Study protocol

BMC Pediatrics

, 12:143

First online:

Open Access This content is freely available online to anyone, anywhere at any time.

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

  • Katharine SteinbeckAffiliated withAcademic Department of Adolescent Medicine, University of Sydney, at Children’s Hospital, Westmead Email author 
  • , Philip HazellAffiliated withThomas Walker Hospital (Rivendell) Child, Adolescent & Family Mental Health Services Hospital Rd Concord West
  • , Robert G CummingAffiliated withSchool of Public Health, University of Sydney
  • , S Rachel SkinnerAffiliated withDiscipline of Pediatrics and Child Health, University of Sydney at Children’s Hospital Westmead
  • , Rebecca IversAffiliated withThe George Institute for Global Health and School of Public Health, University of Sydney
  • , Robert BooyAffiliated withNational 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
  • , Greg FulcherAffiliated withUniversity of Sydney and Department of Endocrinology, Royal North Shore Hospital
  • , David J HandelsmanAffiliated withANZAC Research Institute, University of Sydney and Andrology Department, Concord Hospital
  • , Andrew J MartinAffiliated withFaculty of Education and Social Work, University of Sydney
    • , Geoff MorganAffiliated withNorthern Rivers University Department of Rural Health, Medical School, University of Sydney
    • , Jean StarlingAffiliated withDepartment of Psychological Medicine, The Children’s Hospital at Westmead
    • , Adrian BaumanAffiliated withSchool of Public Health, University of Sydney
    • , Margot L RawsthorneAffiliated withSocial Work & Policy Studies, Faculty of Education and Social Work, University of Sydney
    • , David L BennettAffiliated withDepartment of Adolescent Medicine and NSW Centre for the Advancement of Adolescent Health, The Children’s Hospital at Westmead
    • , Chin Moi ChowAffiliated withDiscipline of Exercise and Sport Science, The University of Sydney
    • , Mary K LamAffiliated withFaculty of Health Sciences, The University of Sydney
    • , Patrick KellyAffiliated withSchool of Public Health, University of Sydney
    • , Ngiare J BrownAffiliated withProfessor of Indigenous Health & Education, University of Wollongong
    • , Karen PaxtonAffiliated withSchool of Rural Health, University of Sydney
    • , Catherine HawkeAffiliated withSchool of Rural Health, University of Sydney



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.


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.


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.


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