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"Anticipatory Guidance in the Nursery and Its Impact on Non-urgent Emergency Department Visits"

This study has been completed.
Sponsor:
Information provided by (Responsible Party):
Kelly Kamimura-Nishimura, Bronx-Lebanon Hospital Center Health Care System
ClinicalTrials.gov Identifier:
NCT01859065
First received: May 17, 2013
Last updated: NA
Last verified: May 2013
History: No changes posted
  Purpose

Kennedy et al, in a study of pediatric Emergency Department (ED) use by newborns less than 14 days of age, revealed that half of all visits in this population were non-acute problems. Other pediatric ED utilization studies have shown similar findings in that 32% to 72% of all visits were for non-urgent problems.

Many studies have found that primiparity and young maternal age are associated with non-acute ED presentations. A recent factor that has been investigated is the effect of early neonatal discharge. Some other factors are nonwhite mothers and mothers on Medicaid. Zandieh et al, found additional predisposing determinants for non-urgent ED visits, such as single parenthood, Hispanic ethnicity, and having perceptions that their child's overall physical health was poor.

Paradis et al found that parents receiving a video intervention rated higher confidence with specific infant care skills and reported feeling better prepared to care for their baby, compared to parents receiving only handouts. However, there isn't any reported study that evaluates the benefits of receiving both, a video intervention along with handouts.

Aim: to demonstrate whether conducting anticipatory guidance related to non-urgent problems will reduce non-urgent ED visits, compared to care as usual (CAU) anticipatory guidance (Sudden Infant Death Syndrome and Shaken Baby Syndrome videos; and unstructured talk about jaundice, vaccinations, appointments, care of umbilical stump, normal urination and bowel movement, fever).


Condition Intervention
Health Knowledge, Attitudes, Practice
Sneezing
Constipation
Nasal Congestion and Inflammations
Behavioral: Intensified anticipatory guidance
Behavioral: Routine

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: Single Blind (Subject)
Primary Purpose: Prevention
Official Title: "Anticipatory Guidance in the Nursery and Its Impact on Non-urgent Emergency Department Visits"

Resource links provided by NLM:


Further study details as provided by Bronx-Lebanon Hospital Center Health Care System:

Primary Outcome Measures:
  • Non-urgent ED visits by neonates [ Time Frame: 1 month ] [ Designated as safety issue: No ]
    Reduction in non-urgent ED visits in mothers who received the intervention (video-based and handout-based anticipatory guidance regarding non-urgent problems), compared to the control group (received CAU anticipatory guidance)


Secondary Outcome Measures:
  • Changes in caregivers' knowledge and attitude [ Time Frame: 1 month ] [ Designated as safety issue: No ]
    Improvement in parental knowledge, attitude and behaviors related to non-urgent problems as a result of receiving anticipatory guidance (video and handouts) regarding non-urgent problems


Enrollment: 323
Study Start Date: December 2011
Study Completion Date: April 2012
Primary Completion Date: April 2012 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Placebo Comparator: Control
Mothers receive routine anticipatory guidance
Behavioral: Routine
Routine anticipatory guidance (control)
Experimental: Intervention
Mothers receive video-based and handout-based anticipatory guidance regarding non-urgent problems in addition to the routine anticipatory guidance
Behavioral: Intensified anticipatory guidance
Mothers receive video-based and handout-based anticipatory guidance regarding non-urgent problems in addition to the routine anticipatory guidance

Detailed Description:

Inclusion Criteria: Mother of a newborn in the Well Baby Nursery (WBN) of Bronx-Lebanon Hospital Center during the 4-month recruitment period of the study.

Exclusion Criteria:

  1. Mothers selected for video-based anticipatory guidance that have a hearing/vision impairment.
  2. Mothers selected for handout-based anticipatory guidance who speak a language other than Spanish or English.

Primary outcome measure: reduction in non-urgent ED visits in mothers who received the intervention (video-based and handout-based anticipatory guidance regarding non-urgent problems), compared to the control group (received CAU anticipatory guidance)

Secondary outcome measure: improvement in parental knowledge, attitude and behaviors related to non-urgent problems as a result of receiving anticipatory guidance (video and handouts) regarding non-urgent problems;

  Eligibility

Genders Eligible for Study:   Female
Accepts Healthy Volunteers:   Yes
Criteria

Inclusion Criteria:

  • Mother of a newborn in the WBN of Bronx-Lebanon Hospital Center during the 4-month recruitment period of the study

Exclusion Criteria:

  • Mothers selected for video-based anticipatory guidance that have a hearing/vision impairment.
  • Mothers selected for handout-based anticipatory guidance who speak a language other than Spanish or English.
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT01859065

Locations
United States, New York
Bronx Lebanon Hospital Center
Bronx, New York, United States, 10457
Sponsors and Collaborators
Bronx-Lebanon Hospital Center Health Care System
Investigators
Principal Investigator: Ayoade Adeniyi, MD Bronx-Lebanon Hospital Center
  More Information

Publications:

Responsible Party: Kelly Kamimura-Nishimura, MD, Pediatric Resident, Bronx-Lebanon Hospital Center Health Care System
ClinicalTrials.gov Identifier: NCT01859065     History of Changes
Other Study ID Numbers: 09 15 11 10
Study First Received: May 17, 2013
Last Updated: May 17, 2013
Health Authority: United States: Institutional Review Board

Keywords provided by Bronx-Lebanon Hospital Center Health Care System:
Non-urgent ED visits
Neonates
Newborn care

Additional relevant MeSH terms:
Constipation
Inflammation
Pathologic Processes
Signs and Symptoms
Signs and Symptoms, Digestive

ClinicalTrials.gov processed this record on November 20, 2014