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Trial registered on ANZCTR
Registration number
ACTRN12618000466246
Ethics application status
Approved
Date submitted
23/03/2018
Date registered
29/03/2018
Date last updated
30/11/2023
Date data sharing statement initially provided
27/05/2022
Type of registration
Prospectively registered
Titles & IDs
Public title
Living with dementia and driving: A telehealth delivered Intervention to improve driving cessation outcomes for people with dementia and their families
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Scientific title
An innovative telehealth approach to supporting older adults with dementia with driving cessation and mobility: Cluster randomised controlled trial
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Secondary ID [1]
294285
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Nil known
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Universal Trial Number (UTN)
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Trial acronym
CarFreeMe-Dementia (Telehealth Cluster RCT)
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Linked study record
This study is a telehealth delivered version of the the CarFreeMe intervention for people with dementia, it is linked to ACTRN12618000388213 face-to-face trial.
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Health condition
Health condition(s) or problem(s) studied:
dementia
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community mobility / lifespace
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social isolation
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wellbeing
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Condition category
Condition code
Neurological
306071
306071
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0
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Dementias
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
The CarFreeMe for people with dementia is a comprehensive support and education based intervention to improve driving cessation outcomes for people with dementia and their family members. The intervention - delivered via telehealth technology - includes seven modules that cover education and practical support, delivered by health professionals who are trained in, for example, occupational therapy, psychology, or nursing. A telehealth-based health professionals, trained in delivery of CarFreeMe, will deliver the intervention to people with dementia and their families in their homes and/or community settings via telehealth technology, with some local health professional support (e.g. to set up and trouble shoot in home). The intervention is individualised according to geographic location and the particular needs and preferences of participants and is intended to be flexible. The individualised program involves a combination of one-to-one sessions, groups, and practical outings and activities with a local experienced health professional, as well as home-based independent written and verbal activities. Delivery will involve 7 x 1 hour sessions, once per week for 7 weeks. The intervention is delivered instead of treatment as usual.
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Intervention code [1]
300582
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Treatment: Other
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Intervention code [2]
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Lifestyle
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Comparator / control treatment
Control condition is treatment as usual, ie. printed information such as pamphlets outlining tips for giving up driving.
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Control group
Active
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Outcomes
Primary outcome [1]
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Lifespace / Community mobility collected via a study provided Smartphone using passive collection of GPS data. GPS data will be collected for a seven day period at each of four timepoints. In addition lifespace is measured with the Lifespace Questionnaire (Stalvey, Owsley, Sloane, & Ball, K. 1999) at each of four timepoints.
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Assessment method [1]
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Timepoint [1]
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T1 = Baseline, prior to commencement
T2 = First follow-up, at week 8 [primary timepoint]
T3 = Second Follow-up, at 3 months post intervention completion [primary timepoint]
T4 = Third Follow-up, at 6 months [primary timepoint]
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Secondary outcome [1]
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Depression, measured by the Geriatric Depression Scale (Yesavage, J., Brink T., & Rose, 2000).
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Assessment method [1]
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Timepoint [1]
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T1 = Baseline, prior to commencement
T2 = First follow-up, at week 8
T3 = Second Follow-up, at 3 months post intervention completion
T4 = Third Follow-up, at 6 months
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Secondary outcome [2]
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Anxiety, measured by the Geriatric Anxiety Index (Pachana, N., Byrne, G., Siddle, H., Koloski, N., Harley, E., & Arnold, E. 2007).
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Assessment method [2]
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Timepoint [2]
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T1 = Baseline, prior to commencement
T2 = First follow-up, at week 8
T3 = Second Follow-up, at 3 months post intervention completion
T4 = Third Follow-up, at 6 months
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Secondary outcome [3]
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Individual Goal setting will be conducted with participants, using the Canadian Occupational Performance Measure (Law et al., 1998)
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Assessment method [3]
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Timepoint [3]
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T1 = Baseline, prior to commencement
T2 = First follow-up, at week 8
T3 = Second Follow-up, at 3 months post intervention completion
T4 = Third Follow-up, at 6 months
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Secondary outcome [4]
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Wellbeing measured by the Personal Wellbeing Index (Cummins, Eckersley, Pallant, Van Vugt, & Misajon. 2003).
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Assessment method [4]
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Timepoint [4]
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T1 = Baseline, prior to commencement
T2 = First follow-up, at week 8
T3 = Second Follow-up, at 3 months post intervention completion
T4 = Third Follow-up, at 6 months
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Secondary outcome [5]
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Self-efficacy measured by the Caregiver Transport and Lifestyle Self Efficacy item (Liddle, J., Sidhu, R., Gustafsson, L., & Pachana, N. 2015)
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Assessment method [5]
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Timepoint [5]
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T1 = Baseline, prior to commencement
T2 = First follow-up, at week 8
T3 = Second Follow-up, at 3 months post intervention completion
T4 = Third Follow-up, at 6 months
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Secondary outcome [6]
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Caregiver strain measured by the Caregiver Burden Index.
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Assessment method [6]
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Timepoint [6]
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T1 = Baseline, prior to commencement
T2 = First follow-up, at week 8
T3 = Second Follow-up, at 3 months post intervention completion
T4 = Third Follow-up, at 6 months
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Secondary outcome [7]
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Readiness for Mobility Transition measured by Assessment of Readiness for Mobility Transition (ARMT):A Tool for Mobility Transition Counseling (MTC)
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Assessment method [7]
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Timepoint [7]
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T1 = Baseline, prior to commencement
T2 = First follow-up, at week 8
T3 = Second Follow-up, at 3 months post intervention completion
T4 = Third Follow-up, at 6 months
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Secondary outcome [8]
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The composite outcome measure: 'number of episodes away from home during the past week' will be counted and the relative 'mode of transport' used (for each of these episodes) will be collected at each of four time points, through semi-structured interview with participants.
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Assessment method [8]
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Timepoint [8]
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T1 = Baseline, prior to commencement
T2 = First follow-up, at week 8
T3 = Second Follow-up, at 3 months post intervention completion
T4 = Third Follow-up, at 6 months
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Eligibility
Key inclusion criteria
(1) the person with dementia will be eligible to participate if he/she has mild to moderate dementia (Mini-Mental State Examination score 12-26 (inclusive), or clinical diagnosis), is living in the community, has ceased driving or plans to cease driving in the next six months and driving cessation is an issue for him/her, and is able to provide informed consent for participation (or have a guardian able to do so) and has a family member/carer able to participate in the trial; (2) family members will be eligible to participate if they identify as the main person providing ongoing informal care of the person with dementia
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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
Persons with dementia may be excluded from participation if they have never obtained a drivers' license or have ceased driving some years ago (2 or more years), have a major physical illness or sensory impairment (or reason other than dementia) that resulted in their stopping driving; or insufficient command of English to be able to respond to study questionnaires.
Family members or support persons may be excluded if they are younger than 18 years of age, or they do not have informal care of the person with dementia.
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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)
opaque sealed envelopes
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Clusters will be randomly assigned to either intervention or control. Clusters will be matched based on similar available health and transport infrastructure in the local area. Clusters will be randomly assigned using a simple lottery method - blinded researcher draws names (on folded pieces of paper) from an opaque envelope - to either the intervention or control conditions. Participants (dyads) will therefore be assigned to either intervention or control based on their locality (cluster).
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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 assessing the outcomes
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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
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Statistical methods / analysis
Primary and secondary outcomes will be compared and analysed at the individual and aggregated cluster levels using repeated measures and generalized estimating equations to adjust for clustering effects within geographical location.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
2/04/2018
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Actual
3/04/2018
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Date of last participant enrolment
Anticipated
31/12/2022
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Actual
28/02/2023
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Date of last data collection
Anticipated
28/02/2023
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Actual
31/07/2023
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Sample size
Target
144
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Accrual to date
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Final
168
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Recruitment in Australia
Recruitment state(s)
ACT,NSW,QLD,SA,WA,VIC
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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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National Health & Medicial Research Council (NHMRC)
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Address [1]
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Level 1, 16 Marcus Clarke Street, Canberra ACT 2601
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Country [1]
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Australia
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Primary sponsor type
Individual
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Name
Dr Theresa Scott
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Address
School of Psychology McElwain Building
The University of Queensland Sir Fred Schonell Drive
St Lucia, Qld 4072
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
298306
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Address [1]
298306
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Country [1]
298306
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
299864
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The University of Queensland Institutional Human Research Ethics Approval
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Ethics committee address [1]
299864
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The University of Queensland Sir Fred Schonell Drive St Lucia Qld 4072
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
299864
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17/11/2017
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Approval date [1]
299864
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15/02/2018
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Ethics approval number [1]
299864
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2018000040
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Summary
Brief summary
This project investigates the effectiveness of a telehealth delivered, evidence-based driving cessation intervention for people with dementia and their family members who are retiring from driving, through a cluster randomised controlled trial. Stopping driving impacts health and quality of life for people with dementia and their care partners, and poses considerable challenges to health professionals who monitor driving issues. Without intensive practical and emotional support to plan for, and eventually, cease driving, people with dementia are at high risk for depression, anxiety, grief, social isolation, unsafe and unlicensed driving and injury. Telehealth or telemedicine – the transmission of clinical health care using telecommunication and information technologies – has been successfully used across a variety of practice contexts in rural and remote settings. It has been shown to improve access to health care for people living in geographically isolated areas - highly relevant for Australia’s dispersed population. Additionally, for the growing numbers of older people living with dementia and their carers who wish to remain in their own homes for as long as possible, telehealth provides important health services which might otherwise be difficult to access in-home and cost-saving advantages over traditional face-to-face delivery. Videoconferencing eliminates the need to travel for treatment, which is important in the context of driving cessation. The CarFreeMe program is a comprehensive support- and education-based intervention targeted at people with dementia and their care partners and family members to manage the transition from driving to non-driving status. CarFreeMe for people with dementia is a translation of a proven driving cessation intervention for people without cognitive decline (formerly UQDrive) and is based on what people who have experienced driving cessation said that they needed to adjust, and stay active and engaged. The intervention is unique in that it is focused on both the practical and emotional issues that are experienced as a result of driving cessation. The intervention includes seven modules that cover education and practical support, delivered by an experienced health professional who is trained in CarFreeMe delivery. In the telehealth format, health professionals (e.g. occupational therapists, psychologists) will be trained to deliver aspects of the intervention directly via a secure telehealth videoconferencing app at the client end, and delivering the program via the telerehabilitation clinic at The University of Queensland (UQ) in Brisbane. The telehealth intervention is designed to be flexible. The individualised program could involve a combination of one-to-one sessions and virtual groups, practical outings and activities with the support of a local experienced health professional, as well as home-based independent written and verbal activities in a provided work book.
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Trial website
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Trial related presentations / publications
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Public notes
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Attachments [1]
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/AnzctrAttachments/374687-Telehealth trial_CFM_2018000040 - Approval Form HRECA.pdf
(Ethics approval)
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Contacts
Principal investigator
Name
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Dr Theresa Scott
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Address
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School of Psychology
The University of Queensland Sir Fred Schonell Drive
St Lucia Qld 4072
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Country
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Australia
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Phone
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+61 7 3443 2546
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Theresa Scott
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Address
81807
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School of Psychology
The University of Queensland Sir Fred Schonell Drive
St Lucia Qld 4072
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Country
81807
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Australia
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Phone
81807
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+61 7 3443 2546
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Fax
81807
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Email
81807
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[email protected]
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Contact person for scientific queries
Name
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Theresa Scott
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Address
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School of Psychology
The University of Queensland Sir Fred Schonell Drive
St Lucia Qld 4072
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Country
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Australia
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Phone
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+61 7 3443 2546
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Fax
81808
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Email
81808
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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 the necessary permissions in place from participants
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What supporting documents are/will be available?
No Supporting Document Provided
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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