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Integrated Maternal Psychosocial Assessment to Care Trial (IMPACT) Full Trial

11. november 2019 opdateret af: Dawn Kingston, University of Calgary

Integrated Maternal Psychosocial Assessment to Care Trial (IMPACT): Intervening Early to Improve Maternal and Family Well-being.

We hypothesize that the intervention will: (1) offer a feasible approach for providing mental healthcare to pregnant women and have a high level of acceptability by pregnant women and healthcare providers; (2) reduce symptoms of depression, stress, anxiety, and parenting stress; improve parenting competence, coping, and relationship adjustment compared to usual care; and (3) reduce the risk of poor maternal-infant attachment. As such, this early intervention holds promise for reducing maternal mental health morbidity and its negative influences on infants, children, and families.

Studieoversigt

Status

Ukendt

Betingelser

Detaljeret beskrivelse

One of the main reasons that women do not receive treatment is that their mood and anxiety problems are not detected. Despite recommendations and high rates of acceptance by providers and women, only a minority of providers conduct psychosocial assessments as part of routine prenatal care. Computer-based 'screening' is an acceptable and feasible approach to assessment of sensitive issues including prenatal and postnatal intimate partner violence, mental health problems, and postpartum depression by patients and providers. It is well-suited for busy clinical settings and is advantageous in that it offers a consistent approach to assessment, is resource-sparing, can be tailored to meet the specific needs of patients, can be used with audio/video for low literacy, provides a real-time summary for patients/providers,achieves similar or higher rates of disclosure of violence and mental health problems, and is preferred by patients because they perceive it as more anonymous compared to interviews or questionnaires.

However, psychosocial assessment on its own is ineffective in preventing or treating mood disorders and unethical in the absence of treatment options. As such, many providers do not assess pregnant women for mood disorders because non-pharmacological treatments are frequently unavailable and pregnant women prefer them. Cognitive behavioural therapy (CBT) is a highly effective, non-pharmacological treatment for depression and anxiety and is recommended by perinatal national Australian guidelines as a potentially effective EARLY intervention for reducing the risk of maternal-child outcomes.

Undersøgelsestype

Interventionel

Tilmelding (Forventet)

5000

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

    • Alberta
      • Stony Plain, Alberta, Canada, T7Z 2M7
        • Westview Health Centre

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

16 år og ældre (Barn, Voksen, Ældre voksen)

Tager imod sunde frivillige

Ja

Køn, der er berettiget til at studere

Kvinde

Beskrivelse

Inclusion criteria:

Pregnant women will be eligible for Phase 2 if they are:

  1. < 28 weeks gestation (to provide the opportunity to complete 6 modules and follow-up questionnaires prior to delivery)
  2. able to speak/read English; and (3) willing to complete email questionnaires

Exclusion Criteria:

  1. >28 weeks gestation
  2. unable to speak/read English
  3. unable to complete email questionnaires

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Enkelt gruppeopgave
  • Maskning: Dobbelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Screening and CBT
Screening and Cognitive Behavioral Therapy. The intervention group will be screened and if they need criteria they will complete the 6, 30-minute online, interactive CBT modules over 6 weeks.
Cognitive Behavioral Therapy- an effective, non-pharmacological treatment for depression and anxiety.
Ingen indgriben: Usual care
Usual prenatal care

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
The primary outcome of this study is the feasibility/acceptability of integrated psychosocial care and its components.
Tidsramme: 6 weeks post randomization
Feasibility/acceptability of the intervention will be assessed through individual face-to-face or telephone-based semi-structured qualitative interviews of both clinic staff and women in the intervention group. The field does not allow for all questions to be provided. Sample question for clinic staff is 'What aspects made it easy/challenging to use the tablet for prenatal assessment as part of routine prenatal care?' Sample questions for intervention group participants: 1)How did you feel about answering these kinds of questions on a tablet?; 2)Please describe any concerns you had about answering these questions on a tablet; 3)How would you prefer the results to be shared with you
6 weeks post randomization

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Maternal depression, anxiety, stress
Tidsramme: on recruitment, 6 weeks post randomization and 3 months postpartum
Depression, Anxiety, and Stress Scale (DASS-21) Self-reported by mother on emailed questionnaire
on recruitment, 6 weeks post randomization and 3 months postpartum
Maternal coping
Tidsramme: on recruitment, 6 weeks post-randomization and 3 months postpartum
The Brief Cope Self-reported by mother on emailed questionnaire
on recruitment, 6 weeks post-randomization and 3 months postpartum
Relationship Adjustment
Tidsramme: on recruitment, 6 weeks post-randomization and 3 months postpartum
Scale: Dyadic Adjustment Scale, DAS-7 Self-reported by mother on emailed questionnaire
on recruitment, 6 weeks post-randomization and 3 months postpartum
Parenting Stress
Tidsramme: 3 months postpartum
Parenting Stress Scale Self-reported by mother
3 months postpartum
Parenting competence
Tidsramme: 3 months postpartum
Parenting Sense of Competence Scale Self-reported by mother on emailed questionnaire
3 months postpartum
Maternal-infant attachment
Tidsramme: 3 months postpartum
Maternal Attachment Inventory (MAI) Self-reported by mother on emailed questionnaire
3 months postpartum
Trait anxiety
Tidsramme: on recruitment, 6 weeks postrandomization, 3 months postpartum
State Trait Anxiety Inventory (STAI) Self-reported by mother on emailed questionnaire
on recruitment, 6 weeks postrandomization, 3 months postpartum

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Efterforskere

  • Ledende efterforsker: Dawn A Kingston, Ph.D, University of Calgary

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart

1. januar 2014

Primær færdiggørelse (Forventet)

1. december 2020

Studieafslutning (Forventet)

1. december 2020

Datoer for studieregistrering

Først indsendt

10. juli 2013

Først indsendt, der opfyldte QC-kriterier

16. juli 2013

Først opslået (Skøn)

17. juli 2013

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

13. november 2019

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

11. november 2019

Sidst verificeret

1. november 2019

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • 00036912

Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .

Kliniske forsøg med Depression

Kliniske forsøg med Cognitive Behavioral Therapy

Abonner