Early-life socioeconomic status (SES) increases the risk of poor mental health outcomes in adulthood. However, the mechanistic pathways underlying this relationship remain poorly understood. While addressing socioeconomic inequalities remains a long-term goal, identifying specific mediating pathways could reveal more immediate opportunities for effective interventions.

Using linked administrative data from New South Wales, Australia (1990–2022), we will emulate a target trial examining the relationship between SES at birth and acute mental health admissions and presentations between the ages of 18 and 25 years. An interventional mediation analysis will be used to examine the effect of multiple mediating pathways, including education, housing stability, child protection contact, parental incarceration and justice system involvement, on the outcome. The analysis will estimate direct and indirect interventional effects, quantifying how much of the SES-mental health relationship could be modified by interventions on specific mediators.

This study has received ethics approval from the University of Newcastle (H-2024-0015) and Aboriginal Health and Medical Research Council (2265/24) Human Research Ethics Committees. All dissemination activities will be conducted in accordance with data access agreements and following approval from all relevant data custodians (New South Wales Health System Data Services). Key findings will be communicated to relevant government agencies and policymakers through policy briefs and stakeholder meetings, and publication in appropriate academic journals.

Type 2 diabetes is a prevalent chronic disease, associated with health complications, premature morbidity and significant healthcare costs. Optimal lifestyle behaviour control and patient self-management are crucial for improving diabetes control; however, they are difficult to achieve in primary care. There is limited research on the use of information from wearable devices to encourage behaviour change. This study will examine the effectiveness and cost-effectiveness of a multi-component health behaviour intervention in achieving clinically significant reductions in haemoglobin A1c (HbA1c) among general practice patients with type 2 diabetes.

The study uses a cluster-randomised controlled design, with general practices randomly assigned to either the Wearables Integrated Technology (WEAR-IT) intervention (n=15) or usual care (n=15). To achieve a sample size of 375 participants, 12–13 patients per practice will be recruited. Patients diagnosed with type 2 diabetes will be eligible to participate if they are aged 18–75 years; have had poorly controlled diabetes (HbA1c≥7.5%), with the cognitive capacity and ability to access the intervention application via an iOS or Android smart device. The WEAR-IT self-management intervention combines information from wearable devices (physical activity, blood glucose and blood pressure) and the electronic medical record, with goal setting and coaching support. The intervention will be primarily delivered by the general practice nurse, with review and confirmation of goals by the general practitioner. Participants attending the usual care practices will receive standard care. Outcome measures, including HbA1c, lipids, blood pressure, quality of life, dietary and exercise behaviours and cost-effectiveness, will be collected at baseline, 6-month (primary endpoint) and 12-month post-randomisation. The primary analysis will compare the change in HbA1c between the intervention and control groups at 6-month follow-up, with long-term outcomes assessed at 12-month post-randomisation.

The study was approved by Bond University (BH00137). Results will be disseminated through peer-reviewed journal publications, conference presentations and summaries to participating sites and patients.

Australian New Zealand Clinical Trials Registry (ACTRN12624000957594).