Constipation Clinical Trial
Official title:
"Anticipatory Guidance in the Nursery and Its Impact on Non-urgent Emergency Department Visits"
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).
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;
;
Allocation: Randomized, Intervention Model: Crossover Assignment, Masking: Single Blind (Subject), Primary Purpose: Prevention
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