Standardized Application of Feeding Evaluations Using SMART Tool

NCT ID: NCT07136610

Last Updated: 2025-08-28

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

RECRUITING

Clinical Phase

NA

Total Enrollment

3500 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-08-01

Study Completion Date

2026-07-31

Brief Summary

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Premature and medically complex infants have delayed development of oral feeding skills, leading to prolonged hospitalization, costs, and family stress. There is no "gold standard" infant feeding skill assessment tool for bedside clinicians. The research team developed a novel feeding skill assessment, the SMART Tool, to monitor infant feeding skill development in the neonatal intensive care unit. This study aims to determine whether this tool improves clinical outcomes, including reduced hospital days and enhanced safety and quality of infant feedings.

Detailed Description

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The current recommendation for preventing infant feeding problems is to provide cue-based feeding, which entails optimizing feeding based on infant cues, including behavioral and physiological signs of stress. These recommendations rely on appropriately recognizing infant feeding cues to inform care instead of applying time-based, volume-driven care irrespective of cues. Care providers vary widely in their subjective assessment of feeding skills, often because they lack standard education on feeding skill assessment and a "gold standard" tool to objectively measure infant oral feeding skill levels. This robust, step-wedge, cluster randomized trial was designed to evaluate the effect of implementing the SMART Tool in 14 different Neonatal Intensive Care Units (NICU) in the Advocate Health Midwest Region. The SMART Tool is a novel feeding assessment tool developed at Advocate Illinois Masonic Medical Center to objectively measure feeding readiness and skill. The psychometric properties were tested through a research study, and strong validity and reliability were established. The Advocate Health Midwest Region NICU standardization committee approved this tool as the sole feeding skill assessment tool to be used at each oral feed (eight times a day) for all NICU infants. Data on infants in the NICU will abstracted from the medical record at the time of discharge or death. The study will use PRISM and the REAIM Framework. The implementation framework consists of three parts that interact to influence outcomes (contextual factors, roll-out strategies, outcomes).

Conditions

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Infant and Young Child Feeding

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

NONE

Study Groups

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SMART Tool

Feeding skill assessment, the SMART Tool to monitor infant feeding skill development in the neonatal intensive care unit.

Group Type EXPERIMENTAL

SMART Tool

Intervention Type BEHAVIORAL

The intervention in this implementation study involves (1) integrating the SMART Tool into electronic health records (EPIC), (2) educating all NICU staff (about 850 nurses, lactation consultants, speech-language pathologists, and physicians), and (3) Quality improvement to reinforce learning.

Interventions

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SMART Tool

The intervention in this implementation study involves (1) integrating the SMART Tool into electronic health records (EPIC), (2) educating all NICU staff (about 850 nurses, lactation consultants, speech-language pathologists, and physicians), and (3) Quality improvement to reinforce learning.

Intervention Type BEHAVIORAL

Other Intervention Names

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feeding skill assessment

Eligibility Criteria

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Inclusion Criteria

* Infants born between August 1, 2025, and July 31, 2026, AND admitted to NICU

Exclusion Criteria

* No oral feeding started by July 15, 2026
Maximum Eligible Age

1 Year

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Wake Forest University Health Sciences

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Ravi Mishra, MBBS, MD

Role: STUDY_CHAIR

Advocate Illinois Masonic Medical Center

Elizabeth Jensen, MPH, PhD

Role: PRINCIPAL_INVESTIGATOR

Wake Forest University Health Sciences

Joseph Chase, MPH

Role: PRINCIPAL_INVESTIGATOR

Advocate Aurora Research Institute

Anne Albi, BS, MS

Role: PRINCIPAL_INVESTIGATOR

Advocate Illinois Masonic Medical Center

Cynthia Lira-Crame, BSN, MSN

Role: PRINCIPAL_INVESTIGATOR

Advocate Illinois Masonic Medical Center

Locations

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Advocate Good Shepherd Hospital

Barrington, Illinois, United States

Site Status RECRUITING

Advocate Trinity Hospital

Chicago, Illinois, United States

Site Status RECRUITING

Advocate Sherman Hospital

Elgin, Illinois, United States

Site Status RECRUITING

Advocate Condell Medical Center

Libertyville, Illinois, United States

Site Status RECRUITING

Advocate Christ Medical Center (Advocate Children's Hospital - Oak Lawn)

Oak Lawn, Illinois, United States

Site Status RECRUITING

Advocate Lutheran General Hospital (Advocate Children's Hospital - Park Ridge)

Park Ridge, Illinois, United States

Site Status RECRUITING

Aurora Medical Center Grafton

Grafton, Wisconsin, United States

Site Status RECRUITING

Aurora BayCare Medical Center

Green Bay, Wisconsin, United States

Site Status RECRUITING

Aurora Medical Center Kenosha

Kenosha, Wisconsin, United States

Site Status RECRUITING

Aurora Sinai Medical Center

Milwaukee, Wisconsin, United States

Site Status RECRUITING

Aurora Medical Center Oshkosh

Oshkosh, Wisconsin, United States

Site Status RECRUITING

Aurora Medical Center - Sheboygan County

Sheboygan, Wisconsin, United States

Site Status RECRUITING

Aurora Medical Center - Summit

Summit, Wisconsin, United States

Site Status RECRUITING

Aurora West Allis Medical Center

West Allis, Wisconsin, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Ravi Mishra, MBBS,MD,FAAP

Role: CONTACT

804.464.7472

Cynthia Liracrame, RN

Role: CONTACT

773.296.7977

Facility Contacts

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Hope Reis, NPD

Role: primary

804-464-7472

Karen Beagles, RN

Role: primary

804-464-7472

Cynthia Manly, RN

Role: primary

804-464-7472

Julie Vannoord

Role: backup

Heidi Gutwoski, NPD

Role: primary

804-464-7472

Edythe Oliver, NPD

Role: primary

804-464-7472

Katie Kurnick, NPD

Role: primary

804-464-7472

Julie Bulgrin, NPD

Role: primary

804-464-7472

Erica Huettl, NPD

Role: primary

804-464-7472

Margaret Loehrke, NPD

Role: primary

804-464-7472

Kate Scythe, NPD

Role: primary

804-464-7472

Abbey Schonscheck, RN

Role: primary

804-464-7472

Michaele Schramm, RN

Role: primary

804-464-7472

Sara Jeanty, NPD

Role: backup

Dawn Hron, NPD

Role: primary

804-464-7472

Shannon Schubel, NPD

Role: primary

804-464-7472

References

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Reference Type BACKGROUND
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Adams-Chapman I, Bann CM, Vaucher YE, Stoll BJ; Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Association between feeding difficulties and language delay in preterm infants using Bayley Scales of Infant Development-Third Edition. J Pediatr. 2013 Sep;163(3):680-5.e1-3. doi: 10.1016/j.jpeds.2013.03.006. Epub 2013 Apr 10.

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Related Links

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https://clinicaltrials.gov/study/NCT05729828

Psychometric Properties of the SMART Feeding Tool

https://institutionalrepository.aah.org/sciday/2024/oral3/3/

Psychometric Properties of SMART Feeding Tool - AHMW SHARE

Other Identifiers

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IRB00132685

Identifier Type: -

Identifier Source: org_study_id

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