Evidence map›Paper›PMID 40086808›Full record

Trial reportBMJ mental health2025

Future Proofing Study: a cluster randomised controlled trial evaluating the effectiveness of a universal school-based cognitive-behavioural programme for adolescent depression.

Aliza Werner-Seidler, Andrew Mackinnon, Philip J Batterham, Alison L Calear, Mark E Larsen, Michelle Torok, Bridianne O'Dea, Kate Maston, Kit Huckvale, Hiroko Fujimoto and 16 more

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ mental health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed.

  1. Multilevel risk and protective factors for self-harm, suicidal ideation and suicide attempt in adolescents.Journal of child psychology and psychiatry, and allied disciplines · 2026
    Article
  2. Article
  3. Longitudinal effects of bushfire harm on adolescent mental health.The Australian and New Zealand journal of psychiatry · 2026
    Article
  4. Review
  5. Article
  6. Article
  7. Review
  8. Article
  9. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

26 authors.

Aliza Werner-SeidlerBlack Dog Institute, UNSW Sydney, Sydney, New South Wales, Australia a.werner-seidler@blackdog.org.au.ORCID 0000-0002-9046-6159
Andrew MackinnonBlack Dog Institute, UNSW Sydney, Sydney, New South Wales, Australia.
Philip J BatterhamCentre for Mental Health Research, Australian National University, Canberra, Australian Capital Territory, Australia.ORCID 0000-0002-4547-6876
Alison L CalearCentre for Mental Health Research, Australian National University, Canberra, Australian Capital Territory, Australia.ORCID 0000-0002-7028-725X
Mark E LarsenCentre for Big Data Research in Health, University of New South Wales, Sydney, New South Wales, Australia.
Michelle TorokBlack Dog Institute, UNSW Sydney, Sydney, New South Wales, Australia.ORCID 0000-0003-3741-8075
Bridianne O'DeaBlack Dog Institute, UNSW Sydney, Sydney, New South Wales, Australia.
Kate MastonBlack Dog Institute, UNSW Sydney, Sydney, New South Wales, Australia.
Kit HuckvaleCentre for Digital Transformation of Health, University of Melbourne, Melbourne, Victoria, Australia.
Hiroko FujimotoBlack Dog Institute, UNSW Sydney, Sydney, New South Wales, Australia.
Lara JohnstonBlack Dog Institute, UNSW Sydney, Sydney, New South Wales, Australia.
Lyndsay BrownBlack Dog Institute, UNSW Sydney, Sydney, New South Wales, Australia.
Alexandra BatholomewBlack Dog Institute, UNSW Sydney, Sydney, New South Wales, Australia.
Debopriyo BalBlack Dog Institute, UNSW Sydney, Sydney, New South Wales, Australia.
Joanne R BeamesCenter for Contextual Psychiatry, Department of Neurosciences, KU Leuven, Leuven, Belgium.
Susan Rachel SkinnerDiscipline of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
Katherine M BoydellBlack Dog Institute, UNSW Sydney, Sydney, New South Wales, Australia.
Susanne SchweizerSchool of Psychology, University of New South Wales, Sydney, New South Wales, Australia.
Raghu LingamSchool of Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia.
Yael PerryThe Kids Research Institute, The University of Western Australia, Perth, Western Australia, Australia.ORCID 0000-0002-7974-3434
Jennifer L HudsonDiscipline of Psychiatry and Mental Health, University of New South Wales, Sydney, New South Wales, Australia.
Ju Lee OeiSchool of Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia.
Katharine SteinbeckDiscipline of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
Maree TeessonThe Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, New South Wales, Australia.
Svetha VenkateshApplied Artificial Intelligence Institute, Deakin University, Melbourne, Victoria, Australia.
Helen ChristensenDiscipline of Psychiatry and Mental Health, University of New South Wales, Sydney, New South Wales, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPsychological prevention programmes delivered in schools may reduce symptoms of depression. However, high-quality, large-scale trials are lacking.

objectiveThe aim was to examine whether a digital cognitive-behavioural programme ('SPARX'), delivered at scale in schools, would reduce depressive symptoms 12 months later.

methodsA cluster randomised controlled trial with parallel arms (intervention; control) was conducted in Australian schools, between August 2019 and December 2022. Cluster randomisation occurred at the school level (1:1 allocation). Investigators were blind to group allocation, and outcomes were assessed at baseline, 6 weeks, 6 months (primary outcome only) and 12 months post baseline. The intervention was delivered via smartphone app. Schools were instructed to provide in-class time for intervention completion. The primary outcome was the difference in depressive symptom change from baseline to 12 months between the intervention and control group. Secondary outcomes were change in anxiety, psychological distress and insomnia.

findings134 schools participated in this study, and baseline data were collected from n=6388 students (n=3266 intervention; n=3122 control). Intent-to-treat analyses showed no difference in depression change between groups from baseline to 12 months, (mean change difference= -0.05, z= -0.32, 95% CI: -0.36 to 0.23, p=0.75). There were no differences on secondary outcomes. Many schools did not provide in-class time for intervention completion, and engagement was low (22% completion rate).

conclusionsScaled delivery of a digital cognitive-behavioural programme did not reduce symptoms of depression, relative to a control group. CLINICAL IMPLICATIONS: Given the variability in the engagement with and delivery of the digital universal cognitive-behavioural programme, caution is required prior to scaled delivery of SPARX in school contexts. TRIAL REGISTRATION NUMBER: ACTRN12619000855123.

Indexed as

Cognitive Behavioral TherapyDepressionSchool Mental Health ServicesAdolescentAnxietyAustraliaFemaleHumansMaleSchool Health ServicesSchoolsStudentsChild & adolescent psychiatryDepression & mood disorders

Identifiers

PMID40086808
PMCPMC11927416

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.