Implementing routine sexual and reproductive health screening into an Australian child and youth mental health service: study protocol for a cluster randomised controlled trial
Bibliographic record
Abstract
BACKGROUND: Adolescents living with mental illness are more likely than their peers to engage in risky sexual behaviours such as unsafe sexual practices or drug misuse, which can result in sexually transmitted infections (STIs), unplanned pregnancies and sexual coercion or violence. One barrier to these adolescents receiving sexual and reproductive health (SRH) care is a lack of skills and confidence of mental health clinicians to discuss SRH concerns. Integrating SRH care for adolescents attending mental health services may facilitate access to timely screening and treatment. METHODS: This pragmatic cluster randomised controlled trial involves an educational intervention to train mental health clinicians to conduct brief SRH screening with adolescents (12-17 years) with complex mental health needs attending a child and youth mental health service (CYMHS). The educational intervention is complemented with a referral pathway for a nurse-led SRH consultation where indicated through screening. The study aims to examine the preliminary feasibility and effectiveness of the educational intervention by measuring the number of referrals by clinicians who receive the training for SRH nurse-led consultations compared to untrained clinicians and to measure changes after training in clinician knowledge, skills and confidence to discuss SRH needs of young people accessing the CYMHS. The acceptability of SRH screening and nurse-led SRH consultations in CYMHS will be assessed through qualitative interviews with clinicians, adolescents accessing CYMHS, and their parents. DISCUSSION: There is an unmet need for care for adolescents living with mental illness who have SRH concerns. This trial seeks to assess the preliminary feasibility, effectiveness and acceptability of a service-wide SRH educational intervention which aims to improve access to SRH care for adolescents accessing CYMHS. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12624001462572. Registered on 16 December 2024. https://anzctr.org.au/ACTRN12624001462572.aspx .
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.049 | 0.043 |
| Meta-epidemiology (narrow) | 0.007 | 0.004 |
| Meta-epidemiology (broad) | 0.017 | 0.008 |
| Bibliometrics | 0.003 | 0.005 |
| Science and technology studies | 0.004 | 0.005 |
| Scholarly communication | 0.006 | 0.005 |
| Open science | 0.005 | 0.003 |
| Research integrity | 0.008 | 0.009 |
| Insufficient payload (model declined to judge) | 0.100 | 0.016 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".