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Translating Evidence Based Developmental Screening Into Pediatric Primary Care (TEDS)

8. november 2011 oppdatert av: Children's Hospital of Philadelphia

Translating Evidence Based Developmental Screening Into Pediatric Primary Care ( Aims 2 and 3 )

The purpose of this study is to examine the feasibility, acceptability and effectiveness of implementing the American Academy of Pediatrics (AAP's) recommendation that clinicians provide developmental surveillance at all well child visits and institute developmental screening at critical developmental periods in childhood, namely at 9, 18, 24 and 30 months of age.

Studieoversikt

Detaljert beskrivelse

The purpose of this study is to examine the feasibility, acceptability and effectiveness of implementing the AAP's recommendation that clinicians provide developmental surveillance at all well child visits and institute developmental screening at critical developmental periods in childhood, namely at 9, 18, 24 and 30 months of age. The study will also examine its acceptance by pediatric practices, its adoption and adaptation in urban pediatric practices, and the effectiveness of a developmental screening protocol that conforms to the AAP and Maternal and Child Health Bureau (MCHB) recommendations compared with that of developmental surveillance alone.

Studietype

Intervensjonell

Registrering (Faktiske)

2314

Fase

  • Fase 2

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiesteder

    • Pennsylvania
      • Philadelphia, Pennsylvania, Forente stater, 19104
        • CHOP - Primary Care Market Street
      • Philadelphia, Pennsylvania, Forente stater, 19104
        • CHOP Primary Care-University City
      • Philadelphia, Pennsylvania, Forente stater, 19139
        • CHOP Primary Care Center- Cobbs Creek
      • Philadelphia, Pennsylvania, Forente stater, 19145
        • CHOP Primary Care - South Philadelphia

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

Ikke eldre enn 2 år (Barn)

Tar imot friske frivillige

Ja

Kjønn som er kvalifisert for studier

Alle

Beskrivelse

Inclusion Criteria:

  1. Age birth to 30 months of age by the start of the intervention phase.
  2. Child's Primary Care Physician has consented to participate in the study
  3. Parental/guardian permission (informed consent).

Exclusion Criteria:

  1. Premature Infants (less than 36 weeks of gestation)
  2. Children with prior identified developmental delay.
  3. Children with major congenital anomalies/genetic disorders
  4. Children placed in foster care

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Screening
  • Tildeling: Randomisert
  • Intervensjonsmodell: Parallell tildeling
  • Masking: Ingen (Open Label)

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Eksperimentell: SRS
School Readiness Specialist (SRS) will administer the screening questionnaire to the subject during the intervention period, at the subject's 9, 18, 24 and 30 month visits. They will then see their PCP for a well child visit in which the results of the test will be interpreted, developmental counseling and/or anticipatory guidance provided as per usual care. EI (Early intervention) referral will be completed, at the discretion of the providers, if the subject fails the developmental screen or the caregivers raise a specific concern about the child's development.
In the SRS intervention arm subjects will complete developmental screening tools with a school readiness specialist at their 9, 18, 24 and 30 month well child visits and then complete their well child visit with their primary care clinician to discuss the results.
Subjects who are randomized to PCP arm will be screened for developmental delays by their Primary Care Clinician at their 9, 18, 24 and 30 month well child visits. The corresponding screening tools may be mailed to the study participants 2 weeks before the scheduled well child visits. Those who do not complete the screening tools or those who did not receive them in the mail will then complete the questionnaire in the office prior to seeing their doctor or with their doctor. The PCP will then score the screening tool and interpret the test results. Developmental counseling and/or anticipatory guidance will be provided, as per usual care. EI referral will be completed, at the discretion of the provider with the approval of the caregiver , if the subject fails the developmental screen or the caregivers raise a specific concern about the child's development.
Eksperimentell: Provider
Primary Care Physician (PCP) will do the developmental screening at the subject's 9, 18, 24 and 30 month well child visits. Once the screening questionnaire is complete the PCP will then score the screening tool and interpret the test results. Developmental counseling and/or anticipatory guidance will be provided, as per usual care. EI (Early intervention) referral will be completed, at the discretion of the providers, if the subject fails the developmental screen or the caregivers raise a specific concern about the child's development.
In the SRS intervention arm subjects will complete developmental screening tools with a school readiness specialist at their 9, 18, 24 and 30 month well child visits and then complete their well child visit with their primary care clinician to discuss the results.
Subjects who are randomized to PCP arm will be screened for developmental delays by their Primary Care Clinician at their 9, 18, 24 and 30 month well child visits. The corresponding screening tools may be mailed to the study participants 2 weeks before the scheduled well child visits. Those who do not complete the screening tools or those who did not receive them in the mail will then complete the questionnaire in the office prior to seeing their doctor or with their doctor. The PCP will then score the screening tool and interpret the test results. Developmental counseling and/or anticipatory guidance will be provided, as per usual care. EI referral will be completed, at the discretion of the provider with the approval of the caregiver , if the subject fails the developmental screen or the caregivers raise a specific concern about the child's development.
Ingen inngripen: Routine
Subjects randomized to routine surveillance will receive routine preventive care as well as developmental surveillance at all well child visits, including the 9, 18, 24 and 30 month visits. EI referral will be completed, at the discretion of the provider, if the PCP observes a developmental delay during surveillance or the caregivers raise a specific concern about the child's development.

Hva måler studien?

Primære resultatmål

Resultatmål
Tidsramme
The primary outcome measure for this study will be the percentage of children enrolled in the study who are identified as having a developmental delay.
Tidsramme: We assessed this between June to October 2010
We assessed this between June to October 2010

Sekundære resultatmål

Resultatmål
Tidsramme
Percentage of children in the study who are referred to Early Intervention Services
Tidsramme: We assessed this in June 2010
We assessed this in June 2010
Percentage of children in the study who enroll in Early Intervention Services
Tidsramme: We will assess this between June to October 2010
We will assess this between June to October 2010
Percent of parents enrolled in the study who report as satisfied with the intervention
Tidsramme: We assessed this between March and September 2010
We assessed this between March and September 2010
Percent of providers enrolled in the study who report as satisfied with the intervention.
Tidsramme: We will assess this between March and September 2010
We will assess this between March and September 2010

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Etterforskere

  • Hovedetterforsker: James P Guevara, MD MPH, Children's Hospital of Philadelphia

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart

1. november 2008

Primær fullføring (Faktiske)

1. oktober 2010

Studiet fullført (Faktiske)

1. oktober 2010

Datoer for studieregistrering

Først innsendt

13. februar 2009

Først innsendt som oppfylte QC-kriteriene

13. februar 2009

Først lagt ut (Anslag)

16. februar 2009

Oppdateringer av studieposter

Sist oppdatering lagt ut (Anslag)

10. november 2011

Siste oppdatering sendt inn som oppfylte QC-kriteriene

8. november 2011

Sist bekreftet

1. november 2011

Mer informasjon

Begreper knyttet til denne studien

Andre studie-ID-numre

  • 2008-9-6124

Denne informasjonen ble hentet direkte fra nettstedet clinicaltrials.gov uten noen endringer. Hvis du har noen forespørsler om å endre, fjerne eller oppdatere studiedetaljene dine, vennligst kontakt register@clinicaltrials.gov. Så snart en endring er implementert på clinicaltrials.gov, vil denne også bli oppdatert automatisk på nettstedet vårt. .

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