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Trial registered on ANZCTR
Registration number
ACTRN12620000647932
Ethics application status
Approved
Date submitted
12/05/2020
Date registered
4/06/2020
Date last updated
29/06/2022
Date data sharing statement initially provided
4/06/2020
Type of registration
Prospectively registered
Titles & IDs
Public title
Training Inhibitory Control in Adolescents in Attention-Deficit/Hyperactivity Disorder
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Scientific title
Training Inhibitory Control in Adolescents in Attention-Deficit/Hyperactivity Disorder: A randomised controlled trial of the Alfi Virtual Reality programme
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Secondary ID [1]
300865
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None
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Universal Trial Number (UTN)
U1111-1250-4678
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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:
Attention-Deficit/Hyperactivity Disorder
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Condition category
Condition code
Mental Health
315377
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0
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Other mental health disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
The Alfi Virtual Reality programme (Alfi VR) is a novel, adaptive, game-based program designed to train inhibitory control in adolescents. Alfi VR is delivered using a HTC Vive headset and controllers, using immersive virtual reality technology. Participants complete 16 twice weekly training sessions over a period of 8 weeks. Training is delivered individually, face to face by trained research assistants. In the game participants are required to complete an Anticipated Response Task, set in a fantasy world where they must protect a magic crystal from dragons. Each training sessions last approximately 20 minutes. Participants must initiate a response and then either complete or inhibit the response based on visual cues. Training sessions are completed at the participants school, during class time. Compliance is defined as having completed 12 of the 16 allocated training sessions.
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Intervention code [1]
317441
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Treatment: Devices
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Intervention code [2]
317651
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Treatment: Other
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Comparator / control treatment
This trial will use a treatment-as-usual control group. The treatment as usual is defined as participants attending their usual classes and programs within the school setting.
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Control group
Active
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Outcomes
Primary outcome [1]
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Response inhibition as measured by the Stop-signal reaction time from the Anticipated Response Task
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Assessment method [1]
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Timepoint [1]
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Post-training assessment. This assessment will occur one week after the completion of the intervention; with the assessment to be scheduled no less than 3 days and no more than 10 days after the final training session.
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Secondary outcome [1]
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Risk taking as measured by the Balloon Analogue Risk Task for Youth
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Assessment method [1]
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Timepoint [1]
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Post-training assessment. This assessment will occur one week after the completion of the intervention; with the assessment to be scheduled no less than 3 days and no more than 10 days after the final training session.
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Secondary outcome [2]
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Impulsivity as measured by the UPPS-P
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Assessment method [2]
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Timepoint [2]
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Post-training assessment. This assessment will occur one week after the completion of the intervention; with the assessment to be scheduled no less than 3 days and no more than 10 days after the final training session.
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Secondary outcome [3]
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Behavioural attention as measured by the SWAN
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Assessment method [3]
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Timepoint [3]
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Post-training assessment. This assessment will occur one week after the completion of the intervention; with the assessment to be scheduled no less than 3 days and no more than 10 days after the final training session.
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Secondary outcome [4]
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Executive function as measured by the BRIEF
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Assessment method [4]
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Timepoint [4]
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Post-training assessment. This assessment will occur one week after the completion of the intervention; with the assessment to be scheduled no less than 3 days and no more than 10 days after the final training session.
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Secondary outcome [5]
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Social functioning as measured by the Social Skills Questionnaire
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Assessment method [5]
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Timepoint [5]
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Post-training assessment. This assessment will occur one week after the completion of the intervention; with the assessment to be scheduled no less than 3 days and no more than 10 days after the final training session.
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Secondary outcome [6]
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Working memory as measured by the Digit Span
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Assessment method [6]
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Timepoint [6]
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Post-training assessment. This assessment will occur one week after the completion of the intervention; with the assessment to be scheduled no less than 3 days and no more than 10 days after the final training session.
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Secondary outcome [7]
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Emotion regulation as measured by the Perth Emotion Regulation Competency Inventory (PERCI)
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Assessment method [7]
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Timepoint [7]
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Post-training assessment. This assessment will occur one week after the completion of the intervention; with the assessment to be scheduled no less than 3 days and no more than 10 days after the final training session.
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Secondary outcome [8]
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Attention (sustained, selective and executive control) as measured by the Attention Network task (ANT)
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Assessment method [8]
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Timepoint [8]
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Post-training assessment. This assessment will occur one week after the completion of the intervention; with the assessment to be scheduled no less than 3 days and no more than 10 days after the final training session.
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Eligibility
Key inclusion criteria
Key inclusion criteria include;
- aged 13 years to 17 years 11 months
- has a diagnosis of ADHD, or an attention deficit (defined as a T-score above 60 on the Inattention, Hyperactive, DSM-Inattention or DSM-Hyperactive subscales of the Conners-3 Parent Rating Scale)
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Minimum age
13
Years
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Maximum age
17
Years
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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
Key exclusion criteria include;
- History of epilepsy or seizures, loss of awareness, or other symptoms linked to an epileptic condition.
- Previous diagnosis of an intellectual or borderline delay, or who score an IQ <80 as measured by the KBIT-2.
- Previous brain injury or neurological disease.
- Sensory (e.g. colour blindness) or physical impairment that affects capacity to comprehend and follow study instruction.
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Study design
Purpose of the study
Treatment
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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)
Group allocation will be completed by a research assistant from within the research group, who is not otherwise assigned to the trial and therefore is not involved in recruitment, screening, enrollment or assessment. Allocation sequences will be generated and concealed in sequential, opaque, sealed envelopes. The participant's study ID will be provided to the research assistant to be recorded on the envelope, prior to the envelope being provided to trial researchers responsible for enrollment and assessment.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Stratified, block randomisation using a computer program (R)
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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
Possible mediating and predictive factors such as anxiety, emotional and behavioural problems, Autism features, family functioning and socioeconomic status will be assessed.
Anxiety, emotional and behavioural problems and family functioning will be assessed at the baseline assessment and the post-training assessment using the Spence Children's Anxiety Scale, The Child Behaviour Checklist (Parent report) and the Family Assessment Device respectively.
Socio-economic status and Autism features will be measured during the screening and enrollment stage through use of a demographic questionnaire and the Social Responsiveness Scale 2nd Edition respectively.
Children will be screened using standardised measures of cognitive functioning (the Kaufman Brief Intelligence Test - 2nd Edition) and attention (the Conners-3 Parent Rating Scale) to confirm eligibility.
The NEPSY-II will be used to measure social cognition by assessing affect recognition and theory of mind.
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
A priori power analysis was conducted in G*Power V.3.1 to determine the necessary sample size required to detect significant changes in inhibitory control from pre-training (baseline) to post-training. A sample size of 98 was required for a Medium effect (f=0.25) and a power of 80%. The study will therefore aim to recruit 100 participants, with 50 per group assuming a 1:1 allocation ratio.
Latent Growth Curve Modelling will be used to compare primary and secondary outcomes from the post-training assessment across groups.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
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Actual
11/06/2020
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Date of last participant enrolment
Anticipated
1/11/2021
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Actual
4/01/2022
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Date of last data collection
Anticipated
20/12/2021
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Actual
7/04/2022
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Sample size
Target
100
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Accrual to date
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Final
35
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment postcode(s) [1]
30141
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3800 - Monash University
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Funding & Sponsors
Funding source category [1]
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Charities/Societies/Foundations
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Name [1]
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5point Foundation
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Address [1]
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PO Box 8096 Camberwell North, Victoria, 3124
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Country [1]
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Australia
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Primary sponsor type
Individual
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Name
Kim Cornish
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Address
Monash University
Wellington Road,
Clayton, VIC 3800
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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]
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Address [1]
305988
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Country [1]
305988
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
305657
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Monash University HREC
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Ethics committee address [1]
305657
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Monash University Wellington Rd. Clayton, VIC 3800
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Ethics committee country [1]
305657
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Australia
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Date submitted for ethics approval [1]
305657
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06/09/2019
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Approval date [1]
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21/10/2019
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Ethics approval number [1]
305657
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21530
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Ethics committee name [2]
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Department of Education and Training
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Ethics committee address [2]
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Victorian Department of Education and Training Level 3, 33 St Andrews Place, East Melbourne VIC 3002
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Ethics committee country [2]
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Australia
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Date submitted for ethics approval [2]
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16/01/2020
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Approval date [2]
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10/03/2020
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Ethics approval number [2]
305877
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2020_004271
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Summary
Brief summary
Children who are inattentive or impulsive often have difficulties in a range of areas including academically and socially. For many children with ADHD, these difficulties will continue on through adolescence and into adulthood, yet there are currently few tools available for those experiencing impulsivity and inattention. The Alfi VR program uses Virtual Reality (VR) to create a novel and engaging platform for teenagers to practice cognitive skills that are associated with impulsivity and inattention. The aim of the study is to determine whether VR cognitive training is associated with improvements in impulse control, and related domains such as attention, social skills and ADHD symptoms. It is hypothesised that adolescents who complete the Alfi VR program will show significant improvements in inhibitory control when compared to adolescents in the control group.
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Trial website
https://www.monash.edu/turner-institute/research/alfi-vr-project
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Hannah Kirk
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Address
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Monash University Wellington Road Clayton, VIC 3800
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Country
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Australia
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Phone
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+61 03 9905 0230
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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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Hannah Kirk
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Address
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Monash University Wellington Road Clayton, VIC 3800
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Country
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Australia
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Phone
101115
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+61 03 9905 3255
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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
101116
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Hannah Kirk
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Address
101116
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Monash University Wellington Road Clayton, VIC 3800
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Country
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Australia
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Phone
101116
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+61 03 9905 3255
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Fax
101116
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Email
101116
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[email protected]
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Data sharing statement
Will the study consider sharing individual participant data?
Yes
Will there be any conditions when requesting access to individual participant data?
Persons/groups eligible to request access:
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Data will be made available on case-by-case basis at the discretion of Primary Sponsor
Conditions for requesting access:
•
-
What individual participant data might be shared?
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Relevant anonymised participant level data available on reasonable request to the researchers.
What types of analyses could be done with individual participant data?
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Undetermined; to be assessed on a case-by-case basis at the discretion of the Primary Sponsor
When can requests for individual participant data be made (start and end dates)?
From:
Data will be available following publication, with no determined end date
To:
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Where can requests to access individual participant data be made, or data be obtained directly?
•
Access subject to approvals by Principal Investigators Dr Hannah Kirk and Professor Kim Cornish
[email protected]
[email protected]
Are there extra considerations when requesting access to individual participant data?
No
What supporting documents are/will be available?
No Supporting Document Provided
Type
Citation
Link
Email
Other Details
Attachment
Study protocol
A study protocol is being submitted for publicatio...
[
More Details
]
Informed consent form
Study-related document.pdf
Ethical approval
Study-related document.pdf
Ethical approval
Study-related document.pdf
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
Training inhibitory control in adolescents with elevated attention deficit hyperactivity disorder traits: a randomised controlled trial of the Alfi Virtual Reality programme.
2022
https://dx.doi.org/10.1136/bmjopen-2022-061626
N.B. These documents automatically identified may not have been verified by the study sponsor.
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