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A Family-Centered Intervention Program for Preterm Infants: Effects and Their Biosocial Pathways

22 augusti 2018 uppdaterad av: National Taiwan University Hospital

Four hypotheses will be tested in this study:

  1. The intervention group performs better in child, parent and transactions outcomes than the control group throughout the follow-up period.
  2. The intervention group shows greater changes in early neurophysiological brain functions and transactions within the family that lead to better neurodevelopmental outcomes than the control group.
  3. Certain polymorphisms of the dopamine-related genes are associated with the neurodevelopmental outcomes in VLBW preterm infants.
  4. Very low birth weight preterm infants carrying more genetic plasticity in the dopamine-related genes may benefit more from the interventions than those carrying less genetic plasticity.

Studieöversikt

Status

Avslutad

Betingelser

Intervention / Behandling

Detaljerad beskrivning

A total of 275 VLBW preterm infants (269 participants and 6 pilots) were recruited at three medical centers in northern and southern Taiwan and were randomly assigned to the FCIP or UCP group. Outcome assessments included primary (neurobehavioral development) and secondary measures (neurophysiological performance, parents' stress and transactions within the family). The neurophysiological and transactions data were examined for whether they mediate intervention effects on child development. In addition, these infants 219 VLBW preterm infants and 118 term infants in our prior intervention studies were collected buccal cells for assessment of the polymorphisms of dopamine-related genes, which are involved in the neurotransmission of cognitive, sensorimotor and behavioral-emotional systems and postulated to be associated with several developmental and psychiatric illnesses. The polymorphisms of dopamine-related genes were examined for potential moderating influence on the effects of the intervention for child development.

Studietyp

Interventionell

Inskrivning (Faktisk)

275

Fas

  • Inte tillämpbar

Kontakter och platser

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

Studieorter

  • Taiwan
      • Tainan, Taiwan, 704
        • National Cheng Kung University Hospital
      • Taipei, Taiwan, 100
        • National Taiwan University Hospital
      • Taipei, Taiwan, 104
        • Mackay Memorial Hospital

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 8 månader (Barn)

Tar emot friska volontärer

Nej

Kön som är behöriga för studier

Allt

Beskrivning

Inclusion Criteria:

  • birth body weight < 1500 grams
  • gestational age < 37 weeks
  • parents of Taiwan nationality, married or together at delivery, and northern family residing in greater Taipei and southern family residing in greater Tainan, Kaohsiung, or Chiayi

Exclusion Criteria:

  • severe neonatal and perinatal diseases (e.g., seizures, hydrocephalus, meningitis, grade III-IV IVH and grade II NEC)
  • congenital or chromosome abnormality
  • mother < 18 years, with mental retardation or history of maternal substance abuse at any time (smoking, alcohol, and drug)

Terminated Criteria:

  • diagnosis of brain injury (e.g., PVL, stage IV ROP or greater)
  • severe cardiopulmonary disease requiring invasive or non-invasive ventilator use at hospital discharge
  • hospital discharge beyond 44 weeks' post-menstrual age.

Studieplan

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

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Förebyggande
  • Tilldelning: Randomiserad
  • Interventionsmodell: Parallellt uppdrag
  • Maskning: Enda

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Experimentell: Family-centered intervention program
FCIP: family members were encouraged to present in all intervention sessions included 5 in-hospital intervention, 7 after-discharge interventions (0, 1, 2, 4, 6, 9, and 12 months of corrected age), and neonatal follow-up at 0, 1, 6, 12, 18, and 24 months of corrected age.
Beteende: Family-centered intervention program
This program was in-hospital intervention, after-discharge intervention, and neonatal follow-up. Five sessions of in-hospital intervention emphasized in the parental involvements with modulation of the NICU, a teaching of child developmental skills, feeding support, massage, interactional activities, child developmental skills, parent support and education, and transition home preparation. The 7-session after-discharge intervention consisted of 4 clinic visits and 3 home visits with specific care in modulation of home environment, teaching of child developmental skills, feeding support, teaching of interactional activities, and parent support and education
Andra namn:
  • FCIP
Övrig: Usual care intervention program
UCP: family members were invited to present at least one session of the 5 in-hospital intervention session. Parents and infants in the UCP group received 7 after-discharge phone calls (0, 1, 2, 4, 6, 9, and 12 months of corrected age) and neonatal follow-up at 0, 1, 6, 12, 18, and 24 months of corrected age.
Beteende: Usual care intervention program
This program was in-hospital intervention, after-discharge consultation, and neonatal follow-up. Five sessions of in-hospital intervention emphasized in the parental involvements with modulation of the NICU, a teaching of child developmental skills, feeding support, massage, interactional activities, child developmental skills, parent support and education, and transition home preparation. The after-discharge service was provided 7-phone calls for the general health consultation.
Andra namn:
  • UCP

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Child: neurodevelopment functions (cognition, language and motor)
Tidsram: 24 months of corrected age
Bayley Scales of Infant and Toddler Development - 2nd and 3rd edition
24 months of corrected age

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Change of neurodevelopment functions (motor) from baseline
Tidsram: 0 months of corrected age
The Neonatal Neurobehavioral Examination-Chinese Version (NNE-C) 2. World Health Organization Quality of Life- Brief Taiwan version
0 months of corrected age
Child: neurodevelopment functions (behavior)
Tidsram: 24 months of corrected age
Child behavior checklist version 1.5-5 Y 2. World Health Organization Quality of Life- Brief Taiwan version
24 months of corrected age
Change of neurodevelopment functions (cognition, language and motor) from baseline
Tidsram: 6,12, and 24 months
Bayley Scales of Infant and Toddler Development - 3rd edition 2. World Health Organization Quality of Life- Brief Taiwan version
6,12, and 24 months
Parental functions and change from baseline (pressure)
Tidsram: 0, 6, 12, 18, and 24 months of corrected age
Parenting Stress Index 2. World Health Organization Quality of Life- Brief Taiwan version
0, 6, 12, 18, and 24 months of corrected age
Parental functions and change from baseline (Quality of Life)
Tidsram: 0, 6, 12, 18, and 24 months of corrected age
World Health Organization Quality of Life- Brief Taiwan version
0, 6, 12, 18, and 24 months of corrected age
Transactional functions and change from baseline
Tidsram: 6, 12, and 18 months of corrected age
Mother-infant interaction in free play at 6, 12, and 18 months of corrected age
6, 12, and 18 months of corrected age
Transactional functions and change from baseline
Tidsram: 6 and 12 months of corrected age
Wakeful Position Questionnaire at 6 and 12 months of corrected age
6 and 12 months of corrected age
Transactions function: affordance
Tidsram: 18 months of corrected age
1. Affordances in the Home Environment Motor Development- Chinese version
18 months of corrected age
Child: Medical data
Tidsram: Birth to 24 months of corrected age
Chart review
Birth to 24 months of corrected age
Child: growth data and change from baseline
Tidsram: 0, 1, 4, 6, 12, 18, and 24 months of corrected age
Chart review and measurement
0, 1, 4, 6, 12, 18, and 24 months of corrected age
Child: neurophysiological functions and change from baseline
Tidsram: 1 and 4 months of corrected age
Electroencephalogram/event-related potential
1 and 4 months of corrected age
Child: genotyping and gene expression
Tidsram: 0 month of corrected age
Buccal cell collection
0 month of corrected age
Parental adherence to Intervention
Tidsram: 32-36 weeks (5 sessions), 0, 1, 2, 4, 6, 9, and 12 months

Only assessed in FCIP group

  1. Parental motivation
  2. Goal attainment
  3. Home activity records
32-36 weeks (5 sessions), 0, 1, 2, 4, 6, 9, and 12 months

Samarbetspartners och utredare

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

Sponsor

National Taiwan University Hospital

Samarbetspartners

National Health Research Institutes, Taiwan

Publikationer och användbara länkar

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Allmänna publikationer

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 (Faktisk)

22 maj 2012

Primärt slutförande (Faktisk)

10 januari 2017

Avslutad studie (Faktisk)

10 januari 2017

Studieregistreringsdatum

Först inskickad

29 januari 2013

Först inskickad som uppfyllde QC-kriterierna

6 mars 2013

Första postat (Uppskatta)

8 mars 2013

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

24 augusti 2018

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

22 augusti 2018

Senast verifierad

1 mars 2017

Mer information

Termer relaterade till denna studie

Nyckelord

Ytterligare relevanta MeSH-villkor

Andra studie-ID-nummer

  • 201103075RB

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