The Climate Schools Combined (CSC) study: Internet-based prevention for anxiety, depression and substance use in young Australians

image - Climate Schools Combined 280
Date Commenced:
08/2013
Expected Date of Completion:
12/2016
Project Supporters:

National Health & Medical Research Council - Project Grant ID: APP1047291

Drug Type:
Project Members: 
image - Maree Teesson Square
Professor
Ph EA Jasmin Bartlett: 02 9385 0167 / j.bartlett@unsw.edu.au
image - 1314158714 Tim Slade 007
Associate Professor
Ph 9385 0267
image - 1314679218 Catherine Chapman 05 0
Senior Research Fellow
Ph 02 9385 0317
image - Louise Birrell
Postdoctoral Fellow
Ph 02 9385 0333
image - Ndarc 131
Research Assistant
Ph 02 8936 1172
image - Louise Mewton
Senior Lecturer
Ph 02 89361131
Project Main 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 Collaborators: External: 

Professor Gavin Andrews
Clinical Research Unit for Anxiety and Depression, UNSW

Professor Steve Allsop
National Drug Research Institute, Curtin University

Dr Nyanda McBride
National Drug Research Institute, Curtin University

Dr Leanne Hides
Centre for Youth Substance Abuse Research, Queensland University of Technology

Aims: 

To evaluate an internet-based, ‘universal’ prevention model for anxiety, depression and substance misuse in adolescents.

Design and Method: 

We seek to demonstrate the effectiveness of the intervention by running a cluster RCT in 84 schools across Australia (NSW, QLD and WA). Schools will be randomly allocated to one of four groups; (1) the ‘Control’ condition (CO), (2) the ‘CLIMATE Schools Mental Health course’ condition (CS MH), (3) the ‘CLIMATE Schools Substance Use course’ condition (CS SU), or (4) the ‘CLIMATE Schools Combined’ (CS C) condition. All students will be assessed via self-report questionnaires which will measure drug knowledge, drug use, related harms, intentions to use drugs and mental health related symptoms. The questionnaires will be administered at baseline, as well as six additional time points over the 3 year trial.

Progress/Update: 

In Term 1 2015, participating students completed follow-up survey 3 and those schools assigned to the CSC and CS MH conditions also completed the 6-lesson Climate Schools Mental Health course. All students then completed follow-up survey 4 immediately post completion of the mental health course. In Term 3 2015, students completed a further follow-up survey. Response rates for all follow-up surveys were approximately 80%. Students will complete two further follow-up surveys in 2016.

In 2014 Brad Shaw joined the CSC team as a Research Assistant to assist Louise Birrell in running the NSW arm of the trial. Our WA and QLD arms are coordinated from NDRI and QUT.

In Term 1 2014, approximately 7000 students from 71 schools across NSW, WA and QLD completed the baseline assessments. Students from the CS SU and CSC groups received the Climate Schools Substance use course over the school year and students from the Control and CS MH groups received their usual health classes. Approximately 85% of students have completed post-intervention surveys in Term 4, 2014. Students will complete the third survey in Term 1, 2015.

Participating students completed two follow-up surveys in 2016. Response rates for these surveys were approximately 70%. Data collection will be completed in December 2016 and results will be analysed in 2017.

Output: 

Publications:

Mewton, L.,  Kessler, R., Slade, T.,  Hobbs, M., Brownhill, L., Birrell, L., Tonks, Z., Teesson, M.,  Newton, N.,  Chapman, C., Allsop, S., Hides, L., McBride, N.  Andrews, G. The psychometric properties of the Kessler Psychological Distress Scale (K6) in a general population sample of adolescents. Psychological Assessment (in press).

Teesson, M., Newton, N., Slade, T., Chapman, C.,Allsop, S., Hides, L., McBride, N., Mewton, L., Tonks, Z., Birrell, L., Brownhill, L., & Andrews, G. (2014). The CLIMATE Schools Combined study: A cluster randomised controlled trial of a universal Internet-based prevention program for youth substance misuse, depression and anxietyBMC Psychiatry, 14:32.  DOI:10.1186/1471-244X-14-32

Teesson, M.,Newton, N. C, Tonks, Z., & Birrell, L. (2013). Duty of Care Procedure for the Climate Schools Combined study, Australia. Sydney: National Drug and Alcohol Research Centre, UNSW.

Teesson, M., Newton, N. C, Tonks, Z., & Birrell, L. (2013). Recruitment Procedure for the Climate Schools Combined study, Australia. Sydney: National Drug and Alcohol Research Centre, UNSW.

Conference presentations:

Shaw, B., Newton, N., Slade, T., Chapman, C.,  Andrews, G., Birrell, L., Tonks, Z., Allsop, S., McBride, N., Hides, L., Mewton, L., Te Pas, N., Poccuca, N., Firmin-Sarra, S., & Teesson, M. (2015). Online substance use interventions. Presented at The National Centre of Research Excellence in Mental Health and Substance Use Conference, Canberra, August 2015.

Te Pas, N., Teesson, M., Newton, N., Slade, T., Chapman, C.,Allsop, S., Hides, L., McBride, N., Mewton, L., Shaw, B., Birrell, L., & Andrews, G. (2015). Online substance use interventions. Presented at The Winter Schools Conference, Brisbane, July 2015.

Slade, T., Chapman, C., Turner, B.,Shaw, B., Newton, N., L., Birrell, Tonks, Z., Mewton, L., &  Teesson, M. (2015). Social networks and the spread of alcohol use attitudes and behaviors in Australian adolescents. Presented at The XXXV Sunbelt Conference of the International Network for Social Network Analysis, Brighton, UK, June, 2015.

Te Pas, Nina, Teesson, M., Newton, N., Slade, T., Chapman, C.,Allsop, S., Hides, L., McBride, N., Mewton, L., Tonks, Z., Birrell, L., & Andrews, G. (2014). An internet-based prevention program for anxiety, depression and substance use to improve the health of young Australians. Presented at The National CREMS Conference during The Mental Health Services Conference, Perth, August 2014.

Tonks, Z., Newton, N.C, Andrews, G., Slade, T., Chapman, C., Birrell, L., & Teesson, M. (2013). The Climate Schools Combined (CSC) Study: Internet-based prevention for anxiety, depression and substance use in young Australians.Poster presented at the National Drug and Alcohol Research Centre Annual Symposium, Sydney, Australia, September 2013.

Birrell, L., Newton, N.C, Andrews, G., Slade, T., Chapman, C., Tonks, Z., & Teesson, M. (2013). Examining the trajectory of anxiety, depression and alcohol use in early adolescence. Poster presented at the National Drug and Alcohol Research Centre Annual Symposium, Sydney, Australia, September 2013.

Birrell, L., Newton, N.C, Andrews, G., Slade, T., Chapman, C., Tonks, Z., & Teesson, M. (2013). Mapping the trajectory of anxiety, depression and alcohol use in early adolescence. Poster presentation, The Mental Health Services Conference, Melbourne, August 2013.

Tonks, Z.,Newton, N.C, Andrews, G., Slade, T., Chapman, C., Birrell, L., & Teesson, M. (2013). The Climate Schools Combined (CSC) Study: Internet-based prevention for anxiety, depression and substance use in young Australians. Poster presentation, The Mental Health Services Conference, Melbourne, August 2013.

Poster:

Z. Tonks, M. Teesson, N. Newton, G. Andrews, T. Slade,  C. Chapman & L. Birrell (2013). The Climate Schools Combined (CSC) Study: Internet-based prevention for anxiety, depression and substance use in young Australians. NDARC Annual Symposium, Sydney, September 4. (See 'Resources' below). 
Benefits: 

It is hypothesised that the CSC intervention would reduce alcohol and other drug use, and reduce risk factors for anxiety and depression at significantly higher levels than existing strategies or the programs would if delivered alone. If so, it will be a most significant contribution to promoting and maintaining the good health of the community in Australia and reducing the burden of disease, social costs, and disability associated with substance abuse.

Drug Type: 
Project Status: 
Current