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Lucas-Herald AK, Forbes O, McDonald H, McNeilly J, Bradley T, Wood D, McDevitt H, Houston J, Mason A. Bone biochemistry in children with fractures presenting with non-accidental injury. Child Abuse Negl 2024; 151:106693. [PMID: 38431992 DOI: 10.1016/j.chiabu.2024.106693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 02/01/2024] [Accepted: 02/07/2024] [Indexed: 03/05/2024]
Abstract
BACKGROUND In cases of fractures in children with suspicion of non-accidental injury (NAI), biochemical markers of calcium homeostasis should be performed. OBJECTIVES To describe the pattern of biochemistry in children with fractures NAI is suspected. PARTICIPANTS AND SETTING Children ≤2 years of age who had undergone a skeletal survey as part of a child protection investigation where 1/+ fracture was identified over a ten-year period (2012-2021) at the Royal Hospital for Children, Glasgow. METHODS A retrospective review of case notes was conducted. Established criteria to classify NAI were used to distinguish confirmed NAI from non-NAI. Biochemical markers of calcium homeostasis were classified as normal or abnormal using local reference ranges. Vitamin D deficiency was classified as Vitamin D < 25 nmol/L and insufficiency as 25-50 nmol/L. RESULTS One hundred and twenty-seven children were identified, of whom 107 (84 %) had bone biochemistry performed. Twenty-nine children (24 %) had injuries that were classified as confirmed NAI. In cases where NAI was confirmed either at case conference or by criminal conviction 14/29 (48 %) had one or more abnormal bone biochemical markers. None of the children displayed clinical or radiological evidence of rickets. Alkaline phosphatase (ALP) was higher in children with confirmed NAI (median 296 vs. 261, p = 0.01) but there were no other statistically significant differences in biochemical levels between those with confirmed NAI compared to those without. Those with confirmed NAI were from areas with lower SIMD score (2.0 vs. 3.0 p = 0.01) but no other differences were found between the groups. CONCLUSION No clear predictors of NAI are demonstrated on biochemistry alone in young children with fractures.
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Affiliation(s)
| | - Owen Forbes
- Child Protection Service, Royal Hospital for Children, Glasgow, UK
| | - Heather McDonald
- Department of Paediatric Endocrinology, Royal Hospital for Children, Glasgow, UK
| | - Jane McNeilly
- Department of Biochemistry, Queen Elizabeth University Hospital, Glasgow, UK
| | - Therese Bradley
- Department of Laboratory Genetics, Queen Elizabeth University Hospital, Glasgow, UK
| | - Daniel Wood
- Department of Laboratory Genetics, Queen Elizabeth University Hospital, Glasgow, UK
| | - Helen McDevitt
- Department of Paediatric Endocrinology, Royal Hospital for Children, Glasgow, UK
| | - James Houston
- Child Protection Service, Royal Hospital for Children, Glasgow, UK
| | - Avril Mason
- Department of Paediatric Endocrinology, Royal Hospital for Children, Glasgow, UK.
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Forbes O, Santos-Fernandez E, Wu PPY, Xie HB, Schwenn PE, Lagopoulos J, Mills L, Sacks DD, Hermens DF, Mengersen K. clusterBMA: Bayesian model averaging for clustering. PLoS One 2023; 18:e0288000. [PMID: 37603575 PMCID: PMC10441802 DOI: 10.1371/journal.pone.0288000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 06/16/2023] [Indexed: 08/23/2023] Open
Abstract
Various methods have been developed to combine inference across multiple sets of results for unsupervised clustering, within the ensemble clustering literature. The approach of reporting results from one 'best' model out of several candidate clustering models generally ignores the uncertainty that arises from model selection, and results in inferences that are sensitive to the particular model and parameters chosen. Bayesian model averaging (BMA) is a popular approach for combining results across multiple models that offers some attractive benefits in this setting, including probabilistic interpretation of the combined cluster structure and quantification of model-based uncertainty. In this work we introduce clusterBMA, a method that enables weighted model averaging across results from multiple unsupervised clustering algorithms. We use clustering internal validation criteria to develop an approximation of the posterior model probability, used for weighting the results from each model. From a combined posterior similarity matrix representing a weighted average of the clustering solutions across models, we apply symmetric simplex matrix factorisation to calculate final probabilistic cluster allocations. In addition to outperforming other ensemble clustering methods on simulated data, clusterBMA offers unique features including probabilistic allocation to averaged clusters, combining allocation probabilities from 'hard' and 'soft' clustering algorithms, and measuring model-based uncertainty in averaged cluster allocation. This method is implemented in an accompanying R package of the same name. We use simulated datasets to explore the ability of the proposed technique to identify robust integrated clusters with varying levels of separation between subgroups, and with varying numbers of clusters between models. Benchmarking accuracy against four other ensemble methods previously demonstrated to be highly effective in the literature, clusterBMA matches or exceeds the performance of competing approaches under various conditions of dimensionality and cluster separation. clusterBMA substantially outperformed other ensemble methods for high dimensional simulated data with low cluster separation, with 1.16 to 7.12 times better performance as measured by the Adjusted Rand Index. We also explore the performance of this approach through a case study that aims to identify probabilistic clusters of individuals based on electroencephalography (EEG) data. In applied settings for clustering individuals based on health data, the features of probabilistic allocation and measurement of model-based uncertainty in averaged clusters are useful for clinical relevance and statistical communication.
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Affiliation(s)
- Owen Forbes
- Centre for Data Science, School of Mathematical Sciences, Queensland University of Technology, Brisbane, QLD, Australia
| | - Edgar Santos-Fernandez
- Centre for Data Science, School of Mathematical Sciences, Queensland University of Technology, Brisbane, QLD, Australia
| | - Paul Pao-Yen Wu
- Centre for Data Science, School of Mathematical Sciences, Queensland University of Technology, Brisbane, QLD, Australia
| | - Hong-Bo Xie
- Centre for Data Science, School of Mathematical Sciences, Queensland University of Technology, Brisbane, QLD, Australia
- School of Information Science and Engineering, Yunnan University, Kunming, China
| | - Paul E. Schwenn
- UQ Poche Centre for Indigenous Health, The University of Queensland, Brisbane, QLD, Australia
| | - Jim Lagopoulos
- Thompson Institute, University of the Sunshine Coast, Birtinya, QLD, Australia
| | - Lia Mills
- Thompson Institute, University of the Sunshine Coast, Birtinya, QLD, Australia
| | - Dashiell D. Sacks
- Thompson Institute, University of the Sunshine Coast, Birtinya, QLD, Australia
| | - Daniel F. Hermens
- Thompson Institute, University of the Sunshine Coast, Birtinya, QLD, Australia
| | - Kerrie Mengersen
- Centre for Data Science, School of Mathematical Sciences, Queensland University of Technology, Brisbane, QLD, Australia
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Forbes O, Schwenn PE, Wu PPY, Santos-Fernandez E, Xie HB, Lagopoulos J, McLoughlin LT, Sacks DD, Mengersen K, Hermens DF. EEG-based clusters differentiate psychological distress, sleep quality and cognitive function in adolescents. Biol Psychol 2022; 173:108403. [DOI: 10.1016/j.biopsycho.2022.108403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 06/27/2022] [Accepted: 07/26/2022] [Indexed: 11/25/2022]
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Forbes O, Hosking R, Mokany K, Lal A. Bayesian spatio-temporal modelling to assess the role of extreme weather, land use change and socio-economic trends on cryptosporidiosis in Australia, 2001-2018. Sci Total Environ 2021; 791:148243. [PMID: 34412375 DOI: 10.1016/j.scitotenv.2021.148243] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 05/23/2021] [Accepted: 05/29/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Intensification of land use threatens to increase the emergence and prevalence of zoonotic diseases, with an adverse impact on human wellbeing. Understanding how the interaction between agriculture, natural systems, climate and socioeconomic drivers influence zoonotic disease distribution is crucial to inform policy planning and management to limit the emergence of new infections. OBJECTIVES Here we assess the relative contribution of environmental, climatic and socioeconomic factors influencing reported cryptosporidiosis across Australia from 2001 to 2018. METHODS We apply a Bayesian spatio-temporal analysis using Integrated Nested Laplace Approximation (INLA). RESULTS We find that area-level risk of reported disease are associated with the proportions of the population under 5 and over 65 years of age, socioeconomic disadvantage, annual rainfall anomaly, and the proportion of natural habitat remaining. This combination of multiple factors influencing cryptosporidiosis highlights the benefits of a sophisticated spatio-temporal statistical approach. Two key findings from our model include: an estimated 4.6% increase in the risk of reported cryptosporidiosis associated with 22.8% higher percentage of postal area covered with original habitat; and an estimated 1.8% increase in disease risk associated with a 77.99 mm increase in annual rainfall anomaly at the postal area level. DISCUSSION These results provide novel insights regarding the predictive effects of extreme rainfall and the proportion of remaining natural habitat, which add unique explanatory power to the model alongside the variance associated with other predictive variables and spatiotemporal variation in reported disease. This demonstrates the importance of including perspectives from land and water management experts for policy making and public health responses to manage environmentally mediated diseases, including cryptosporidiosis.
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Affiliation(s)
- Owen Forbes
- Research School of Population Health, Australian National University, Acton, Australia; School of Mathematical Sciences, Queensland University of Technology, Brisbane, Australia; ARC Centre of Excellence for Mathematical and Statistical Frontiers (ACEMS), Brisbane, Australia
| | - Rose Hosking
- Research School of Population Health, Australian National University, Acton, Australia
| | - Karel Mokany
- Macroecological Modelling, CSIRO Land & Water, Black Mountain Laboratories, Canberra, ACT, Australia
| | - Aparna Lal
- Research School of Population Health, Australian National University, Acton, Australia.
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Calear AL, Morse AR, Batterham PJ, Forbes O, Banfield M. Silence is Deadly: A controlled trial of a public health intervention to promote help-seeking in adolescent males. Suicide Life Threat Behav 2021; 51:274-288. [PMID: 33876483 DOI: 10.1111/sltb.12703] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To test the effectiveness of a male-targeted upstream public health intervention in increasing help-seeking intentions for mental disorders and suicide in an adolescent population. METHOD A two-arm controlled trial was conducted with 10 schools in the Australian Capital Territory. A total of 594 male adolescents aged between 16 and 18 years participated in the study. Participants in the intervention condition received the single session Silence is Deadly program, while participants in the control condition completed usual classes. All participants completed a pre-intervention, post-intervention, and a 6- to 12-week follow-up survey assessing help-seeking intentions, attitudes, and behaviors. RESULTS At follow-up, the Silence is Deadly program was found to significantly increase help-seeking intentions from friends, which was in line with the program's messaging to seek help from and provide support to friends in times of distress or suicide risk. The program did not have an effect on help-seeking intentions for other sources of help or on help-seeking attitudes and behavior. CONCLUSIONS The present study provides preliminary support for male-targeted public health interventions for suicide that use male-focused norming and role modeling to improve help-seeking in this population.
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Affiliation(s)
- Alison L Calear
- Centre for Mental Health Research, The Australian National University, Canberra, ACT, Australia
| | - Alyssa R Morse
- Centre for Mental Health Research, The Australian National University, Canberra, ACT, Australia
| | - Philip J Batterham
- Centre for Mental Health Research, The Australian National University, Canberra, ACT, Australia
| | - Owen Forbes
- Centre for Mental Health Research, The Australian National University, Canberra, ACT, Australia
| | - Michelle Banfield
- Centre for Mental Health Research, The Australian National University, Canberra, ACT, Australia
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Morse AR, Forbes O, Jones BA, Gulliver A, Banfield M. Whose story is it? Mental health consumer and carer views on carer participation in research. Health Expect 2019; 24 Suppl 1:3-9. [PMID: 31461561 PMCID: PMC8137495 DOI: 10.1111/hex.12954] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 07/08/2019] [Accepted: 08/01/2019] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Mental health carers contribute a unique set of perspectives and lived experiences to research; however, national research ethics guidelines do not specifically address the issues that affect informal carers as participants. OBJECTIVE This study sought to explore Australian mental health consumer and carer views on the ethical conduct of research involving mental health carers. DESIGN A public forum (n = 14; consumer = 5, carer = 9) and a subsequent series of interviews (n = 10; consumer = 5, carer = 4, both = 1) were conducted to investigate consumer and carer views on mental health research ethics. Data collection and analysis drew strongly on methodological features of grounded theory. RESULTS Conducting research involving carers and consumer-carer relationships raises potential concerns related to story ownership. Lived experience stories have shared and separate elements; thus, it is important to consider potential risks to the privacy of non-participants and of social harm to participants' relationships when conducting research in this space. These risks could be minimized and managed through communication between researchers and participants, and within relationships. CONCLUSIONS When conducting research involving carers and consumer-carer relationships, researchers may need to facilitate the negotiation of information-sharing boundaries within relationships and the safe and confidential telling of shared stories.
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Affiliation(s)
- Alyssa R Morse
- ACACIA: The ACT Consumer and Carer Mental Health Research Unit, Centre for Mental Health Research, Research School of Population Health, The Australian National University, Canberra, Australian Capital Territory, Australia
| | - Owen Forbes
- ACACIA: The ACT Consumer and Carer Mental Health Research Unit, Centre for Mental Health Research, Research School of Population Health, The Australian National University, Canberra, Australian Capital Territory, Australia
| | - Bethany A Jones
- ACACIA: The ACT Consumer and Carer Mental Health Research Unit, Centre for Mental Health Research, Research School of Population Health, The Australian National University, Canberra, Australian Capital Territory, Australia
| | - Amelia Gulliver
- ACACIA: The ACT Consumer and Carer Mental Health Research Unit, Centre for Mental Health Research, Research School of Population Health, The Australian National University, Canberra, Australian Capital Territory, Australia
| | - Michelle Banfield
- ACACIA: The ACT Consumer and Carer Mental Health Research Unit, Centre for Mental Health Research, Research School of Population Health, The Australian National University, Canberra, Australian Capital Territory, Australia
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Morse AR, Forbes O, Jones BA, Gulliver A, Banfield M. Australian Mental Health Consumer and Carer Perspectives on Ethics in Adult Mental Health Research. J Empir Res Hum Res Ethics 2019; 14:234-242. [PMID: 31018753 DOI: 10.1177/1556264619844396] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Barriers to research arise when national ethical guidelines governing the inclusion of consumers in mental health research are implemented at the local level. Equivalent guidelines for research involving carers are not available. A social science investigation of Australian mental health consumer and carer perspectives on research ethics procedures was conducted in two interlinked stages: (a) a discussion forum with consumers, carers, and lived-experience researchers and (b) in-depth interviews with consumers and carers. Data collection and analysis drew strongly on methodological features of grounded theory. Privacy, confidentiality, and stigmatizing ethics procedures were key issues for consumer and carer participants. Recommendations for research practice include the following: considering the impact of information sharing on participants' relationships and adopting individual-focused approaches to managing research risks.
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Affiliation(s)
- Alyssa R Morse
- 1 The Australian National University, Acton, Australian Capital Territory, Australia
| | - Owen Forbes
- 1 The Australian National University, Acton, Australian Capital Territory, Australia
| | - Bethany A Jones
- 1 The Australian National University, Acton, Australian Capital Territory, Australia
| | - Amelia Gulliver
- 1 The Australian National University, Acton, Australian Capital Territory, Australia
| | - Michelle Banfield
- 1 The Australian National University, Acton, Australian Capital Territory, Australia
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Ray S, Forbes O. Quick-Wee is an effective technique for urine collection in infants. Arch Dis Child Educ Pract Ed 2018; 103:280-281. [PMID: 28993431 DOI: 10.1136/archdischild-2017-313619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Satyajit Ray
- Department of paediatrics, Royal Hospital for Children, Glasgow, UK
| | - Owen Forbes
- Department of paediatrics, Royal Hospital for Children, Glasgow, UK
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Banfield M, Randall R, O'Brien M, Hope S, Gulliver A, Forbes O, Morse AR, Griffiths K. Lived experience researchers partnering with consumers and carers to improve mental health research: Reflections from an Australian initiative. Int J Ment Health Nurs 2018; 27:1219-1229. [PMID: 29847015 DOI: 10.1111/inm.12482] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/29/2018] [Indexed: 11/28/2022]
Abstract
UNLABELLED Consumer and carer involvement in mental health research is a growing and developing field. Whilst there has been policy and in-principle support for such involvement from governments around the world, lived experience researchers conducting academic research in partnership with other consumers and carers remains uncommon. ACACIA The Australian Capital Territory Consumer and Carer Mental Health Research Unit is based at The Australian National University and employs academic researchers with lived experience to undertake research directly relevant to the needs of mental health consumers and carers with the aim of influencing policy and practice. In this study, we share our experience of developing and conducting research within ACACIA to provide a model for meaningfully engaging mental health consumers and carers throughout the research process.
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Affiliation(s)
- Michelle Banfield
- ACACIA: The ACT Consumer and Carer Mental Health Research Unit, Centre for Mental Health Research, The Australian National University, Acton, Australian Capital Territory, Australia
| | - Rebecca Randall
- ACACIA: The ACT Consumer and Carer Mental Health Research Unit, Centre for Mental Health Research, The Australian National University, Acton, Australian Capital Territory, Australia
| | - Mearon O'Brien
- ACACIA: The ACT Consumer and Carer Mental Health Research Unit, Centre for Mental Health Research, The Australian National University, Acton, Australian Capital Territory, Australia
| | - Sophie Hope
- ACACIA: The ACT Consumer and Carer Mental Health Research Unit, Centre for Mental Health Research, The Australian National University, Acton, Australian Capital Territory, Australia
| | - Amelia Gulliver
- ACACIA: The ACT Consumer and Carer Mental Health Research Unit, Centre for Mental Health Research, The Australian National University, Acton, Australian Capital Territory, Australia
| | - Owen Forbes
- ACACIA: The ACT Consumer and Carer Mental Health Research Unit, Centre for Mental Health Research, The Australian National University, Acton, Australian Capital Territory, Australia
| | - Alyssa R Morse
- ACACIA: The ACT Consumer and Carer Mental Health Research Unit, Centre for Mental Health Research, The Australian National University, Acton, Australian Capital Territory, Australia
| | - Kathleen Griffiths
- ACACIA: The ACT Consumer and Carer Mental Health Research Unit, Centre for Mental Health Research, The Australian National University, Acton, Australian Capital Territory, Australia.,Research School of Psychology, The Australian National University, Acton, Australian Capital Territory, Australia
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Banfield M, Forbes O. Health and social care coordination for severe and persistent mental illness in Australia: a mixed methods evaluation of experiences with the Partners in Recovery Program. Int J Ment Health Syst 2018; 12:13. [PMID: 29636791 PMCID: PMC5883333 DOI: 10.1186/s13033-018-0194-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Accepted: 03/27/2018] [Indexed: 11/20/2022] Open
Abstract
Background Care coordination has been identified as a person-centred response to the difficulty in meeting the needs of people with severe and persistent mental illness and complex needs. This study evaluated the processes and outcomes of the Partners in Recovery initiative in the Australian Capital Territory, a program established to improve coordination of health and social care for this population. Methods Client, carer and service provider experiences were investigated using a combination of quantitative and qualitative methods. Quantitative data were collected through questionnaires completed by clients (n = 25) and service providers (n = 14). Qualitative data comprised open-ended written feedback from the surveys, together with semi-structured interviews with selected clients (n = 6), carers (n = 2), and service providers (n = 4). In both study elements, questions focused on dimensions of experience such as communication, continuity and coordination, teamwork and sustainability. Descriptive statistics were calculated for quantitative data; qualitative data were analysed using content analysis. Results Clients were satisfied with the program across the majority of experience dimensions, and there was evidence of improved access to coordinated care. Support Facilitators (care coordinators) were central to client and carer reports of the impacts of the program, and to coordination between services through connections built at the individual level. Challenges included difficulties with information continuity, a lack of role clarity for service providers, and uncertainty about the legacy of the program given the absence of formal agreements connecting different services. Conclusions The Support Facilitator role was critical to the success of the program. Support Facilitators acted as a source of stability and relational continuity for clients, while also enabling connections with external services through the development of individual level partnerships and personal networks. Systems level coordination was limited by communication difficulties and a lack of formalised infrastructure to support cooperation between services, calling into question the lasting impact of the program for system change. Electronic supplementary material The online version of this article (10.1186/s13033-018-0194-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Michelle Banfield
- Centre for Mental Health Research, Research School of Population Health, The Australian National University, Canberra, Australia
| | - Owen Forbes
- Centre for Mental Health Research, Research School of Population Health, The Australian National University, Canberra, Australia
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Calear AL, Banfield M, Batterham PJ, Morse AR, Forbes O, Carron-Arthur B, Fisk M. Silence is deadly: a cluster-randomised controlled trial of a mental health help-seeking intervention for young men. BMC Public Health 2017; 17:834. [PMID: 29061168 PMCID: PMC5653993 DOI: 10.1186/s12889-017-4845-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Accepted: 10/12/2017] [Indexed: 12/05/2022] Open
Abstract
Background Young men are consistently less likely to seek help for mental health problems than their female peers. This is particularly concerning given the high rates of suicide among male adolescents. The school system has been identified as an ideal setting for the implementation of prevention and early intervention programs for young people. The current trial aims to determine the effectiveness of the Silence is Deadly program in increasing positive help-seeking intentions for mental health problems and suicide among male secondary school students. Methods This study is a two-arm, cluster-randomised, controlled trial that will compare the Silence is Deadly program to a wait-list control condition. Eight Australian high schools will be recruited to the trial, with male students in grades 11 and 12 (16 to 18 years of age) targeted for participation. The program is an innovative male-tailored suicide prevention intervention, comprising a presentation that emphasises role-modelling and legitimises help-seeking for personal and emotional problems, and a brief video that features celebrity athletes who counter existing male norms around help-seeking and encourage communication about personal and emotional issues. The program also includes a discussion of how to help a friend in distress and ends with a question and answer session. The primary outcome measure for the current study is help-seeking intentions. Secondary outcomes include help-seeking behaviour, help-seeking attitudes, help-seeking stigma, mental health symptoms, and suicidal ideation. Data will be collected pre-intervention, post-intervention, and at 3-month follow-up. Primary analyses will compare changes in help-seeking intentions for the intervention condition relative to the wait-list control condition using mixed-effects repeated-measures analyses that account for clustering within schools. Discussion If proven to be effective, this targeted help-seeking intervention for adolescent males, which is currently only delivered in one jurisdiction, could be more widely delivered in Australian high schools. The Silence is Deadly program has the potential to significantly contribute to the mental health of young men in Australia by improving help-seeking for suicidality and mental health problems, allowing this population to better access treatment and support sooner. Trial registration Australian New Zealand Clinical Trials Registry, ACTRN12617000658314. Registered on 8 May 2017. Electronic supplementary material The online version of this article (10.1186/s12889-017-4845-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Alison L Calear
- Centre for Mental Health Research, Research School of Population Health, The Australian National University, 63 Eggleston Road, Acton, ACT, 2601, Australia.
| | - Michelle Banfield
- Centre for Mental Health Research, Research School of Population Health, The Australian National University, 63 Eggleston Road, Acton, ACT, 2601, Australia
| | - Philip J Batterham
- Centre for Mental Health Research, Research School of Population Health, The Australian National University, 63 Eggleston Road, Acton, ACT, 2601, Australia
| | - Alyssa R Morse
- Centre for Mental Health Research, Research School of Population Health, The Australian National University, 63 Eggleston Road, Acton, ACT, 2601, Australia
| | - Owen Forbes
- Centre for Mental Health Research, Research School of Population Health, The Australian National University, 63 Eggleston Road, Acton, ACT, 2601, Australia
| | - Bradley Carron-Arthur
- Centre for Mental Health Research, Research School of Population Health, The Australian National University, 63 Eggleston Road, Acton, ACT, 2601, Australia
| | - Martin Fisk
- Menslink, 27/27 Mulley Street, Holder, ACT, 2611, Australia
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