Optimising a digital intervention to support parents experiencing socio-economic disadvantage to improve adolescent health behaviours: Protocol for the Health4Life Parents & Teens factorial trial

Katrina E Champion¹, Lily Davidson², Emily Hunter³, Louise Thornton⁴, Bonnie Spring⁵, Bridie Osman⁶, Matthew Sunderland⁷, Cath Chapman⁸, Tracy Burrows⁹, Tim Slade¹⁰, Stephanie R Partridge¹¹, Lauren Gardner¹², Belinda Parmenter¹³, Louise A Baur¹⁴, Maree Teesson¹⁵, Cathrine Mihalopoulos¹⁶, Alex Haidinger¹⁷, Tara Finn¹⁸, Lyra Egan¹⁹, George Johnson²⁰, Emily Stockings²¹, Susan Woolfenden²², Nicola C Newton²³, David R Lubans²⁴

Affiliations

¹ The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia; Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia. Electronic address: katrina.champion@sydney.edu.au.
² The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia. Electronic address: lily.davidson@sydney.edu.au.
³ The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia. Electronic address: e.hunter@sydney.edu.au.
⁴ The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia; School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia. Electronic address: louise.thornton@sydney.edu.au.
⁵ Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Department of Behavioral Science and Social Medicine, Florida State University College of Medicine, Tallahassee, FL, USA. Electronic address: bonnie.spring@fsu.edu.
⁶ The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia. Electronic address: bridie.osman@sydney.edu.au.
⁷ The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia. Electronic address: matthew.sunderland@sydney.edu.au.
⁸ The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia. Electronic address: cath.chapman@sydney.edu.au.
⁹ Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia; School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia. Electronic address: tracy.burrows@newcastle.edu.au.
¹⁰ The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia. Electronic address: tim.slade@sydney.edu.au.
¹¹ Susan Wakil School of Nursing and Midwifery, The University of Sydney, Sydney, NSW, Australia; Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia. Electronic address: stephanie.partridge@sydney.edu.au.
¹² The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia. Electronic address: lauren.gardner@sydney.edu.au.
¹³ School of Health Sciences, University of New South Wales, Sydney, NSW, Australia; School of Health, University of the Sunshine Coast, QLD, Australia. Electronic address: bparmenter@usc.edu.au.
¹⁴ Children's Hospital Westmead Clinical School, The University of Sydney, Westmead, New South Wales, Australia. Electronic address: louise.baur@sydney.edu.au.
¹⁵ The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia. Electronic address: maree.teesson@sydney.edu.au.
¹⁶ School of Public Health and Preventative Medicine, Monash University, Australia. Electronic address: cathy.mihalopoulos@monash.edu.
¹⁷ The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia. Electronic address: alexander.haidinger@sydney.edu.au.
¹⁸ Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia; Centre for Active Living and Learning, College of Human and Social Futures, University of Newcastle, Callaghan, NSW, Australia. Electronic address: tara.finn@newcastle.edu.au.
¹⁹ The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia. Electronic address: lyra.egan@sydney.edu.au.
²⁰ Sydney Institute for Women, Children and their Families, Sydney Local Health District, Sydney, NSW, Australia. Electronic address: george.johnson@health.nsw.gov.au.
²¹ The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia. Electronic address: emily.stockings@sydney.edu.au.
²² Sydney Institute for Women, Children and their Families, Sydney Local Health District, Sydney, NSW, Australia; Community Paediatric Research Group, Sydney Medical School, University of Sydney, Sydney, NSW, Australia. Electronic address: susan.woolfenden@health.nsw.gov.au.
²³ The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia. Electronic address: nicola.newton@sydney.edu.au.
²⁴ Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia; Centre for Active Living and Learning, College of Human and Social Futures, University of Newcastle, Callaghan, NSW, Australia; Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland. Electronic address: david.lubans@newcastle.edu.au.

PMID: 40393617
DOI: 10.1016/j.cct.2025.107958

Free article

Optimising a digital intervention to support parents experiencing socio-economic disadvantage to improve adolescent health behaviours: Protocol for the Health4Life Parents & Teens factorial trial

Katrina E Champion et al. Contemp Clin Trials. 2025 Jul.

Free article

. 2025 Jul:154:107958.

doi: 10.1016/j.cct.2025.107958. Epub 2025 May 18.

Authors

Affiliations

¹ The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia; Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia. Electronic address: katrina.champion@sydney.edu.au.
² The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia. Electronic address: lily.davidson@sydney.edu.au.
³ The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia. Electronic address: e.hunter@sydney.edu.au.
⁴ The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia; School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia. Electronic address: louise.thornton@sydney.edu.au.
⁵ Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Department of Behavioral Science and Social Medicine, Florida State University College of Medicine, Tallahassee, FL, USA. Electronic address: bonnie.spring@fsu.edu.
⁶ The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia. Electronic address: bridie.osman@sydney.edu.au.
⁷ The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia. Electronic address: matthew.sunderland@sydney.edu.au.
⁸ The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia. Electronic address: cath.chapman@sydney.edu.au.
⁹ Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia; School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia. Electronic address: tracy.burrows@newcastle.edu.au.
¹⁰ The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia. Electronic address: tim.slade@sydney.edu.au.
¹¹ Susan Wakil School of Nursing and Midwifery, The University of Sydney, Sydney, NSW, Australia; Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia. Electronic address: stephanie.partridge@sydney.edu.au.
¹² The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia. Electronic address: lauren.gardner@sydney.edu.au.
¹³ School of Health Sciences, University of New South Wales, Sydney, NSW, Australia; School of Health, University of the Sunshine Coast, QLD, Australia. Electronic address: bparmenter@usc.edu.au.
¹⁴ Children's Hospital Westmead Clinical School, The University of Sydney, Westmead, New South Wales, Australia. Electronic address: louise.baur@sydney.edu.au.
¹⁵ The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia. Electronic address: maree.teesson@sydney.edu.au.
¹⁶ School of Public Health and Preventative Medicine, Monash University, Australia. Electronic address: cathy.mihalopoulos@monash.edu.
¹⁷ The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia. Electronic address: alexander.haidinger@sydney.edu.au.
¹⁸ Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia; Centre for Active Living and Learning, College of Human and Social Futures, University of Newcastle, Callaghan, NSW, Australia. Electronic address: tara.finn@newcastle.edu.au.
¹⁹ The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia. Electronic address: lyra.egan@sydney.edu.au.
²⁰ Sydney Institute for Women, Children and their Families, Sydney Local Health District, Sydney, NSW, Australia. Electronic address: george.johnson@health.nsw.gov.au.
²¹ The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia. Electronic address: emily.stockings@sydney.edu.au.
²² Sydney Institute for Women, Children and their Families, Sydney Local Health District, Sydney, NSW, Australia; Community Paediatric Research Group, Sydney Medical School, University of Sydney, Sydney, NSW, Australia. Electronic address: susan.woolfenden@health.nsw.gov.au.
²³ The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia. Electronic address: nicola.newton@sydney.edu.au.
²⁴ Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia; Centre for Active Living and Learning, College of Human and Social Futures, University of Newcastle, Callaghan, NSW, Australia; Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland. Electronic address: david.lubans@newcastle.edu.au.

PMID: 40393617
DOI: 10.1016/j.cct.2025.107958

Abstract

Background: Youth experiencing socio-economic disadvantage often have elevated rates of health risk behaviours. Although adolescence is a time of increasing autonomy for youth, parents continue to play a significant role in their health. Parent-based interventions can reduce barriers faced by families experiencing disadvantage and improve adolescent outcomes. However, few such interventions addressing multiple risk behaviours exist for this population. This study aims to: i) systematically test the individual and synergistic effects of four parent-based intervention components, and ii) assemble an optimised intervention in which all components are effective in improving parental encouragement of adolescent health habits, while imposing the least possible burden on parents.

Methods: Guided by the Multiphase Optimisation Strategy, we will conduct a 2⁴ factorial trial with 389 parents of adolescents in Australia. All parents will receive six online modules (screen time, smoking/vaping, alcohol, sleep, food/nutrition, physical activity). Parents will be randomised to receive 1 of 16 combinations of additional components: text messages, tailored feedback, stress management, and health coaching. Parents will complete surveys at baseline and 3-months post-baseline. The primary outcome is change in parental encouragement of adolescent health habits at 3-months (proximal outcome). Parent's health behaviours, self-efficacy, stress, communication and the acceptability and burden (perceived effort to complete) of each component will also be assessed.

Discussion: This study will result in a digital intervention for families experiencing socio-economic disadvantage that is as effective as possible in improving parental encouragement of adolescent health habits, and that can be delivered with minimal burden, which is critical for translation.

Trial registration: The trial was prospectively registered with the Australian New Zealand Clinical Trials Registry (ACTRN12624001492549 date registered: 20/12/2024).

Keywords: Adolescents; Digital; Multiphase optimisation strategy; Parents; Risk behaviours; Socio-economic disadvantage.

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Conflict of interest statement

Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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Optimising a digital intervention to support parents experiencing socio-economic disadvantage to improve adolescent health behaviours: Protocol for the Health4Life Parents & Teens factorial trial

Affiliations

Optimising a digital intervention to support parents experiencing socio-economic disadvantage to improve adolescent health behaviours: Protocol for the Health4Life Parents & Teens factorial trial

Authors

Affiliations

Abstract

Conflict of interest statement

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources

Medical