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Can a digital intervention 'Momentum improve social functioning and transdiagnostic symptoms for Australian youth at ultrahigh risk for psychosis? Protocol for a superiority randomised controlled trial comparing treatment as usual with and without Momentu

Por: Mangelsdorf · S. N. · Cagliarini · D. · Nelson · B. · McEnery · C. · Whiting · J. · Chinnery · G. · Valentine · L. · Lee · Y. Y. · Mihalopoulos · C. · Liu · V. · Bendall · S. · Koval · P. · DAlfonso · S. · Gonzalez-Blanch · C. · Ryan · R. M. · Lederman · R. · H Lim · M. · McGorry · P. · Po
Introduction

Existing psychological and pharmacological interventions for young people at ultra-high risk (UHR) for psychosis have shown benefit in at least delaying the transition to psychosis, but they have limited benefit for comorbid disorders or social dysfunction, which are prominent for those at UHR. We developed a moderated online social therapy platform (named Momentum) including: (1) transdiagnostic therapeutic interventions targeting social functioning, depression, generalised anxiety and social anxiety; (2) a moderated, peer-led online community and (3) specialised human support from clinicians, career consultants and peer workers. The aim of this trial is to determine whether, in addition to treatment as usual (TAU), Momentum, a 12-month digital intervention, informed by the complex intervention framework, is superior to 12 months of TAU in improving social functioning in UHR young people.

Methods and analysis

The study design is a prospective, parallel group, rater-masked randomised controlled trial. We will recruit young people aged 14–27 years, meeting one or more UHR for psychosis criteria. Participants are randomly assigned to the condition using randomly permutated blocks with a 1:1 allocation ratio. Participants are stratified by age (

Ethics and dissemination

Melbourne Health Human Research Ethics Committee (HREC/42964/MH-2018) provided ethics approval for this study. Findings will be made available through scientific journals and forums and to the public via social media and the Orygen website. De-identified individual participant data will be available after publication for 3 years via the Health Data Australia catalogue (https://www.researchdata.edu.au/health). Requests must include a methodologically sound proposal. Specific conditions of use may apply and will be specified in a data sharing agreement (or similar) that the requester must agree to before access is granted. Supplementary material including study protocol, informed consent material and statistical analysis plan will also be available.

Trial registration number

Australian New Zealand Clinical Trial Registry (ANZCTR), ACTRN12619001411134.

Physical activity promotion and health-enhancing physical activity education policy in EU healthcare: a cross-sectional survey of 27 member states

Por: Leese · C. · Whiting · S. · Mendes · R.
Objectives

Analyse data collected through the WHO Regional Office for Europe to describe the proportion of European Union (EU) member states that have relevant policies related to physical activity (PA) counselling and exercise referral schemes in healthcare settings and the education of health professionals in health-enhancing PA (HEPA).

Design

Cross-sectional survey.

Setting and participants

An online survey (LimeSurvey) was sent to nominated government representatives of the 27 EU member states (via the EU PA Focal Point Network) in March 2021. The survey was open for 2 months, with support offered to all national representatives by the WHO Regional Office for Europe throughout. The survey had been developed by a panel of experts and was previously disseminated (and analysed) in 2015 and 2018.

Outcomes measures

National recommendations regarding (1) PA counselling in healthcare settings and (2) the inclusion of HEPA within teaching curricula.

Results

All 27 countries responded. Of the 18 countries that reported national policies to provide PA counselling by healthcare professionals (HCPs), all reported that counselling on PA was provided through primary care, with an additional half also reporting PA counselling provision as part of secondary care. Twenty-one countries reported that HEPA is taught in the curricula of HCPs, but large variations exist regarding which cadres of HCPs have HEPA integrated within their curricula and whether the HEPA teaching is a mandatory or optional component of training.

Conclusions

Despite PA counselling being a key recommendation for promoting PA at the population level, only two-thirds of EU member states have national policies in place. Although three-quarters of EU member states report healthcare education curricula, including HEPA, more research is required to understand the methods and content of delivery and the subsequent effectiveness on knowledge and clinical outcomes.

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