Prevention

Prevention

Stream Description

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Anxiety, depressive and substance use disorders account for three quarters of the disability attributed to mental disorders. The peak of this disability occurs in those 15-24 years old and corresponds with the typical period of onset of these problems. Critically, anxiety, depression and substance use disorders share common risk factors.

To reduce the occurrence and cost of such disorders, preventative interventions need to begin early, before the problems begin to cause disability, and vocational, educational and social harm.  To date, the focus of our research has been on developing and evaluating universal internet-based programs to prevent substance use and related harms in adolescents. Our most recent trial involves combining these universal programs with selective personality-targeted interventions with an aim of maximising outcomes for both high and low risk youth.

 

Completed Projects

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Feasibility of the Climate Schools program in the United Kingdom

Prof Patricia Conrod
Funding Body: University of New South Wales
Description:

The aim of this study was to examine the feasibility and acceptability of the universal internet-based Climate Schools program in the United Kingdom.Climate Schools is an evidence-based prevention course, aimed at reducing alcohol and cannabis use and consists of two sets of six lessons delivered approximately six months apart.  322 students were recruited from Year 9 classes at two secondary schools in London and were assessed at baseline and immediately following the full intervention on their levels of alcohol and cannabis use, as well as related knowledge, harms, and attitudes.Results from this feasibility trial were promising and evaluations from teachers and students were extremely positive. Internet-based drug prevention is therefore feasible and acceptable for use in the United Kingdom. A full evaluation trial of the Climate Schools program is now needed.

Project Contacts: A/Prof Nicola Newton
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Illicit drug resources for teachers, students and parents

Funding Body: Australian Government Department of Health and Ageing
Description:

The aim of this project was to develop, test and deliver an illicit drugs resource package for use by teachers, parents, and high school students. The project included the development of information booklets as well as an interactive game for young people to teach them about the harms associated with illicit drugs. 

In 2013, focus groups were conducted with Year 10 students, parents and teachers to obtain feedback on the booklet content and design. This feedback was incorporated and final booklets were launched electronically in June 2014. In November 2014, 60 copies of the booklets were distributed to every secondary school in Australia. 

In 2013, student focus groups were conducted to gain feedback and suggestions for the development of an interactive drug education game. This student input informed development of the game “Pure Rush” in collaboration with the game development company 2and2. Pure Rush is targeted at Year 8-10 students and contains educational messages about the potential harms of cannabis, methamphetamine, hallucinogens and pills such as ecstasy. The game differs from the handful of existing drug education games in its use of  the popular “race” genre rather than role playing; and its emphasis on interactive learning, with characters experiencing the effects of any illicit drugs they collide with (e.g. cannabis slows them down). Focus testing with Year 9 students was conducted in 2014 with a prototype version and later the final game to gain feedback and assess benefits associated with gameplay. The game was released in June 2014, and can be played online, or installed as an app for iOS or Android. 

Access the drug education booklets for teachers, parents and students.

Access the Pure Rush interactive drug education game. 

Project Contacts: A/Prof Nicola Newton

Ongoing Projects

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The Climate Schools Combined (CSC) study: Internet-based prevention for anxiety, depression and substance use in young Australians

Prof Gavin Andrews, Prof Steve Allsop and Dr Nyanda McBride
Funding Body: National Health and Medical Research Council
Description:

Anxiety, depressive and substance use disorders account for three quarters of the disability attributed to mental disorders.  Moreover, research indicates that these disorders are often comorbid, share common risk factors and interact. The peak of these disorders occurs in those aged 15-24 years old, which also corresponds with the typical period of onset. It is therefore important that effective preventative interventions begin early, before patterns of mental health and substance use disorder symptoms are established and begin to cause disability, as well as vocational, educational and social harm.

An array of preventative interventions for these disorders currently exists, however the effectiveness of these programs is contentious. Furthermore, interventions are typically designed to target a single disorder at one time and there are few effective preventive programs which concurrently target these common disorders. The current study aims to address this gap by evaluating an integrative approach known as the CLIMATE Schools Combined (CSC) intervention, which includes the evidence-based ‘universal’ CLIMATE Schools Substance Use course and the ‘universal’ CLIMATE Schools Mental Health course. It is anticipated that this integrative approach will be more effective in reducing problems and symptoms associated with substance use and mental health disorders compared to the stand-alone interventions and school-based health education as usual. The CSC study will be the first trial, internationally, to develop an integrative model for dissemination in schools across Australia.

Project Contacts: A/Prof Nicola Newton
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Climate Schools Interactive (CSI) study: A cluster randomised controlled trial of the internet-based Climate Schools: Ecstasy & Emerging Drugs Module

Funding Body: National Health and Medical Research Council; Australian Government Department of Health and Ageing
Description:

The use of ecstasy is a public health problem and is associated with a range of social costs and harms. Recently, there has been growing concern about the misuse of new psychoactive substances (NPS) designed to mimic the effects of illicit drugs, including ecstasy. The CSI Study aims to evaluate the efficacy of the first online school-based prevention program for ecstasy and NPS, known as the Climate Schools; Ecstasy & Emerging Drugs module.

Progress/Findings: The CSI Study commenced in 2014, with students at participating schools (n=11 schools, 1126 students) completing an online self-report baseline survey. Intervention schools (n=5) successfully implemented the Climate Schools: Ecstasy and Emerging Drugs Module between March and May and positive feedback was received from both teachers and students about the program. Students completed a survey immediately after the intervention survey, as well as a 6- and 12-month follow-up survey. A fifth and final survey was completed in 2016, which provides 24-month follow-up data for the cohort.

Project Contacts: Dr Katrina Champion
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Positive Choices: National Drug Prevention Online Portal

Dr Nyanda McBride, Prof Steve Allsop
Funding Body: Australian Government Department of Health
Description:

Positive Choices: National Drug Prevention Online Portal

Providing young people with up-to-date, evidence-based information and support is the best way to prevent the harms associated with drug and alcohol use.  The Department of Health have identified the need for a national portal to help school communities access evidence-based information and drug prevention programs.  The portal was developed in consultation with education and drug and alcohol experts, as well as target users (teachers, parents and students). Research literature and drug education websites were systematically reviewed to identify resources meeting pre-specified inclusion criteria for relevance and quality. The Positive Choicesportal was launched in December 2015 as part of the Australian Government’s drug education and prevention strategy. Regular review and scoping is conducted to ensure the information and resource database is up-to-date, and training opportunities are provided through the quarterly Positive Choices webinar series. Regular updates about relevant research and new resources are available via the subscriber newsletterfacebook and twitter accounts.

The portal is freely accessible at www.positivechoices.org.au.

Project Contacts: Dr Lexine Stapinski
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Evaluation of the CAYLUS youth worker brokerage program

Prof Anthony Shakeshaft, Dr Fiona Shand
Funding Body: Central Australian Youth Link Up Service (CAYLUS)
Description:

Established in 2002, the Central Australian Youth Link Up Service (CAYLUS) supports community initiatives aimed at reducing the supply of, demand for, and harms associated with, substance misuse among young people across Central Australia (spanning approximately 900 square kilometres). Youth substance misuse remains a pressing concern in Central Australia. In particular, the work of CAYLUS focuses on the misuse of volatile substances (e.g., petrol sniffing, paint, aerosols), which includes liaising with retailers of high-risk products to assist with their management. CAYLUS also assists remote communities in the development, funding and implementation of youth programs.

 

To inform the continued improvement of its programs and ensure that its activities are responsive to community needs, CAYLUS is seeking to establish a rolling monitoring and evaluation process for the activities it runs through the CAYLUS Youth Worker Brokerage Program. The Centre of Research in Mental Health and Substance Use (CREMS) aims to generate new research to increase the knowledge base regarding the nature, prevention and treatment of mental health and substance use disorders. In addition, a fundamental objective of the CREMS is to build research capacity in this area, and assist community agencies develop and conduct their own research. In keeping with this objective, researchers from the CREMS will assist CAYLUS establish a rolling monitoring and evaluation process for the activities it runs through the Youth Worker Brokerage Program, specifically examining the impact of its programs and activities on local level community crime and petrol sniffing. By improving the capacity of the CAYLUS staff to evaluate and monitor their service, the standard of youth programs may be informed and improved, and the enduring disability associated with substance misuse may be reduced.

 

Stage 1 of the evaluation was completed in February 2016. The Executive Report is available for download here.

 

Stage 2 of the evaluation of the CAYLUS Youth Worker Brokerage program commenced in June 2016, and will be ongoing until 2019. In stage 2, CREMS will continue to provide assistance to CAYLUS in  maintain a rolling monitoring and evaluation process for the activities it runs through the CAYLUS Youth Worker Brokerage. The project will examine the ongoing impact and perceived impact of programs and activities supported by this brokerage on local level community crime (particularly crime involving young people) and petrol sniffing.”

Project Contacts: Dr Christina Marel
Cracks in the ice

An online toolkit to provide evidence-based information about crystal methamphetamine ('Ice') for the Australian community

Prof Steve Allsop and Dr Nyanda McBride (National Drug Research Institute)
Funding Body: Australian Government Department of Health
Description:

Phase 1: Development

The aim of this project is to develop and disseminate an online toolkit to improve access to evidence-based information about crystal methamphetamine (“ice”), raise awareness about the potential harms and mental health problems associated with the use of ice, and provide information about how to access services and support for the Australian community.

Scoping and content development for the Cracks in the Ice online toolkit was conducted in 2015, and initial end-user consultation was conducted in January 2016 to understand information needs about ice among the Australian community. A beta-version of the Cracks in the Ice toolkit was focus tested among end-users (including consumers, families and friends of people who use ice, health professionals, teachers and community groups) in August 2016. The Cracks in the Ice Community Toolkit was launched on 3rd April 2017 by the Minister for Health, Hon Greg Hunt, and is available online atwww.cracksintheice.org.au. Subscribe now for updates about Cracks in the Ice or follow us on Facebook and Twitter.

 

Phase 2: Ongoing maintenance and development of Cracks in the Ice

The aim of this phase of the project is to to support the ongoing maintenance, development and promotion of the online toolkit. New resources will be added to further develop and enhance the content and functionality of the Cracks in the Ice toolkit including a Community Forum Toolkit and a smartphone application (‘app’). To enable end users to evaluate the usefulness of the online toolkit, a ‘Think Aloud’ evaluation will also be undertaken and new toolkit content will be developed on response to user questions and feedback

Project Contacts: Ms Louise Birrell
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The Brain Games

Funding Body: Australian Rotary Health
Description:

Emerging research suggests that deficits in executive functioning are a core feature of mental disorders across the full spectrum of psychopathology. Cognitive training exercises that focus on improving executive functioning have been shown to reduce symptoms related to schizophrenia, major depression and ADHD, as well as eliciting changes in alcohol consumption. However, it is not yet clear whether such training is also effective in preventing the onset of psychological symptoms and substance use in adolescents at risk for developing a broad range of psychopathology. In a sample of adolescents (n=220), the current study will examine whether cognitive training is effective in reducing a range of psychopathology in youth at high risk for developing a mental illness, as determined by a standardised measure of personality. It is expected that a targeted cognitive training program will prevent the onset of a range of mental illnesses and substance misuse in high risk youth.

Project Contacts: Dr Louise Mewton
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Pathways to prevention: The effectiveness of universal and selective prevention in altering developmental pathways to alcohol and cannabis related harms in young adults

Prof Patricia Conrod
Funding Body: National Health and Medical Research Council
Description:

Young adulthood marks a period of increased alcohol and cannabis use, and heightened risk of associated harms including injury, violent behaviour, and onset of alcohol or drug use disorders. To reduce this substantial burden, effective prevention is essential and needs to be initiated before patterns of use are established. School-based prevention programs have proven an effective way to reduce the onset and escalation of alcohol and drug use. However, little is known about the durability of these effects during the transition to adulthood, a period characterised by unique risks and challenges.

 
This project brings together an international team who have developed two complementary prevention approaches: the universal “Climate” program and the selective “Preventure” program. Both have proven effective in reducing alcohol and cannabis harms in the short-term. The project builds on our NHMRC-funded trial, the Climate and Preventure (CAP) study, which was the world-first RCT of a comprehensive strategy combining universal and selective prevention. This trial cohort (n = 2,190) is now on the verge of the important transition into early adulthood, and provides a unique opportunity to address crucial questions about the sustainability of prevention effects.
 
This study will advance the evidence base in three significant ways: i) it will provide the world-first evaluation of the long-term (7-year) effectiveness of universal and selective prevention; ii) it will answer critical questions about the potential benefits of these approaches in reducing alcohol and drug-related
violence during the high-risk early adulthood period; and iii) it will provide crucial information about the mechanisms of change underlying these prevention.
 

 

 
Project Contacts: A/Prof Nicola Newton
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Making InRoADs: Trial of an innovative early intervention to Interrupt the cycle of Anxiety and Drinking in young Australians

Funding Body: Australian Rotary Health, Society of Mental Health Research (SMHR) Early Career Researcher Fellowship to Lexine Stapinski
Description:

Anxiety and alcohol use disorders are among the most prevalent and debilitating of mental health disorders, and commonly co-occur. There is limited evidence about the temporal sequence, although the available data suggests anxiety typically predates alcohol use disorders, and the use of alcohol to cope with anxiety is commonly reported. Increasingly, anxiety and alcohol comorbidity is understood as a clinically important mutually-reinforcing relationship, yet current prevention and treatment approaches are limited by single disorder models.

 The transition into early adulthood is a unique developmental period, characterized by numerous personal and social role changes. Young adulthood also marks a period of increased vulnerability for onset of both anxiety and alcohol use disorders. The unique challenges of this early adulthood period combined with the emergence of anxiety and alcohol use disorder symptoms require a developmentally-targeted early intervention to empower young adults, enhance anxiety coping skills, and prevent the escalation of drinking. This project involves a randomised controlled trial of a new, therapist-supported online early intervention for anxious young people at risk of alcohol use disorders. 

Project Contacts: Dr Lexine Stapinski

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