リソースの少ない環境でHIVとともに生きる若者のメンタルヘルスとアドヒアランスを改善するためのグループベースの介入
IMPAACT 2016 - リソースの少ない環境で HIV とともに生きる若者のメンタルヘルスと抗レトロウイルス療法 (ART) のアドヒアランスを改善するためのグループベースの介入の評価
調査の概要
状態
状態
条件
条件
介入・治療
介入・治療
詳細な説明
研究の種類
研究の種類
入学 (実際)
入学
段階
段階
- 適用できない
連絡先と場所
研究連絡先
研究連絡先
- 名前:Nicole Montañez, MSW
- 電話番号:11844 919-544-7040
- メール:nmontanez@fhi360.org
研究連絡先のバックアップ
- 名前:Jennifer Libous, MS
- 電話番号:18131 202-884-8131
- メール:jlibous@fhi360.org
研究場所
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Chitungwiza、ジンバブエ
- St. Mary's CRS 30303
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Harare、ジンバブエ
- Harare Family Care CRS 31890
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Harare、ジンバブエ
- Seke North CRS 30306
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Gaborone、ボツワナ
- Gaborone Prevention/Treatment Trials CRS 12701
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Molepolole、ボツワナ
- Molepolole Prevention/Treatment Trials CRS 12702
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Blantyre、マラウイ
- College of Medicine CRS 30301
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Lilongwe、マラウイ
- University of North Carolina Lilongwe CRS 12001
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Soweto、南アフリカ
- Soweto IMPAACT CRS 8052
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参加基準
適格基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
説明
参加基準 - 青少年の参加者の場合:
- 上映時、15~19歳。
- サイトの標準操作手順 (SOP) によって決定され、サイトの IRB/EC ポリシーおよび手順と一致するように、独立したインフォームド コンセントを提供する法定年齢に達している場合: 潜在的な若者は、研究参加のために書面によるインフォームド コンセントを提供する意思があり、提供することができます。
- 独立したインフォームドコンセントを提供する法定年齢に達していない場合:親または保護者は、研究参加のために書面によるインフォームドコンセントを提供する意思があり、提供することができ、潜在的な若者の参加者は、研究参加のために書面によるインフォームドコンセントを提供する意思があり、提供することができます。
- 医療記録に記載されているように、または確認検査によって異なる時点で収集された2つのサンプルの文書化された検査に基づいて、HIV感染が確認されました。
- -スクリーニング時に、登録調査官または被指名人によって確認されたように、彼または彼女のHIV感染を認識しています。
- -スクリーニング時に、医療記録文書に基づいて、スクリーニングの少なくとも24週間前にARTが処方されました。
スクリーニングで、中等度から重度のメンタルヘルス症状の以下の指標の少なくとも1つを満たす:
- -患者健康アンケート-9(PHQ-9)スコア≥10
- 全般性不安障害-7 (GAD-7) スコア≧10
- UCLA 心的外傷後ストレス障害反応指数 (UCLA PTSD-RI) スコア > 35
包含基準 - 介護者参加者の場合:
- 保護者: 生物学的親、法定後見人、または無作為化試験に参加している青少年に情緒的、心理的、および/または情報のケアを提供する人物として定義され、青少年によって特定され、青少年が書面による参加許可を提供した人この研究で。
- -独立した同意を提供する法定年齢であり、研究への参加について書面によるインフォームドコンセントを提供する意思と能力がある。
除外基準 - 青少年の参加者の場合:
- エントリー時に、メンタルヘルスまたはARTアドヒアランス介入を提供する研究に参加します。
- IMPAACT 2016 フォーカス グループまたはパイロット テストに参加済み
- 治験責任医師の意見では、インフォームド・コンセントおよびインフォームド・コンセントを排除する、研究への参加を危険なものにする、研究結果データの解釈を複雑にする、または研究目的の達成を妨げるその他の状態、不利な社会的状況または認知障害。
除外基準 - 介護者参加者の場合:
IMPAACT 2016 フォーカス グループまたはパイロット テストに参加済み。
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:支持療法
- 割り当て:ランダム化
- 介入モデル:並列代入
- マスキング:なし(オープンラベル)
アーム数
武器と介入
参加者グループ / アーム参加者グループ / アーム |
介入・治療介入・治療 |
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実験的:Youth TI-CBT Intervention Arm
For youth, the TI-CBT intervention arm consisted of six 2-hour TI-CBT group sessions led by Indigenous Youth Leaders (IYL) during weeks 1 to 8 and one 2-hour booster group session at 6-months.
The TI-CBT Intervention was delivered in a group format.
The TI-CBT Intervention arm had 15 groups with an average of 8.5 youth per group (range 6-11).
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For youth, each TI-CBT group session was led by IYL.
TI-CBT teaches techniques and ways to manage distress through psychosocial health education, cognitive restructuring, and "mastery of trauma", which refers to the process by which survivors of psychological trauma work through the traumatic experience in a meaningful way, and are able to move on with life.
TI-CBT addresses both the trauma of learning one has HIV and the trauma associated with managing a chronic and stigmatized illness.
The intervention highlights links between HIV and traditional gender roles, gender inequities, and gender-based violence.
Finally, the relaxation training teaches youth strategies to relax and these are integrated at the beginning and end of each session.
TI-CBT Youth Intervention Manuals were distributed to sites for translation, backtranslation, and cultural adaptation in preparation for the Randomized Trial.
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アクティブコンパレータ:Youth Discussion Control Arm
For youth, the Discussion Control arm consisted of six 2-hour discussion group sessions led by IYL during weeks 1 to 8 and one 2-hour booster discussion group session at 6 months.
The Discussion Control was delivered in a group format.
The Discussion Control arm had 15 groups with an average of 8.4 youth per group (range 5-10).
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For youth, each discussion group session was led by IYL. Discussion topics were selected by youth in the group.
Discussion Control sessions took place at a separate time from TI-CBT Intervention sessions to minimize contamination.
Youth and caregiver group sessions were also held separately.
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実験的:Caregiver TI-CBT Intervention Arm
For caregivers, the TI-CBT Intervention arm consisted of two 2-hour TI-CBT group sessions on two separate weeks within 8 weeks of their youth's first group session and one 2-hour booster group session at 6-months led by adult study staff.
The TI-CBT Intervention was delivered in group format.
The TI-CBT Intervention arm had 15 groups with an average of 7.7 caregivers per group (range 5-10).
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For caregivers, each TI-CBT group session was led by adult study staff.
TI-CBT teaches techniques and ways to manage distress through psychosocial health education, cognitive restructuring, and "mastery of trauma", which refers to the process by which survivors of psychological trauma work through the traumatic experience in a meaningful way, and are able to move on with life.
TI-CBT addresses both the trauma of learning one has HIV and the trauma associated with managing a chronic and stigmatized illness.
The intervention highlights links between HIV and traditional gender roles, gender inequities, and gender-based violence.
Finally, the relaxation training teaches strategies to relax and these are integrated at the beginning and end of each session.
TI-CBT Caregiver Intervention Manuals were distributed to sites for translation, backtranslation, and cultural adaptation in preparation for the Randomized Trial.
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アクティブコンパレータ:Caregivers Discussion Control Arm
For caregivers, the Discussion Control arm consisted of: two 2-hour discussion group sessions on two separate weeks within 8 weeks of their youth's first group session and one 2-hour booster discussion group session at 6 months led by adult study staff.
The Discussion Control intervention was delivered in a group format.
The Discussion Control arm had 15 groups with an average of 7.6 caregivers per group (range 3-10).
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For caregivers, each discussion group session was led by adult study staff.
Discussion topics were selected by caregivers in the group.
Discussion Control sessions took place at a separate time from TI-CBT Intervention sessions to minimize contamination.
Youth and caregiver group sessions were also held separately.
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この研究は何を測定していますか?
主要な結果の測定
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Group-level Mean General Anxiety Disorder-7 (GAD-7) at 6 Months
時間枠:at 6 months
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Average (standard deviation) of the group-level mean General Anxiety Disorder-7 (GAD-7) score within arm.
The GAD-7 features 7 items assessing frequency of anxiety symptoms over the past 2 weeks on a scale from 0="Not at all" to 3="Nearly every day".
Responses to the 7 items are summed to obtain a GAD-7 score ranging from 0 (least) to 21 (most severe symptoms).
A score of 10 or more points indicates moderate to severe anxiety symptoms.
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at 6 months
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Group-level Mean UCLA Post-Traumatic Stress Disorder-Reaction Index (UCLA-PTSD-RI) at 6 Months
時間枠:at 6 months
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Average (standard deviation) of the group-level mean UCLA Post Traumatic Stress Disorder-Reaction Index (PTSD-RI) score within arm.
The UCLA PTSD-RI assesses DSM-IV criteria for PTSD in youth.
If prior trauma is endorsed, assessment asks whether 31 PTSD symptoms have occurred within the past month on a scale from 0="None" to 4="Most of the time".
A scoring algorithm is applied to the 31 items to calculate a score ranging from 0 (least) to 80 (most severe symptoms).
A score of 35 or more indicates moderate to severe PTSD symptoms.
If no trauma is endorsed, no score is calculated.
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at 6 months
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Group-level Mean Composite Mental Health Measure at 6 Months
時間枠:at 6 months
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Average (standard deviation) of the group-level mean Composite score within arm.
Composite scores are a study-specific measure of combined mental health symptoms.
A participant's PHQ-9, GAD-7, and UCLA PTSD-RI scores at the given timepoint are each standardized according to baseline to get Z scores.
The 3 Z scores are summed to obtain a Composite score.
Composite scores are not Z scores themselves and can range from -Inf to +Inf, with greater scores reflecting more severe symptoms overall.
Composite scores of 0 at baseline represent average symptom levels overall, but otherwise do not have a meaningful central value.
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at 6 months
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Group-level Mean Patient Health Questionnaire-9 (PHQ-9) at 6 Months
時間枠:at 6 months
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Average (standard deviation) of the group-level mean Patient Health Questionnaire-9 (PHQ-9) score within arm.
The PHQ-9 features 9 items assessing the frequency of depression symptoms over the past 2 weeks on a scale from 0="Not at all" to 3="Nearly every day".
Responses to the 9 items are summed to obtain a PHQ-9 score ranging from 0 (least) to 27 (most severe symptoms).
A score of 10 or more points indicates moderate to severe depression symptoms.
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at 6 months
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二次結果の測定
二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Group-level Mean General Anxiety Disorder-7 (GAD-7) at IPL (Immediately Post-Last Group Session)
時間枠:After initial treatment completion (initial treatment lasted an average of 6 weeks)
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Average (standard deviation) of the group-level mean General Anxiety Disorder-7 (GAD-7) score within arm.
The GAD-7 features 7 items assessing frequency of anxiety symptoms over the past 2 weeks on a scale from 0="Not at all" to 3="Nearly every day".
Responses to the 7 items are summed to obtain a GAD-7 score ranging from 0 (least) to 21 (most severe symptoms).
A score of 10 or more points indicates moderate to severe anxiety symptoms.
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After initial treatment completion (initial treatment lasted an average of 6 weeks)
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Group-level Mean Patient Health Questionnaire-9 (PHQ-9) at IPL (Immediately Post Last Group Session)
時間枠:After initial treatment completion (initial treatment lasted an average of 6 weeks)
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Average (standard deviation) of the group-level mean Patient Health Questionnaire-9 (PHQ-9) score within arm.
The PHQ-9 features 9 items assessing the frequency of depression symptoms over the past 2 weeks on a scale from 0="Not at all" to 3="Nearly every day".
Responses to the 9 items are summed to obtain a PHQ-9 score ranging from 0 (least) to 27 (most severe symptoms).
A score of 10 or more points indicates moderate to severe depression symptoms.
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After initial treatment completion (initial treatment lasted an average of 6 weeks)
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Group-level Mean UCLA Post-Traumatic Stress Disorder-Reaction Index (UCLA PTSD-RI) at IPL (Immediately Post-Last Group Session)
時間枠:After initial treatment completion (initial treatment lasted an average of 6 weeks)
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Average (standard deviation) of the group-level mean UCLA Post Traumatic Stress Disorder-Reaction Index (PTSD-RI) score within arm.
The UCLA PTSD-RI assesses DSM-IV criteria for PTSD in youth.
If prior trauma is endorsed, assessment asks whether 31 PTSD symptoms have occurred within the past month on a scale from 0="None" to 4="Most of the time".
A scoring algorithm is applied to the 31 items to calculate a score ranging from 0 (least) to 80 (most severe symptoms).
A score of 35 or more indicates moderate to severe PTSD symptoms.
If no trauma is endorsed, no score is calculated.
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After initial treatment completion (initial treatment lasted an average of 6 weeks)
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Group-level Mean Composite Mental Health Measure at IPL (Immediately Post-Last Group Session)
時間枠:After initial treatment completion (initial treatment lasted an average of 6 weeks)
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Average (standard deviation) of the group-level mean Composite score within arm.
Composite scores are a study-specific measure of combined mental health symptoms.
A participant's PHQ-9, GAD-7, and UCLA PTSD-RI scores at the given timepoint are each standardized according to baseline to get Z scores.
The 3 Z scores are summed to obtain a Composite score.
Composite scores are not Z scores themselves and can range from -Inf to +Inf, with greater scores reflecting more severe symptoms overall.
Composite scores of 0 at baseline represent average symptom levels overall, but otherwise do not have a meaningful central value.
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After initial treatment completion (initial treatment lasted an average of 6 weeks)
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Group-level Mean ART Adherence at 6 Months
時間枠:at 6 months
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Average (standard deviation) of the group-level mean antiretroviral therapy (ART) adherence score within arm.
The Wilson 3-Item Adherence Scale assessed self-reported ART adherence.
Within the past 30 days, the 3 items correspond to missed daily doses (0-30), adherence to medication instructions ("Very poor" to "Excellent"), and frequency of perfect use ("Never" to "Always").
Responses on the three items are transformed linearly to scores between 0 and 100 points and averaged to obtain a single score.
Scores range from 0 (worst) possible adherence to 100 (best possible adherence).
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at 6 months
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Viral Load at 6 Months
時間枠:at 6 months
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HIV-1 RNA
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at 6 months
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Group-level Mean ART Adherence at IPL (Immediately Post-Last Group Session).
時間枠:After initial treatment completion (initial treatment lasted an average of 6 weeks).
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Self-report - Wilson 3-item scale (range 0-100, higher=better)
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After initial treatment completion (initial treatment lasted an average of 6 weeks).
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Viral Load at IPL (Immediately Post-Last Group Session)
時間枠:After initial treatment completion (initial treatment lasted an average of 6 weeks)
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HIV-1 RNA
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After initial treatment completion (initial treatment lasted an average of 6 weeks)
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協力者と研究者
スポンサー
スポンサー
協力者
協力者
捜査官
捜査官
- スタディチェア:Dorothy Dow, MD, MSc、Duke University
出版物と役立つリンク
一般刊行物
- Dow DE, Libous J, Ponatshego PL, Masheto G, Mvalo T, Payesa C, Buckley J, Stranix-Chibanda L, Nematadzira T, Vhembo T, Ace A, Warshaw M, Townley E, Lee S, Allison S, Donenberg G and the IMPAACT 2016 Team. High levels of mental distress among youth with HIV in Southern Africa: A description of enrollment into IMPAACT 2016, a randomized controlled trial of a peer-led, group-based mental health intervention. Presented at IAS, Kigali, Rwanda, 15 July 2025.
- Libous J, Jeffrey R, George K, Montañez N, Warshaw M, Shakes Raesi M, Ponatshego PL, Maliwichi L, Vhembo T, Mutasa T, Bere CT, Galvin L, Townley E, Varechtchouk O, Dow D, Donenberg G, and the IMPAACT 2016 Team. IMPAACT 2016: The ADAPT-ITT Framework Leveraging Youth and Supporter Voices in the Adaptation of a Trauma-Informed Cognitive Behavioral Therapy Group-Based Intervention for Youth Living with HIV and Mental Health Distress. Presented at Fast Track Cities, Paris, France, 13-15 October 2024.
- Vhemo T, Mhembere T, Mbengeranwa T, Bere TC, Mutasa T, Katsande R, Gumbo J, Mudzonga N, Nematadzira T, Maturure SJ, Mandima PF, Maonera S, Stranix-Chibanda L. High Prevalence of Common Mental Health Disorders Amongst Adolescents With HIV in Zimbabwe: IMPAACT 2016; Presented at International Workshop on Pediatrics & HIV, Munich, Germany, 19-20 July 2024.
- Libous JL, Montañez N, Donenberg G, Kapetanovic S, Dow D. IMPAACT 2016: Operationalizing the ADAPT-ITT Model to drive local adaptation of an intervention to improve mental health and medication adherence in youth living with HIV. Presented at Society for Clinical Research Associates 29th Annual Conference, Virtual, 23-26 September 2020.
- Warshaw M, Dow D, Kapetanovic S, Libous J, Reding C, Montañez , Donenberg G. IMPAACT 2016: Interdisciplinary Collaboration at Multiple Levels. Society for Clinical Trials 41st Annual Meeting, Baltimore, MD (Virtual), 2020.
- Libous JL, Montanez NA, Dow DE, Kapetanovic S, Buckley J, Kakhu TJ, Kamthunzi P, Maliwichi LA, Vhembo T, Chawana TD, Nematadzira T, Donenberg GR. IMPAACT 2016: Operationalizing HIV Intervention Adaptations to Inform the Science and Outcomes of Implementation. Front Reprod Health. 2021 May 28;3:662912. doi: 10.3389/frph.2021.662912. eCollection 2021.
研究記録日
主要日程の研究
研究開始 (実際)
研究開始
一次修了 (実際)
一次修了
研究の完了 (実際)
研究の完了
試験登録日
最初に提出
最初に提出
QC基準を満たした最初の提出物
QC基準を満たした最初の提出物
最初の投稿 (実際)
最初の投稿
学習記録の更新
投稿された最後の更新 (実際)
投稿された最後の更新
QC基準を満たした最後の更新が送信されました
QC基準を満たした最後の更新が送信されました
最終確認日
最終確認日
詳しくは
本研究に関する用語
キーワード
その他の研究ID番号
その他の研究ID番号
- IMPAACT 2016
- DAIDS ID #38506 (その他の識別子:DAIDS/NIAID/NIH)
個々の参加者データ (IPD) の計画
個々の参加者データ (IPD) を共有する予定はありますか?
IPD プランの説明
IPD 共有時間枠
IPD 共有アクセス基準
データは、IMPAACT ネットワークによって承認されたデータの使用について方法論的に適切な提案を提供する研究者と共有されます。
分析の種類: 具体的には、IMPAACT ネットワークによって承認された提案の目的を達成するために必要な分析の種類について。
メカニズム: 研究者は、https://www.impaactnetwork.org/resources/study-proposals.htm の IMPAACT「データ要求」フォームを使用して、データへのアクセス要求を送信できます。 承認された提案の研究者は、データを受け取る前に IMPAACT データ使用契約に署名する必要があります。
IPD 共有サポート情報タイプ
- STUDY_PROTOCOL
- SAP
医薬品およびデバイス情報、研究文書
米国FDA規制医薬品の研究
米国FDA規制機器製品の研究
この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。