Quasi-experimental evaluation of an online health and well-being screening questionnaire (Digital Health Contact [DHC]) used in secondary schools in the UK

ISRCTN	ISRCTN22788883
DOI	https://doi.org/10.1186/ISRCTN22788883
ClinicalTrials.gov (NCT)	Nil known
Clinical Trials Information System (CTIS)	Nil known
Protocol serial number	Nil known
Sponsor	University of Bristol
Funders	NIHR School for Public Health Research- Public Health Practice Evaluation Scheme (PHPES), National Institute for Health Research

Submission date: 29/10/2020
Registration date: 23/02/2021
Last edited: 13/12/2022

Recruitment status: No longer recruiting
Overall study status: Completed
Condition category: Other

Prospectively registered

Protocol

Statistical analysis plan

Results

Individual participant data

Plain English summary of protocol

Background and study aims
A UK local authority area introduced an online questionnaire, called the Digital Health Contact (DHC). The DHC is a universal, online, health and well-being screening questionnaire delivered to secondary school children in years 7, 9 and 11. At-risk children, identified by the self-completed questionnaire, are offered an appointment with the school nurse. The aim of this study is to evaluate the effectiveness of this online health and well-being screening questionnaire (the Digital Health Contact). Specifically, whether the DHC affected the number of referrals to the school nurse and if this had a positive impact on the well-being of these young people.

Who can participate?
Students in years 7, 9 and 11 in participating schools

What does the study involve?
Once a year, children from participating schools in academic years 7, 9 and 11 complete the online questionnaire. The questionnaire covers general mental health topics such as depression and anxiety, as well as other public health topics such as diet and sleep. Responses are processed automatically, if a young person responds in such a way that indicates urgent, unmet needs (red flagged), a referral alert is sent to the school nurse. The nurse will organise a face-to-face consultation with the young person to conduct a health assessment. The researchers will analyse anonymous data from the DHC collected during the pilot phase (2017/2018) and the three subsequent years.

What are the possible benefits and risks of participating?
The data being analysed is anonymised secondary data, so there are no potential risks as a result of processing the data. However, it is anticipated that should the researchers find important results this may inform the further development of the DHC and potentially increase the uptake of it by additional schools. It is currently envisaged that the DHC may identify students who have developed any mental health difficulties or those who have health behaviours or concerns which may impair their educational performance or their long-term health, prior to them seeking help.

Where is the study run from?
University of Bristol (UK)

When is the study starting and how long is it expected to run for?
March 2020 to April 2021

Who is funding the study?
NIHR School for Public Health Research- Public Health Practice Evaluation Scheme (PHPES) (UK)

Who is the main contact?
Dr Frank de Vocht, frank.devocht@bristol.ac.uk
Dr Patricia Nicole Albers, patricia.albers@bristol.ac.uk

Contact information

Dr Frank de Vocht
Scientific

Canynge Hall
39 Whatley Road
Bristol
BS8 2PS
United Kingdom

ORCID ID	0000-0003-3631-627X
Phone	+44 (0) 117 928 7239
Email	frank.devocht@bristol.ac.uk

Dr Patricia Nicole Albers
Scientific

Canynge Hall
39 Whatley Road
Bristol
BS8 2PS
United Kingdom

ORCID ID	0000-0001-5710-8483
Phone	+44 (0)117 928 7364
Email	patricia.albers@bristol.ac.uk

Dr Patricia Nicole Albers
Public

Canynge Hall
39 Whatley Road
Bristol
BS8 2PS
United Kingdom

ORCID ID	0000-0001-5710-8483
Phone	+44 (0) 117 928 7364
Email	patricia.albers@bristol.ac.uk

Study information

Primary study design	Interventional
Study design	This study is designed as a natural experiment to explore the effectiveness of a digital health and well-being screening tool used in schools, the study includes intervention and control schools, as well as repeated measures for a sub-sample of the population
Secondary study design	Non randomised study
Study type	Participant information sheet
Scientific title	Evaluation of the Digital Health Contact (DHC): an online, school-based health promotion, screening and population health intelligence intervention for children and young people
Study acronym	DHC
Study objectives	Aim: to evaluate the effectiveness of an online health and well-being screening questionnaire (Digital Health Contact) implemented in secondary schools in the UK. Objectives: 1. To assess whether the DHC has affected the number of referrals to the school nurse and possibly onto further pathways of care 2. To assess whether the introduction of the DHC has resulted in a positive impact on the wellbeing of young people who were seen by the school nurse following their answers to the DHC
Ethics approval(s)	Approved 29/09/2020, University of Bristol Faculty of Health Sciences Research Ethics Committee (First Floor South, Senate House, Tyndall Avenue, Bristol, BS8 1TH, UK; +44 (0)117 331 8197; research-governance@bristol.ac.uk), ref: 110982
Health condition(s) or problem(s) studied	Health, mental health, and well-being in school children
Intervention	The study includes an intervention arm and a control arm. The intervention schools received the DHC questionnaire for their Year 7, 9 and 11 students to complete while the control schools proceeded as usual. Data collected from both groups of schools were the number of referrals to the school nurse, attendance to referrals, and actions taken following consultation. The questionnaire is completed once a year by students in years 7, 9 and 11. The researchers will obtain 4 years of data which means for most students they should have two timepoints, while for some (those in year 11 in the first 2 years) they will only have one timepoint.
Intervention type	Other
Primary outcome measure(s)	Number of young people identified as having an unmet need (red flagged) identified based on the DHC, collected in Years 1 to 4 (2017 to 2020)
Key secondary outcome measure(s)	1. Number of children that were referred to a school nurse recorded by the schools and provided by the data custodian 1.1. Number of children that attend these referrals recorded by the schools and provided by the data custodian 1.2. The onward actions including the number of onward referrals recorded by the schools and provided by the data custodian 1.3. Wellbeing measured using the DHC at participating schools, once per academic year
Completion date	30/04/2021

Eligibility

Participant type(s)	All
Age group	Child
Sex	All
Target sample size at registration	3786
Total final enrolment	3786
Key inclusion criteria	1. All year 7 students in the participating schools with parental consent and who also provided assent 2. All year 9 and 11 students in the participating schools who provide consent
Key exclusion criteria	Does not meet inclusion criteria
Date of first enrolment	01/09/2017
Date of final enrolment	30/04/2021

Locations

Countries of recruitment

United Kingdom
England

Study participating centre

University of Bristol

Canynge Hall
Bristol
BS8 2PS
United Kingdom

Results and Publications

Individual participant data (IPD) Intention to share	No
IPD sharing plan summary	Not expected to be made available
IPD sharing plan	The datasets generated during and/or analysed during the current study are not expected to be made available as the researchers are not the data controller and are merely processing the anonymised data. They are acting as processors of this data under a data-sharing agreement and unfortunately cannot agree to sharing the data.

Study outputs

Output type	Details	Date created	Date added	Peer reviewed?	Patient-facing?
Results article		16/02/2022	13/12/2022	Yes	No
Results article		29/03/2022	13/12/2022	Yes	No
Participant information sheet	Participant information sheet	11/11/2025	11/11/2025	No	Yes

Editorial Notes

13/12/2022: Publication references added.
23/03/2022: The intention to publish date has been changed from 31/03/2022 to 30/06/2022.
19/02/2021: Trial's existence confirmed by the University of Bristol Faculty of Health Sciences Research Ethics Committee.