评估澳大利亚针对中学生的一项基于网络的心理健康服务：一项整群随机对照试验方案
Evaluating a Web-Based Mental Health Service for Secondary School Students in Australia: Protocol for a Cluster Randomized Controlled Trial.
作者信息
O'Dea Bridianne, King Catherine, Subotic-Kerry Mirjana, Anderson Melissa, Achilles Melinda Rose, Parker Belinda, Mackinnon Andrew, Anderson Josey, Cockayne Nicole, Christensen Helen
机构信息
Black Dog Institute, Sydney, Australia.
Faculty of Medicine, University of New South Wales, Sydney, Australia.
出版信息
JMIR Res Protoc. 2019 May 17;8(5):e12892. doi: 10.2196/12892.
BACKGROUND
Mental health problems are prevalent among Australian secondary school youth; however, help-seeking is low. Schools offer an ideal setting to address these concerns. The Black Dog Institute has developed a Web-based mental health service for secondary schools that is modeled on the principles of stepped care. The Smooth Sailing service aims to improve help-seeking and reduce anxiety and depressive symptoms in secondary school students. The acceptability of this service has been demonstrated in a pilot study. A full trial is now warranted.
OBJECTIVE
This study protocol for a cluster randomized controlled trial (RCT) aims to evaluate the effectiveness of the Smooth Sailing Web-based service for improving help-seeking intentions and behavior, and reducing depressive and anxiety symptoms, alongside other mental health outcomes, when compared with a school-as-usual control condition in secondary school youth.
METHODS
This RCT aims to recruit 1600 students from 16 secondary schools in regional and urban locations throughout New South Wales, Australia. Schools are randomly assigned to the intervention or school-as-usual control condition at the school level. Approximately 100 students from 1 or multiple grades are recruited from each participating school. Participants complete measures at 3 timepoints: baseline, 6 weeks post, and 12 weeks post, with the primary outcome assessed at 12 weeks posttest. Participants assigned to the intervention condition register to the Web-based service at baseline and receive care in accordance with the service model. Participants in the control condition receive school-as-usual.
RESULTS
The first baseline assessment occurred on February 22, 2018, with the 12-week endpoint assessments completed on Friday, June 29, 2018. Control schools are currently receiving the service, due for completion by June 30, 2019. The trial results are expected to demonstrate improved help-seeking intentions and behavior among students assigned to the intervention condition, alongside improvements in symptoms of depression, anxiety, distress, and other mental health outcomes when compared with students assigned to the control condition.
CONCLUSIONS
To our knowledge, this is the first time that a Web-based mental health service based on the principles of stepped care will have been integrated into, and evaluated in, the Australian school context. The findings of this trial will have implications for the suitability of this type of service model in Australian schools and for the delivery of school-based mental health services more broadly.
TRIAL REGISTRATION
Australian New Zealand Clinical Trials Registry ACTRN12618001539224 https://anzctr.org.au/Trial/Registration/TrialReview.aspx?id=375821&isReview=true (Archived by WebCite at http://www.webcitation.org/77N3MDGS6).
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/12892.
背景
心理健康问题在澳大利亚中学生中普遍存在；然而，寻求帮助的比例较低。学校为解决这些问题提供了理想的环境。黑狗研究所为中学开发了一种基于网络的心理健康服务，该服务以分级护理原则为模式。“一帆风顺”服务旨在提高中学生寻求帮助的意愿，并减轻焦虑和抑郁症状。这项服务的可接受性已在一项试点研究中得到证实。现在有必要进行全面试验。
目的
本集群随机对照试验（RCT）的研究方案旨在评估与中学青年常规学校对照条件相比，“一帆风顺”基于网络的服务在改善寻求帮助的意愿和行为、减轻抑郁和焦虑症状以及其他心理健康结果方面的有效性。
方法
这项RCT旨在从澳大利亚新南威尔士州各地的16所中学招募1600名学生。学校在学校层面被随机分配到干预组或常规学校对照组。从每所参与学校招募1或多个年级的约100名学生。参与者在3个时间点完成测量：基线、干预后6周和干预后12周，主要结果在干预后12周评估。分配到干预组的参与者在基线时注册到基于网络的服务，并根据服务模式接受护理。对照组的参与者接受常规学校服务。
结果
第一次基线评估于2018年2月22日进行，12周终点评估于2018年6月29日星期五完成。对照学校目前正在接受该服务，预计2019年6月30日完成。试验结果预计将表明，与分配到对照组的学生相比，分配到干预组的学生寻求帮助的意愿和行为有所改善，同时抑郁、焦虑、痛苦和其他心理健康结果的症状也有所改善。
结论
据我们所知，这是首次将基于分级护理原则的基于网络的心理健康服务纳入澳大利亚学校环境并进行评估。该试验的结果将对这种服务模式在澳大利亚学校的适用性以及更广泛地提供基于学校的心理健康服务产生影响。
试验注册
澳大利亚新西兰临床试验注册中心ACTRN12618001539224 https://anzctr.org.au/Trial/Registration/TrialReview.aspx?id=375821&isReview=true（由WebCite存档于http://www.webcitation.org/77N3MDGS6）。
国际注册报告标识符（IRRID）：DERR1-10.2196/12892。
Zotero 插件