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.

 

Ongoing Projects

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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

Development of culturally-appropriate resources to prevent alcohol and drug-related harms among young Aboriginal and Torres Strait Islander people

A/Prof James Ward
Funding Body: Australian Government Department of Health
Description:

In partnership with Gilimbaa, an Indigenous Creative Agency, this project involves development of culturally appropriate school-based resources to prevent drug-related harms among young Aboriginal and Torres Strait Islander people. Development will be in consultation and collaboration with schools, teachers and young Indigenous Australians. An Expert Advisory Group has been established to guide the project. Scoping of existing resources and research literature will inform development of a central access portal, and a culturally-appropriate curriculum program based on the Climate Schools storyboard format. The online portal will facilitate dissemination of information and evidence-based approaches to prevent drug-related harms among young Aboriginal and Torres Strait Islander people.

Project Contacts: Ms Mieke Snijder

Development of an integrated online intervention for Students and Parents to prevent alcohol and cannabis harms among adolescents / Climate Schools Plus

Funding Body: Australian Government Department of Health
Description:

Building on the successful Climate Schools: Student Programme, Climate Schools Plus will incorporate a parenting component aiming to enable parents to prevent alcohol and cannabis harms among their adolescent children. The parenting component is based on a successful program developed by Dr Ina Koning at Utrecht University, The Netherlands.

In phase 1 of the project an Expert Advisory Group will be established to guide the design and development of the Climate Schools Plus Student and Parent Programme and focus testing and end-user consultation will be undertaken. Phase 2 will involve an implementation and effectiveness trial of the Programme. Climate Schools Plus will be the first online integrated student and parent program to prevent alcohol and cannabis harms among adolescents.

Project Contacts: Dr Cath Chapman
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School-based prevention: A study into the benefits for young Australians of two drug prevention programs

Ms Anna Smout, Mr Marius Mather, Professor Patricia Conrod, Assistant Professor Natalie Castellanous-Ryan
Funding Body: NHMRC
Description:

The Climate andPreventure (CAP) study was initiated in 2011 by Nicola Newton, Maree Teesson, Tim Slade and Patricia Conrod as a school-based prevention initiative targeting alcohol and drug use. The CAP study was the first ever randomised control trial of a comprehensive prevention approach combining both universal (Climate; delivered to all students) and selective (Preventure; delivered to high-risk students) intervention techniques. Twenty-six schools and 2,190 year 8 participants were recruited to the CAP trial in 2012, and randomised to one of four conditions: (1) Control (health education as usual), (2) Climate (universal prevention for all), (3) Preventure (selective prevention delivered only to 43% of students with high-risk personality profiles), or (4) Climate and Preventure (both universal and selective approaches). All students were followed up for 3 years post baseline. Results at 3 years have shown the effectiveness of universal and selective approaches in preventing harmful alcohol use among low- and high-risk adolescents. The CAP long-term follow up is an opportunistic extension of the landmark CAP 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 3 years, inviting the participants to take part in an online survey assessing demographic information, drinking and drug use habits, and behavioural and personality inventories. This $465,967 NHMRC funded long-term follow up project will be the first in the world to examine whether combining universal and selective drug prevention strategies enhances durability of effects in the longer-term, over a 7-year period from adolescence to early adulthood. The findings will inform policy nationally and internationally, as economic modelling suggests substantial societal benefit can be gained from even modest reductions in drug and alcohol use.

Project Contacts: Dr Nicola Newton
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CAP study – Combining effective universal and targeted approaches to drug prevention

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

More than one quarter of Australian teenagers put themselves at risk of short-term alcohol-related harm at least once a month and 17% use an illicit drug at least once a year. As such, the need for prevention is clear. Although an array of school-based prevention programs exist, the majority show minimal effects in reducing drug use and related harms, and some have even report iatrogenic effects. Given that school–based drug prevention is the primary means by which drug education is delivered, it is essential to focus on increasing program efficacy. Ideally, preventive interventions should aim to delay onset in both adolescents with low-risk profiles who may be influenced to take up substances due to peer influence and social conformity, and adolescents with high-risk profiles whose underlying vulnerability to psychopathology can lead to substance misuse. Yet, there appear to be no models of well implemented programs that do this. The current proposal addresses this gap by developing and evaluating a comprehensive approach to preventing substance use and related harms in adolescents by combining effective ‘universal’ and ‘targeted’ school-based prevention programs. The proposed model, known as the CAP (Climate and Preventure) intervention, builds on our unique success in this area through developing the effective universal Climate, and targeted Preventure programs.

Project Contacts: Dr Nicola Newton
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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: Dr 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

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: Dr 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: Dr Nicola Newton

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