Counseling for Prematurity Using a Multimedia Education Tool

NCT ID: NCT03225885

Last Updated: 2019-02-27

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

76 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-12-01

Study Completion Date

2019-01-25

Brief Summary

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This study evaluates the effectiveness of prenatal counseling when verbal counseling is supplemented with a multi-media mobile application versus a written gestational age handout.

Detailed Description

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Approximately 500,000 infants are born prematurely in the United States every year. Premature birth prior to 27 weeks gestation currently accounts for approximately 40% of infant mortality within the United States. When compared to full term infants, premature infants have a higher risk of physical or cognitive impairment and prematurity care accounts for over 26 billion dollars annually. Parents of premature infants are placed under significant emotional, financial, and personal stress. However, parental education about prematurity is often not evidenced based, varies significantly between OB and Neonatology providers, and lacks educational aids to help parents comprehend the information provided.

Several medical societies (American Academy of Pediatrics (AAP), American Congress of Obstetrics and Gynecology (ACOG), National Institute of Child Health and Human Development (NICHD)) and parental advocates have voiced concern that the current practice is sub-optimal. Several studies have looked at this challenging situation from the family's perspective and have shown that parents find this counseling to be helpful but rarely reassuring and often stressful. Cognitive science research has recommended the use of multimedia information to simultaneously use both text and visual cognitive channels to improve information uptake and retention. Policy statements from the AAP, ACOG, and NICHD have all emphasized the importance of improving the prenatal counseling process to give our parents the most information possible so that they can make the best choices possible for their vulnerable infant.

Potential study participants will be identified after hospitalization at Froedtert Hospital for premature labor. As per current clinical practice all mothers and their support person will have a neonatology consult requested by the obstetrician. These potential participants will be screened for eligibility in the study. Mothers and their support person will then be consented for participation and will be randomized to receive either verbal counseling with printed gestational age handout or verbal counseling with the multimedia information regarding prematurity. Participation of the pregnant woman's support person will be allowed by not required. If both mother and support person consent to participate, the support person will be will be assigned the same group as the mother. Participants will take a baseline STAI (State-Trait Anxiety Inventory) at time of randomization. After prenatal counseling has been completed by a neonatal provider (neonatology attending or fellow) the participants will be provided the validated questionnaire (previously developed) to assess their knowledge of prematurity based on the AAP recommended information for parents anticipating a premature birth. Participants will also retake the STAI.

Conditions

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Premature Birth Counseling Decision Making Prenatal Care Infant, Premature Resuscitation

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Randomized controlled trial where participants are assigned to 1 of 2 groups for the duration of the study. One group will receive verbal counseling and a printed gestational age handout. The other group will receive verbal counseling and a bedside iPad with the multimedia information about prematurity.
Primary Study Purpose

OTHER

Blinding Strategy

NONE

Study Groups

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Printed Handout

Participants in this arm will receive verbal prematurity counseling from a Neonatologist or Neonatal fellow as well as a printed gestational age specific handout about prematurity.

Group Type ACTIVE_COMPARATOR

Printed Handout

Intervention Type OTHER

Printed Handout is a gestational age specific handout that addresses resuscitation and prematurity information.

Multimedia Information

Participants in this arm will receive verbal prematurity counseling from a Neonatologist or Neonatal fellow as well as have bedside access to iPad multimedia information regarding prematurity.

Group Type EXPERIMENTAL

Multimedia Information

Intervention Type OTHER

Is a multi-media mobile application that addresses information about prematurity, resuscitation, and NICU hospitalization.

Interventions

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Multimedia Information

Is a multi-media mobile application that addresses information about prematurity, resuscitation, and NICU hospitalization.

Intervention Type OTHER

Printed Handout

Printed Handout is a gestational age specific handout that addresses resuscitation and prematurity information.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* English speaking
* Admitted to Labor and Delivery unit due to concerns for premature delivery, gestational age of fetus between 22 weeks 0 days and 33 weeks 6 days

Exclusion Criteria

* known significant genetic abnormality or congenital anomaly that would effect survival or counseling that parents receive
* participants will be excluded from analysis if delivery occurs prior to completion of questionnaires as other sources of information become available after birth
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Marquette University

OTHER

Sponsor Role collaborator

Children's National Research Institute

OTHER

Sponsor Role collaborator

AMAG Pharmaceuticals, Inc.

INDUSTRY

Sponsor Role collaborator

Medical College of Wisconsin

OTHER

Sponsor Role lead

Responsible Party

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Mir A Basir

Associate Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Mir A Basir, MD

Role: PRINCIPAL_INVESTIGATOR

Medical College of Wisconsin

Locations

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Froedtert Hospital

Milwaukee, Wisconsin, United States

Site Status

Countries

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United States

References

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Cummings J; COMMITTEE ON FETUS AND NEWBORN. Antenatal Counseling Regarding Resuscitation and Intensive Care Before 25 Weeks of Gestation. Pediatrics. 2015 Sep;136(3):588-95. doi: 10.1542/peds.2015-2336.

Reference Type BACKGROUND
PMID: 26324869 (View on PubMed)

Raju TNK, Mercer BM, Burchfield DJ, Joseph GF Jr. Periviable birth: executive summary of a joint workshop by the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Society for Maternal-Fetal Medicine, American Academy of Pediatrics, and American College of Obstetricians and Gynecologists. Obstet Gynecol. 2014 May;123(5):1083-1096. doi: 10.1097/AOG.0000000000000243.

Reference Type BACKGROUND
PMID: 24785861 (View on PubMed)

Muthusamy AD, Leuthner S, Gaebler-Uhing C, Hoffmann RG, Li SH, Basir MA. Supplemental written information improves prenatal counseling: a randomized trial. Pediatrics. 2012 May;129(5):e1269-74. doi: 10.1542/peds.2011-1702. Epub 2012 Apr 9.

Reference Type BACKGROUND
PMID: 22492766 (View on PubMed)

Paivio A. Dual coding theory: Retrospect and current status. Can J Psychol. 45(3):255-87, 1991

Reference Type BACKGROUND

Rau NM, Mcintosh JJ, Flynn KE, Szabo A, Ahamed SI, Asan O, Hasan MK, Basir MA. Multimedia tablet or paper handout to supplement counseling during preterm birth hospitalization: a randomized controlled trial. Am J Obstet Gynecol MFM. 2023 Apr;5(4):100875. doi: 10.1016/j.ajogmf.2023.100875. Epub 2023 Jan 26.

Reference Type DERIVED
PMID: 36708966 (View on PubMed)

Other Identifiers

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PRO00028712

Identifier Type: -

Identifier Source: org_study_id

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