Internet-based Treatment of Early Childhood Fecal Incontinence

NCT ID: NCT00067769

Last Updated: 2015-12-07

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

91 participants

Study Classification

INTERVENTIONAL

Study Start Date

2003-10-31

Study Completion Date

2007-07-31

Brief Summary

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Encopresis, also known as fecal incontinence, is the voluntary or involuntary passage of stools causing soiling of clothes by a child over 4 years of age. The purpose of this study is to evaluate an Internet intervention for the treatment of encopresis.

Detailed Description

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An estimated 2.3% of children suffer from encopresis. Enhanced Toilet Training (ETT) is one of the most effective ways of treating this disorder. When delivered by skilled and knowledgeable clinicians, ETT is twice as effective as intensive medical management alone. Although ETT is effective in treating encopretic children, there are six major barriers to its implementation: 1) availability of a knowledgeable and skilled clinician; 2) parental acceptance of referral to a mental health professional; 3) expense of service; 4) burden of time and distance to access such specialty services; 5) child resistance to disclosure of embarrassing material; and 6) willingness of the child and parent to follow treatment recommendations. This project will circumvent these barriers by developing an interactive Internet-based ETT program. The study will then assess the feasibility of the program by determining the acceptance, function, and effectiveness of the intervention.

This project will have four phases. Phase 1 will identify optimal Internet and treatment elements as well as issues in need of experimental investigation. Phase 2 will investigate how to enhance Internet interventions. Phase 3 will evaluate the relative benefit of adding the Internet treatment to clinical services provided by clinicians in the fields of medicine and mental health. Phase 4 will investigate the relative long-term benefits of adding such an Internet-based intervention to professional care to determine its impact on symptom improvement, relapse prevention, quality of life, and its cost-effectiveness. Phase 4 will also assess to what extent the program is disseminated worldwide when made available on the Internet.

Conditions

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Encopresis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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TAU

Patients received treatment as usual (TAU) as defined as continued clinical care.

Group Type ACTIVE_COMPARATOR

treatment as usual

Intervention Type BEHAVIORAL

Routine clinical care.

TAU+UCanPoopToo

Patients received treatment as usual (TAU) plus the Internet intervention (UCanPoopToo.)

Group Type EXPERIMENTAL

Internet-based intervention UCanPoopToo

Intervention Type BEHAVIORAL

Internet-based intervention to administer Enhanced Toilet Training (ETT).

Interventions

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Internet-based intervention UCanPoopToo

Internet-based intervention to administer Enhanced Toilet Training (ETT).

Intervention Type BEHAVIORAL

treatment as usual

Routine clinical care.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Child seen by pediatrician, family physician, or psychologist for the treatment of encopresis
* Access to the Internet, either through a family computer or a community computer

Exclusion Criteria

* Diagnosis of either mental retardation (IQ \< 85) or
* A primary illness responsible for fecal soiling (e.g., spina bifida)
Minimum Eligible Age

6 Years

Maximum Eligible Age

12 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)

NIH

Sponsor Role collaborator

University of Virginia

OTHER

Sponsor Role lead

Responsible Party

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Daniel Cox, PhD

Professor, Department of Psychiatry and NB Sciences

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Daniel J Cox, PhD

Role: PRINCIPAL_INVESTIGATOR

University of Virginia

Locations

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University of Virginia Health System

Charlottesville, Virginia, United States

Site Status

Countries

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United States

References

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Ritterband LM, Cox DJ, Walker LS, Kovatchev B, McKnight L, Patel K, Borowitz S, Sutphen J. An Internet intervention as adjunctive therapy for pediatric encopresis. J Consult Clin Psychol. 2003 Oct;71(5):910-7. doi: 10.1037/0022-006X.71.5.910.

Reference Type BACKGROUND
PMID: 14516239 (View on PubMed)

Cox DJ, Morris JB Jr, Borowitz SM, Sutphen JL. Psychological differences between children with and without chronic encopresis. J Pediatr Psychol. 2002 Oct-Nov;27(7):585-91. doi: 10.1093/jpepsy/27.7.585.

Reference Type BACKGROUND
PMID: 12228330 (View on PubMed)

Borowitz SM, Cox DJ, Sutphen JL, Kovatchev B. Treatment of childhood encopresis: a randomized trial comparing three treatment protocols. J Pediatr Gastroenterol Nutr. 2002 Apr;34(4):378-84. doi: 10.1097/00005176-200204000-00012.

Reference Type BACKGROUND
PMID: 11930093 (View on PubMed)

Brooks RC, Copen RM, Cox DJ, Morris J, Borowitz S, Sutphen J. Review of the treatment literature for encopresis, functional constipation, and stool-toileting refusal. Ann Behav Med. 2000 Summer;22(3):260-7. doi: 10.1007/BF02895121.

Reference Type BACKGROUND
PMID: 11211851 (View on PubMed)

Borowitz SM, Cox DJ, Sutphen JL. Differences in toileting habits between children with chronic encopresis, asymptomatic siblings, and asymptomatic nonsiblings. J Dev Behav Pediatr. 1999 Jun;20(3):145-9. doi: 10.1097/00004703-199906000-00002.

Reference Type BACKGROUND
PMID: 10393070 (View on PubMed)

Cox DJ, Sutphen J, Borowitz S, Kovatchev B, Ling W. Contribution of behavior therapy and biofeedback to laxative therapy in the treatment of pediatric encopresis. Ann Behav Med. 1998 Spring;20(2):70-6. doi: 10.1007/BF02884451.

Reference Type BACKGROUND
PMID: 9989311 (View on PubMed)

Cox DJ, Sutphen J, Ling W, Quillian W, Borowitz S. Additive benefits of laxative, toilet training, and biofeedback therapies in the treatment of pediatric encopresis. J Pediatr Psychol. 1996 Oct;21(5):659-70. doi: 10.1093/jpepsy/21.5.659.

Reference Type BACKGROUND
PMID: 8936895 (View on PubMed)

Ling W, Cox DJ, Sutphen J, Borowitz S. Psychological factors in encopresis: comparison of patients to nonsymptomatic siblings. Clin Pediatr (Phila). 1996 Aug;35(8):427. doi: 10.1177/000992289603500814. No abstract available.

Reference Type BACKGROUND
PMID: 8862907 (View on PubMed)

Other Identifiers

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5R01HD028160-12

Identifier Type: NIH

Identifier Source: secondary_id

View Link

11116

Identifier Type: -

Identifier Source: org_study_id