Obstructive Sleep Apnea Clinical Trial
Official title:
Evaluating the Efficacy of Clinical Decision Support and Sleep Navigation to Enhance Primary to Specialty Care Management of Sleep Disordered Breathing
Verified date | October 2023 |
Source | Children's Hospital of Philadelphia |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Interventional |
The purpose of the study is to examine the feasibility, acceptability, and initial outcomes of clinical decision support (CDS) and a Sleep Navigation program to enhance primary to specialty care management of pediatric sleep-disordered breathing (SDB).
Status | Active, not recruiting |
Enrollment | 33 |
Est. completion date | June 1, 2024 |
Est. primary completion date | September 1, 2023 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 2 Years to 17 Years |
Eligibility | Inclusion Criteria: Caregiver-child dyads: 1. Child is between 2 years and 17 years of age 2. Child has an abnormal SDB screen (i.e., a positive response to whether the child snores 3 or more nights/week) on the sleep screener used as part of well child visit care in the Children's Hospital of Philadelphia (CHOP) primary care network 3. Child receives well child care at Cobbs Creek or Karabots CHOP primary care network sites 4. Parental/guardian permission (informed consent) and if applicable, child assent 5. Caregiver participant is the parent or legal guardian of the child subject 6. Caregiver is 18 years of age or older 7. English-speaking Clinicians: 8. Primary care clinician practicing at Cobbs Creek or Karabots CHOP primary care network sites 9. English-speaking Exclusion Criteria: Caregiver-child dyads: 1. Caregiver is not the parent or legal guardian of child participant or is <18 years of age 2. Non-English speaking, as intervention sessions and qualitative interviews will be conducted in English 3. Child receives well child care at a non-participating primary care site at enrollment 4. Caregivers/guardians or subjects who, in the opinion of the Investigator, may be non-compliant with study schedules or procedures Clinicians: 5. Does not see patients at Cobs Creek or Karabots CHOP primary care network sites 6. Non-English speaking, as qualitative interviews will be conducted in English |
Country | Name | City | State |
---|---|---|---|
United States | Children's Hospital of Philadelphia | Philadelphia | Pennsylvania |
Lead Sponsor | Collaborator |
---|---|
Children's Hospital of Philadelphia |
United States,
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Bonuck KA, Chervin RD, Cole TJ, Emond A, Henderson J, Xu L, Freeman K. Prevalence and persistence of sleep disordered breathing symptoms in young children: a 6-year population-based cohort study. Sleep. 2011 Jul 1;34(7):875-84. doi: 10.5665/SLEEP.1118. — View Citation
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Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | CDS feasibility (proportion of patients screened for SDB at well child visits of all those eligible for screening at well child visits over the study period) | Proportion of patients screened for SDB at well child visits will be calculated with data from the electronic health records. | up to 12 months | |
Primary | Clinician Decision Support Acceptability | Clinician Decision Support acceptability will be measured through clinician-completed system usability survey.
This measure is rated on a 5-point Likert scale (1=strongly disagree; 2=somewhat disagree; 3=neither agree or disagree; 4=somewhat agree; and 5=strongly agree) with a range in score from 12 to 60. Higher total scores indicate better acceptability. |
up to 12 months | |
Primary | Acceptability of the CDS Tool | CDS acceptability will be measured by semi-structured qualitative interviews completed by the clinicians. Up to 15 primary care clinicians will be invited to participate in an interview focused on acceptability of the CDS tool. The interview includes multiple, open-ended questions completed by the clinician. | up to 12 months | |
Primary | Sleep Navigator feasibility (number of Sleep Navigation activities completed among those randomized to receive Sleep Navigation) | Feasibility will be measured using data from the Sleep Navigator-completed intervention-specific fidelity checklist. | within 8 months of baseline assessment | |
Primary | Sleep Navigator feasibility (Sleep Navigation activities completed among those randomized to receive Sleep Navigation) | Feasibility will be measured using data from the caregiver-completed qualitative interview. | within 8 months of baseline assessment | |
Primary | Acceptability of the Sleep Navigation program (Treatment Evaluation Inventory-Short Form) | Acceptability of the Sleep Navigation program will be measured through the Treatment Evaluation Inventory-Short Form that has been adapted for the Sleep PASS program. This measure is rated on a 5-point Likert scale (1=strongly disagree; 2=disagree; 3=neutral; 4=agree; and 5=strongly agree) with a range in raw score from 11 to 55. Higher total scores indicate better acceptability. | within 8 months of baseline assessment | |
Primary | Acceptability of the Sleep Navigation program (Multicultural Therapy Competency Inventory) | Sleep Navigation acceptability will be measured through the Multicultural Therapy Competency Inventory- Client Version questionnaire that has been adapted for the Sleep PASS program. This measure is rated on a 5-point Likert scale (1=strongly disagree; 2=disagree; 3=neutral; 4=agree; and 5=strongly agree) with a range in raw score from 5 to 25. Higher total scores indicate better outcomes. | within 8 months of baseline assessment | |
Secondary | Sleep specialty care referral rates | The change in referral rates will be measured through the proportion of patients referred for SDB specialty care of those identified with sleep disordered breathing symptoms based on well visit sleep screener over the study period. | through study completion, an average of 1 year | |
Secondary | Completion of sleep specialty care referral | The change in referral completion for child sleep disordered breathing care will be measured through the proportion of patients randomized to Sleep Navigation who complete their specialty care referral of those referred to specialty care. | through study completion, an average of 1 year | |
Secondary | Caregiver knowledge of Sleep Disordered Breathing (SDB) | The magnitude and direction of change in caregiver knowledge of SDB will be measured through the obstructive Sleep Disordered Breathing and Adenotonsillectomy knowledge scale for caregivers. This measure is rated on a dichotomous scale (True/False) with a total raw score range of 0 to 39. Correct answers are summed to attain an overall percentage score representing the degree of knowledge level, with a minimum value of zero and a maximum of 100%. A higher percentage indicates better outcomes. | at baseline and within 8 months of baseline assessment | |
Secondary | Child SDB symptoms: Pediatric Sleep Questionnaire | The magnitude and direction of change in child sleep will be measured through the Pediatric Sleep Questionnaire scores, the most validated questionnaire assessing children's SDB symptoms. This measure is rated on a dichotomous scale ("yes" = 1, "no" = 0, and "don't know"=missing). The result is a proportion that ranges from 0.0 to 1.0. Scores greater than 0.33 are considered positive and suggestive of high risk for a pediatric sleep-related breathing disorder. | at baseline and within 8 months of baseline assessment | |
Secondary | Child sleep habits: Brief Child Sleep Questionnaire (BCSQ) | The magnitude and direction of change in child sleep will be measured through the BCSQ which assesses child sleep habits including sleep time, total sleep duration, night waking, aspects of the sleep environment, etc. The BCSQ uses a nominal scale system. Scores on each subscale and the total score are scaled from 0 to 100. Higher scores denote better sleep quality, more positive perception of child sleep, and parent behaviors that promote healthy and independent sleep. | at baseline and within 8 months of baseline assessment | |
Secondary | Patient-Reported Outcomes Measurement Information System (PROMIS) Sleep Disturbances | The PROMIS Sleep Disturbances survey would measure the magnitude and direction of change in child sleep. This measure is rated on a 5-point Likert scale (1=never; 2=rarely; 3=sometimes; 4=often; and 5=always) with a range in score from 8 to 40. The raw scores are converted to a standardized T-score, with higher scores indicating greater severity of sleep disturbance. | at baseline and within 8 months of baseline assessment | |
Secondary | Patient-Reported Outcomes Measurement Information System (PROMIS) Sleep-Related Impairment | The PROMIS Sleep-Related Impairment survey would measure the magnitude and direction of change in child sleep. This measure is rated on a 5-point Likert scale (1=never; 2=rarely; 3=sometimes; 4=often; and 5=always) with a range in score from 8 to 40. The raw scores are converted to a standardized T-score, with higher scores indicating greater severity of sleep-related impairment. | at baseline and within 8 months of baseline assessment | |
Secondary | Child sleep practices | Sleep practices would be assessed using the Patient-Reported Outcomes Measurement Information System Sleep Practices survey. This measure assesses 5 sleep practices: sleep timing, sleep routines and consistency, technology use before bedtime, sleep environment, and the need for parental presence to fall asleep. This measure is rated on a nominal scale and 5-point Likert scale. Scores on each subscale and the total score are scaled from 0 to 100. Higher scores indicate better sleep practices. | at baseline and within 8 months of baseline assessment | |
Secondary | Child obstructive sleep apnea symptoms | The change in child obstructive sleep apnea (OSA) symptoms will be measured through the OSA-18, a validated caregiver-completed questionnaire. This measure is rated on a 7-point Likert scale. Total raw score ranges from 18 to 126. Higher scores indicates worse outcomes. | at baseline and within 8 months of baseline assessment |
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