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

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: Dr Louise Birrell
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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 exists, the majority show minimal effects in reducing drug use and related harms, and some have even reported 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.

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.

Follow-up for this trial has since been extended and will continue to 7 years post-baseline (until 2019). For more information about The CAP long-term follow up, please click here:

https://comorbidity.edu.au/content/pathways-prevention-effectiveness-universal-and-selective-prevention-altering-developmental

 

Project Contacts: A/Prof Nicola Newton
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Development of culturally-appropriate resources to prevent alcohol and drug-related harms among young Aboriginal and Torres Strait Islander people

Ms Danielle Bradd
Funding Body: Australian Government Department of Health
Description:

In partnership with Gilimbaa, an Indigenous Creative Agency, this project involves the development of a culturally appropriate drug information and prevention portal and a curriculum-based drug prevention program to prevent drug-related harms among young Aboriginal and Torres Strait Islander people. An Expert Advisory Group has been established to guide the project.

The portal and curriculum-based drug prevention program are being developed in consultation and collaboration with schools, teachers and young Indigenous Australians.

A literature review and scoping of existing resources and evidence about preventative strategies and culturally appropriate approaches have also been completed to inform the development of the resources.

On 26 September 2017 the Positive Choices Aboriginal and Torres Strait Islander portal launched. The new portal, integrated into the Positive Choices website, contains alcohol and other drug education and information resources developed for Aboriginal and Torres Strait Islander students, their teachers and parents. The online portal facilitates the dissemination of information and evidence-based approaches to prevent drug-related harms among young Aboriginal and Torres Strait Islander people.

The portal is freely accessible at https://positivechoices.org.au/indigenous/

Outputs:

Snijder, M., Stapinski, L., Lees, B., Newton, N., Champion, K., Chapman, C., Ward, J. & Teesson, M. (2018). Protocol for a systematic review of substance use prevention programs for Indigenous adolescents in the United States of America, Canada, Australia and New Zealand. JMIR Research Protocols, 7(2): e38.

 

Project Contacts: Dr Mieke Snijder
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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

Healthy, wealthy and wise: The long-term effectiveness of a combined prevention model for anxiety, depression and substance use in adolescents.

Prof Steve Allsop (Curtin); Dr Nyanda McBride (Curtin); Dr Mary-Lou Chatterton (Deakin); Dr Cathy Mihalopoulos (Deakin); Prof Leanne Hides (QUT); Catherine Quinn (UQ)
Funding Body: NHMRC
Description:

The transition from adolescence to young adulthood is characterised by immense social and vocational change. Young adulthood also marks a period of increased use of alcohol and other drugs, heightened risk of harms associated with this use and onset of substance use and mental health issues. A young person’s ability to cope with these challenges can have a profound impact on their subsequent life-course, their communities and Australia’s economic future.

 

After following one the largest adolescent cohorts in Australia from year 8 to 10 within the ‘Climate Schools Combined’ project, the Healthy, Wealthy and Wise study presents a unique opportunity to continue to follow these individuals until 2021, as they make the critical transition from secondary school into early adulthood.  More specifically, this landmark study will allow the long-term durability and cost-effectiveness of school-based programs for substance use, anxiety and depression to be assessed.

 

Project Contacts: Ms Annalise Healy
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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 two common and debilitating disorders that often co-occur. If left untreated, these conditions can fuel each other in a self-perpetuating cycle, leading to more severe symptoms and greater impairment. Typical onset of these disorders is between adolescence and early adulthood, with anxiety symptoms usually emerging earlier and marking a particular risk for harmful alcohol use and progression to alcohol use disorder. The unique challenges associated with the transition to adulthood, 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.

The Inroads program, (inroads.org.au) funded by Australian Rotary Health, is a therapist-supported, cognitive behavioural therapy (CBT)-based, internet-delivered early intervention for young adults aged 17 to 24 years that simultaneously targets anxiety symptoms, alcohol use, and the interconnections between them. The program has been adapted from our effective Combined Alcohol and Social Phobia (CASP) cognitive behavioural therapy program for adults. Participants complete five online skills-based modules over an 8-week period. Therapist support is provided via emails and text/phone contact providing personalised feedback, trouble-shooting, and activity suggestions aligned to module content.

The trial is currently recruiting participants. For more information or to enrol, visit: www.inroads.org.au

Project Contacts: Dr Lexine Stapinski
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Pathways to prevention: The effectiveness of universal and selective prevention in altering the developmental pathways to alcohol related harms in young adults

Funding Body: NHMRC
Description:

The Climate and Preventure (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: A/Prof Nicola Newton
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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.

Outputs:

Stapinski L., Lawler S., Newton N. C., Reda B., Chapman C, & Teesson, M. (2017). Empowering young people to make Positive Choices: Evidence‐based resources for the prevention of alcohol and other drug use in Australian schools. Learning Communities Journal, 21, 152-167.

Stapinski, L. A., Reda, B., Newton, N. C., Lawler, S., Rodriguez, D., Chapman, C., & Teesson, M. (2017). Development and evaluation of 'Pure Rush': An online serious game for drug education. Drug Alcohol Rev

Lawler, S., Newton, N., Champion, K., & Stapinski, L. A. (2017). Talking about alcohol and drugs. In R. Manocha (Ed.), Growing Happy, Healthy Young Minds: Generation Next (pp. 133-159.). Sydney, Australia: Hachette Australia.

Project Contacts: Dr Lexine Stapinski
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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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The Climate Schools Plus Study: An integrated online intervention for students and parents to prevent alcohol and cannabis-related harms among adolescents

Funding Body: Australian Government Department of Health
Description:

This study will investigate the first online alcohol and substance use prevention program targeted at both students and their parents. Students will receive the Climate Schools substance use modules during their health classes, while their parents will be asked to view webinars, rank rules and access their own modules/summaries in line with the student program from home. The attitudes and behaviours of students and parents towards alcohol and cannabis will be assessed over three years, to investigate the influence of the Climate Schools Plus program on these outcomes.

The aim of this project is to evaluate the efficacy of Climate Schools Plus (CSP), a novel online program for parents and students to prevent adolescent substance use and related harms. CSP combines an effective student program, the Climate Schools: Alcohol and Alcohol & Cannabis courses, with a new parent program recently developed by our team.

The investigators will determine the effectiveness of the CSP by running a cluster randomised controlled trial in approximately 12 schools. Schools will be randomly allocated to either the ‘Climate Schools Plus’ condition (CSP) or the ‘Control’ condition.

The student component of the CSP condition consists of the Climate Schools: Alcohol and Alcohol & Cannabis courses (i.e., online lessons to be delivered during class time at school).

The parent component of the CSP condition consists of 2 webinars (approximately 5 minutes each, at the beginning of Years 8 and 9), which provide overviews of alcohol and cannabis use and harms in adolescents and highlight the role parents play in preventing substance use. Parents will also have access to six brief online modules over the two years and will be emailed weekly summaries of student lessons for the duration of the student component. Students in the control condition will receive school health education as usual.

This evidence-based intervention has the potential to provide a sustainable and scalable improvement to the well-being of young Australians, and to reduce the substantial costs associated with substance use.

This study has been approved by the University of New South Wales Human Research Ethics Committee (HC17852) and is funded by the Australian Government Department of Health and the Society for Mental Health Research. If you are interested in participating or would like further information, please see the Climate Schools Plus website (www.climateschoolsplus.org.au) or you can direct your enquiries to Chloe Conroy at info@climateschoolsplus.org.au

Project Contacts: Ms Chloe Conroy

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