intervention - Students will receive 12 x 40-minute lessons delivered as part of the Year 8 (Year 9 in QLD) Health and Physical Education syllabus. Each lesson consists of an interactive computer component and class activities from the program manual, administered by their usual teacher.

c) The Climate Schools-Mental Health only intervention - Students will receive 6 x 40-minute lessons delivered as part of the Year 9 (Year 10 in QLD) Health and Physical Education syllabus. Each lesson consists of computer lessons and activities from the program manual, to be administered by their usual teacher.
Control group
Active

Outcomes
Primary outcome [1] 289893 0
Use and harmful use of alcohol and cannabis. Students will be asked to rate the frequency and quantity of their alcohol consumption in standard drinks, frequency of drinking to excess (defined as having more than five standard drinks on a single occasion), and age of first alcohol consumption. These questions are were originally adapted from the School Health and Alcohol Harm Reduction Project (SHAHRP) ‘Patterns of Alcohol’ index and trials of the Preventure program, and reflect those used in previous CLIMATE Schools trials. Cannabis and other drug use will be measured by questions based on the National Drug Strategy Household Survey (NDHS), 2010, and the Australian Secondary Students Alcohol and Drug Survey (ASSAD), 2011. This allows for comparison between use in the current sample and a large scale representative group of Australians.

Long-term follow-up: Primary outcome 1: Drinking frequency and binge drinking will be assessed using an adapted version of the Patterns of Alcohol Index. Probable diagnosis of alcohol use disorder will be measured using a self-report symptom checklist based on DSM-5 criteria. Frequency and quantity of current and past tobacco and e-cigarette use will also be measured. A shortened version of the Patterns of Cannabis Use instrument, will be used to measure use and frequency of cannabis use. Probable diagnosis of cannabis use disorder will be measured using a self-report symptom checklist based on DSM-5 criteria. Other drug use will be measured by questions based on the National Drug Strategy Household Survey (NDHS), 2010, and the Australian Secondary Students Alcohol and Drug Survey (ASSAD), 2011.
Timepoint [1] 289893 0
Assessed at baseline and at 6, 12, 18, 24 and 30 months after study commencement. Long-term follow-up: Primary outcomes will be assessed long-term via the administration of two additional follow-up surveys spanning 5 and 7 years post-intervention.
Primary outcome [2] 289894 0
Overall anxiety/depression levels . The ‘Kessler 6 plus’ scale (K6+) will be used to assess psychological distress in the past month. Depression symptoms will be measured using the ‘Patient Health Questionnaire 8’ (PHQ8), while anxiety symptoms will be measured by the ‘Generalised Anxiety Disorder 7-item scale’ (GAD-7). The 3-item ‘Mini Social Phobia Inventory’ (mini-SPIN) will assess social anxiety symptoms. The ‘Strengths and Difficulties Questionnaire’ (SDQ) will be used to assess both positive and negative attributes of the students.

Long-term follow-up: Primary outcome 2: The K6+, PHQ-9, GAD-7 and mini SPIN, SDQ will be used to assess overall anxiety/depression levels (as listed above). The Distress Questionnaire 5 (DQ5) will also assess general psychological distress in relation to the past 30 days.
Timepoint [2] 289894 0
Assessed at baseline and at 6, 12, 18, 24 and 30 months after study commencement. Long-term follow-up: Primary outcomes will be assessed long-term via the administration of two additional follow-up surveys spanning 5 and 7 years post intervention.
Primary outcome [3] 289895 0
Anxiety, depression and substance use knowledge.

Alcohol related knowledge will be assessed using a questionnaire originally adapted from the SHAHRP 16-item ‘Knowledge of Alcohol’ index, and as used in previous trials using the CLIMATE Schools programs. Participants’ knowledge about cannabis will be assessed by 16 items from the ‘Knowledge about Cannabis’ scale used in previous CLIMATE Schools trials. Participants’ knowledge about coping with anxiety and depression will be assessed from 7 questions that cover appraisal, reality focused and emotion focused coping.
Timepoint [3] 289895 0
Assessed at baseline and at 6, 12, 18, 24 and 30 months after study commencement.
Secondary outcome [1] 303498 0
Alcohol use related harms. Alcohol related harms will be assessed using the 23-item Rutgers Alcohol Problem Index (RAPI).

Long-term follow-up: Alcohol use related harms and consequences of drinking alcohol will be assessed by the Brief Young Adult Alcohol Consequences Questionnaire.
Timepoint [1] 303498 0
Assessed at baseline and at 6, 12, 18, 24 and 30 months after study commencement. Long-term follow-up: Secondary outcomes will be assessed long-term via the administration of two additional follow-up surveys spanning 5 and 7 years post-intervention.
Secondary outcome [2] 303499 0
Peer alcohol use. Peer alcohol use will be measured by the self-reported proportion of friends who drink alcohol.

Long-term follow-up: Peer alcohol and cannabis use will be measured by the self-reported proportion of friends who drink alcohol and who use cannabis.
Timepoint [2] 303499 0
Assessed at baseline and at 6, 12, 18, 24 and 30 months after study commencement. Long-term follow-up: Secondary outcomes will be assessed long-term via the administration of two additional follow-up surveys spanning 5 and 7 years post-intervention.
Secondary outcome [3] 303500 0
Self-efficacy to resist peer pressure.

The 10-item ‘Resistive Self-Regulatory Efficacy Scale’ will be used to measure participants’ perceived efficacy to resist peer pressure to engage in high risk activities.
Timepoint [3] 303500 0
Assessed at baseline and at 6, 12, 18, 24 and 30 months after study commencement. Long-term follow-up: Secondary outcomes will be assessed long-term via the administration of two additional follow-up surveys spanning 5 and 7 years post intervention.
Secondary outcome [4] 303501 0
General disability. Quality of life will be measured by the ‘Child Health Utility 9D’ (CHU 9D) and days out of role will be measured by the ‘Kessler 6 plus’ scale (K6+).

Timepoint [4] 303501 0
Assessed at baseline and at 6, 12, 18, 24 and 30 months after study commencement. Long-term follow-up: Secondary outcomes will be assessed long-term via the administration of two additional follow-up surveys spanning 5 and 7 years post-intervention.
Secondary outcome [5] 303502 0
Truancy.

Truancy will be measured by asking the number of days students had off without their parents’ permission in the previous school year.
Timepoint [5] 303502 0
Assessed at baseline and at 6, 12, 18, 24 and 30 months after study commencement. Long-term follow-up: Secondary outcomes will be assessed long-term via the administration of two additional follow-up surveys spanning 5 and 7 years post intervention.
Secondary outcome [6] 303503 0
The Link between personality and substance use. The Substance Use Risk Profile Scale (SURPS) will be used to assess for variation in personality risk for substance abuse/dependence along 4 dimensions: Sensation Seeking, Impulsivity, Anxiety Sensitivity and Hopelessness.

Long-term follow-up: The personality trait of perfectionism will be measured by the Brief Frost Multidimensional Perfectionism Scale
Timepoint [6] 303503 0
The SURPS is assessed at baseline and at 6, 12, 18, 24 and 30 months after study commencement. Long-term follow-up: The personality trait of perfectionism will be assessed long-term via the administration of two additional follow-up surveys spanning 5 and 7 years post intervention.
Secondary outcome [7] 345278 0
Moderators of the primary outcomes listed above in primary outcome boxes 1-3 (and measured through the scales detailed in the primary outcome 1-3 boxes above) will be also be examined including, baseline risk in relation to substance use (measured through self-report alcohol and other drug consumption and related-harms) and mental health symptoms (measured through the self-report PHQ-A, GAD-7, K6, Mini-spin and SDQ).
Timepoint [7] 345278 0
Assessed at baseline and at 6, 12, 18, 24 and 30 months after study commencement. Long-term follow-up: Secondary outcomes will be assessed long-term via the administration of two additional follow-up surveys spanning 5 and 7 years post intervention.
Secondary outcome [8] 346868 0
Suicide risk. Three questions from the Youth Risk Behaviour System will assess thoughts and plans in relation to suicide.
Timepoint [8] 346868 0
Assessed long-term via the administration of two additional follow-up surveys spanning 5 and 7 years post intervention.
Secondary outcome [9] 346869 0
Psychotic experiences. The Community Assessment of Psychic Experiences-Positive Scale (CAPE-P15) will assess psychotic symptoms in the past 3 months.
Timepoint [9] 346869 0
Assessed long-term via the administration of two additional follow-up surveys spanning 5 and 7 years post intervention.
Secondary outcome [10] 346870 0
Emotion regulation will be assessed through the Emotion Regulation Questionnaire (ERQ).
Timepoint [10] 346870 0
Assessed long-term via the administration of two additional follow-up surveys spanning 5 and 7 years post intervention.
Secondary outcome [11] 346871 0
Peer networks. To investigate social networks and how patterns of behaviour develop in relation to substance use and mental health, participants will be asked to nominate their six closest friends. They will also be asked to report on their social connections with up to six people with whom they spent their free time over the past 12 months. These questions include measures of frequency and mode of contact, relationships, closeness, how many are considered drinking associates and perceived mental health symptoms of these people.
Timepoint [11] 346871 0
Assessed long-term via the administration of two additional follow-up surveys spanning 5 and 7 years post intervention.
Secondary outcome [12] 346872 0
Cost effectiveness. The cost effectiveness of the intervention will be assessed through self-report questions measuring resource use, including health service visits, type, and costs, as well as linkage to Medicare data. Medication use will be measured through self-report and linkage to PBS data. Work capacity, receipt of government support and housing will also be measured via self-report questions.
Timepoint [12] 346872 0
Assessed long-term via the administration of two additional follow-up surveys spanning 5 and 7 years post intervention.

Eligibility
Key inclusion criteria
All students (both male and female) aged between 13-14 years, in Year 8 of Secondary School at the beginning of the trial in 2014, (except for QLD students who will be in Year 9 of Secondary School at the beginning of the trial).

Long-term follow-up: Those that participated at baseline will be eligible to continue with the study, via the administration of two additional follow-up surveys spanning 5 and 7 years post intervention.
Minimum age
13 Years
Maximum age
14 Years
Gender
Both males and females
Can healthy volunteers participate?
Yes
Key exclusion criteria
Non consenters – parental and student

Long-term follow-up: Those who did not participate in the baseline survey and who do not provide consent to take part in the long-term follow up study are not eligible to take part in the two long-term follow-up surveys spanning 5 and 7 years post intervention.

Study design
Purpose of the study
Prevention
Allocation to intervention
Randomised controlled trial
Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Schools will be randomised to one of the four study groups using the rall function of the statistical program Stata. Allocation will be concealed via central randomisation using computer software.
Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Schools will be randomised to one of the four study groups using the statistical program Stata (simple randomisation using computer software).
Masking / blinding
Blinded (masking used)
Who is / are masked / blinded?


The people assessing the outcomes
Intervention assignment
Parallel
Other design features
Phase
Not Applicable
Type of endpoint(s)
Efficacy
Statistical methods / analysis
Sample Size
To account for cluster randomisation, sample size calculations were based on recent sample size requirements developed by Heo & Leon (Heo & Leon, 2009) to detect intervention by time interactions in longitudinal cluster randomized clinical trials. The CSC trial will be powered to detect differences in the overall sample as well as across the three States of NSW, QLD and WA. To allow for comparisons in each State, six schools (with at least 100 students) in each of the four intervention groups are required per state, giving a total of 24 schools (with at least 2400 students) per State. This achieves 80 per cent power to detect a standardized between-group mean difference of 0.15 (p = 0.05) in outcomes at the end of the trial with seven measurement occasions. An effect size of 0.15 is comparable to previous school-based trials of universal mental health and substance use prevention programs (Cuijpers, van Straten, Smit, Mihalopoulos, & Beekman, 2008; Teesson, Newton, & Barrett, 2012; Vogl et al., 2009) and would have substantial benefits on a population level based on recent economic modelling (Nherera & Jacklin, 2009). To account for school dropouts during the trial, which we expect to be approximately 10 per cent, we aim to recruit at least 28 schools (with at least 2800 students) in each State. This will result in an overall total of 8400 students from 84 schools at baseline to test the efficacy of the CS-C intervention in comparison to the other groups both nationally and state-wide. Based on previous research using the CLIMATE Schools programs, school participation rates for similar trials are approximately 30 per cent (Newton, Andrews, Teesson, & Vogl, 2009; Vogl et al., 2009). Therefore, to recruit a total of 84 schools, approximately 270 schools will be approached to participate.
Statistical Analysis
Baseline equivalence and attrition between groups will be examined using single-level analyses; one-way analyses of variance to examine normally distributed data, Chi-square to examine binominal data, and Mann-Whitney U-test to examine non-normally distributed data. To examine intervention by time interaction effects, mixed effects regression will be used due to the multi-level and hierarchical nature of the data. To account for intracluster variance within State or schools, intervention effects will primarily be examined using hierarchical linear modelling (HLM) for normally distributed data and hierarchical generalized linear modeling using a Poisson distribution for count data. Outcome variables will be entered at post-test to allow for comparisons between groups immediately after the intervention and growth terms will be analysed to determine the magnitude of the follow-up effects. Analyses will be conducted using the program HLM 6. If unconditional models reveal that less than 10% of systematic variance exists at the between-state or school level for any outcome variable, HLM will be abandoned and single-level analyses will be used. For these variables, ANCOVAs utilising the SPSS GLM procedure will be conducted to account for any baseline differences that might exist between groups. Bonferroni adjustments will be made for multiple comparisons. OR and 95% CI will also be calculated.

Recruitment
Recruitment status
Active, not recruiting
Date of first participant enrolment
Anticipated
Actual
Date of last participant enrolment
Anticipated
Actual
Date of last data collection
Anticipated
Actual
Sample size
Target
Accrual to date
Final
Recruitment in Australia
Recruitment state(s)
NSW,QLD,WA

Funding & Sponsors
Funding source category [1] 287528 0
Government body
Name [1] 287528 0
National Health and Medical Research Council
Australian Government Department of Health and Ageing
Address [1] 287528 0
National Health and Medical Research Council
GPO Box 1421
Canberra ACT 2601
Country [1] 287528 0
Australia
Primary sponsor type
Individual
Name
Professor Maree Teesson
Address
The Matilda Centre for Research in Mental Health and Substance Use
Level 6, Jane Foss Russell building (G02)
University of Sydney NSW 2006
Country
Australia
Secondary sponsor category [1] 286279 0
University
Name [1] 286279 0
The Matilda Centre for Research in Mental Health and Substance Use
Address [1] 286279 0
Level 6, Jane Foss Russell building (G02),
University of Sydney, NSW 2006
Country [1] 286279 0
Australia
Secondary sponsor category [2] 298771 0
Charities/Societies/Foundations
Name [2] 298771 0
Australian Rotary Health
Address [2] 298771 0
PO Box 3455,
Parramatta NSW 2124
Country [2] 298771 0
Australia
Other collaborator category [1] 277501 0
University
Name [1] 277501 0
Clinical Research Unit for Anxiety and Depression, UNSW and St Vincents Hospital
Address [1] 277501 0
Clinical Research Unit for Anxiety and Depression (CRUfAD)
Level 4, The O'Brien Centre
St Vincent's Hospital
394-404 Victoria Street
Darlinghurst NSW 2010
Sydney Australia
Country [1] 277501 0
Australia
Other collaborator category [2] 277502 0
University
Name [2] 277502 0
Curtin University
Address [2] 277502 0
Kent St
Bentley WA 6102
Country [2] 277502 0
Australia
Other collaborator category [3] 277503 0
University
Name [3] 277503 0
Queensland University of Technology
Address [3] 277503 0
2 George St
Brisbane QLD 4000
Country [3] 277503 0
Australia
Other collaborator category [4] 280108 0
University
Name [4] 280108 0
University of Queensland
Address [4] 280108 0
St Lucia
QLD 4072
Country [4] 280108 0
Australia
Other collaborator category [5] 280109 0
University
Name [5] 280109 0
Deakin University
Address [5] 280109 0
Burwood Campus,
221 Burwood Hwy
Burwood VIC 3125
Country [5] 280109 0
Australia
Other collaborator category [6] 280983 0
University
Name [6] 280983 0
The University of New South Wales
Address [6] 280983 0
High St, Kensington, NSW 2052
Country [6] 280983 0
Australia

Ethics approval
Ethics application status
Approved
Ethics committee name [1] 289510 0
University of New South Wales, Human Research Ethics Committee
Ethics committee address [1] 289510 0
Ethics Secretariat
UNSW Grants Management Office
Rupert Myers Building, Level 3, South Wing
The University of New South Wales
SYDNEY NSW 2052
Ethics committee country [1] 289510 0
Australia
Date submitted for ethics approval [1] 289510 0
Approval date [1] 289510 0
09/05/2013
Ethics approval number [1] 289510 0
HREC # HC13073
Ethics committee name [2] 303804 0
The University of Sydney Human Research Ethics Committee
Ethics committee address [2] 303804 0
Research Integrity & Ethics Administration
Research Portfolio
Level 3, Administration Building (F23)
University of Sydney NSW 2006
Ethics committee country [2] 303804 0
Australia
Date submitted for ethics approval [2] 303804 0
Approval date [2] 303804 0
19/12/2018
Ethics approval number [2] 303804 0
2018/906

Summary
Brief summary
The current study will evaluate an integrative internet-based approach to prevent mental health and substance use problems in adolescence. The intervention is known as Climate Schools Combined (CSC), and comprises of a twelve-lesson substance use course, and a six-lesson mental health course. Together the CSC program simultaneously targets alcohol, cannabis, depressive and anxiety disorders with the aim of reducing substance use and decreasing anxiety and depressive symptoms.

The study is being run in 71 schools across QLD, NSW and WA. The CSC intervention will be compared to the individual Climate Schools Substance Use intervention, the Climate Schools Mental Health intervention, and the control condition. The RCT will be conducted over three years, with the delivery of the Substance Use course in Year 8 (except QLD students whom will receive the course in Year 9) and the Mental Health course in Year 9 (Year 10 for QLD).

This study will be the first time such an intervention has been trialed, and is the first intervention designed to fit within the school syllabus to concurrently target substance use and mental health.

Long term follow up: The approved extended long-term follow up will provide the first ever evaluation of the long-term effectiveness of combining universal approaches to the prevention of substance use, anxiety and depression and will examine the durability of intervention effects into the longer-term, over a 7-year period from adolescence to early adulthood.
Trial website
www.cscstudy.org.au
Trial related presentations / publications
Published papers:

Teesson M., Newton N.C., Slade T., Chapman C., Allsop S., Hides L., McBride N., Mewton L., Tonks Z., Birrell L., Brownhill, L., Andrews, G. The CLIMATE schools combined study: a cluster randomised controlled trial of a universal Internet-based prevention program for youth substance misuse, depression and anxiety. BMC Psychiatry 2014, 14(1):32

Mewton, L., Kessler, R., Slade, T., Hobbs, M., Brownhill, L., Birrell, L., Tonks, Z., Teesson, M., Newton, N., Chapman, C., Allsop, S., Hides, L., McBride, N. Andrews, G. (2016) ‘The psychometric properties of the Kessler Psychological Distress Scale (K6) in a general population sample of adolescents’, Psychological Assessment, 28 (10): 1232 – 1242

Conference presentations:

Tonks, Z., Newton, N., Andrews, G., Slade, T., Chapman, C., Birrell, L., & Teesson, M. ‘The Climate Schools Combined (CSC) Study: Internet-based prevention for anxiety, depression and substance use in young Australians ’, Poster presentation, The Mental Health Services Conference , Melbourne, August 2013

Tonks, Z., Newton, N., Andrews, G., Slade, T., Chapman, C., Birrell, L., & Teesson, M. ‘The Climate Schools Combined (CSC) Study: Internet-based prevention for anxiety, depression and substance use in young Australians ’, Poster presentation, National Drug and Alcohol Research Centre Symposium, Sydney, September, 2013

Tonks, Z., Slade, T., Newton, N., Teesson, T., Chapman, C., Birrell, L., Mattick R., Kypri, K., Bruno, R., Najman, J., McBride, N., Hutchinson, D., Wadolowski, M., & Aiken, A. ‘The role of alcohol-specific rules on adolescent drinking trajectories in an Australian sample’, Oral presentation, Society for Mental Health Research Conference, Adelaide, Australia, December, 2014

Slade, T., Chapman, C., Turner, B., Shaw, B., Newton, N., Birrell, L., Tonks, Z., Mewton, L., Teesson, M. ‘Social networks and the spread of alcohol use attitudes and behaviors in Australian adolescents’, Oral presentation, XXXV Sunbelt Conference of the International Network for Social Network Analysis, Brighton, U.K., June, 2015

B., Shaw, Slade, T., Newton, N., Chapman, C., Andrews, G., Birrell, L., Tonks, Z., Mewton, L., Allsop, S., Hides, L., McBride, N., Te Pas, N., Firmin-Sarra, S., Pocuca, N., & Teesson, M. ‘Baseline characteristics of The CSC Study: An innovative internet-based universal prevention trial for alcohol, cannabis and mental health problems in adolescents’, Poster presentation, Centre of Research Excellence in Mental Health and Substance Use Annual Colloquium, Canberra, Australia, August, 2015

Pas, N., McBride, N., Newton, N., Slade, T., Chapman, C., Andrews, G., Mewton, L., Allsop, S., Hides, L., Birrell, L., Pocuca, N., Firmin-Sarra, S., Tonks, Z., B., Shaw, & Teesson, M. ‘Substance use and harms in young Australians’, Poster presentation, The Australasian Professional Society on Alcohol and Other Drugs Conference, Perth, Australia, November, 2015

Chapman, C., Shaw, B., Birrell, L., Newton, N., Slade, T., Andrews, G., Mewton, L., Allsop, S.,
Te Pas, N., McBride, N., Chapman, C., Hides, L., Pocuca, N., Firmin-Sarra, S., Tonks, Z., & Teesson, M. ‘Substance use and harms in young Australians’, Poster presentation, The Australasian Professional Society on Alcohol and Other Drugs Conference, Perth, Australia, November, 2015

Birrell, L., Newton, N., Slade, T., Chapman, C., Andrews, G., Mewton, L., Allsop, S., McBride, N., Hides, L., Te Pas, N., Pocuca, N., Firmin-Sarra, S., Tonks, Z., Shaw, B., Teesson, M., ‘Mental health and substance use prevention in schools: The climate schools combined study’, Oral presentation, Society for Mental Health Research Conference, Brisbane, Australia, December, 2015

Slade, T., Chapman, C., Turner, B., Shaw, B., Newton, N., Birrell, L., Tonks, Z., Mewton, L., Teesson, M. Changes in friendship networks and the link between mental health and alcohol use. Paper presented at World Congress of Behavioural and Cognitive Therapies, Melbourne, Australia, June, 2016

Chapman, C., Shaw, B., Birrell, L., Newton, N., Slade, T, Andrews, G., Mewton, L., Allsop, S., Hides, L., McBride, N., Te Pas, N., Pocuca, N., Firmin-Sarra, S., Tonks, Z., Teesson, M. The Climate Schools Combined (CSC) Study: Internet-based prevention for anxiety, depression and substance use in young people. Paper presented at The Mental Health Services Conference of Australia and New Zealand, Auckland, NZ, (August, 2016)

Chapman, C., Shaw, B., Birrell, L., Newton, N., Slade, T., Andrews, G., Mewton, L., Allsop, S., Hides, L., McBride, N., Te Pas, N., Pocuca, N., Firmin-Sarra, S., Tonks, Z., Teesson, M. The Climate Schools Combined (CSC) Study: Internet-based prevention for anxiety, depression and substance use in young people. Paper presented at The National Drug and Alcohol Research Centre Annual Symposium, Sydney, Australia (September, 2016)

Birrell, L., Shaw, B., Chapman, C., Newton, N., Slade, T., Andrews, G. , Allsop, S., McBride, N., Hides, L., Mewton, L., Te Pas, N., Pocuca, N., Firmin-Sarra, S., Tonks, Z., & Teesson, M., ‘The CSC Study: An Internet-based universal prevention trial for alcohol, cannabis and mental health problems in adolescence’, Oral presentation, Centre of Research Excellence in mental Health and Substance Use Annual Colloquium, Sydney, Australia, December, 2016

Shaw, B., Slade, T.. Newton, N.,Chapman, C., Mewton, L., Andrews, G. , Allsop, S., McBride, N., Hides, L., Birrell, L., Te Pas, N., Pocuca, N., Firmin-Sarra, S., Tonks, Z., & Teesson, M., ‘The CSC Study: An Internet-based universal prevention trial for alcohol, cannabis and mental health problems in adolescence’, Oral presentation, Society of Mental Health Research, Sydney, Australia, December, 2016

Teesson, M., Birrell L, Newton, N., Slade T., Chapman, C., Mewton, L., Allsop, S., Hides, L., McBride, N., Shaw, B., Andrews, G. The Climate Schools Combined Study. Mental health outcomes of a combined approach to preventing substance use and mental health problems amongst adolescents, Poster presentation, 39th Annual Meeting of the Society of Behavioural Medicine, New Orleans, Louisiana, USA April, 2018

Pocuca, Nina,Hides, Leanne,Quinn, Catherine A.,White, Melanie J.,Mewton, Louise,Newton, Nicola Clare,Slade, Tim,Chapman, Cath,Andrews, Gavin,Teesson, Maree,Allsop, Steve,McBride, Nyanda. The interactive effects of personality profiles and perceived peer drinking on early adolescent drinking. Psychology of Addictive Behaviors, Vol 32(2), Mar 2018, 230-236
Public notes

Contacts
Principal investigator
Name 41134 0
Prof Maree Teesson
Address 41134 0
The Matilda Centre for Research in Mental Health and Substance Use, JFR Building G02, The University of Sydney, NSW, 2006
Country 41134 0
Australia
Phone 41134 0
+61 2 8627 9048
Fax 41134 0
+61 2 8627 8145
Email 41134 0
maree.teesson@sydney.edu.au
Contact person for public queries
Name 41135 0
Prof Maree Teesson
Address 41135 0
The Matilda Centre for Research in Mental Health and Substance Use, JFR Building G02, The University of Sydney, NSW, 2006
Country 41135 0
Australia
Phone 41135 0
+61 2 8627 9048
Fax 41135 0
+61 2 8627 8145
Email 41135 0
maree.teesson@sydney.edu.au
Contact person for scientific queries
Name 41136 0
Prof Maree Teesson
Address 41136 0
The Matilda Centre for Research in Mental Health and Substance Use, JFR Building G02, The University of Sydney, NSW, 2006
Country 41136 0
Australia
Phone 41136 0
+61 2 8627 9048
Fax 41136 0
+61 2 8627 8145
Email 41136 0
maree.teesson@sydney.edu.au

Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
No/undecided IPD sharing reason/comment
In accordance with our ethical obligations as outlined by the University of Sydney HREC (HREC 2018/906), we must ensure the privacy of the participants in our study and as such, the individual participant data in this trial will not be made publicly available.
What supporting documents are/will be available?
Study protocol
How or where can supporting documents be obtained?
Type [1] 2949 0
Study protocol
Citation [1] 2949 0
Birrell L, Newton NC, Slade T, Chapman C, Mewton L, McBride N, et al. Evaluating the Long-Term Effectiveness of School-Based Depression, Anxiety, and Substance Use Prevention Into Young Adulthood: Protocol for the Climate School Combined Study. JMIR Research Protocols. 2018;7(11):e11372.
Email [1] 2949 0
Other [1] 2949 0
Attachment [1] 2949 0
Summary results
Have study results been published in a peer-reviewed journal?
No
Other publications
Have study results been made publicly available in another format?
No
Results – basic reporting
Results – plain English summary