- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03833284
Transvaginal Ultrasound: Preterm Birth Prevention in Appalachia
January 4, 2022 updated by: Niraj Chavan
Implementation of a Transvaginal Ultrasound Surveillance Program in Women With a History of Previous Preterm Birth: Disseminating Evidenced Based Practices for Reducing Preterm Birth in Appalachian Kentucky
Preterm Birth is the number one cause of infant morbidity and mortality worldwide and represents an important health disparity in the United States, particularly across the state of Kentucky.
The best biomarker for the prediction of preterm birth is transvaginal ultrasound (TVU).
This study will attempt to identify and rectify provider and patient related barriers to TVU screening implementation.
Study Overview
Status
Completed
Conditions
Intervention / Treatment
Detailed Description
Preterm birth is the number one cause of infant morbidity and mortality worldwide and represents an important health disparity in the United States, and especially across the state of Kentucky.
The best biomarker for the prediction of preterm birth is transvaginal ultrasound (TVU) measurement of cervical length.
However, several unique provider and patient related barriers for implementation of this screening limit the widespread uptake of this evidence based practice in Appalachian KY.
The investigators propose to adopt a dissemination and implementation science approach using the Consolidated Framework for Implementation Research (CFIR) as the guiding framework for identification of key areas of knowledge deficits as well as attitudes, practices and perceived barriers among prenatal care providers and patients in eastern KY towards TVU cervical length screening using a mixed - methods design.
This will be utilized to develop a multifaceted implementation strategy best suited for addressing and overcoming barriers identified by the target population in eastern KY.
The investigators anticipate that such an implementation strategy will likely include an educational component targeting obstetric care providers and patients in addition to hands-on TVU cervical length evaluation as well as telemedicine support and surveillance.
Three community based sites (Hazard, Morehead and Ashland, KY) will be recruited for implementation of this multi-component pilot program focused on community engagement and outreach targeting obstetric providers and their patients.
At the end of the pilot implementation phase, acceptability of the study intervention and feasibility of implementation will be evaluated along with a preliminary assessment of effectiveness of implementation.
Study Type
Interventional
Enrollment (Actual)
56
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
-
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Kentucky
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Lexington, Kentucky, United States, 40536
- University of Kentucky
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-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
18 years to 49 years (Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria: Participant
- Female Sex
- Prior history of preterm birth (for initial set of interviews), no preterm birth history required for intervention feedback
- Current pregnant status
Exclusion Criteria: Participant
- Male Sex
Inclusion Criteria: Provider
- Certified as obstetric/gynecologic provider
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Non-Randomized
- Interventional Model: Single Group Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Participant Barriers to TVU Screening
Patients with a history of pre-term birth will be identified through a review of their medical history.
Patients will then be asked to complete a survey assessing their knowledge of transvaginal ultrasound screening.
Patients will then be asked to attend in-person or online workshops designed to increase patient knowledge of TVU screening guidelines and benefits.
Finally, patients will complete exit surveys to determine whether their attitudes and beliefs towards screening have changed over time.
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Workshops tailored toward patients to increase knowledge about TVU screening guidelines and benefits.
|
Experimental: Provider Barriers to TVU Screening
Obstetric and Gynecologic Providers will be identified based on prior working relationships with the University of Kentucky outreach programs.
Chosen providers will be asked to complete a survey assessing their attitudes towards TVU screening.
Following completion, providers will be asked to attend either in-person or online workshops designed to increase provider knowledge of TVU screening guidelines and benefits.
Finally, providers will complete exit surveys to determine whether their attitudes and beliefs toward screening have changed over time.
|
Workshops tailored toward providers to increase knowledge about TVU screening guidelines and benefits.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in attitudes towards TVU screening among patients and practitioners
Time Frame: At baseline and at one year.
|
The primary purpose of this study is to evaluate the change in attitudes towards TVU screening among patients and practitioners.
This will be accomplished by conducting a qualitative interview with each participant at baseline and again at one year (after completing the CLEAR program workshop).
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At baseline and at one year.
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Potential for future TVU screening implementation based on changes in attitudes towards TVU screening among providers and participants.
Time Frame: At baseline and at one year.
|
The primary purpose of this study is to evaluate the change in attitudes towards TVU screening among patients and practitioners.
This will be accomplished by conducting a qualitative interview with each participant at baseline and again at one year (after completing the CLEAR program workshop).
Analysis of these interviews will aid in determining feasibility of implementing a future TVU screening component in Obstetric and Gynecologic care.
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At baseline and at one year.
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Rate of preterm birth at <34 weeks gestation
Time Frame: Through study completion, average of 1 year from study initiation
|
Subjects (patients) included in this study will be followed to determine rate of preterm birth at various time points.
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Through study completion, average of 1 year from study initiation
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Rate of preterm birth at <37 weeks gestation
Time Frame: Through study completion, average of 1 year from study initiation
|
Subjects (patients) included in this study will be followed to determine rate of preterm birth at various time points.
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Through study completion, average of 1 year from study initiation
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Number of TVU scans identifying a short cervix (≤ 25 mm) in any pregnant women at each study site
Time Frame: Through study completion, average of 1 year from study initiation.
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Records of TVU scans identifying a short cervix among the study population will be analyzed to determine the rate of short cervix issues among the population.
The percentage will aid in determining the need for future TVU screening in similar populations.
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Through study completion, average of 1 year from study initiation.
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Rate of inpatient hospitalization for preterm labor management prior to delivery
Time Frame: Through study completion, average of 1 year from study initiation.
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Subjects (patients) included in this study will be followed to determine whether they are subjects to hospitalization prior to birthing due to complications associated with preterm labor.
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Through study completion, average of 1 year from study initiation.
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Rates of clinical therapy
Time Frame: Through study completion, average of 1 year from study initiation.
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Defined as prescribing vaginal progesterone or performing cervical cerclage
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Through study completion, average of 1 year from study initiation.
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Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Investigators
- Principal Investigator: Niraj Chavan, University of Kentucky
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Actual)
June 3, 2019
Primary Completion (Actual)
October 29, 2021
Study Completion (Actual)
October 29, 2021
Study Registration Dates
First Submitted
January 3, 2019
First Submitted That Met QC Criteria
February 5, 2019
First Posted (Actual)
February 6, 2019
Study Record Updates
Last Update Posted (Actual)
January 5, 2022
Last Update Submitted That Met QC Criteria
January 4, 2022
Last Verified
January 1, 2022
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- 45131
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
NO
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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