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

8 november 2011 uppdaterad 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.

Studieöversikt

Detaljerad beskrivning

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.

Studietyp

Interventionell

Inskrivning (Faktisk)

2314

Fas

  • Fas 2

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studieorter

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

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

Inte äldre än 2 år (Barn)

Tar emot friska volontärer

Ja

Kön som är behöriga för studier

Allt

Beskrivning

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

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Undersökning
  • Tilldelning: Randomiserad
  • Interventionsmodell: Parallellt uppdrag
  • Maskning: Ingen (Open Label)

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Experimentell: 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.
Experimentell: 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.
Inget ingripande: 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.

Vad mäter studien?

Primära resultatmått

Resultatmått
Tidsram
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.
Tidsram: We assessed this between June to October 2010
We assessed this between June to October 2010

Sekundära resultatmått

Resultatmått
Tidsram
Percentage of children in the study who are referred to Early Intervention Services
Tidsram: We assessed this in June 2010
We assessed this in June 2010
Percentage of children in the study who enroll in Early Intervention Services
Tidsram: 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
Tidsram: 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.
Tidsram: We will assess this between March and September 2010
We will assess this between March and September 2010

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Utredare

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

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart

1 november 2008

Primärt slutförande (Faktisk)

1 oktober 2010

Avslutad studie (Faktisk)

1 oktober 2010

Studieregistreringsdatum

Först inskickad

13 februari 2009

Först inskickad som uppfyllde QC-kriterierna

13 februari 2009

Första postat (Uppskatta)

16 februari 2009

Uppdateringar av studier

Senaste uppdatering publicerad (Uppskatta)

10 november 2011

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

8 november 2011

Senast verifierad

1 november 2011

Mer information

Termer relaterade till denna studie

Andra studie-ID-nummer

  • 2008-9-6124

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