Pain Clinical Trial
Official title:
Caring for Babies During the Newborn Screening Blood Test: How do Parents Help? A Pilot RCT
Newborn infants have blood work procedures in their first days of life that cause pain, distress and physiological changes. Breastfeeding (BF), skin to skin care (SSC), or giving sweet solutions (sucrose or glucose) has been shown to be effective for reducing babies' pain. However, recent studies of neonatal pain management practices demonstrate infrequent use of these strategies. There is a need for parent-targeted interventions, to support parents' involvement in comforting their infants during painful procedures. This pilot RCT will inform all aspects of a full-scale trial and will evaluate the effectiveness of the BSweet2Babies video when shown to parents of newborns prior to newborn screening, on subsequent use of effective pain reduction strategies during the newborn screening blood test. The participants will be randomized to either the control group (usual care), or to the intervention group and will be shown the brief BSweet2Babies video on caring for infants during blood work. The intervention group will be asked to complete a second survey after viewing the video. To evaluate the use of BF, SSC, or sucrose during newborn screening, the research assistant will collect data from the electronic medical record.
Background: Newborn infants have blood work procedures for screening and medical monitoring
in their first days of life that cause pain, distress and physiological changes.
Breastfeeding (BF), skin to skin care (SSC), or giving small amounts of sweet solutions
(sucrose or glucose) with or without a pacifier, effectively and safely reduce pain in
newborn infants during painful procedures. However, recent studies of neonatal pain
management practices demonstrate infrequent use of these strategies. There is a clear need
for developing and testing acceptable parent-targeted interventions, alongside health care
provider-targeted knowledge translation (KT) interventions, to support parents' involvement
in comforting their infants during painful procedures. To address this knowledge to action
(KTA) gap, Denise Harrison's Be Sweet to Babies team developed the BSweet2Babies video, which
shows parents the effectiveness of BF, SSC, and sucrose during infant bloodwork and how they
can use and advocate for these pain treatment strategies.
Objectives: To conduct a pilot randomized controlled trial (RCT) that will inform all aspects
of a full-scale trial of the parent-targeted BSweet2Babies knowledge to action (KTA)
intervention. The objective of the full scale trial will be to evaluate the effectiveness of
the BSweet2Babies video when shown to parents of newborns prior to newborn screening, on
subsequent use of effective pain reduction strategies during the newborn screening blood
test.
Study design and methods: This study is a pilot 2-armed RCT that will enroll 100 parents in
the mother baby unit at The Ottawa Hospital. Following consent, the research assistant will
randomize parents to one of two groups: the intervention group (viewing the BSweet2Babies
video prior to their baby's newborn screening blood test) or the control group (no
intervention). Parents in both groups will complete a brief baseline survey to establish
previous knowledge and use of pain management strategies. Participants in the intervention
group will subsequently view the 5 minute BSweet2Babies video. Lastly, participants in the
intervention group will be asked to complete a second online survey after viewing the video.
To evaluate the use of BF, SSC or sucrose during newborn screening, the study research
assistant will collect the data from the baby's electronic medical record.
Outcome Measures: The primary outcome is the use of BF, SSC or sucrose during newborn
screening measured using data from the electronic medical records. The secondary outcomes
are: i) feasibility of recruiting parents and showing the video prior to the infants' newborn
screening; ii) effectiveness (i.e. did the video influence intent to use/advocate for one of
the strategies); iii acceptability (i.e. would they recommend the video to other parents and
suggested improvements to the video). The secondary outcomes will be measured with the online
survey.
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