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Longitudinal, Multi-Dimensional Assessment of Recovery and Added Benefit of a Behavioral Health Intervention for Children With Abusive Head Trauma

8 de setembro de 2020 atualizado por: University of Colorado, Denver
Family dynamics and caregiver responses to a child with traumatic brain injury are implicated both as precipitating events as well as factors influencing outcomes of abusive head trauma (AHT). However, no family behavioral health intervention exists to meet the unique needs of families with infants and very young children with AHT. The study was initially designed as a randomized controlled trial (RCT) to assess the efficacy of an evidence-based behavioral intervention to improve outcomes for families and children with AHT. However, rates of recruitment were so low that the investigators and funder amended the study to be intervention only (with IRB approval). At that time, there were five participants and only one had been assigned to the intervention arm. Only one additional family was recruited, and that family did not complete study measures prior to the time at which the intervention would start and did not receive the intervention. The investigators did examine outcomes in multiple dimensions, including clinical, cognitive, family, caregiver, child behavior, and service usage over time but connot compare to patients not receiving the intervention. The investigators were not able to examine characteristics of patients and families best suited for this behavioral health intervention.

Visão geral do estudo

Descrição detalhada

27 children (ages 3 months to 2 years) and their caregiver referred to the Non-Accidental Brain Injury Care Clinic at the Children's Hospital Colorado (CHCO) were recruited for participation in the study, 7 families consented. One family received the Attachment and Biobehavioral (ABC) intervention. One family discontinued participation. The data collection schedule was 1 month post-injury, 3 months, 6 months, 9 months, and 12 months. Outcomes in multiple dimensions, were assessed including clinical recovery, cognitive, language, and motor functioning, family functioning, caregiver mental health including anxiety, depression, competency, and stress. The investigators also examined service use over time. Analyses will assess trajectories of recovery for both groups using data for all time points.

Tipo de estudo

Intervencional

Inscrição (Real)

7

Estágio

  • Não aplicável

Contactos e Locais

Esta seção fornece os detalhes de contato para aqueles que conduzem o estudo e informações sobre onde este estudo está sendo realizado.

Locais de estudo

    • Colorado
      • Aurora, Colorado, Estados Unidos, 80045
        • Children's Hospital of Colorado

Critérios de participação

Os pesquisadores procuram pessoas que se encaixem em uma determinada descrição, chamada de critérios de elegibilidade. Alguns exemplos desses critérios são a condição geral de saúde de uma pessoa ou tratamentos anteriores.

Critérios de elegibilidade

Idades elegíveis para estudo

3 meses a 2 anos (Filho)

Aceita Voluntários Saudáveis

Não

Gêneros Elegíveis para o Estudo

Tudo

Descrição

Inclusion Criteria:

  • Children who have experienced AHT as determined by the CHCO Child Protection Team
  • Caregivers who speak English
  • Families who live in the Denver Metro area and,
  • Child-victim age between 3 months and 2 years of age

Exclusion Criteria:

  • Those with significant disability that would inhibit participation in the intervention,
  • Those scoring below 6 months on developmental measures will not be eligible.

Plano de estudo

Esta seção fornece detalhes do plano de estudo, incluindo como o estudo é projetado e o que o estudo está medindo.

Como o estudo é projetado?

Detalhes do projeto

  • Finalidade Principal: Cuidados de suporte
  • Alocação: Randomizado
  • Modelo Intervencional: Atribuição Paralela
  • Mascaramento: Solteiro

Armas e Intervenções

Grupo de Participantes / Braço
Intervenção / Tratamento
Experimental: ABC Intervention
The investigators will deliver the "Attachment and Biobehavioral Catch-up (ABC)" in the home weekly using live, in-room coaching, to give caregivers feedback as they use targeted skills during interactions with the child. The intervention will last 10 sessions. Study participants in both groups will complete study measures at baseline, 1 month, 3 months, post-intervention, 6 months, and 12 months.
Attachment and Biobehavioral Catch-up (ABC) is an in-home, 10-session, manualized parent-training program for children ages 6 months through 2 years who have experienced early adversity. ABC utilizes parent-child interactions to enhance positive interactions with the child through live coaching with particular focus on nurturing behaviors, following the child's lead, non-frightening behaviors. These behaviors include appropriate soothing and comforting when a child is distressed, responding to or imitating a child in a contingent way, and displaying warmth.
Sem intervenção: Standard of Care
Subjects will receive normal standard of care without the "Attachment and Biobehavioral Catch-up (ABC)".

O que o estudo está medindo?

Medidas de resultados primários

Medida de resultado
Descrição da medida
Prazo
Evaluation of cognitive scores of children receiving the ABC intervention to those receiving usual care.
Prazo: 6 months
Compare the Cognitive scale standard score from the Bayley Scales of Infant and Toddler Development-Third Edition of those receiving the intervention to those receiving care as usual. The cognitive scale standard score ranges from 50-150. Higher scores indicate better cognitive functioning.
6 months
Evaluation of motor scores of children receiving the ABC intervention to those receiving usual care.
Prazo: 6 months
Compare the overall Motor standard score from the Bayley Scales of Infant and Toddler Development-Third Edition of those receiving the intervention to those receiving care as usual. The overall Motor score is a combined score from the Gross Motor and Fine Motor Scales of the Bayley III. The overall motor score is a summed value from the Gross Motor and Fine Motor subscales. Subscale scores are added, then standardized (Mean = 100, SD =15). The range of values for the overall Motor standard score is 50-150. Higher values indicate better motor functioning.
6 months
Evaluation of socioemotional scores of children receiving the ABC intervention to those receiving care as usual.
Prazo: 6 months
Compare scores from the Social-Emotional standard score on the Bayley Scales of Infant and Toddler Development-Third Edition of those receiving the intervention to those receiving care as usual. The range of values for the Social-Emotional Scale is 50-150. Higher values indicate better social-emotional functioning.
6 months
Evaluation of language scores of children receiving the ABC intervention to those receiving care as usual.
Prazo: 6 months
Compare scores on the overall language score on the Bayley Scales of Infant and Toddler Development-Third Edition of those receiving the intervention to those receiving care as usual. The overall language score is the summed score from the Expressive Language and Receptive Language subscales. The summed value is then standardized (mean = 100, SD = 15). The range of values are 50-150. Higher values indicate better language functioning.
6 months
Evaluation of depression scores of caregivers receiving the ABC intervention to those receiving care as usual.
Prazo: 6 months
Compare caregiver depression scores of those receiving the intervention to those receiving care as usual. Depression is measured using the Center for Epidemiological Depression Scale (CES-D). Values range from 0-60. Higher values indicate greater depressive symptoms.
6 months
Evaluation of anxiety scores of caregivers receiving the ABC intervention to those receiving care as usual.
Prazo: 6 months
Compare caregiver scores from the Generalized Anxiety scale (GAD) of those receiving the intervention to those receiving care as usual. The range of values is 0 -21. Higher values indicate greater anxiety symptoms.
6 months
Evaluation of parenting stress scores of caregivers receiving the ABC intervention to those receiving care as usual.
Prazo: 6 months
Compare scores on the Parenting Stress Index-Short Form of those receiving the intervention to those receiving care as usual. Scores on the PSI-SF are a sum of scores from non-duplicate items from the Parental Distress subscale, Parent-child dysfunctional interaction subscale, and the difficult child subscale. Range of values for the total score are 36-180. Higher values indicate greater parental distress.
6 months
Evaluation of family functioning of caregivers receiving the ABC intervention to those receiving care as usual.
Prazo: 6 months
Compare scores from the General Functioning subscale of the Family Assessment Device of those receiving the intervention to those receiving care as usual. Scores on the General Functioning subscale range from 12 to 48. Higher values indicate greater family dysfunction.
6 months
Evaluation of screener scores of child abuse risk of caregivers receiving the ABC intervention to those receiving care as usual.
Prazo: 6 months
Compare scores on the Child Abuse Potential Inventory -Brief Version of caregivers receiving the intervention to those receiving care as usual. Scores on the brief version range from 0-34. Higher scores indicate greater potential risk of child abuse.
6 months
Evaluation of caregiver reported service utilization for children receiving the ABC intervention to those receiving care as usual.
Prazo: 6 months
Compare the utilization of occupational, physical, speech, vision, feeding, or developmental therapy, as well as receipt of nursing care and family psychological services of those families receiving the intervention compared to those receiving care as usual. Service utilization is captured through a project developed measure asking the respondent if his/her child received any service on the list of services since the last interview period. Any endorsement of any service will be coded affirmative. Indicators of use of those receiving the intervention will be compare to those receiving care as usual.
6 months
Evaluation of cognitive scores of children receiving the ABC intervention to those receiving usual care.
Prazo: 9 months
Compare the Cognitive scale standard score from the Bayley Scales of Infant and Toddler Development-Third Edition of those receiving the intervention to those receiving care as usual. The cognitive scale standard score ranges from 50-150. Higher scores indicate better cognitive functioning.
9 months
Evaluation of cognitive scores of children receiving the ABC intervention to those receiving usual care.
Prazo: 12 months
Compare the Cognitive scale standard score from the Bayley Scales of Infant and Toddler Development-Third Edition of those receiving the intervention to those receiving care as usual. The cognitive scale standard score ranges from 50-150. Higher scores indicate better cognitive functioning.
12 months
Evaluation of motor scores of children receiving the ABC intervention to those receiving usual care.
Prazo: 9 months
Compare the overall Motor standard score from the Bayley Scales of Infant and Toddler Development-Third Edition of those receiving the intervention to those receiving care as usual. The overall Motor score is a combined score from the Gross Motor and Fine Motor Scales of the Bayley III. The overall motor score is a summed value from the Gross Motor and Fine Motor subscales. Subscale scores are added, then standardized (Mean = 100, SD =15). The range of values for the overall Motor standard score is 50-150. Higher values indicate better motor functioning.
9 months
Evaluation of motor scores of children receiving the ABC intervention to those receiving usual care.
Prazo: 12 months
Compare the overall Motor standard score from the Bayley Scales of Infant and Toddler Development-Third Edition of those receiving the intervention to those receiving care as usual. The overall Motor score is a combined score from the Gross Motor and Fine Motor Scales of the Bayley III. The overall motor score is a summed value from the Gross Motor and Fine Motor subscales. Subscale scores are added, then standardized (Mean = 100, SD =15). The range of values for the overall Motor standard score is 50-150. Higher values indicate better motor functioning.
12 months
Evaluation of socioemotional scores of children receiving the ABC intervention to those receiving care as usual.
Prazo: 9 months
Compare scores from the Social-Emotional standard score on the Bayley Scales of Infant and Toddler Development-Third Edition of those receiving the intervention to those receiving care as usual. The range of values for the Social-Emotional Scale is 50-150. Higher values indicate better social-emotional functioning.
9 months
Evaluation of socioemotional scores of children receiving the ABC intervention to those receiving care as usual.
Prazo: 12 months
Compare scores from the Social-Emotional standard score on the Bayley Scales of Infant and Toddler Development-Third Edition of those receiving the intervention to those receiving care as usual. The range of values for the Social-Emotional Scale is 50-150. Higher values indicate better social-emotional functioning.
12 months
Evaluation of language scores of children receiving the ABC intervention to those receiving care as usual.
Prazo: 9 months
Compare scores on the overall language score on the Bayley Scales of Infant and Toddler Development-Third Edition of those receiving the intervention to those receiving care as usual. The overall language score is the summed score from the Expressive Language and Receptive Language subscales. The summed value is then standardized (mean = 100, SD = 15). The range of values are 50-150. Higher values indicate better language functioning.
9 months
Evaluation of language scores of children receiving the ABC intervention to those receiving care as usual.
Prazo: 12 months
Compare scores on the overall language score on the Bayley Scales of Infant and Toddler Development-Third Edition of those receiving the intervention to those receiving care as usual. The overall language score is the summed score from the Expressive Language and Receptive Language subscales. The summed value is then standardized (mean = 100, SD = 15). The range of values are 50-150. Higher values indicate better language functioning.
12 months
Evaluation of depression scores of caregivers receiving the ABC intervention to those receiving care as usual.
Prazo: 9 months
Compare caregiver depression scores of those receiving the intervention to those receiving care as usual. Depression is measured using the Center for Epidemiological Depression Scale (CES-D). Values range from 0-60. Higher values indicate greater depressive symptoms.
9 months
Evaluation of depression scores of caregivers receiving the ABC intervention to those receiving care as usual.
Prazo: 12 months
Compare caregiver depression scores of those receiving the intervention to those receiving care as usual. Depression is measured using the Center for Epidemiological Depression Scale (CES-D). Values range from 0-60. Higher values indicate greater depressive symptoms.
12 months
Evaluation of anxiety scores of caregivers receiving the ABC intervention to those receiving care as usual.
Prazo: 9 months
Compare caregiver scores from the Generalized Anxiety scale (GAD) of those receiving the intervention to those receiving care as usual. The range of values is 0 -21. Higher values indicate greater anxiety symptoms.
9 months
Evaluation of anxiety scores of caregivers receiving the ABC intervention to those receiving care as usual.
Prazo: 12 months
Compare caregiver scores from the Generalized Anxiety scale (GAD) of those receiving the intervention to those receiving care as usual. The range of values is 0 -21. Higher values indicate greater anxiety symptoms.
12 months
Evaluation of parenting stress scores of caregivers receiving the ABC intervention to those receiving care as usual.
Prazo: 9 months
Compare scores on the Parenting Stress Index-Short Form of those receiving the intervention to those receiving care as usual. Scores on the PSI-SF are a sum of scores from non-duplicate items from the Parental Distress subscale, Parent-child dysfunctional interaction subscale, and the difficult child subscale. Range of values for the total score are 36-180. Higher values indicate greater parental distress.
9 months
Evaluation of parenting stress scores of caregivers receiving the ABC intervention to those receiving care as usual.
Prazo: 12 months
Compare scores on the Parenting Stress Index-Short Form of those receiving the intervention to those receiving care as usual. Scores on the PSI-SF are a sum of scores from non-duplicate items from the Parental Distress subscale, Parent-child dysfunctional interaction subscale, and the difficult child subscale. Range of values for the total score are 36-180. Higher values indicate greater parental distress.
12 months
Evaluation of family functioning of caregivers receiving the ABC intervention to those receiving care as usual.
Prazo: 9 months
Compare scores from the General Functioning subscale of the Family Assessment Device of those receiving the intervention to those receiving care as usual. Scores on the General Functioning subscale range from 12 to 48. Higher values indicate greater family dysfunction.
9 months
Evaluation of family functioning of caregivers receiving the ABC intervention to those receiving care as usual.
Prazo: 12 months
Compare scores from the General Functioning subscale of the Family Assessment Device of those receiving the intervention to those receiving care as usual. Scores on the General Functioning subscale range from 12 to 48. Higher values indicate greater family dysfunction.
12 months
Evaluation of screener scores of child abuse risk of caregivers receiving the ABC intervention to those receiving care as usual.
Prazo: 9 months
Compare scores on the Child Abuse Potential Inventory -Brief Version of caregivers receiving the intervention to those receiving care as usual. Scores on the brief version range from 0-34. Higher scores indicate greater potential risk of child abuse.
9 months
Evaluation of screener scores of child abuse risk of caregivers receiving the ABC intervention to those receiving care as usual.
Prazo: 12 months
Compare scores on the Child Abuse Potential Inventory -Brief Version of caregivers receiving the intervention to those receiving care as usual. Scores on the brief version range from 0-34. Higher scores indicate greater potential risk of child abuse.
12 months
Evaluation of caregiver reported service utilization for children receiving the ABC intervention to those receiving care as usual.
Prazo: 9 months
Compare the utilization of occupational, physical, speech, vision, feeding, or developmental therapy, as well as receipt of nursing care and family psychological services of those families receiving the intervention compared to those receiving care as usual. Service utilization is captured through a project developed measure asking the respondent if his/her child received any service on the list of services since the last interview period. Any endorsement of any service will be coded affirmative. Indicators of use of those receiving the intervention will be compare to those receiving care as usual.
9 months
Evaluation of caregiver reported service utilization for children receiving the ABC intervention to those receiving care as usual.
Prazo: 12 months
Compare the utilization of occupational, physical, speech, vision, feeding, or developmental therapy, as well as receipt of nursing care and family psychological services of those families receiving the intervention compared to those receiving care as usual. Service utilization is captured through a project developed measure asking the respondent if his/her child received any service on the list of services since the last interview period. Any endorsement of any service will be coded affirmative. Indicators of use of those receiving the intervention will be compare to those receiving care as usual.
12 months

Medidas de resultados secundários

Medida de resultado
Descrição da medida
Prazo
Evaluation clusters of patient and family characteristics that benefit most from a parenting intervention component
Prazo: 1 month, 3 month, 6 months, 9 months, 12 months
Compare any changes in Demographic, family, and injury data aggregated in a latent class approach to identify which constellations of risk and protective factors were most amenable to the intervention.
1 month, 3 month, 6 months, 9 months, 12 months

Colaboradores e Investigadores

É aqui que você encontrará pessoas e organizações envolvidas com este estudo.

Investigadores

  • Investigador principal: Terri H Lewis, PhD, University of Colorado, Denver

Datas de registro do estudo

Essas datas acompanham o progresso do registro do estudo e os envios de resumo dos resultados para ClinicalTrials.gov. Os registros do estudo e os resultados relatados são revisados ​​pela National Library of Medicine (NLM) para garantir que atendam aos padrões específicos de controle de qualidade antes de serem publicados no site público.

Datas Principais do Estudo

Início do estudo (Real)

1 de abril de 2018

Conclusão Primária (Real)

30 de junho de 2020

Conclusão do estudo (Real)

30 de junho de 2020

Datas de inscrição no estudo

Enviado pela primeira vez

10 de janeiro de 2018

Enviado pela primeira vez que atendeu aos critérios de CQ

26 de fevereiro de 2018

Primeira postagem (Real)

27 de fevereiro de 2018

Atualizações de registro de estudo

Última Atualização Postada (Real)

10 de setembro de 2020

Última atualização enviada que atendeu aos critérios de controle de qualidade

8 de setembro de 2020

Última verificação

1 de setembro de 2020

Mais Informações

Termos relacionados a este estudo

Outros números de identificação do estudo

  • 17-1221
  • IHEA101376 (Número de outro subsídio/financiamento: Colorado Department of Human Services)

Plano para dados de participantes individuais (IPD)

Planeja compartilhar dados de participantes individuais (IPD)?

NÃO

Informações sobre medicamentos e dispositivos, documentos de estudo

Estuda um medicamento regulamentado pela FDA dos EUA

Não

Estuda um produto de dispositivo regulamentado pela FDA dos EUA

Não

Essas informações foram obtidas diretamente do site clinicaltrials.gov sem nenhuma alteração. Se você tiver alguma solicitação para alterar, remover ou atualizar os detalhes do seu estudo, entre em contato com register@clinicaltrials.gov. Assim que uma alteração for implementada em clinicaltrials.gov, ela também será atualizada automaticamente em nosso site .

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