- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT07679074
CREST: Samphire Guided Care Program on Wellbeing, Work Productivity, and Quality of Life (CREST)
A 12-Week Prospective Cohort Study Evaluating the Efficacy of the Samphire Guided Care Program on Wellbeing, Work Productivity, and Quality of Life in Individuals With Menstrual and Pelvic Health Conditions
This study evaluates the feasibility and efficacy of the Samphire Guided Care (SGC) program
- a 12-week structured digital health program combining clinician-led onboarding, at-home neuromodulation using the Lutea tDCS device, neuromodulation coach support, and app-based symptom tracking - on work productivity, employee wellbeing, and quality of life in individuals experiencing mood and cognitive symptoms associated with menstruation, perimenopause, or menopause.
Study Overview
Status
Conditions
Detailed Description
The CREST study is a prospective, observational, two-group cohort study conducted in a fully decentralized, at-home format. No randomization, blinding, or placebo comparator is employed.
All enrolled participants receive access to the full SGC program, which includes: a clinician-led eligibility assessment at onboarding conducted by a third-party women's health clinician; at-home transcranial direct current stimulation (tDCS) using the Lutea consumer wellness device (for eligible participants who opt in); ongoing support from a Samphire neuromodulation coach; and app-based symptom tracking via the Alethios digital research platform.
Participants are prospectively allocated to one of two groups based on neuromodulation eligibility, device uptake, and adherence: Group A (neuromodulation cohort, target n=35) comprises participants assessed as eligible who accept the device and complete at least 30% of recommended sessions across the 12-week program; Group B (comparison cohort, target n=15) comprises participants who either decline the device or complete fewer than 30% of sessions.
Group allocation is determined retrospectively at Week 12 based on automated device usage logs. Both groups complete identical assessment schedules.
Primary outcomes are work productivity (WPAI subscales) and employee wellbeing (EQ-5D-5L).
Secondary outcomes include PHQ-9, GAD-7, ISI, WPAI, PSST, and BrainHQ cognitive assessment.
Exploratory outcomes include pain NRS, PGIC, NPS, HCRU, optional wearable physiological data, and clinician-rated CGI-S and CGI-I.
All study activities are conducted remotely via the Alethios digital research platform and Samphire mobile application. Electronic informed consent is obtained prior to any study-related data collection.
Study Type
Enrollment (Estimated)
Contacts and Locations
Study Contact
- Name: Nirav Shah, MD, MPH
- Phone Number: 6267201547
- Email: nirav@investigator.alethios.com
Study Contact Backup
- Name: Zeenia Framroze
- Email: support@alethios.com
Study Locations
-
-
California
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San Francisco, California, United States, 94105
- Recruiting
- Alethios Digital Research Platform (Decentralized)
-
Principal Investigator:
- Nirav Shah, MD, MPH
-
Contact:
- Zeenia Framroze
- Email: support@alethios.com
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Sampling Method
Study Population
Description
Inclusion Criteria:
- Self-identified female, aged 18-65 years at the time of enrollment
- Basic English literacy
- Able and willing to provide informed consent electronically
- Residing in the United States
- Reporting mood or cognitive symptoms associated with menstruation, perimenopause, or menopause (must endorse a minimum of three of the following: irritability, emotional dysregulation, brain fog, fatigue, reduced concentration, sleep disruption, or low mood)
- Symptoms present for at least 3 months and sufficiently severe to interfere with daily functioning, work performance, quality of life, or interpersonal relationships
- Currently in full-time employment with medical benefits as part of compensation package
- Access to a smartphone with internet access compatible with the Samphire mobile application
- Able to safely operate the study device in the home environment
- Willing to complete baseline, mid-program, and end-of-program questionnaires and engage with the 12-week guided care program
Exclusion Criteria:
- Pregnancy, breastfeeding, or actively planning pregnancy during the study period
- History of epilepsy or seizure disorder
- Severe or unstable neurological disease that, in the opinion of the study team, may increase risk or interfere with participation
- Implanted electronic or metal devices in the head, neck, or brain region contraindicated for tDCS use
- Active scalp lesions, open wounds, or dermatologic conditions at electrode sites that may interfere with safe device use
- Current diagnosis of schizophrenia, bipolar disorder, or other severe psychiatric condition that would make participation inappropriate, as determined by screening
- Active suicidal ideation, recent suicidal behavior, or clinically significant self-injurious behavior, as determined by participant self-report during screening
- Inability to provide informed consent or safely use the device in the home environment
- Current participation in another interventional neurotechnology or drug study
Study Plan
How is the study designed?
Design Details
Cohorts and Interventions
Group / Cohort |
Intervention / Treatment |
|---|---|
|
Group A - Neuromodulation Cohort
Participants assessed as eligible for neuromodulation at the clinician onboarding consultation who accept the Lutea device and complete at least 30% of recommended tDCS sessions across the 12-week program.
Group A participants receive the full SGC program including clinician consultation, Lutea device, neuromodulation coach support, and app-based symptom tracking.
|
The Lutea device (Samphire Group, Inc.) is an FCC-registered consumer wellness wearable that delivers low-intensity transcranial direct current stimulation (tDCS) targeting the primary motor cortex (M1) and dorsolateral prefrontal cortex (DLPFC).
Sessions are 20 minutes in duration at a recommended frequency of multiple sessions per week, self- administered at home.
The device does not meet the FDA's statutory definition of a medical device; it is intended for general wellness purposes and is not cleared or approved for the diagnosis, cure, mitigation, treatment, or prevention of any disease.
Other Names:
A 12-week structured digital health program comprising: clinician-led neuromodulation eligibility assessment and care pathway assignment at onboarding; ongoing neuromodulation coach support; and app-based daily symptom tracking via the Alethios digital research platform.
All participants in both groups receive this program component.
Other Names:
|
|
Group B - Comparison Cohort
Participants who either decline the Lutea device following the clinician consultation, or who accept the device but complete fewer than 30% of recommended sessions across the 12-week program.
Group B participants receive the same SGC program components as Group A excluding substantive neuromodulation engagement.
|
A 12-week structured digital health program comprising: clinician-led neuromodulation eligibility assessment and care pathway assignment at onboarding; ongoing neuromodulation coach support; and app-based daily symptom tracking via the Alethios digital research platform.
All participants in both groups receive this program component.
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Work Productivity and Activity Impairment (WPAI) - Overall Work Impairment
Time Frame: Baseline to Week 12
|
Within-participant change in WPAI Overall Work Impairment subscale score from baseline to end of program.
Scores range from 0 to 100%, with higher scores indicating greater impairment.
A reduction of 7 percentage points or more is considered clinically meaningful.
|
Baseline to Week 12
|
|
EQ-5D-5L Utility Index Score
Time Frame: Baseline to Week 12
|
Within-participant change in EQ-5D-5L utility index score from baseline to end of program. Scores range from 0 to 1, with higher scores indicating better health-related quality of life. A change of 0.07 utility units or more is considered clinically meaningful. |
Baseline to Week 12
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Patient Health Questionnaire-9 (PHQ-9)
Time Frame: Baseline, Week 6, Week 12
|
Within-participant change in PHQ-9 total score.
Range 0-27; higher scores indicate greater depressive symptom severity.
MCID: 5 points.
|
Baseline, Week 6, Week 12
|
|
Generalized Anxiety Disorder-7 (GAD-7)
Time Frame: Baseline, Week 6, Week 12
|
Within-participant change in GAD-7 total score.
Range 0-21; higher scores indicate greater anxiety symptom severity.
MCID: 4 points.
|
Baseline, Week 6, Week 12
|
|
Insomnia Severity Index (ISI)
Time Frame: Baseline, Week 6, Week 12
|
Within-participant change in ISI total score.
Range 0-28; higher scores indicate greater insomnia severity.
MCID: 6 points.
|
Baseline, Week 6, Week 12
|
|
WPAI Absenteeism, Presenteeism, and Activity Impairment Subscales
Time Frame: Baseline, Week 6, Week 12
|
Within-participant change in WPAI subscale scores for absenteeism (work time missed), presenteeism (impairment while working), and activity impairment (impairment in daily activities).
All subscales scored 0-100%; higher scores indicate greater impairment.
|
Baseline, Week 6, Week 12
|
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Premenstrual Symptoms Screening Tool (PSST)
Time Frame: Baseline to Week 12
|
Within-participant change in PSST total score across 19 symptom items and 5 functional impact items.
Items rated 1-4 (Not at all to Severe); higher scores indicate greater premenstrual symptom burden.
|
Baseline to Week 12
|
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BrainHQ Cognitive Assessment
Time Frame: Baseline to Week 12
|
Within-participant change in BrainHQ composite cognitive performance score from baseline to end of program.
|
Baseline to Week 12
|
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Healthcare Resource Utilization (HCRU)
Time Frame: Baseline to Week 12
|
Within-participant change in self-reported healthcare contacts (ER visits, specialist consultations, primary care visits, prescription medication changes) related to hormonal health symptoms, assessed using a study-specific questionnaire adapted from MEPS items.
|
Baseline to Week 12
|
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Pain Numerical Rating Scale (NRS)
Time Frame: Baseline, Week 6, Week 12
|
Within-participant change in average pelvic or menstrual pain over the past 7 days. Scored 0-10; higher scores indicate greater pain severity. MCID: 2 points. Exploratory outcome. |
Baseline, Week 6, Week 12
|
|
Patient Global Impression of Change (PGIC)
Time Frame: Week 12
|
Participant-rated overall impression of change in hormonal health symptoms since study start.
7-point scale from Very much improved (1) to Very much worse (7).
Exploratory.
|
Week 12
|
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Net Promoter Score (NPS)
Time Frame: Week 12, Week 24
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Participant likelihood to recommend the SGC program.
Scored 0-10.
Exploratory engagement metric for employer-facing reporting.
|
Week 12, Week 24
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Clinical Global Impression of Severity (CGI-S)
Time Frame: Baseline
|
Clinician-rated impression of overall symptom severity at onboarding consultation. 7-point scale. Administered by contracted women's health clinician. Exploratory. |
Baseline
|
|
Clinical Global Impression of Improvement (CGI-I)
Time Frame: Week 12
|
Clinician-rated impression of overall symptom improvement from baseline to end of program. 7-point scale. Administered by contracted women's health clinician. Exploratory. |
Week 12
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Nirav Shah, MD, MPH, Samphire Group, Inc.
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Urogenital Diseases
- Genital Diseases
- Pain
- Neurologic Manifestations
- Mental Disorders
- Pathologic Processes
- Female Urogenital Diseases
- Female Urogenital Diseases and Pregnancy Complications
- Behavioral Symptoms
- Genital Diseases, Female
- Mood Disorders
- Depressive Disorder
- Menstruation Disturbances
- Fatigue
- Pathological Conditions, Signs and Symptoms
- Behavior
- Signs and Symptoms
- Endometriosis
- Pelvic Pain
- Premenstrual Syndrome
- Mental Fatigue
- Dysmenorrhea
- Premenstrual Dysphoric Disorder
- Therapeutics
- Behavioral Disciplines and Activities
- Electric Stimulation Therapy
- Convulsive Therapy
- Psychiatric Somatic Therapies
- Electroshock
- Psychological Techniques
- Transcranial Direct Current Stimulation
Other Study ID Numbers
- SAM-003
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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