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Increasing Documentation and Disclosure of Sickle Cell Trait Status: An Implementation Science Approach

Primary Purpose

Sickle Cell Trait

Status
Not yet recruiting
Phase
Not Applicable
Locations
Study Type
Interventional
Intervention
SCT Documentation and Disclosure Toolkit (SCT-DD)
Sponsored by
Nemours Children's Clinic
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional health services research trial for Sickle Cell Trait focused on measuring electronic health record, pediatric, newborn screen, implementation

Eligibility Criteria

undefined - undefined (Child, Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Outpatient pediatric primary care providers within Nemours and their patients

Exclusion Criteria:

  • none

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Active Comparator

    Active Comparator

    Arm Label

    "All-in"

    "Add-in"

    Arm Description

    In the "all-in" arm, pediatric primary care physicians receive all toolkit components at once.

    In the "add-in" arm, pediatric primary care physicians will have sequential addition of toolkit components in 3 month increments

    Outcomes

    Primary Outcome Measures

    Penetration
    Rate of documentation and disclosure of NBS and SCT by 2 months of age within the medical history section of the electronic health record by chart review.
    Acceptability
    Acceptability of toolkit components by pediatric primary care providers by survey
    Self-efficacy
    Increase in the intention and confidence to document/discuss SCT result by pediatric primary care providers by survey
    Feasibility of using toolkit components
    Percent of pediatric primary care providers who use individual toolkit components by survey

    Secondary Outcome Measures

    Dispersion
    Proportion of children over 2 months of age who have SCT newly documented within the electronic health record via chart review
    Knowledge
    Proportion of caregivers who accurately reported their child's SCT status via survey

    Full Information

    First Posted
    May 17, 2022
    Last Updated
    September 5, 2023
    Sponsor
    Nemours Children's Clinic
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    1. Study Identification

    Unique Protocol Identification Number
    NCT05387564
    Brief Title
    Increasing Documentation and Disclosure of Sickle Cell Trait Status: An Implementation Science Approach
    Official Title
    Increasing Documentation and Disclosure of Sickle Cell Trait Status: An Implementation Science Approach
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    September 2023
    Overall Recruitment Status
    Not yet recruiting
    Study Start Date
    November 2023 (Anticipated)
    Primary Completion Date
    July 2024 (Anticipated)
    Study Completion Date
    December 2024 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Nemours Children's Clinic

    4. Oversight

    Studies a U.S. FDA-regulated Drug Product
    No
    Studies a U.S. FDA-regulated Device Product
    No

    5. Study Description

    Brief Summary
    The hemoglobinopathy newborn screen (NBS) performed on all neonates in the U.S. allows for early life-saving medical care for infants with sickle cell disease (SCD), an autosomal recessive genetic disorder. Because of its detection method, the NBS incidentally reveals hemoglobinopathy traits including sickle cell trait (SCT). In an effort to uphold the rights of the newborn to their medical data and preserve autonomy in medical decision making, pediatric and genetic society guidelines recommend disclosure and documentation of SCT results during infancy. Despite this guidance, a large guideline-to-practice gap exists: SCT status is grossly under-documented in the pediatric electronic health record and few adults report knowing their SCT status despite universal screening. We plan to evaluate the effect of a toolkit of SCT Documentation and Disclosure (SCT-DD) strategies on documentation and disclosure of SCT by pediatric primary care providers in a 2-arm randomized interrupted time series trial.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Sickle Cell Trait
    Keywords
    electronic health record, pediatric, newborn screen, implementation

    7. Study Design

    Primary Purpose
    Health Services Research
    Study Phase
    Not Applicable
    Interventional Study Model
    Sequential Assignment
    Masking
    None (Open Label)
    Allocation
    Randomized
    Enrollment
    500 (Anticipated)

    8. Arms, Groups, and Interventions

    Arm Title
    "All-in"
    Arm Type
    Active Comparator
    Arm Description
    In the "all-in" arm, pediatric primary care physicians receive all toolkit components at once.
    Arm Title
    "Add-in"
    Arm Type
    Active Comparator
    Arm Description
    In the "add-in" arm, pediatric primary care physicians will have sequential addition of toolkit components in 3 month increments
    Intervention Type
    Behavioral
    Intervention Name(s)
    SCT Documentation and Disclosure Toolkit (SCT-DD)
    Intervention Description
    A toolkit of implementation strategies
    Primary Outcome Measure Information:
    Title
    Penetration
    Description
    Rate of documentation and disclosure of NBS and SCT by 2 months of age within the medical history section of the electronic health record by chart review.
    Time Frame
    Every 1 month through study completion, on average 1 year
    Title
    Acceptability
    Description
    Acceptability of toolkit components by pediatric primary care providers by survey
    Time Frame
    Every 3 months through study completion, on average 1 year
    Title
    Self-efficacy
    Description
    Increase in the intention and confidence to document/discuss SCT result by pediatric primary care providers by survey
    Time Frame
    Every 3 months through study completion, on average 1 year
    Title
    Feasibility of using toolkit components
    Description
    Percent of pediatric primary care providers who use individual toolkit components by survey
    Time Frame
    Every 3 months through study completion, on average 1 year
    Secondary Outcome Measure Information:
    Title
    Dispersion
    Description
    Proportion of children over 2 months of age who have SCT newly documented within the electronic health record via chart review
    Time Frame
    Every 1 month through study completion, on average 1 year
    Title
    Knowledge
    Description
    Proportion of caregivers who accurately reported their child's SCT status via survey
    Time Frame
    Every 1 months through study completion, on average 1 year

    10. Eligibility

    Sex
    All
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Outpatient pediatric primary care providers within Nemours and their patients Exclusion Criteria: none
    Central Contact Person:
    First Name & Middle Initial & Last Name or Official Title & Degree
    Corinna Schultz, MD, MSHP
    Phone
    3023313088
    Email
    corinna.schultz@nemours.org
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Corinna Schultz, MD, MSHP
    Organizational Affiliation
    Nemours
    Official's Role
    Principal Investigator

    12. IPD Sharing Statement

    Plan to Share IPD
    No

    Learn more about this trial

    Increasing Documentation and Disclosure of Sickle Cell Trait Status: An Implementation Science Approach

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