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Trial registered on ANZCTR
Registration number
ACTRN12621000594820
Ethics application status
Approved
Date submitted
12/03/2021
Date registered
19/05/2021
Date last updated
9/02/2024
Date data sharing statement initially provided
19/05/2021
Type of registration
Prospectively registered
Titles & IDs
Public title
Testing a new psychological treatment for adults after mild brain injury
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Scientific title
ACTION-TBI: Effect of acceptance and commitment treatment on functional recovery after mild traumatic brain injury in adults
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Secondary ID [1]
303674
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Nil known
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Universal Trial Number (UTN)
U1111-1266-0296
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Trial acronym
ACTION-TBI
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Mild traumatic brain injury
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Condition category
Condition code
Neurological
318879
318879
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0
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Other neurological disorders
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Injuries and Accidents
319369
319369
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0
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Other injuries and accidents
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Participants randomised to the intervention arm will receive five sessions of Acceptance and Commitment Therapy. The sessions will be delivered individually, in-person by a Registered Psychologist or Intern Psychologist (working under close supervision of a Registered Psychologist). Sessions will consist of 5x 1 hour sessions covering normalcy of human suffering, difference between goals and committed action, engaging in committed action in conjunction with values, separating self from thoughts, use of mindfulness, understanding the part of you that notices, contacting the present moment and responding to thoughts flexibly. The five session incorporating these techniques will be held once per week. Sessions will be conducted within a Psychology Clinic at a New Zealand University or concussion service. The total duration of the intervention will be 5 hours. Attendance at each session and rates of withdrawal from the intervention will be monitored.
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Intervention code [1]
319972
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Rehabilitation
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Intervention code [2]
320319
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Behaviour
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Comparator / control treatment
Participants randomised to the control arm will receive five sessions of Cognitive Behaviour Therapy which is current best practice. The sessions will be delivered individually, in-person by a Registered Psychologist or Intern Psychologist (working under close supervision of a Registered Psychologist). Sessions will consist of 5x 1 hour, held once per week. The total intervention will be 5 hours over 5 weeks. and will include approaches such as psychoeducation, goal setting, relaxation techniques, identifying unhelpful thoughts, cognitive restructuring and problem solving techniques, Sessions will be conducted within a Psychology Clinic at a New Zealand University or at a concussion clinic
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Control group
Active
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Outcomes
Primary outcome [1]
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Total Disability Score of the WHO Disability Assessment Schedule (WHODAS 2.0)
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Assessment method [1]
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Timepoint [1]
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Post-Intervention (5 weeks)
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Secondary outcome [1]
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Depression sub-scale score of the Depression, Anxiety and Stress Scales -21
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Assessment method [1]
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Timepoint [1]
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Post-intervention (5 weeks)
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Secondary outcome [2]
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Total score from the Rivermead Post-Concussion Symptoms Questionnaire
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Assessment method [2]
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Timepoint [2]
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Post-intervention (5 weeks)
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Secondary outcome [3]
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Total score from the Valued Living Questionnaire (How consistently they have lived in accordance with values)
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Assessment method [3]
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Timepoint [3]
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Post-intervention (5 weeks)
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Secondary outcome [4]
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Total score from the Acceptance and Action Questionnaire
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Assessment method [4]
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Timepoint [4]
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Post-intervention (5 weeks)
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Secondary outcome [5]
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Anxiety sub-scale score of the Depression, Anxiety and Stress Scales -21
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Assessment method [5]
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Timepoint [5]
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post-intervention (5 weeks)
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Secondary outcome [6]
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Stress sub-scale score of the Depression, Anxiety and Stress Scales -21
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Assessment method [6]
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Timepoint [6]
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post-intervention (5 weeks)
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Secondary outcome [7]
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The numbers of participants meeting the eligibility criteria recruited per month will be recorded
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Assessment method [7]
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Timepoint [7]
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Post-intervention (5 weeks)
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Secondary outcome [8]
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Total time taken to meet the recruitment target for this feasibility study will be calculated,
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Assessment method [8]
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Timepoint [8]
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Post-intervention (5 weeks)
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Secondary outcome [9]
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Qualitative interviews will explore participant’s experiences of the intervention, their understanding of the approach and its techniques, aspects of the intervention that were helpful or unhelpful and any changes they feel would be beneficial.
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Assessment method [9]
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Timepoint [9]
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Following post-intervention questionnaires (6-7 weeks)
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Eligibility
Key inclusion criteria
1) clinical diagnosis of a mild traumatic brain injury (concussion)
2) aged between 18 and 65
3) between 14 days and 6-months post-injury
4) score of >16 on the Rivermead Post-concussion Questionnaire on screening or indictors of prolonged recovery determined by clinician
5) able to provide independent informed consent
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Minimum age
18
Years
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Maximum age
65
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Having an unstable comorbid mental or physical health condition that could affect participation in the trial or influence outcome
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Study design
Purpose of the study
Treatment
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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)
Central randomisation using RedCap database
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Simple randomisation with 1:1 allocation ratio
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people assessing the outcomes
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
This is a feasibility study to determine safety, cultural appropriateness and to explore and trends in efficacy for people post mild TBI and so no formal sample size calculation was conducted.
Quantitative Analyses: Descriptive data on the time in weeks between referral, pre-intervention assessment, commencement of the intervention, consent rate and timeframe of the intervention sessions will be provided. Chi square tests or Fisher’s Exact tests (where relevant) will be used to determine if there are any differences in the proportion of participants completing all intervention sessions between the two groups and consent and attrition rates of eligible Maori and Pasifika participants compared to Europeans. The numbers of participants meeting the eligibility criteria recruited per month will be recorded and total time taken to meet the recruitment target for this feasibility study will be calculated. An effect size for the full trial will be estimated based on group comparisons controlling for baseline scores to refine the power calculation for the main trial and determine the necessary sample size to ensure statistical power of the main trial.
Qualitative Analysis: Following completion of the intervention, a qualitative interview will explore participant’s experiences of the intervention, their understanding of the approach and its techniques, aspects of the intervention that were helpful or unhelpful and any changes they feel would be beneficial. Participants will be asked about the relevance of the intervention and techniques to them and whether they felt the intervention was responsive to their culture. The qualitative analysis will identify whether further modifications to the programmes or study procedures are needed. Qualitative data will be analysed using the qualitative descriptive approach to identify how the intervention helped or hindered participants recovery. The qualitative data will be used to augment the interpretation of the quantitative analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/06/2021
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Actual
2/08/2021
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Date of last participant enrolment
Anticipated
30/09/2022
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Actual
29/12/2023
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Date of last data collection
Anticipated
4/11/2022
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Actual
6/01/2024
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Sample size
Target
24
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Accrual to date
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Final
47
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Recruitment outside Australia
Country [1]
23531
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New Zealand
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State/province [1]
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Wellington
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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Health Research Council of New Zealand
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Address [1]
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Level 3/110 Stanley Street, Grafton, Auckland 1010
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Country [1]
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New Zealand
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Primary sponsor type
University
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Name
Auckland University of Technology
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Address
55 Wellesley Street East, Auckland Central, Auckland 1010
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Country
New Zealand
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Secondary sponsor category [1]
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None
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Name [1]
308839
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Address [1]
308839
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Country [1]
308839
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
308079
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Southern Health and Disability Ethics Committee (NZ)
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Ethics committee address [1]
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Ministry of Health Health and Disability Ethics Committees PO Box 5013. Wellington 6140
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Ethics committee country [1]
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New Zealand
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Date submitted for ethics approval [1]
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26/03/2021
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Approval date [1]
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17/05/2021
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Ethics approval number [1]
308079
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21/STH/117
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Summary
Brief summary
Previously it was believed that most people recover from a mTBI within days to weeks following injury, However we now know that up to 50% of people can experience ongoing symptoms that can impact daily functioning for months or even years after a brain injury. Experiencing ongoing symptoms can be distressing for those affected and approaches to help people manage their symptoms can help to improve recovery. Acceptance and Commitment Therapy (ACT) is one psychological approach that may help to improve recovery, We expect that the ACT intervention will be feasible to deliver within community-based concussion services, but some modifications to its content and how it is delivered may be necessary,
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Trial website
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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 Alice Theadom
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Address
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AR238, AUT North Campus, Private Bag 92006. Auckland 1142 , New Zealand
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Country
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New Zealand
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Phone
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+64 21 2460728
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Fax
109458
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Email
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[email protected]
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Contact person for public queries
Name
109459
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Alice Theadom
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Address
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AR238, AUT North Campus, Private Bag 92006. Auckland 1142 , New Zealand
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Country
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New Zealand
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Phone
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+64 21 2460728
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Fax
109459
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Email
109459
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[email protected]
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Contact person for scientific queries
Name
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Alice Theadom
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Address
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AR238, AUT North Campus, Private Bag 92006. Auckland 1142 , New Zealand
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Country
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New Zealand
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Phone
109460
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+64 21 2460728
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Fax
109460
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Email
109460
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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
Due to ethics concerns around potential identification of participants given the small sample size for this feasibility study, recruitment from a single region and need for specific patient request to make anonymous data available.
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What supporting documents are/will be available?
No Supporting Document Provided
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
10999
Study protocol
[email protected]
11000
Informed consent form
[email protected]
11001
Ethical approval
[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.
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