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Trial registered on ANZCTR
Registration number
ACTRN12618001578291
Ethics application status
Approved
Date submitted
31/08/2018
Date registered
24/09/2018
Date last updated
21/06/2021
Date data sharing statement initially provided
30/08/2019
Type of registration
Prospectively registered
Titles & IDs
Public title
Evaluating an attention training to reduce and prevent symptoms of posttraumatic stress in Australian military personnel returning to civilian life
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Scientific title
Evaluating the effectiveness of attention control training to reduce and prevent PTSD symptomatology in transitioning Australian military personnel
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Secondary ID [1]
293333
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None
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Universal Trial Number (UTN)
U1111-1213-9315
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Trial acronym
SOAR
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Post Traumatic Stress Disorder
305424
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Condition category
Condition code
Mental Health
304703
304703
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0
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Other mental health disorders
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Mental Health
304704
304704
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0
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Depression
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Attention control training (ACT)
In ACT, participants perform four computer-delivered attention training sessions, 7 minutes per training session, over four weeks. Participants are required to attend in-person to the designated local office for the SOAR trial to complete the task on a laptop computer. The expectation is that participants complete one session a week for four weeks, although some flexibility will be allowed based on other time commitments associated with transitioning from the military. In each session the dot-probe task is administered. The task consists of 160 trials. Each trial begins with a centrally-presented fixation cross that is then replaced by a pair of neutral and threat words. A target probe appears in the location previously occupied by one of the words, and participants are requested to discriminate the probe type via button press. Targets appear with equal probability at the location of threat and neutral stimuli, in order to modify the fluctuations in attention allocation. Adherence to the intervention and instructions provided will be monitored using response time and accuracy rates; cases with extreme outliers will be excluded from analysis.
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Intervention code [1]
299589
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Prevention
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Comparator / control treatment
Comparison task
In the comparison task, participants perform four computer-delivered attention training sessions, 7 minutes per training session, over four weeks. In each session the dot-probe task is administered. The task consists of 160 trials. Each trial begins with a centrally-presented fixation cross that then replaced by a pair of neutral - neutral words. A target probe then appears in the location previously occupied by one of the words, and participants are requested to discriminate the probe type via button press. This comparator task is presumably inactive.
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Control group
Active
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Outcomes
Primary outcome [1]
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Diagnosis of PTSD symptoms as measured by the PTSD Checklist (PCL-5). The PCL-5 is a 20-item self-report scale with scores ranging from 0 to 80, with higher scores reflecting more symptoms of PTSD. A proposed cut-off of >33 is indicative of probable PTSD (Weathers, Litz, Keane, Palmieri, Marx, & Schnurr, 2013).
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Assessment method [1]
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Timepoint [1]
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Pre-intervention, post-intervention (4 weeks), at 3 month follow-up (primary timepoint), and 12 month follow-up.
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Primary outcome [2]
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PTSD symptom severity as measured by the PTSD Checklist (PCL-5). The PCL-5 is a 20-item self-report scale with scores ranging from 0 to 80, with higher scores reflecting more symptoms of PTSD (Weathers, Litz, Keane, Palmieri, Marx, & Schnurr, 2013)..
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Assessment method [2]
307408
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Timepoint [2]
307408
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Pre-intervention, post-intervention (4 weeks), at 3 month follow-up (primary timepoint), and 12 month follow-up.
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Secondary outcome [1]
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Symptoms of depression as measured by the Patient Health Questionnaire (PHQ-9). The PHQ-9 is a nine item self-report questionnaire that measures depression severity. Items are rated from ‘0’ (not at all) to ‘3’ (nearly every day), with total scores ranging from 0-27.
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Assessment method [1]
340456
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Timepoint [1]
340456
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Pre-intervention, post-intervention (4 weeks), at 3 month follow-up, and 12 month follow-up.
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Secondary outcome [2]
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Symptom of anxiety as measured by the Generalized Anxiety Disorder (GAD-7). The GAD-7 is a seven item self-report questionnaire that measures anxiety severity, and is commonly used as a screening tool for generalized anxiety disorder (GAD). Items are rated from 0-3.
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Assessment method [2]
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Timepoint [2]
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Pre-intervention, post-intervention (4 weeks), at 3 month follow-up, and 12 month follow-up
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Secondary outcome [3]
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Functional impairment as measured by the Work and Social Adjustment Scale (WSAS).
The WSAS (Mundt, Marks, Shear, & Greist, 2002) is a 5 item measure that captures functional impairment across the domains of ‘work’, ‘home management’, ‘social leisure activities’, ‘private leisure activities’ and ‘family and relationships’. Participants are required to rate on a scale of 0 (not at all) and 8 (very severely) how much their problems interfere with each domain.
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Assessment method [3]
351125
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Timepoint [3]
351125
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Pre-intervention, post-intervention (4 weeks), at 3 month follow-up, and 12 month follow-up
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Eligibility
Key inclusion criteria
1. Must be 18 years of age or older
2. Must be a current serving member of the full-time ADF
3. Must be separating from the full-time ADF in the next 12 weeks
4. Must be able to commit to and complete the intervention before separation from ADF
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
1. Report current self-identified treatment for bipolar or a psychotic disorder (due to the potential influences of medication and psychological symptoms on cognition)
2. Currently receiving medical treatment that may significantly impair their reaction times
3. Unable to use a computer keyboard
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Study design
Purpose of the study
Prevention
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Allocation concealment will be used for this trial. Specifically, a central randomisation website will be utilised across sites that assigns a participant to either condition 1 or 2, where neither participants nor administering research assistants will know which is the intervention and which the control.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Simple randomisation using a randomisation table created by computer software (i.e. computerised sequence generation), with stratification by trial site
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people administering the treatment/s
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
Based on an expected PTSD incidence rate of 20% in the control group and 15% in the treatment group, a total sample size of 1806 participant is required to detect a minimally important difference of 5% in PTSD rates at 3-months post-intervention, assuming 80% power and an alpha of 0.05.
Descriptive statistics will be used to summarise characteristics of intervention and control conditions, with regards to baseline characteristics and patterns of change over time. Differences between intervention and control conditions, on both primary and secondary outcomes, will be evaluated in a regression-based framework and in accordance with intention-to-treat (ITT) principles.
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Recruitment
Recruitment status
Stopped early
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Data analysis
No data analysis planned
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Reason for early stopping/withdrawal
Participant recruitment difficulties
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Date of first participant enrolment
Anticipated
1/10/2018
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Actual
6/03/2019
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Date of last participant enrolment
Anticipated
1/03/2021
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Actual
26/03/2020
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Date of last data collection
Anticipated
1/03/2022
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Actual
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Sample size
Target
1806
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Accrual to date
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Final
59
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Recruitment in Australia
Recruitment state(s)
ACT,NSW,NT,QLD,SA,WA,VIC
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Funding & Sponsors
Funding source category [1]
297957
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Government body
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Name [1]
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Veterans and Veterans' Families Counselling Service
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Address [1]
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Veterans and Veterans Families Counselling Service (VVCS)
6-8 Campion St
Deakin (Canberra)
ACT 2600
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Country [1]
297957
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Australia
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Primary sponsor type
University
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Name
University of Melbourne
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Address
161 Barry St
Carlton (Melbourne)
VIC 3053
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Country
Australia
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Secondary sponsor category [1]
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Government body
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Name [1]
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Veterans and Veterans' Families Counselling Service
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Address [1]
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Veterans and Veterans Families Counselling Service (VVCS)
6-8 Campion St
Deakin (Canberra)
ACT 2600
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Country [1]
297020
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Australia
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Other collaborator category [1]
280104
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University
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Name [1]
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Tel Aviv University
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Address [1]
280104
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School of Psychological Sciences and Sagol School of Neuroscience
Tel Aviv University
P.O. Box 39040
Tel Aviv
6997801
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Country [1]
280104
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Israel
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Other collaborator category [2]
280321
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Government body
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Name [2]
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Australian Government Department of Defence
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Address [2]
280321
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PO Box 7911
Canberra BC ACT 2610
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Country [2]
280321
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
298999
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The Departments of Defence and Veterans’ Affairs Human Research Ethics Committee (DDVA HREC)
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Ethics committee address [1]
298999
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Office of Commander Joint Health Department of Defence PO Box 7911 Campbell Park Offices Canberra ACT 2610
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Ethics committee country [1]
298999
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Australia
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Date submitted for ethics approval [1]
298999
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01/03/2018
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Approval date [1]
298999
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06/06/2018
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Ethics approval number [1]
298999
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040-18
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Summary
Brief summary
In the course of military training, personnel are trained to attend to cues in their environment that may signal threat, and in deployment situations this training can be life-saving. Upon return to civilian life however, constantly feeling alert and attending to cues that seem threatening can become a problem and in some cases this has been shown to be associated with the development of posttraumatic stress disorder (PTSD). PTSD is a common and often severe problem for many who serve in the military. In particular, it can involve constantly being on the lookout for danger, which may be compounded by training received during military training to be vigilant. Attention control training (ACT) is an intervention designed to modify the fluctuations in attention to threat that underpins PTSD. ACT is brief, computerised program that is delivered once weekly for four weeks. The trial will involve 1806 current serving personnel between 18 to 70 years of age who are transitioning out of the military within the next 12 weeks. Participation involves a number of short self-report assessments and attending weekly ACT or control training sessions over four consecutive weeks. All self-report assessments will be completed online using a mobile phone, and will be done four times in total: immediately before the intervention, immediately post-intervention (4 weeks), and at 3 and 12-months follow-up. The results of this trial will inform the broader military community both in Australia and overseas by improving our understanding of effective preventions for the development of mental health symptoms after military service.
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Trial website
http://soar.phoenixaustralia.org.au/home.php
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Prof Meaghan O'Donnell
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Address
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Director of Research
Phoenix Australia
University of Melbourne
Level 3 Alan Gilbert Building
161 Barry St
Carlton
VIC 3053
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Country
78950
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Australia
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Phone
78950
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+61, 03, 9035 7883
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Fax
78950
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Email
78950
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[email protected]
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Contact person for public queries
Name
78951
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Tracey Varker
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Address
78951
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Phoenix Australia
University of Melbourne
Level 3 Alan Gilbert Building
161 Barry St
Carlton
VIC 3053
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Country
78951
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Australia
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Phone
78951
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+61, 03, 9035 7586
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Fax
78951
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Email
78951
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[email protected]
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Contact person for scientific queries
Name
78952
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Tracey Varker
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Address
78952
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Phoenix Australia
University of Melbourne
Level 3 Alan Gilbert Building
161 Barry St
Carlton
VIC 3053
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Country
78952
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Australia
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Phone
78952
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+61, 03, 9035 7586
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Fax
78952
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Email
78952
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
We do not have ethical approval to share individual participant data.
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What supporting documents are/will be available?
No Supporting Document Provided
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
4418
Study protocol
[email protected]
4419
Statistical analysis plan
[email protected]
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
Download to PDF