The University Of Sydney Rural Adolescent Cohort Study

Background

Professor Bruce Robinson, Dean of the Faculty of Medcine at the University of Sydney has brought together a multidisciplinary group of academics and experts in rural health to develop a cohort study of adolescent health in rural New South Wales.

The ARCHER study will explore the physical and mental health and wellbeing of children as they progress from childhood through adolescence in rural areas. ARCHER represents the Adolescent Rural Cohort, Hormones, Health, Environment, Education & Relationships.

The study will help to expand the research culture in rural NSW and will provide opportunities for student research in rural locations and attract medical practitioners and health professionals with research interests to work in rural areas.

Adolescent health is a priority
Adolescence and puberty have been overlooked in research and yet adolescence is a time of immense physical, developmental and social change. Behaviours acquired during adolescence may persist throughout life. Adolescence is a vital time for establishing good foundations for health. National and state plans confirm the need to invest in the health and well being of children and young people.

Adolescents, particularly those in rural areas, are at risk of premature mortality and morbidity from accidental and intentional injuries, sexually transmitted diseases and substance abuse. They are at risk of obesity and may develop diabetes and cardiovascular disease in later life. Untreated mental illness may develop into chronic debilitating, disability. Yet little is known about the biological process of puberty and how it interacts with the social environment and impacts on psychosocial development. We do not understand the factors that protect the health and well being of adolescents and prevent mental and physical illness.

The Aims of the Rural Adolescent Cohort Study
The main aims of the study are to:

• Describe the relationship between the biological changes of puberty, adolescent behaviours and physical and mental health outcomes.
  Describe the interaction of individual, family, community and environmental factors on adolescent physical and mental health outcomes
  Increase our knowledge of adolescent health and its determinants in rural NSW
  Improve our understanding of the risk factors and natural history of common conditions such a diabetes, cardiovascular disease and depression.
  Inform strategies on early prevention and intervention

Study Design
The proposed study design is a longitudinal cohort study, which will recruit adolescents from Dubbo, Orange, Lismore Broken Hill and Moree. The participants will be asked to complete a questionnaire, have a simple physical examination and biological samples collected. The cohort will be followed until the children are at least four years, with annual re-collection of data. Nested studies may be included.

The ARCHER@KWS is a feasibility study to validate the methods and ensure the most effective and appropriate conduct of the main cohort study.

Data linkage and the use of some of the same measurements tools as other studies will increase the breadth of the study help determine whether associations are specific to the NSW rural population. International comparisons may be possible with the George Institute studies in rural China and India.

Community and Adolescent Participation
Community engagement is vital to the success of the study. We need to understand local issues and concerns on adolescent health to ensure the relevance and quality of the study.

The study group will:

• Consult with key organizations, their representatives and the community in each of the study areas.
  Reflect the research areas prioritised by the community in the cohort study.
  Involve the community in the planning and execution of the study.
  Ensure appropriate consultation with the Indigenous population.
  Seek and encourage adolescent participation in the naming, design and execution of the study.
  Collect novel information on parental and young adolescent views about participation in research and the factors that may influence participation and retention in the study with parent and adult focus groups.

Funding
The study has seed funding from the Medical Foundation of the University of Sydney. A study of this magnitude and potential consequence will need the significant further financial support to ensure success.

Timetable

2007

• Consult and engage stakeholders, the communities and adolescents (ongoing)
  Plan & apply for ethical approval for pilot study
  Refine and prioritise research questions (ongoing)

2008

• Pilot study Phase I through a school in Orange ARCHER@KWS
  Funding application
  Commence community engagement

2009

• NHMRC project grant application
  Community engagement
  Pilot Study Phase II Community recruitment and follow up of phase I

2010

• Commence rural cohort study in rural NSW

Contact us:
archer@med.usyd.edu.au
Dr Catherine Hawke or Karen Paxton, Project Development Manager