P3+ Intervention Phase

NCT ID: NCT02898688

Last Updated: 2020-08-05

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

2200 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-06-12

Study Completion Date

2020-07-06

Brief Summary

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This study will address vaccine uptake both for pregnant women and for their children, through 20 months of age, to test the hypothesis that exposure to the P3+ intervention package will increase the likelihood a pregnant woman gets herself vaccinated against influenza and pertussis before delivery and get her child vaccinated on time. This study builds off of a prior intervention, developed by Emory, at the practice, provider, and patient levels (P3) to develop, implement and evaluate an enhanced intervention (P3+) to improve vaccination uptake among pregnant women, and later, their children.

Detailed Description

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This study will address vaccine uptake both for pregnant women and for their children, through 20 months of age, to test the hypothesis that exposure to the P3+ intervention package will increase the likelihood a pregnant woman gets herself vaccinated against influenza and pertussis before delivery and get her child vaccinated on time.

This study uses a multi-level factorial design which randomizes at both the practice and the patient level. Obstetric practices in Georgia and Colorado will be randomized to be either an intervention practice or a control practice. The women recruited in the practices and enrolled in the study will be randomly assigned to the intervention arm or the control arm.

Women randomized to the intervention arm will complete a computer-based questionnaire (administered via iPad with a preloaded study app) which asks for their basic demographic and contact information and asks questions about their vaccine knowledge, attitudes, and beliefs. Immediately following the questionnaire, participants will receive the individual level intervention (videos providing information on vaccines) on the same iPad. In order to best answer their questions and not provide information beyond the scope of what the study participants need or want, the videos provided to each participant will be selected based on responses to the survey questions. There are 6 videos: one discusses the dangers of the diseases prevented by vaccines, and the others address specific vaccine concerns (concerns include vaccine ingredients, children receiving simultaneous vaccines (multiple vaccines at one time), and the safety of receiving the tdap or flu vaccine during pregnancy). If the participant does not have any concerns, they will only see the video about dangers of vaccine preventable diseases. Participants expressing concerns in the survey will receive up to two videos addressing those concerns, based on an order of priority determined by the study researchers.

Women randomized to the control arm will also complete a computer-based questionnaire which includes their personal information and vaccine knowledge, attitudes, and beliefs questions but will then continue to receive usual prenatal care rather than view informational videos.

All enrolled women complete two follow-up surveys when their children are 30 days and 18 months of age.

Conditions

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Vaccination

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

FACTORIAL

Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

NONE

Study Groups

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Control Site + Control Patient

The obstetric practice site is randomized to be a control site and the patient is randomized to the control group.

Group Type OTHER

Control Site

Intervention Type BEHAVIORAL

Control sites will continue with their standard practice regarding discussing vaccines with their patients.

Patient-level Control Group

Intervention Type BEHAVIORAL

Participants randomized the control arm will complete a computer-based questionnaire, on an iPad with a preloaded app. The questionnaire asks about vaccine knowledge, attitudes, and beliefs and the participant's intent to receive vaccinations during pregnancy and to vaccinate their baby. The questionnaire includes questions requiring a "yes" or "no" response, degree of agreement with vaccine-related statements (ranging from strongly agree to strongly disagree), questions to capture the vaccines participants plan to get for themselves and their children, and open-ended questions.

Control Site + Intervention Patient

The obstetric practice site is randomized to be a control site and the patient is randomized to receive the intervention.

Group Type EXPERIMENTAL

Control Site

Intervention Type BEHAVIORAL

Control sites will continue with their standard practice regarding discussing vaccines with their patients.

Patient-level Intervention Group

Intervention Type BEHAVIORAL

Participants randomized to the intervention arm will complete a computer-based questionnaire on an iPad with a preloaded app, prior to watching informational videos covering topics on maternal and childhood vaccines. The questionnaire asks about vaccine knowledge, attitudes, beliefs, and the participant's intent to receive vaccinations during pregnancy and to vaccinate their baby. The questions require "yes" or "no" responses, degree of agreement with vaccine-related statements (ranging from strongly agree to strongly disagree), and open-ended responses. After watching at least one informational video, the participant completes a questionnaire asking about the perceived usefulness of the app, degree of agreement with the vaccine information presented in the video, and ways to make the app more useful to participants.

Intervention Site + Control Patient

The obstetric practice site is randomized to be an intervention site and the patient is randomized to the control group.

Group Type EXPERIMENTAL

Intervention Site

Intervention Type BEHAVIORAL

Intervention Sites will each assign a Vaccine Champion and will have Assessment, Feedback, Incentives, and eXchange (AFIX) visits. AFIX is a quality improvement program to raise immunization coverage levels, reduce missed opportunities to vaccinate, and improve standards of practices at the provider level. A Continuing Medical Education (CME) module will be given to all providers, covering the recommended maternal vaccinations and how to talk to patients about vaccines. Intervention sites will have access to written materials covering all recommended maternal and infant vaccinations, the diseases they prevent, potential adverse reactions and common patient questions with talking points and references for each topic.

Patient-level Control Group

Intervention Type BEHAVIORAL

Participants randomized the control arm will complete a computer-based questionnaire, on an iPad with a preloaded app. The questionnaire asks about vaccine knowledge, attitudes, and beliefs and the participant's intent to receive vaccinations during pregnancy and to vaccinate their baby. The questionnaire includes questions requiring a "yes" or "no" response, degree of agreement with vaccine-related statements (ranging from strongly agree to strongly disagree), questions to capture the vaccines participants plan to get for themselves and their children, and open-ended questions.

Intervention Site + Intervention Patient

The obstetric practice site is randomized to be an intervention site and the patient is randomized to receive the intervention.

Group Type EXPERIMENTAL

Intervention Site

Intervention Type BEHAVIORAL

Intervention Sites will each assign a Vaccine Champion and will have Assessment, Feedback, Incentives, and eXchange (AFIX) visits. AFIX is a quality improvement program to raise immunization coverage levels, reduce missed opportunities to vaccinate, and improve standards of practices at the provider level. A Continuing Medical Education (CME) module will be given to all providers, covering the recommended maternal vaccinations and how to talk to patients about vaccines. Intervention sites will have access to written materials covering all recommended maternal and infant vaccinations, the diseases they prevent, potential adverse reactions and common patient questions with talking points and references for each topic.

Patient-level Intervention Group

Intervention Type BEHAVIORAL

Participants randomized to the intervention arm will complete a computer-based questionnaire on an iPad with a preloaded app, prior to watching informational videos covering topics on maternal and childhood vaccines. The questionnaire asks about vaccine knowledge, attitudes, beliefs, and the participant's intent to receive vaccinations during pregnancy and to vaccinate their baby. The questions require "yes" or "no" responses, degree of agreement with vaccine-related statements (ranging from strongly agree to strongly disagree), and open-ended responses. After watching at least one informational video, the participant completes a questionnaire asking about the perceived usefulness of the app, degree of agreement with the vaccine information presented in the video, and ways to make the app more useful to participants.

Interventions

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Control Site

Control sites will continue with their standard practice regarding discussing vaccines with their patients.

Intervention Type BEHAVIORAL

Intervention Site

Intervention Sites will each assign a Vaccine Champion and will have Assessment, Feedback, Incentives, and eXchange (AFIX) visits. AFIX is a quality improvement program to raise immunization coverage levels, reduce missed opportunities to vaccinate, and improve standards of practices at the provider level. A Continuing Medical Education (CME) module will be given to all providers, covering the recommended maternal vaccinations and how to talk to patients about vaccines. Intervention sites will have access to written materials covering all recommended maternal and infant vaccinations, the diseases they prevent, potential adverse reactions and common patient questions with talking points and references for each topic.

Intervention Type BEHAVIORAL

Patient-level Control Group

Participants randomized the control arm will complete a computer-based questionnaire, on an iPad with a preloaded app. The questionnaire asks about vaccine knowledge, attitudes, and beliefs and the participant's intent to receive vaccinations during pregnancy and to vaccinate their baby. The questionnaire includes questions requiring a "yes" or "no" response, degree of agreement with vaccine-related statements (ranging from strongly agree to strongly disagree), questions to capture the vaccines participants plan to get for themselves and their children, and open-ended questions.

Intervention Type BEHAVIORAL

Patient-level Intervention Group

Participants randomized to the intervention arm will complete a computer-based questionnaire on an iPad with a preloaded app, prior to watching informational videos covering topics on maternal and childhood vaccines. The questionnaire asks about vaccine knowledge, attitudes, beliefs, and the participant's intent to receive vaccinations during pregnancy and to vaccinate their baby. The questions require "yes" or "no" responses, degree of agreement with vaccine-related statements (ranging from strongly agree to strongly disagree), and open-ended responses. After watching at least one informational video, the participant completes a questionnaire asking about the perceived usefulness of the app, degree of agreement with the vaccine information presented in the video, and ways to make the app more useful to participants.

Intervention Type BEHAVIORAL

Other Intervention Names

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Practice/provider-Level Control Practice/provider-Level Intervention

Eligibility Criteria

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Inclusion Criteria

* Have not previously participated in this study
* Currently pregnant
* Up to 26 weeks gestational age
* Able to understand and communicate in English

Exclusion Criteria

* Have received pertussis vaccine during the current pregnancy
Minimum Eligible Age

18 Years

Maximum Eligible Age

50 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

Yes

Sponsors

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National Institute of Allergy and Infectious Diseases (NIAID)

NIH

Sponsor Role collaborator

Emory University

OTHER

Sponsor Role lead

Responsible Party

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Robert Bednarczyk

Assistant Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Robert Bednarczyk, PhD

Role: PRINCIPAL_INVESTIGATOR

Emory University

Daniel Salmon, PhD, MPH

Role: PRINCIPAL_INVESTIGATOR

Johns Hopkins Bloomberg School of Public Health

Locations

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CU Center for Midwifery

Aurora, Colorado, United States

Site Status

CU Maternal and Fetal Medicine Clinic

Aurora, Colorado, United States

Site Status

University Nurse Midwives

Aurora, Colorado, United States

Site Status

Boulder Women's Care

Boulder, Colorado, United States

Site Status

St. Joe's Midwives

Denver, Colorado, United States

Site Status

Partners in Women's Health at Rose

Denver, Colorado, United States

Site Status

Rocky Mountain OBGYN

Denver, Colorado, United States

Site Status

Colorado Mountain Medical

Edwards, Colorado, United States

Site Status

Bella Natural Women's Care

Englewood, Colorado, United States

Site Status

Associates in Women's Health

Golden, Colorado, United States

Site Status

Women's Health Group Thornton

Thornton, Colorado, United States

Site Status

Atlanta Women's Specialists

Alpharetta, Georgia, United States

Site Status

Roswell Ob/Gyn

Alpharetta, Georgia, United States

Site Status

Athens Midwifery

Athens, Georgia, United States

Site Status

Athens Ob-Gyn

Athens, Georgia, United States

Site Status

Women's Healthcare Associates of Athens

Athens, Georgia, United States

Site Status

Emory Clinic

Atlanta, Georgia, United States

Site Status

Riverbend OB/GYN and Counseling

Atlanta, Georgia, United States

Site Status

Peachtree Women's Clinic

Cumming, Georgia, United States

Site Status

Comprehensive Women's OB/GYN

Duluth, Georgia, United States

Site Status

Dunwoody Ob-Gyn

Dunwoody, Georgia, United States

Site Status

Atlanta Gynecology & Obstetrics

Lilburn, Georgia, United States

Site Status

Women's Medical Center

Tyrone, Georgia, United States

Site Status

Countries

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United States

References

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Dudley MZ, Omer SB, O'Leary ST, Limaye RJ, Ellingson MK, Spina CI, Brewer SE, Bednarczyk RA, Chamberlain AT, Malik F, Frew PM, Church-Balin C, Riley LE, Ault KA, Orenstein WA, Halsey NA, Salmon DA. MomsTalkShots, tailored educational app, improves vaccine attitudes: a randomized controlled trial. BMC Public Health. 2022 Nov 21;22(1):2134. doi: 10.1186/s12889-022-14498-7.

Reference Type DERIVED
PMID: 36411403 (View on PubMed)

Dudley MZ, Limaye RJ, Omer SB, O'Leary ST, Ellingson MK, Spina CI, Brewer SE, Chamberlain AT, Bednarczyk RA, Malik F, Frew PM, Salmon DA. Factors associated with referring close contacts to an app with individually-tailored vaccine information. Vaccine. 2020 Mar 17;38(13):2827-2832. doi: 10.1016/j.vaccine.2020.02.019. Epub 2020 Feb 22.

Reference Type DERIVED
PMID: 32098739 (View on PubMed)

Provided Documents

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Document Type: Informed Consent Form

View Document

Other Identifiers

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5R01AI110482-02

Identifier Type: NIH

Identifier Source: secondary_id

View Link

IRB00090267

Identifier Type: -

Identifier Source: org_study_id

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