Trial Outcomes & Findings for A Family Centered Intervention to Promote Optimal Child Development (NCT NCT01941186)

NCT ID: NCT01941186

Last Updated: 2016-10-21

Results Overview

Completed intake and evaluation by the early intervention (EI) agency was assessed by parent report and by chart review. A member of the study team contacted parents within 6 months of the first study visit to obtain this information. Additionally, a chart review seeking written feedback information regarding referral disposition from the EI agency was completed.

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

64 participants

Primary outcome timeframe

Up to 1 year after randomization

Results posted on

2016-10-21

Participant Flow

Participants were recruited from 2 urban pediatric practice sites within the Children's Hospital of Philadelphia Pediatric Research Consortium, a primary care-based network including 31 practices in 2 states, between December 2013 and September 2014.

164 parent-child dyads were assessed for eligibility and 100 were excluded. Reasons for exclusion were primarily because potential subjects either not meeting eligibility criteria (i.e., already received early intervention) or they declined to participate. 64 parent-child dyads were consented and randomized.

Participant milestones

Participant milestones
Measure
Patient Decision Aid
After positive screen for a developmental concern the intervention group received the Patient Decision Aid (PDA), as well as, a text message reminder to follow up with Early Intervention. Patient Decision Aid: Short informational video on developmental delays and early intervention services aimed at helping parents make an informed decision about whether to pursue early intervention services.
Routine Care
After screening positive for a potential development delay those in the control received routine care, in this case, a handout explaining Early Intervention services.
Randomization/Allocation to Study Group
STARTED
31
33
Randomization/Allocation to Study Group
COMPLETED
31
33
Randomization/Allocation to Study Group
NOT COMPLETED
0
0
Follow-up
STARTED
31
33
Follow-up
COMPLETED
30
33
Follow-up
NOT COMPLETED
1
0

Reasons for withdrawal

Reasons for withdrawal
Measure
Patient Decision Aid
After positive screen for a developmental concern the intervention group received the Patient Decision Aid (PDA), as well as, a text message reminder to follow up with Early Intervention. Patient Decision Aid: Short informational video on developmental delays and early intervention services aimed at helping parents make an informed decision about whether to pursue early intervention services.
Routine Care
After screening positive for a potential development delay those in the control received routine care, in this case, a handout explaining Early Intervention services.
Follow-up
Lost to Follow-up
1
0

Baseline Characteristics

A Family Centered Intervention to Promote Optimal Child Development

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Patient Decision Aid
n=31 Participants
After positive screen for a developmental concern the intervention group received the Patient Decision Aid (PDA), as well as, a text message reminder to follow up with Early Intervention. Patient Decision Aid: Short informational video on developmental delays and early intervention services aimed at helping parents make an informed decision about whether to pursue early intervention services.
Routine Care
n=33 Participants
After screening positive for a potential development delay those in the control arm received routine care, in this case, a handout explaining Early Intervention services.
Total
n=64 Participants
Total of all reporting groups
Age, Customized
Child: Age 1-12 months
3 participants
n=5 Participants
4 participants
n=7 Participants
7 participants
n=5 Participants
Age, Customized
Child: Age 13-24 months
20 participants
n=5 Participants
22 participants
n=7 Participants
42 participants
n=5 Participants
Age, Customized
Child: Age 25-36 months
8 participants
n=5 Participants
7 participants
n=7 Participants
15 participants
n=5 Participants
Age, Customized
Parent: 20 years and Under
2 participants
n=5 Participants
3 participants
n=7 Participants
5 participants
n=5 Participants
Age, Customized
Parent: 21-30 Years
15 participants
n=5 Participants
18 participants
n=7 Participants
33 participants
n=5 Participants
Age, Customized
Parent: 31-40 Years
10 participants
n=5 Participants
6 participants
n=7 Participants
16 participants
n=5 Participants
Age, Customized
Parent: Over 40 Years
2 participants
n=5 Participants
2 participants
n=7 Participants
4 participants
n=5 Participants
Age, Customized
Parent: Unknown Age
2 participants
n=5 Participants
4 participants
n=7 Participants
6 participants
n=5 Participants
Sex: Female, Male
Female
5 Participants
n=5 Participants
5 Participants
n=7 Participants
10 Participants
n=5 Participants
Sex: Female, Male
Male
26 Participants
n=5 Participants
28 Participants
n=7 Participants
54 Participants
n=5 Participants
Race/Ethnicity, Customized
Black/African American
24 participants
n=5 Participants
32 participants
n=7 Participants
56 participants
n=5 Participants
Race/Ethnicity, Customized
Other
7 participants
n=5 Participants
1 participants
n=7 Participants
8 participants
n=5 Participants
Region of Enrollment
United States
31 participants
n=5 Participants
33 participants
n=7 Participants
64 participants
n=5 Participants
Parent's Education
Less than High School
1 participants
n=5 Participants
4 participants
n=7 Participants
5 participants
n=5 Participants
Parent's Education
High School Graduate
23 participants
n=5 Participants
27 participants
n=7 Participants
50 participants
n=5 Participants
Parent's Education
Post Secondary Education
7 participants
n=5 Participants
2 participants
n=7 Participants
9 participants
n=5 Participants
Parent's Employment Status
Employed
17 participants
n=5 Participants
20 participants
n=7 Participants
37 participants
n=5 Participants
Parent's Employment Status
Unemployed
14 participants
n=5 Participants
13 participants
n=7 Participants
27 participants
n=5 Participants
Parent's Marital Status
Married/Living with Partner
13 participants
n=5 Participants
13 participants
n=7 Participants
26 participants
n=5 Participants
Parent's Marital Status
Divorced/Separated
4 participants
n=5 Participants
2 participants
n=7 Participants
6 participants
n=5 Participants
Parent's Marital Status
Never Married
14 participants
n=5 Participants
18 participants
n=7 Participants
32 participants
n=5 Participants

PRIMARY outcome

Timeframe: Up to 1 year after randomization

Population: One parent-child dyad had missing information regarding EI intake and evaluation. Given the absence of information on referral outcome, this parent-child dyad was included in the final evaluation as having not received an EI intake and evaluation.

Completed intake and evaluation by the early intervention (EI) agency was assessed by parent report and by chart review. A member of the study team contacted parents within 6 months of the first study visit to obtain this information. Additionally, a chart review seeking written feedback information regarding referral disposition from the EI agency was completed.

Outcome measures

Outcome measures
Measure
Patient Decision Aid
n=31 Participants
After positive screen for a developmental concern the intervention group received the Patient Decision Aid (PDA), as well as, a text message reminder to follow up with Early Intervention. Patient Decision Aid: Short informational video on developmental delays and early intervention services aimed at helping parents make an informed decision about whether to pursue early intervention services.
Routine Care
n=33 Participants
After screening positive for a potential development delay those in the control received routine care, in this case, a handout explaining Early Intervention services.
Patient Decision Aid: Somewhat Disagree
Percentage of parents who answered "somewhat disagree" to questions during pre and post
Patient Decision Aid: Somewhat Agree
Percentage of parents who answered "somewhat agree" to questions during pre and post intervention
Patient Decision Aid: Agree
Percentage of parents who answered "agree" to questions during pre and post intervention
Patient Decision Aid: Strongly Agree
Percentage of parents who answered "Strongly Agree" to questions during pre and post intervention
Routine Care: Strongly Disagree
Percentage of parents who answered "strongly disagree" to questions during pre and post intervention
Routine Care: Disagree
Percentage of parents who answered "disagree" to questions during pre and post intervention
Routine Care: Somewhat Disagree
Percentage of parents who answered "somewhat disagree" to questions during pre and post intervention
Routine Care: Somewhat Agree
Percentage of parents who answered "somewhat agree" to questions during pre and post intervention.
Routine Care: Agree
Percentage of parents who answered "agree" to questions during pre and post intervention
Routine Care: Strongly Agree
Percentage of parents who answered "strongly agree" to questions during pre and post intervention
Difference in the Number of Participants Who Completed Early Intervention Intake and Evaluation Visits Between Treatment Groups
Early Intervention Evaluation
17 participants
17 participants
—
—
—
—
—
—
—
—
—
—
Difference in the Number of Participants Who Completed Early Intervention Intake and Evaluation Visits Between Treatment Groups
Early Intervention Intake
20 participants
21 participants
—
—
—
—
—
—
—
—
—
—

SECONDARY outcome

Timeframe: Up to 7 days

Population: All parent-child dyads who were enrolled and randomized were included in the analysis.

Pre and post knowledge and attitudes regarding developmental delay and early intervention (EI) were assessed by asking participants to respond to 14 statements using a 6 point Likert scale that ranged from strongly disagree to strongly agree. Questions mapped to the video decision aid content viewed by participants. Participants in the intervention arm completed the questions before and after watching the video and participants in the control arm completed the questions sequentially. Secondary outcome measures assessed in the survey included Parent Uncertainty About Early Intervention and Parental Predisposition for Early Intervention.

Outcome measures

Outcome measures
Measure
Patient Decision Aid
n=31 Participants
After positive screen for a developmental concern the intervention group received the Patient Decision Aid (PDA), as well as, a text message reminder to follow up with Early Intervention. Patient Decision Aid: Short informational video on developmental delays and early intervention services aimed at helping parents make an informed decision about whether to pursue early intervention services.
Routine Care
n=31 Participants
After screening positive for a potential development delay those in the control received routine care, in this case, a handout explaining Early Intervention services.
Patient Decision Aid: Somewhat Disagree
n=31 Participants
Percentage of parents who answered "somewhat disagree" to questions during pre and post
Patient Decision Aid: Somewhat Agree
n=31 Participants
Percentage of parents who answered "somewhat agree" to questions during pre and post intervention
Patient Decision Aid: Agree
n=31 Participants
Percentage of parents who answered "agree" to questions during pre and post intervention
Patient Decision Aid: Strongly Agree
n=31 Participants
Percentage of parents who answered "Strongly Agree" to questions during pre and post intervention
Routine Care: Strongly Disagree
n=33 Participants
Percentage of parents who answered "strongly disagree" to questions during pre and post intervention
Routine Care: Disagree
n=33 Participants
Percentage of parents who answered "disagree" to questions during pre and post intervention
Routine Care: Somewhat Disagree
n=33 Participants
Percentage of parents who answered "somewhat disagree" to questions during pre and post intervention
Routine Care: Somewhat Agree
n=33 Participants
Percentage of parents who answered "somewhat agree" to questions during pre and post intervention.
Routine Care: Agree
n=33 Participants
Percentage of parents who answered "agree" to questions during pre and post intervention
Routine Care: Strongly Agree
n=33 Participants
Percentage of parents who answered "strongly agree" to questions during pre and post intervention
Change in Parental Knowledge and Attitudes From Pre- to Post-Intervention
EI helps kids w/develop delay (pre)
6 percentage of participants
0 percentage of participants
0 percentage of participants
16 percentage of participants
42 percentage of participants
35 percentage of participants
0 percentage of participants
0 percentage of participants
0 percentage of participants
9 percentage of participants
64 percentage of participants
27 percentage of participants
Change in Parental Knowledge and Attitudes From Pre- to Post-Intervention
You have to pay for EI services (post)
55 percentage of participants
35 percentage of participants
0 percentage of participants
6 percentage of participants
3 percentage of participants
0 percentage of participants
39 percentage of participants
45 percentage of participants
9 percentage of participants
3 percentage of participants
3 percentage of participants
0 percentage of participants
Change in Parental Knowledge and Attitudes From Pre- to Post-Intervention
EI services can be in home or daycare (pre)
6 percentage of participants
3 percentage of participants
3 percentage of participants
6 percentage of participants
51 percentage of participants
29 percentage of participants
0 percentage of participants
0 percentage of participants
3 percentage of participants
6 percentage of participants
48 percentage of participants
42 percentage of participants
Change in Parental Knowledge and Attitudes From Pre- to Post-Intervention
EI services can be in home or daycare (post)
3 percentage of participants
3 percentage of participants
0 percentage of participants
6 percentage of participants
35 percentage of participants
52 percentage of participants
0 percentage of participants
0 percentage of participants
0 percentage of participants
15 percentage of participants
45 percentage of participants
39 percentage of participants
Change in Parental Knowledge and Attitudes From Pre- to Post-Intervention
I'm comfortable with EI staff in my home (pre)
6 percentage of participants
3 percentage of participants
3 percentage of participants
16 percentage of participants
29 percentage of participants
42 percentage of participants
0 percentage of participants
3 percentage of participants
3 percentage of participants
12 percentage of participants
48 percentage of participants
33 percentage of participants
Change in Parental Knowledge and Attitudes From Pre- to Post-Intervention
Resources like EI can help my family & I (post)
3 percentage of participants
0 percentage of participants
0 percentage of participants
10 percentage of participants
35 percentage of participants
52 percentage of participants
0 percentage of participants
0 percentage of participants
0 percentage of participants
12 percentage of participants
58 percentage of participants
30 percentage of participants
Change in Parental Knowledge and Attitudes From Pre- to Post-Intervention
All learn to talk, walk, think @ same time (pre)
48 percentage of participants
35 percentage of participants
6 percentage of participants
10 percentage of participants
0 percentage of participants
0 percentage of participants
52 percentage of participants
33 percentage of participants
9 percentage of participants
3 percentage of participants
0 percentage of participants
3 percentage of participants
Change in Parental Knowledge and Attitudes From Pre- to Post-Intervention
All learn to talk, walk, think @ same time (post)
42 percentage of participants
35 percentage of participants
3 percentage of participants
6 percentage of participants
3 percentage of participants
9 percentage of participants
52 percentage of participants
30 percentage of participants
9 percentage of participants
6 percentage of participants
3 percentage of participants
0 percentage of participants
Change in Parental Knowledge and Attitudes From Pre- to Post-Intervention
Longer to talk, walk, think may be delayed (pre)
10 percentage of participants
32 percentage of participants
10 percentage of participants
23 percentage of participants
19 percentage of participants
6 percentage of participants
9 percentage of participants
33 percentage of participants
21 percentage of participants
21 percentage of participants
6 percentage of participants
9 percentage of participants
Change in Parental Knowledge and Attitudes From Pre- to Post-Intervention
Longer to talk, walk, think may be delayed (post)
10 percentage of participants
10 percentage of participants
10 percentage of participants
23 percentage of participants
35 percentage of participants
13 percentage of participants
15 percentage of participants
30 percentage of participants
12 percentage of participants
33 percentage of participants
6 percentage of participants
3 percentage of participants
Change in Parental Knowledge and Attitudes From Pre- to Post-Intervention
All with delays get better on their own (pre)
19 percentage of participants
29 percentage of participants
6 percentage of participants
19 percentage of participants
19 percentage of participants
6 percentage of participants
3 percentage of participants
30 percentage of participants
15 percentage of participants
30 percentage of participants
15 percentage of participants
6 percentage of participants
Change in Parental Knowledge and Attitudes From Pre- to Post-Intervention
All with delays get better on their own (post)
16 percentage of participants
39 percentage of participants
10 percentage of participants
29 percentage of participants
3 percentage of participants
3 percentage of participants
18 percentage of participants
21 percentage of participants
21 percentage of participants
24 percentage of participants
9 percentage of participants
6 percentage of participants
Change in Parental Knowledge and Attitudes From Pre- to Post-Intervention
Behavior/Learning probs in school w/o help (pre)
10 percentage of participants
16 percentage of participants
6 percentage of participants
26 percentage of participants
29 percentage of participants
13 percentage of participants
6 percentage of participants
9 percentage of participants
12 percentage of participants
30 percentage of participants
27 percentage of participants
15 percentage of participants
Change in Parental Knowledge and Attitudes From Pre- to Post-Intervention
Behavior/Learning probs in school w/o help (post)
3 percentage of participants
3 percentage of participants
6 percentage of participants
13 percentage of participants
45 percentage of participants
29 percentage of participants
3 percentage of participants
0 percentage of participants
15 percentage of participants
30 percentage of participants
30 percentage of participants
21 percentage of participants
Change in Parental Knowledge and Attitudes From Pre- to Post-Intervention
Know more about child's develop than others (pre)
10 percentage of participants
10 percentage of participants
10 percentage of participants
19 percentage of participants
19 percentage of participants
32 percentage of participants
6 percentage of participants
24 percentage of participants
12 percentage of participants
33 percentage of participants
15 percentage of participants
9 percentage of participants
Change in Parental Knowledge and Attitudes From Pre- to Post-Intervention
Know more about child's develop than others (post)
10 percentage of participants
6 percentage of participants
6 percentage of participants
29 percentage of participants
29 percentage of participants
19 percentage of participants
6 percentage of participants
12 percentage of participants
15 percentage of participants
24 percentage of participants
27 percentage of participants
15 percentage of participants
Change in Parental Knowledge and Attitudes From Pre- to Post-Intervention
If delayed want to work with child on my own (pre)
23 percentage of participants
39 percentage of participants
10 percentage of participants
10 percentage of participants
16 percentage of participants
3 percentage of participants
9 percentage of participants
27 percentage of participants
24 percentage of participants
18 percentage of participants
21 percentage of participants
0 percentage of participants
Change in Parental Knowledge and Attitudes From Pre- to Post-Intervention
If delayed want to work with child on my own (pos)
23 percentage of participants
35 percentage of participants
16 percentage of participants
16 percentage of participants
3 percentage of participants
6 percentage of participants
6 percentage of participants
27 percentage of participants
21 percentage of participants
9 percentage of participants
18 percentage of participants
18 percentage of participants
Change in Parental Knowledge and Attitudes From Pre- to Post-Intervention
EI helps kids w/develop delay (post)
3 percentage of participants
0 percentage of participants
0 percentage of participants
13 percentage of participants
42 percentage of participants
42 percentage of participants
0 percentage of participants
0 percentage of participants
0 percentage of participants
18 percentage of participants
48 percentage of participants
33 percentage of participants
Change in Parental Knowledge and Attitudes From Pre- to Post-Intervention
You have to pay for EI services (pre)
23 percentage of participants
45 percentage of participants
13 percentage of participants
13 percentage of participants
6 percentage of participants
0 percentage of participants
27 percentage of participants
39 percentage of participants
21 percentage of participants
6 percentage of participants
6 percentage of participants
0 percentage of participants
Change in Parental Knowledge and Attitudes From Pre- to Post-Intervention
EI provider must come to home (pre)
13 percentage of participants
16 percentage of participants
16 percentage of participants
23 percentage of participants
19 percentage of participants
13 percentage of participants
9 percentage of participants
36 percentage of participants
18 percentage of participants
15 percentage of participants
12 percentage of participants
9 percentage of participants
Change in Parental Knowledge and Attitudes From Pre- to Post-Intervention
EI provider must come to home (post)
10 percentage of participants
23 percentage of participants
10 percentage of participants
23 percentage of participants
23 percentage of participants
13 percentage of participants
12 percentage of participants
7 percentage of participants
15 percentage of participants
21 percentage of participants
18 percentage of participants
6 percentage of participants
Change in Parental Knowledge and Attitudes From Pre- to Post-Intervention
Once EI starts you cannot stop (pre)
32 percentage of participants
35 percentage of participants
16 percentage of participants
3 percentage of participants
13 percentage of participants
0 percentage of participants
45 percentage of participants
36 percentage of participants
6 percentage of participants
3 percentage of participants
3 percentage of participants
6 percentage of participants
Change in Parental Knowledge and Attitudes From Pre- to Post-Intervention
Once EI starts you cannot stop (post)
48 percentage of participants
32 percentage of participants
6 percentage of participants
6 percentage of participants
3 percentage of participants
3 percentage of participants
39 percentage of participants
42 percentage of participants
9 percentage of participants
0 percentage of participants
6 percentage of participants
3 percentage of participants
Change in Parental Knowledge and Attitudes From Pre- to Post-Intervention
Studies show EI helps make progress (pre)
6 percentage of participants
3 percentage of participants
0 percentage of participants
13 percentage of participants
45 percentage of participants
32 percentage of participants
0 percentage of participants
0 percentage of participants
6 percentage of participants
18 percentage of participants
58 percentage of participants
18 percentage of participants
Change in Parental Knowledge and Attitudes From Pre- to Post-Intervention
Studies show EI helps make progress (post)
3 percentage of participants
0 percentage of participants
0 percentage of participants
10 percentage of participants
42 percentage of participants
45 percentage of participants
0 percentage of participants
0 percentage of participants
6 percentage of participants
9 percentage of participants
58 percentage of participants
27 percentage of participants
Change in Parental Knowledge and Attitudes From Pre- to Post-Intervention
Resources like EI can help my family & I (pre)
6 percentage of participants
0 percentage of participants
3 percentage of participants
13 percentage of participants
35 percentage of participants
42 percentage of participants
0 percentage of participants
0 percentage of participants
0 percentage of participants
9 percentage of participants
52 percentage of participants
39 percentage of participants
Change in Parental Knowledge and Attitudes From Pre- to Post-Intervention
I'm comfortable w/EI staff in my home (post)
3 percentage of participants
0 percentage of participants
6 percentage of participants
10 percentage of participants
39 percentage of participants
42 percentage of participants
0 percentage of participants
0 percentage of participants
6 percentage of participants
12 percentage of participants
45 percentage of participants
36 percentage of participants

OTHER_PRE_SPECIFIED outcome

Timeframe: Up to 7 days

Population: All survey data is presented collectively in Secondary Outcome Measure, "Change in Parental Knowledge and Attitudes From Pre- to Post-Intervention". A separate analysis was not completed.

Parental uncertainty about whether to enroll their child in Early Intervention will be evaluated using a survey.

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: Up to 7 days

Population: All survey data is presented collectively in Secondary Outcome Measure, "Change in Parental Knowledge and Attitudes From Pre- to Post-Intervention". A separate analysis was not completed.

Parental predisposition for early intervention services will be measured using surveys.

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: Up to 7 days

Population: Data was not collected regarding the time to complete PDA and/or number of Early Intervention referrals for the total population, thus data for this outcome measure was not able to be analyzed as outlined at the time of protocol development.

The feasibility of the patient decision aid (PDA) will be measured by calculating the number of individuals who refuse to participate, time that it takes to complete the PDA, and the number of patients who complete the Early Intervention referral.

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: Up to 7 days

Population: Provider information was not collected as outlined in the initial protocol design. All survey data is presented collectively in Secondary Outcome Measure, "Change in Parental Knowledge and Attitudes From Pre- to Post-Intervention". This includes elements of parent acceptability. A separate analysis was not completed.

The acceptability of using the patient decision aid for early intervention will be assessed by having patients and providers complete surveys on the intervention.

Outcome measures

Outcome data not reported

Adverse Events

Patient Decision Aid

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Routine Care

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Manuel Jimenez, MD, MS

Child Health Institute of New Jersey

Phone: 732-235-6230

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place