Open Access Study protocol

The study design and methodology for the ARCHER study - adolescent rural cohort study of hormones, health, education, environments and relationships

Katharine Steinbeck1*, Philip Hazell2, Robert G Cumming3, S Rachel Skinner4, Rebecca Ivers5, Robert Booy6, Greg Fulcher7, David J Handelsman8, Andrew J Martin9, Geoff Morgan10, Jean Starling11, Adrian Bauman3, Margot L Rawsthorne12, David L Bennett13, Chin Moi Chow14, Mary K Lam15, Patrick Kelly3, Ngiare J Brown16, Karen Paxton17 and Catherine Hawke18

Author Affiliations

1 Academic Department of Adolescent Medicine, University of Sydney, at Children’s Hospital, Westmead, Sydney NSW 2145, Australia

2 Thomas Walker Hospital (Rivendell) Child, Adolescent & Family Mental Health Services Hospital Rd Concord West, Sydney, NSW 2138, Australia

3 School of Public Health, University of Sydney, Sydney, NSW 2006, Australia

4 Discipline of Pediatrics and Child Health, University of Sydney at Children’s Hospital Westmead, Sydney, NSW 2145, Australia

5 The George Institute for Global Health and School of Public Health, University of Sydney, Sydney, NSW 2006, Australia

6 National Centre for Immunisation Research and Surveillance of Vaccine Preventable Disease, Kids Research Institute, The Children’s Hospital at Westmead. Sydney Institute for Emerging infections and Biosecurity (SEIB), The University of Sydney, Sydney, NSW 2006, Australia

7 University of Sydney and Department of Endocrinology, Royal North Shore Hospital, Sydney, NSW 2065, Australia

8 ANZAC Research Institute, University of Sydney and Andrology Department, Concord Hospital, Sydney, NSW 2006, Australia

9 Faculty of Education and Social Work, University of Sydney, Sydney, NSW 2006, Australia

10 Northern Rivers University Department of Rural Health, Medical School, University of Sydney, PO Box 3074, Lismore, NSW 2480, Australia

11 Department of Psychological Medicine, The Children’s Hospital at Westmead, Locked Bag 4001, Westmead, NSW 2145, Australia

12 Social Work & Policy Studies, Faculty of Education and Social Work, University of Sydney, Sydney, NSW 2006, Australia

13 Department of Adolescent Medicine and NSW Centre for the Advancement of Adolescent Health, The Children’s Hospital at Westmead, Sydney, NSW 2145, Australia

14 Discipline of Exercise and Sport Science, The University of Sydney, Lidcombe, NSW 2141, Australia

15 Faculty of Health Sciences, The University of Sydney, Lidcombe, NSW 1825, Australia

16 Professor of Indigenous Health & Education, University of Wollongong, Wollongong, NSW 2522, Australia

17 School of Rural Health, University of Sydney, PO Box 1043, Dubbo, NSW 2830, Australia

18 School of Rural Health, University of Sydney, PO Box 1191, Orange, NSW 2800, Australia

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BMC Pediatrics 2012, 12:143  doi:10.1186/1471-2431-12-143

Published: 5 September 2012

Abstract

Background

Adolescence is characterized by marked psychosocial, behavioural and biological changes and represents a critical life transition through which adult health and well-being are established. Substantial research confirms the role of psycho-social and environmental influences on this transition, but objective research examining the role of puberty hormones, testosterone in males and oestradiol in females (as biomarkers of puberty) on adolescent events is lacking. Neither has the tempo of puberty, the time from onset to completion of puberty within an individual been studied, nor the interaction between age of onset and tempo. This study has been designed to provide evidence on the relationship between reproductive hormones and the tempo of their rise to adult levels, and adolescent behaviour, health and wellbeing.

Methods/Design

The ARCHER study is a multidisciplinary, prospective, longitudinal cohort study in 400 adolescents to be conducted in two centres in regional Australia in the State of New South Wales. The overall aim is to determine how changes over time in puberty hormones independently affect the study endpoints which describe universal and risk behaviours, mental health and physical status in adolescents. Recruitment will commence in school grades 5, 6 and 7 (10–12 years of age). Data collection includes participant and parent questionnaires, anthropometry, blood and urine collection and geocoding. Data analysis will include testing the reliability and validity of the chosen measures of puberty for subsequent statistical modeling to assess the impact over time of tempo and onset of puberty (and their interaction) and mean-level repeated measures analyses to explore for significant upward and downward shifts on target outcomes as a function of main effects.

Discussion

The strengths of this study include enrollment starting in the earliest stages of puberty, the use of frequent urine samples in addition to annual blood samples to measure puberty hormones, and the simultaneous use of parental questionnaires.

Keywords:
Puberty; Hormones; Adolescent; Cohort studies; Rural health; Behaviour; Wellbeing; Public health; Protocol; Paediatrics