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Infant Mental Health-Home Visiting Randomized Controlled Trial (IMH-HV RCT)

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ClinicalTrials.gov Identifier: NCT03175796
Recruitment Status : Recruiting
First Posted : June 5, 2017
Last Update Posted : October 17, 2017
Sponsor:
Collaborator:
Michigan Department of Health and Human Services
Information provided by (Responsible Party):
Kate Rosenblum, University of Michigan

May 17, 2017
June 5, 2017
October 17, 2017
October 12, 2017
April 30, 2019   (Final data collection date for primary outcome measure)
  • PTSD Checklist (PCL-5) [ Time Frame: 1 Year ]
    Change in caregiver PTSD symptoms via measurement on PCL-5 with a range of 0 (no symptoms) to 80 (high level symptom endorsement).
  • Generalized Anxiety Disorder (GAD-7) [ Time Frame: 1 Year ]
    Change in caregiver anxiety via measurement on GAD-7 with a range of 0 (no symptoms) to 21 (high level of anxiety symptoms endorsed).
  • Patient Health Questionnaire (PHQ-9) [ Time Frame: 1 Year ]
    Change in caregiver self-reported depression via measurement on PHQ-9 with a range of 0 (no depression symptoms) to 27 (high level of depression symptoms endorsed).
  • Brief Child Abuse Potential Inventory (BCAP) [ Time Frame: 1 Year ]
    Change in caregiver self-reported emotional distress, rigidity, social isolation (risks associated with child maltreatment) via measurement on BCAP with a range of 0-24.
  • Working Model of the Child Interview (WMCI) [ Time Frame: 1 year ]
    Categorization of caregiver perception of child and relationship with child that moves from distorted or disengaged to balanced via measurement on the WMCI.
  • Infant Toddler Social-Emotional Assessment (ITSEA) [ Time Frame: 1 Year ]
    Change in caregiver reported social-emotional behavior problems of child via measurement on ITSEA using t-scores derived from ITSEA-provided standard norms
Same as current
Complete list of historical versions of study NCT03175796 on ClinicalTrials.gov Archive Site
Not Provided
Not Provided
Not Provided
Not Provided
 
Infant Mental Health-Home Visiting Randomized Controlled Trial
Infant Mental Health-Home Visiting Randomized Controlled Trial

The primary objective is to rigorously evaluate the effectiveness of the Infant Mental Health Home Visiting (IMH-HV) model on maternal and child outcomes according to legislative standards via a randomized controlled trial. The research team will recruit caregivers and their children (0-24 months) or pregnant women (n=72) from locations across Washtenaw County to participate in the IMH-HV RCT. Half of the women will be randomly assigned to a treatment as usual (TAU) control group (with access to all available community resources), and half of the women will be randomly assigned to the treatment group (i.e., IMH-HV). Women assigned to the control group will not receive IMH-HV treatment through the study team, but will not be prohibited from seeking or accessing IMH-HV treatment or any other services through community resources. Women assigned to the treatment group will receive IMH-HV treatment for 12 months through the study team with rigorous monitoring of fidelity to the IMH-HV model. All study participants will undergo assessments across the 12-month period of the treatment trial (i.e., baseline (randomization will occur after baseline), mid-points (3, 6 and 9 months) and follow-up (12 months) after randomization).

The purpose of this study is to evaluate efficacy of the Infant Mental Health Home-Visiting (IMH-HV) model on parental and child outcomes according to legislative standards and consistent with the State of Michigan's benchmarks. If this study confirms the efficacy of the IMH-HV model, this will support the sustainability of IMH-HV in the state of Michigan as evidence from a randomized controlled trial is necessary in order to access certain state and federal dollars. Access to evidence-based and sustainable parenting support can ultimately improve outcomes for this vulnerable population. Specifically this study aims to:

  1. Conduct a randomized controlled trial to evaluate the efficacy of IMH-HV treatment utilizing rigorous outcomes monitoring and evaluation methodology to establish that the families served achieve the intended positive benefit. Eligible caregivers and children or pregnant women will be assigned to the control group or the treatment group and both groups will receive research assessments at regular intervals measuring key impacts of the IMH-HV model.
  2. Determine IMH-HV efficacy via analysis of treatment impact on key caregiver, child, and family indicators. The hypothesis is that there will be positive impacts of IMH-HV, with caregiver, child, and family-level improvements from baseline to post assessment on key indicators, including:

    1. Improved child outcomes as reflected in strengthened child physical and behavioral health, development and school readiness, and reduced risk for child maltreatment.
    2. Improved parental outcomes including improved parent mental health, decreased child abuse potential, and enhanced positive parenting.
    3. Improved family environment including decrease in crime and family violence, enhance linkage to referrals and improve family economics and self-sufficiency.
  3. Identify factors associated with family improvement, including dosage and fidelity of treatment. It is the hypothesis that a dose-response association between the number of home visiting sessions and treatment impact, and a positive association between fidelity of treatment delivered and positive child and family outcomes.
A small number of inclusion/exclusion criteria have not been disclosed in this record to preserve scientific integrity. They will be added to make this record complete once all study data is collected.
Interventional
Not Applicable
Allocation: Randomized
Intervention Model: Parallel Assignment
Intervention Model Description:

IMH-HV is a relationship-focused mental health intervention that aims to improve caregiver and child outcomes, including: improved caregiver mental health; enhanced positive parenting; decreased risk for physical/emotional neglect and/or abuse; and reduced risk for negative child outcomes including impaired development, cognitive delay and behavioral problems. In addition, IMH-HV services aim to reduce the probability of intergenerational transmission of the effects of unresolved loss and trauma in parents.

The IMH-HV Model uses a range of strategies for intervention, such as:

  • attending to the health and basic material needs of the infant/toddler, parent(s), and family members;
  • providing developmental guidance for positive parenting behavior;
  • providing counseling/emotional support for the parents;
  • developing parents' life coping skills and social support; and
  • providing infant/parent psychotherapy.
Masking: None (Open Label)
Primary Purpose: Treatment
Infant Mental Health
Behavioral: Infant Mental Health-Home Visiting
Behavioral intervention aimed to increase parental competencies and promote mental health and sensitive caregiving.
  • Experimental: IMH-HV Treatment Group
    Infant Mental Health-Home Visiting. Weekly home visits for up to one year by a trained IMH-HV treatment provider. Treatment delivery consistent with the IMH-HV manual.
    Intervention: Behavioral: Infant Mental Health-Home Visiting
  • No Intervention: Treatment as Usual Control Group
    No intervention provided as part of participation in this study; families are free to access community resources including any available treatment(s) in the community.
Not Provided

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Recruiting
144
Same as current
April 30, 2019
April 30, 2019   (Final data collection date for primary outcome measure)

Inclusion Criteria:

Mothers (biological or adoptive) who:

  • are the permanent, primary caregiver of a child between the ages of 0-24 months old or 29+ weeks pregnant;
  • are at least 18 years of age;
  • who speak and understand English; and,
  • who meet specified criteria for: childhood experiences, depression, challenges with child, and socio-economic status.

Exclusion Criteria:

  • Women who live farther than 20 miles away from Ann Arbor
  • Women who are already enrolled in Infant Mental Health-Home Visiting services
  • Women who meet criteria for alcohol/substance use disorders, or who screen positive for psychosis
Sexes Eligible for Study: All
Gender Based Eligibility: Yes
Gender Eligibility Description: Mothers that are primary, permanent caregivers of a child 0-24 months (male or female) OR 29+ weeks pregnant
Child, Adult, Older Adult
Yes
Contact: Rachel Waddell, MSW (734) 998-0089 rhenson@med.umich.edu
Contact: Emily Alfafara, BA (734) 998-8145 emalfafa@med.umich.edu
United States
 
 
NCT03175796
HUM00124224
No
Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
Plan to Share IPD: Undecided
Kate Rosenblum, University of Michigan
University of Michigan
Michigan Department of Health and Human Services
Principal Investigator: Katherine Rosenblum, PhD University of Michigan
University of Michigan
October 2017

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP