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Australian State/Territory : QLD
Research Topic : Randomized Controlled Trial
Scheme : NHMRC Project Grants
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  • Funded Activity

    Evaluation Of Internet-based, Cognitive Behaviour Therapy For The Treatment Of Anxiety Disorders In Adolescents

    Funder
    National Health and Medical Research Council
    Funding Amount
    $570,750.00
    Summary
    Anxiety disorders affect around 5-10% of adolescents and are associated with a range of adverse consequences if left untreated. The majority of young people with anxiety disorders do not seek nor receive treatment. This may be due partly to the perceived stigma of attending a mental health clinic and logistic problems of attending therapy. A challenge is to identify ways in which treatment can be made more accessible to adolescents in need, particularly those in rural and remote areas. Contrary .... Anxiety disorders affect around 5-10% of adolescents and are associated with a range of adverse consequences if left untreated. The majority of young people with anxiety disorders do not seek nor receive treatment. This may be due partly to the perceived stigma of attending a mental health clinic and logistic problems of attending therapy. A challenge is to identify ways in which treatment can be made more accessible to adolescents in need, particularly those in rural and remote areas. Contrary to original beliefs, evidence shows that the internet can be used to deliver effective psychological therapies for a range of mental health problems, including anxiety disorders. So far this research has focused on adults, but adolescents may be in a particularly strong position to benefit from these forms of therapy, being experienced users of internet resources. This research investigates the effectiveness of internet-based cognitive-behaviour therapy (CBT) in the treatment for anxiety disorders in adolescents. Recently we have piloted CBT for anxious children that combines clinic and internet therapy, with half the therapy sessions in the clinic and half over the internet. Pilot data show that clinic + internet therapy produced significant reductions in anxiety and is almost as effective full clinic-based therapy. The proposed research builds on our pilot work by evaluating the effectiveness of a more extensive internet-based therapy in which all sessions are completed using the internet and with an older age group. The research also examines the factors that predict which young people will respond most positively to the intervention so that the treatment can be matched to those most likely to benefit from it in the future. The aim is to develop an effective internet-based treatment for adolescents with anxiety disorders that is easily accessed and suitable for use in rural and remote populations, requiring minimal face-to-face therapist contact.
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    Funded Activity

    Improved Support For Regional And Remote Paediatric Oncology Families: A Randomised Controlled Trial Of Videotelephony

    Funder
    National Health and Medical Research Council
    Funding Amount
    $304,843.00
    Summary
    Childhood cancer presents a major life stressor for the entire family. Significant changes to the everyday lives of families, practically, socially and emotionally cause major disruption. There is evidence that this disruption results in isolation and poor communication between family members, anxiety, low self-esteem and school problems for siblings and anxiety, post-traumatic stress symptoms and risk of depression for parents. Providing ongoing support to these families is an essential part of .... Childhood cancer presents a major life stressor for the entire family. Significant changes to the everyday lives of families, practically, socially and emotionally cause major disruption. There is evidence that this disruption results in isolation and poor communication between family members, anxiety, low self-esteem and school problems for siblings and anxiety, post-traumatic stress symptoms and risk of depression for parents. Providing ongoing support to these families is an essential part of care. The Royal Children's Hospital (RCH) Paediatric Oncology Service in Brisbane is the major tertiary paediatric referral centre for Queensland, northern New South Wales and the southwest Pacific. A multidisciplinary team of medical, nursing, and allied health professionals provides care and support to children with cancer, as well as their families. Each year around 100 newly diagnosed patients are cared for. Around 60% of the families cared for by the service live in regional and remote areas. There are a number of challenges which inhibit the equitable provision of specialist health services to these areas including availability of health care professionals and accessibility due to distance, time, cost and transport. For paediatric oncology families, opportunities to receive support are limited. One possible solution is the use of online support mechanisms, such as videotelephony, to facilitate the provision of much needed support to patients, parents, siblings and the family as a whole. The objective of this research is to see if videotelephony can be used to support regional and remote families of the Royal Children's Hospital Paediatric Oncology Service providing indizidualised communication, education, counselling and monitoring. This will present a new and innovative use of videophone technology as well as a new method for supporting regional and remote oncology patients and their families.
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    Funded Activity

    Helping Women Meet Their Activity Goals: Randomised Trial Of A Personalised Program Delivered By Mobile Telephone

    Funder
    National Health and Medical Research Council
    Funding Amount
    $493,346.00
    Summary
    Cardiovascular disease is the leading cause of death in Australian women, but is less likely among women who are active. Because women are less active than men, and women with young children are the least active of all, we developed a program to increase postnatal women's physical activity. Women in the pilot study reported high program satisfaction and more physical activity, because the program focused on them (not their kids) and helped them prioritise time for physical activity.
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    Funded Activity

    Improving Outcomes Of Preschool Language Delay In The Community: Randomised Trial

    Funder
    National Health and Medical Research Council
    Funding Amount
    $927,327.00
    Summary
    7-15% of preschool children have language delay, so are vulnerable to poor lifelong academic, social and economic outcomes. Small trials suggest that intervention helps. This randomized trial aims to find out the population costs and benefits of optimized intervention for 4 year olds following systematic identification of language delay. Because we have studied the 1500 participants since infancy, the trial could also shed light on why some children respond better than others to treatment.
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    Funded Activity

    Impact Of An Infant Sleep Intervention On Infant Sleep And Maternal Wellbeing: A Cluster Controlled Trial

    Funder
    National Health and Medical Research Council
    Funding Amount
    $205,500.00
    Summary
    Infant sleep problems and postnatal depression are common in the Australian community. Over a third of Australians report a problem with their infant's sleep in the second six months of life whilst 10-15% of Australian women will experience an episode of depression in the first year after their child is born. Both infant sleep problems and postnatal depression have been associated with serious outcomes including child abuse, child behaviour problems, maternal physical and emotional problems, fam .... Infant sleep problems and postnatal depression are common in the Australian community. Over a third of Australians report a problem with their infant's sleep in the second six months of life whilst 10-15% of Australian women will experience an episode of depression in the first year after their child is born. Both infant sleep problems and postnatal depression have been associated with serious outcomes including child abuse, child behaviour problems, maternal physical and emotional problems, family stress and family breakdown. This study builds on previous work conducted by researchers at the Centre for Community Child Health, Royal Children's Hospital, Melbourne. In this work, a brief behavioural intervention significantly decreased infant sleep problems and symptoms of maternal depression, particularly for depressed mothers. The intervention consisted of controlled crying and removal of sleep associations such as a dummy which the infant had become dependent upon to fall asleep. Mothers who received the intervention reported 20% fewer sleep problems and a 45% reduction in depression symptoms compared with mothers who did not receive the intervention. The interention also improved maternal sleep quality and quantity and reduced the need for professional sleep services. It was acceptable to mothers, of low cost and was minimally disruptive to families - in contrast to many current strategies directed primarily at postnatal depression. This trial aims to determine whther a similar intervention delivered by Victorian Maternal and Child health nurses within their usual practice settings can replicate these important benefits.
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    Funded Activity

    Effective Management Of Acute Whiplash Injuries Requires A Pragmatic Approach: An RCT With Stratified Treatments

    Funder
    National Health and Medical Research Council
    Funding Amount
    $382,550.00
    Summary
    Whiplash injuries from a motor vehicle crash continue to incur substantial personal and financial costs to the community and the insurance industry. The current approaches to an acute whiplash injury in Australia and internationally have failed to lessen the rate of how many people develop chronic neck pain. Between 40 and 60% still have pain 6 months after injury. Motor Accident Insurance Commission (Qld) figures indicate that 20% of patients with chronic whiplash account for 60% of the costs. .... Whiplash injuries from a motor vehicle crash continue to incur substantial personal and financial costs to the community and the insurance industry. The current approaches to an acute whiplash injury in Australia and internationally have failed to lessen the rate of how many people develop chronic neck pain. Between 40 and 60% still have pain 6 months after injury. Motor Accident Insurance Commission (Qld) figures indicate that 20% of patients with chronic whiplash account for 60% of the costs. Transition from an acute to a chronic condition must be prevented. A new direction in management in the acute stage is urgently required as once the pain has become chronic, it is difficult to help. This research will conduct a novel randomised controlled trial for acute whiplash. It will test individually prescribed multi-professional management against usual care with the aim to lessen the numbers who go on to develop chronic pain. It will be the first clinical trial that acknowledges from the outset that the whiplash injuries and affects people in different ways. Our previous research with acute whiplash patients has documented the variations in presentation from physical, physiological and psychological perspectives. In this trial, management will be prescribed as directed by measurable pain, muscle and psychological impairments in the individual, rather than regard all patients as the same as in other trials. This trial will offer individualised treatments; medical, physiotherapy and-or psychological using an empirically derived treatment algorithm. Cost-effectiveness of the program will be evaluated against that incurred during usual care. It is predicted that early multi-professional management will be less expensive in the long term than existing approaches. This RCT stands to extend knowledge in the management of whiplash associated disorders (WAD).
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    Funded Activity

    Comparison Of Cognitive-behavioural Treatments For Children With PTSD Following An Accidental Injury: A Multi-site RCT.

    Funder
    National Health and Medical Research Council
    Funding Amount
    $359,111.00
    Summary
    Children who experience a traumatic event are at increased risk of developing Post traumatic stress disorder (PTSD). Despite the significant consequences, and the poor prognosis of this disorder, few evaluations of interventions for PTSD in children exist. This project will compare two active treatments (child vs. family-focused cognitive behaviour therapy) for children experiencing PTSD following an accidental injury (the most common category of traumatic events experienced by children).
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    Funded Activity

    Impact Of DTP Schedules On The Immunogenicity Of 2 Doses Of 13v-PCV Followed By An Early Booster

    Funder
    National Health and Medical Research Council
    Funding Amount
    $2,651,687.00
    Summary
    This project aims to come up with a vaccination schedule to make pneumococcal vaccines more effective and affordable for Fiji and other developing countries. We will evaluate schedules involving a 2 dose primary series in early infancy with a booster at 9 months of age. We will compare the immune responses to 3 different primary series and 2 booster options. The results of this project will be used to provide advice, at global and country levels, regarding introduction of pneumococcal vaccines.
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