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Published in: Trials 1/2016

Open Access 01-12-2016 | Study protocol

The Sources of Strength Australia Project: study protocol for a cluster randomised controlled trial

Authors: Alison L. Calear, Jacqueline L. Brewer, Philip J. Batterham, Andrew Mackinnon, Peter A. Wyman, Mark LoMurray, Fiona Shand, Dominique Kazan, Helen Christensen

Published in: Trials | Issue 1/2016

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Abstract

Background

The school system has been identified as an ideal setting for the implementation of prevention and early intervention programs for suicide. However, in Australia, suicide-prevention programs that are routinely delivered in the schools are lacking. Internationally, evidence exists for the effectiveness of peer-led interventions that take a social connectedness approach to improve help-seeking for suicide. The aim of the current trial is to test the effectiveness of the Sources of Strength program to promote help-seeking for suicide in adolescents in Australian high schools.

Methods/design

This study is a two-arm, cluster-randomised, controlled trial that will compare the evidence-based Sources of Strength program to a wait-list control condition. Sixteen Australian high schools will be recruited to the trial, with all adolescents in years 7 to 10 (12–16 years of age) invited to participate. Peer leaders from intervention-condition schools will receive training in the Sources of Strength program and will integrate positive messages, across 3 months, with the support of adult advisors. Activities may take the form of class presentations, posters, videos, and messages on social media sites and will aim to change help-seeking norms, strengthen youth-adult connections, and promote positive coping. The primary outcome measure for the study is help-seeking intentions, whereas secondary outcomes include help-seeking behaviour, help-seeking attitudes and norms, referral of distressed peers, availability of adult help, positive coping, and suicidal behaviour. Data will be collected pre-intervention, post-intervention (after the initial 3 months of messaging), and at the end of the first (6-month follow-up) and the second year after implementation (18-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-effect repeated-measures analyses to account for clustering within schools.

Discussion

If proven effective, this universal social connectedness program for suicide could be more widely delivered in Australian high schools, providing a valuable new resource. The Sources of Strength program has the potential to significantly contribute to the mental health of young people in Australia by improving help-seeking for suicide. The findings from this research will also contribute to the evidence-base for peer-leadership programs internationally.

Trial registration

Australian New Zealand Clinical Trials Registry, ACTRN12616000048​482. Registered on 19 January 2016.
Appendix
Available only for authorised users
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Metadata
Title
The Sources of Strength Australia Project: study protocol for a cluster randomised controlled trial
Authors
Alison L. Calear
Jacqueline L. Brewer
Philip J. Batterham
Andrew Mackinnon
Peter A. Wyman
Mark LoMurray
Fiona Shand
Dominique Kazan
Helen Christensen
Publication date
01-12-2016
Publisher
BioMed Central
Published in
Trials / Issue 1/2016
Electronic ISSN: 1745-6215
DOI
https://doi.org/10.1186/s13063-016-1475-1

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