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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT06175104
Registration number
NCT06175104
Ethics application status
Date submitted
3/11/2023
Date registered
18/12/2023
Titles & IDs
Public title
HeartGPS: A Study Exploring the Effects of a Psychological Intervention for Parents and Their Babies After Prenatal Cardiac Diagnosis
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Scientific title
HeartGPS: A Longitudinal Randomized Controlled Trial Examining the Effects of a Prenatally-Delivered Psychological Intervention for Parents and Their Babies With Single Ventricle Congenital Heart Disease
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Secondary ID [1]
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SPR201912
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Universal Trial Number (UTN)
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Trial acronym
HeartGPS
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Heart Defects, Congenital
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Anxiety in Pregnancy
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Depression, Postpartum
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Trauma, Psychological
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Neurodevelopmental Disorders
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Condition category
Condition code
Mental Health
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Depression
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Reproductive Health and Childbirth
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Childbirth and postnatal care
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Cardiovascular
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Other cardiovascular diseases
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Human Genetics and Inherited Disorders
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Other human genetics and inherited disorders
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Reproductive Health and Childbirth
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Fetal medicine and complications of pregnancy
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Neurological
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Other neurological disorders
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Mental Health
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Other mental health disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
BEHAVIORAL - HeartGPS
Experimental: HeartGPS (Treatment Arm) - Participants will receive usual fetal cardiac care plus the HeartGPS intervention. This is a novel psychological intervention leveraging virtual technology and user-centered design to reduce maternal psychological stress and anxiety after prenatal cardiac diagnosis and improve neurodevelopmental outcomes for infants with single ventricle CHD.
GPS stands for: Guiding through emotions, Providing information and support, and Strengthening connections.
The intervention includes sessions with a trained psychologist, coupled with tailored educational resources, and a personalized care plan to support longer-term parent, child, and family wellbeing.
No intervention: Usual Fetal Cardiac Care (Control Arm) - In the usual care arm, participants will receive the information, support, and resources currently offered by their fetal heart care team. This can include support from their doctor or nurse, a social worker, psychologist, or support group, as well as information booklets, websites, and other resources to help parents learn more about their baby's heart condition.
BEHAVIORAL: HeartGPS
HeartGPS includes three key components:
1. Sessions with a psychologist trained to deliver the intervention using attachment-based and trauma-informed therapy techniques, coupled with mind-body skills. The intervention can be delivered in-person or via telehealth, in accordance with participants' preferences.
2. Educational resources, including a series of modules to complement the sessions and evidence-based tools to support psychological adjustment and coping, parent-infant bonding and attachment, and parent-clinician communication.
3. A personalized care plan, charting mental health care needs, goals, and preferences, with evidence-based strategies to support longer-term wellbeing.
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Intervention code [1]
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BEHAVIORAL
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Maternal anxiety symptoms
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Assessment method [1]
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Maternal anxiety symptoms will be measured using the validated, 20-item, self-report State-Trait Anxiety Inventory State subscale. Response options for each item range from 1 ('Not at all') to 4 ('Very much so'), yielding a total possible score ranging from 20 to 80, with higher scores indicating greater anxiety symptoms.
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Timepoint [1]
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Baseline, approx. 36 weeks gestation, infant age 28 days, infant age 6 months, infant age 12 months
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Primary outcome [2]
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Maternal depressive symptoms
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Assessment method [2]
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Maternal depressive symptoms will be measured using the validated, 10-item, self-report Edinburgh Depression Scale. Response options for each item range from 0 to 3, yielding a total possible score ranging from 0 to 30, with higher scores indicating greater depressive symptoms.
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Timepoint [2]
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Baseline, approx. 36 weeks gestation, infant age 28 days, infant age 6 months, infant age 12 months
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Primary outcome [3]
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Maternal traumatic stress symptoms
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Assessment method [3]
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Maternal traumatic stress symptoms will be measured using the validated, 20-item, self-report Posttraumatic Stress Disorder Checklist for Diagnostic Statistical Manual of Mental Disorders, 5th edition (DSM-5). Response options for each item range from 0 ('Not at all') to 4 ('Extremely'), yielding a total possible score ranging from 0 to 80, with higher scores indicating greater traumatic stress symptoms.
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Timepoint [3]
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Baseline, approx. 36 weeks gestation, infant age 28 days, infant age 6 months, infant age 12 months
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Secondary outcome [1]
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Infant neurobehavior
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Assessment method [1]
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Infant neurobehavior will be assessed using the NeoNatal Neurobehavioral Scale (NNNS-II). The NNNS-II examines infant neurobehavioral organization, neurological reflexes, motor development (active and passive tone), and signs of stress. Analysis of the NNNS-II is based on summary scores for attention (possible scores: 1-9), handling (0-1), self-regulation (1-9), arousal (1-9), excitability (0-15), lethargy (0-15), hypotonicity (0-10), hypertonicity (0-10), non-optimal reflexes (0-15), asymmetric reflexes (0-16), habituation (1-9), quality of movement (1-9), and stress-abstinence (0-1). Some items may not be administered due to infant sternal precautions. Each infant is assigned to a mutually exclusive profile (category) based on their pattern of scores across the summary scores.
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Timepoint [1]
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Infant corrected-age 28 to 56 days
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Secondary outcome [2]
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Infant neurodevelopment
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Assessment method [2]
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Infant neurodevelopment will be assessed using the Bayley Scales of Infant Development - Fourth Edition (BSID-4). Cognitive, language, and motor domains will be assessed, as well as infant social-emotional and adaptive behavior development. For each subtest or subdomain the highest possible score is 19, and the lowest possible score is 1. Scores from 8 to 12 are considered average.
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Timepoint [2]
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Infant corrected-age 12 months (approximate)
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Secondary outcome [3]
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Mother-infant dyadic synchrony
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Assessment method [3]
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Mother-infant dyadic synchrony will be assessed using a standardized, 3-minute, free-play observational procedure, called the Child-Adult Relationship Experimental (CARE) Index. Four aspects of affective attunement (facial expression, vocal expressions, position and body contact, expressions of affection), and three aspects of behavioral attunement (pacing of turns, control, choice of activity) will each be rated and combined to generate an overall dyadic synchrony score ranging from 0-14, with higher scores indicating greater synchrony.
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Timepoint [3]
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Infant corrected-age 12 months (approximate)
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Eligibility
Key inclusion criteria
Inclusion Criteria
1. Pregnant person carrying a fetus diagnosed with single ventricle congenital heart disease (CHD).
2. Single ventricle CHD diagnosis between 16 and 30 weeks gestation.
3. Singleton pregnancy.
4. Pregnant person is planning to continue with the pregnancy.
5. Pregnant person is able to participate and complete study assessments in English.
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Minimum age
18
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Exclusion Criteria
1. Fetus with comorbid condition with a predictable adverse impact on neurodevelopment (e.g., DiGeorge Syndrome).
2. Fetal or maternal medical condition determined by treating physician to be contraindicative to study participation.
3. Parent with an untreated major psychiatric condition, substance use disorder, or other circumstances that would interfere with study engagement or safe participation in the trial.
4. Parent with a moderate to severe intellectual disability.
5. Parent age <18 years.
6. Surrogate for pregnancy.
Prenatal administration of oral or intravenous corticosteroids for fetal lung maturation will be recorded but are not a reason for exclusion.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
NA
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Not yet recruiting
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
1/01/2024
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
1/12/2027
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Actual
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Sample size
Target
104
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
NSW
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Recruitment hospital [1]
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Sydney Children's Hospital - Randwick
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Recruitment hospital [2]
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The Children's Hospital at Westmead - Westmead
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Recruitment postcode(s) [1]
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2031 - Randwick
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Recruitment postcode(s) [2]
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2145 - Westmead
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Recruitment outside Australia
Country [1]
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United States of America
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State/province [1]
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California
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Country [2]
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United States of America
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State/province [2]
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Ohio
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Country [3]
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United States of America
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State/province [3]
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Tennessee
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Funding & Sponsors
Primary sponsor type
Other
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Name
Children's Hospital Medical Center, Cincinnati
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Address
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Country
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Other collaborator category [1]
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Other
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Name [1]
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Children's Hospital Los Angeles
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Address [1]
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Country [1]
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Other collaborator category [2]
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Other
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Name [2]
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Vanderbilt University Medical Center
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Address [2]
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Country [2]
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Other collaborator category [3]
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Other
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Name [3]
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Sydney Children's Hospitals Network
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Address [3]
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Country [3]
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Other collaborator category [4]
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Other
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Name [4]
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University of Pittsburgh
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Address [4]
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Country [4]
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Ethics approval
Ethics application status
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Summary
Brief summary
Babies with single ventricle congenital heart disease (SVCHD) are often diagnosed during pregnancy. While prenatal diagnosis has important clinical benefits, it is often stressful and overwhelming for parents, and many express a need for psychological support. HeartGPS is a psychological intervention for parents who receive their baby's diagnosis of SVCHD during pregnancy. It includes 8 sessions with a psychologist, coupled with tailored educational resources, and a personalized care plan. The intervention focuses on fostering parent psychological adjustment and wellbeing, and supporting parents to bond with their baby in ways that feel right for them. Through this study, the investigators will learn if HeartGPS is useful and effective for parents and their babies when it is offered in addition to usual fetal cardiac care. The investigators will examine the effects of the HeartGPS intervention on parental anxiety, depression, and traumatic stress; fetal and infant brain development; parent-infant bonding; and infant neurobehavioral and neurodevelopmental outcomes. The investigators will also explore mechanisms associated with stress biology during pregnancy, infant brain development and neurodevelopmental outcomes, and parent and infant intervention effects.
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Trial website
https://clinicaltrials.gov/study/NCT06175104
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Nadine A. Kasparian, PhD
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Address
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Children's Hospital Medical Center, Cincinnati
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Nadine A. Kasparian, PhD
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Address
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Country
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Phone
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513-636-5575
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
Yes
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What data in particular will be shared?
Participant data that underlie the results reported in the published paper, after deidentification (text, tables, figures, and appendices).
Supporting document/s available: Study protocol
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When will data be available (start and end dates)?
Beginning 12 months and ending 24 months following publication.
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Available to whom?
Investigators whose proposed use of the data has been approved by an independent review committee identified for this purpose.
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Available for what types of analyses?
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How or where can data be obtained?
IPD available at link: https://www.cincinnatichildrens.org/research/divisions/b/psychology/labs/kasparian
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT06175104