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Trial registered on ANZCTR
Registration number
ACTRN12617000360314
Ethics application status
Approved
Date submitted
3/03/2017
Date registered
8/03/2017
Date last updated
2/08/2017
Type of registration
Retrospectively registered
Titles & IDs
Public title
Parenting program versus telephone support for Mexican parents of children with acquired brain injury: a blind randomized controlled trial.
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Scientific title
- Signposts for Building Better Behavior- a parenting program to prevent difficult behavior in children with acquired brain injury: Feasibility and efficacy with a Mexican population
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Secondary ID [1]
291332
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None
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Universal Trial Number (UTN)
U1111-1193-6891
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Acquired brain injury
302311
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Condition category
Condition code
Mental Health
301897
301897
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0
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Other mental health disorders
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Neurological
301961
301961
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0
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Other neurological disorders
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Injuries and Accidents
301962
301962
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0
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Other injuries and accidents
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Signposts for building better behavior (Signposts). The Spanish version includes a workbook translated to Spanish with permission from the Parenting Research Centre, Victoria, Australia, and the module "Dealing with a Head Injury in the Family” translated with permission of Damith Woods. Two Signpost’s certified practitioners reviewed the translation to assure that the content was accurate. The parents are able to take notes during the sessions and a sheet listing the key concepts of the session is provided. The provider is a clinical neuropsychologist and a certified Signposts practitioner. The content per session is the following: Introduction, dealing with a head injury in the family and measuring your child behavior (Session 1); Systematic use of daily interactions (Session 2); Replacing difficult behavior with useful behavior (Session 3); Planning for better behavior (Session 4); Teaching your child new skills (Session 5); Dealing with stress and your family as a team (Session 6). Signposts is a manualized parenting program that aims to develop skills in parents to improve behavior. Signposts promotes parental self-regulation because the parent chooses the goals, measures and monitors the child behaviors, chooses the strategies and evaluates the effectiveness. This parenting program is delivered in 6 face to face weekly sessions of 2.5 hours each. The sessions are delivered in groups of a maximum of 8 parents. The intervention is conducted at Iskalti-Condesa, one of the clinics of Iskalti Centre of Psychological and Educational Support. This clinic is close to the center of Mexico City and is well equipped to conduct neuropsychological assessments and provide the intervention program. To improve intervention adherence a checklist with the topics of each session is included and filled by the certified practitioner who delivers the program.
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Intervention code [1]
297360
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Behaviour
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Intervention code [2]
297362
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Rehabilitation
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Comparator / control treatment
The participants in the control group receive an information sheet specifically designed for this study with strategies for challenging behaviors and weekly phone calls during 6 weeks done by a psychologist. The phone calls are designed for the parents and aim to imrpove academic skills of the child. Each phone call lasts approximately 15 minutes. During the phone calls exercises which aim to improve academic skills, such as math’s or reading are suggested. The academic skill is chosen based on the area of main concern of the parent.
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Control group
Active
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Outcomes
Primary outcome [1]
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Child behavior at home assessed with Eyberg Child Behavior Inventory (ECBI, Eyberg & Pincus, 1999) and the Child Behavior Checklist parent form (CBCL:Achenbach et al., 2001).
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Assessment method [1]
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Timepoint [1]
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Baseline, and immediately after the intervention and three months once the intervention was concluded.
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Primary outcome [2]
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Parenting practices assessed with the The Parenting Scale (Arnold, 1993).
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Assessment method [2]
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Timepoint [2]
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Baseline, and immediately after the intervention and three months once the intervention was concluded.
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Primary outcome [3]
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Parent stress assessed with the Parent Stress Index short form (Abidin, 2012).
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Assessment method [3]
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Timepoint [3]
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Baseline, and immediately after the intervention and three months once the intervention was concluded.
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Secondary outcome [1]
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Child behavior at school as assessed with the Sutter-Eyberg Student Behavior Inventory-Revised (SESBI, Eyberg & Pincus, 1999) and the Teacher Report Form (TRF, Achenbach & Resco, 2001).
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Assessment method [1]
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Timepoint [1]
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Baseline, and immediately after the intervention and three months once the intervention was completed.
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Secondary outcome [2]
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Child´s cognitive self-regulation as assessed with the Metacognition Index score from the Behavior Rating Inventory of Executive Function parent form (Gioia, lsquith, Guy, & Kenworthy, 2000), the Test of Everyday Attention for Children Second Edition (Manly et al., 2016) scores from the: Balloon-hunt and the Hide and seek (5-8 years) or Hector cancellation and Hecuba visual search (> 8 years) and Matching Familiar Figure Test (Buela-Casal, Carretero-Dios, & Santos-Roig, 2005).
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Assessment method [2]
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Timepoint [2]
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Baseline, immediately after the intervention and three months once the intervention was completed.
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Secondary outcome [3]
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Child´s emotional self-regulation as assesed with the Emotional control subscale from the Behavior Rating Inventory of Executive Function parent form (Gioia, lsquith, Guy, & Kenworthy, 2000) and the Emotion Regulation Checklist. (Shields & Cicchetti, 1997).
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Assessment method [3]
332341
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Timepoint [3]
332341
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Baseline, immediately after the intervention and three months once the intervention was completed.
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Secondary outcome [4]
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Child´s behavior self-regulation as assessed with the Behavior Regulation Index from the Behavior Rating Inventory of Executive Function parent form (Gioia, lsquith, Guy, & Kenworthy, 2000) and 10-minute Delay Gratification Task (Mischel, 1972).
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Assessment method [4]
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Timepoint [4]
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Baseline, immediately after the intervention and three months once the intervention was completed.
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Secondary outcome [5]
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Parent self-efficacy as assessed by the parent sense of competence scale (Menéndez, Jiménez, & Hidalgo, 2011).
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Assessment method [5]
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Timepoint [5]
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Baseline, immediately after the intervention and three months once the intervention was completed.
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Secondary outcome [6]
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Feasibility as assessed with the the percentage of sessions attended or phone calls answered and the total score of the Abbreviated Acceptability Rating Profile-Parenting (Tarnowski & Simonian, 1992).
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Assessment method [6]
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Timepoint [6]
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Once the intervention was completed
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Secondary outcome [7]
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Social risk as measured considering: Family structure, education of the primary caregiver and occupation of the primary income earner (Murray et al., 2014).
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Assessment method [7]
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Timepoint [7]
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Baseline
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Secondary outcome [8]
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Family burden as assessed with the Family burden injury interview (Burgess et al., 1999).
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Assessment method [8]
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Timepoint [8]
332348
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Baseline
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Secondary outcome [9]
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Parent depressive symptoms as assessed with the Beck´s Depression Inventory (Beck, Steer, & Brown, 2011).
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Assessment method [9]
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Timepoint [9]
332349
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Baseline
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Secondary outcome [10]
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Parent´s anxiety symptoms as assessed with the Inventory Anxiety State Trait (Spielberg & Diaz-Guerrero, 1975).
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Assessment method [10]
332350
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Timepoint [10]
332350
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Baseline
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Secondary outcome [11]
332351
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Parent Self-regulation as assessed with the Behavior Rating Inventory of Executive Function Adult Self-report (Roth, Isquith, & Gioia, 2005),
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Assessment method [11]
332351
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Timepoint [11]
332351
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Baseline
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Secondary outcome [12]
332352
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Child´s Intelectual ability assessed with the Wechsler Intelligence Scale for Children WISC-IV- (Wechsler, 2007).
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Assessment method [12]
332352
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Timepoint [12]
332352
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Baseline
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Eligibility
Key inclusion criteria
1) Parents must have a child aged between six and twelve years of age
(2) The child has a diagnosis of an ABI (defined as damage to the brain that occurs after birth)
(3) Child with a medical reference stating type of brain injury
(4) The injury is diagnosed at least 3 months previous to the start of the pre intervention assessment
(5) Enough medical history to determine injury level of severity (Glasgow coma scale in a medical report or neuroimaging evidence of mass lesion or neurological deficits reported by the treating medical clinician)
(6) Mothers or fathers can participate together or individually
(7) Parents must have an active and current parenting role with the child
(8) Parents must be able to comply with the study intervention and assessment protocols as is determine by the researcher during initial contact with the parent
(9) Parents must be over 18 years
(10) Parents must be able to write and read in Spanish.
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Minimum age
6
Years
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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
(1) Parent with symptoms of psychosis or borderline personality (determined by a face to face interview)
(2) Child with incomplete treatment of chemotherapy
(3) Child programmed for neurosurgery
(4) Child receiving other kinds of behavior modification therapy
(5) Parent or child with history of psychiatric illness
(6) Uncontrolled seizures in the child
(7) Parent does not have current access to child
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Study design
Purpose of the study
Educational / counselling / training
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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)
Allocation is not concealed
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Simple randomization using a randomization table created by computer software
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people assessing the outcomes
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
We calculated the sample size in order to detect a difference of 0.8 SD between the two treatment arms, with a significance level of 0.05 and power of 0.80. Allowing for an estimated 20% lost to follow-up, we therefore aim to recruit a total of 66 participants, Descriptive analysis of pre-intervention child, parent and family characteristics will be conducted to explore the characteristics of families enrolled. Comparisons of continuous measures will be made using independent sample t-test or Mann-Whitney U tests (depending on the distributions of the samples). Chi squared tests will carry out between-group comparison of categorical variables.
Intervention efficacy will be assessed by comparing the outcomes of the groups at post-intervention assessment and follow-up assessment using an independent t-test or its non-parametric equivalent, depending on the distribution of the samples. Potential confounds (e.g., social risk) and moderators (e.g., child age, time since injury) will be explored. As secondary analysis linear regressions will be completed to identify predictors of intervention outcome. Both completed and intention-to-treat analyses will be conducted. The level of significance for all analyses will be 0.05.
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Recruitment
Recruitment status
Active, not recruiting
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Date of first participant enrolment
Anticipated
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Actual
25/03/2016
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Date of last participant enrolment
Anticipated
30/04/2017
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Actual
5/05/2017
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Date of last data collection
Anticipated
30/09/2017
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Actual
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Sample size
Target
66
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Accrual to date
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Final
71
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Recruitment outside Australia
Country [1]
8706
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Mexico
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State/province [1]
8706
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Mexico City
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Funding & Sponsors
Funding source category [1]
295795
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University
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Name [1]
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The University of Melbourne
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Address [1]
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Parkville, Melbourne Victoria, 3010
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Country [1]
295795
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Australia
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Funding source category [2]
295817
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Government body
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Name [2]
295817
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The National Council for Science and Technology CONACYT
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Address [2]
295817
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Avenida Insurgentes Sur 1685, Guadalupe Inn, Alvaro Obregon, Ciudad de Mexico DF, 03940
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Country [2]
295817
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Mexico
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Primary sponsor type
Individual
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Name
Vicki Anderson
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Address
Royal Children's Hospital, 50 Flemington Rd, Parkville VIC 3052, Australia
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Country
Australia
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Secondary sponsor category [1]
294666
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Individual
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Name [1]
294666
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Guillermina Yanez Tellez
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Address [1]
294666
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Universidad Nacional Autonoma de Mexico, Av De Los Barrios 1, Los Reyes Iztacala, Hab Los Reyes Iztacala Barrio de los Arboles/Barrio de los Heroes, 54090 Tlalnepantla, Mexico
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Country [1]
294666
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Mexico
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Secondary sponsor category [2]
294668
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Individual
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Name [2]
294668
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Cathy Catroppa
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Address [2]
294668
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Royal Children's Hospital, 50 Flemington Rd, Parkville VIC 3052, Australia
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Country [2]
294668
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Australia
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Other collaborator category [1]
279459
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Individual
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Name [1]
279459
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Clara Luz Chavez Arana
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Address [1]
279459
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Royal Children's Hospital, 50 Flemington Rd, Parkville VIC 3052, Australia
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Country [1]
279459
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Australia
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Other collaborator category [2]
279461
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Individual
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Name [2]
279461
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Belen Prieto Corona
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Address [2]
279461
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Universidad Nacional Autonoma de Mexico, Av De Los Barrios 1, Los Reyes Iztacala, Hab Los Reyes Iztacala Barrio de los Arboles/Barrio de los Heroes, 54090 Tlalnepantla, Mexico
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Country [2]
279461
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Mexico
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Other collaborator category [3]
279462
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Individual
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Name [3]
279462
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Miguel Angel de Leon
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Address [3]
279462
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Iskalti Centre of Psychological and Educational Support , Av. Claveria No. 81, Colonia Claveria, Delegacion Azcapotzalco,Mexico, 02080
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Country [3]
279462
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Mexico
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Other collaborator category [4]
279463
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Individual
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Name [4]
279463
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Antonio Garcia
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Address [4]
279463
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Unit of High Specialty, La Raza, IMSS, Eje 1 Pte. (Calzada Vallejo), Vallejo Poniente, 07790 Ciudad de Mexico, CDMX
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Country [4]
279463
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Mexico
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Other collaborator category [5]
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Individual
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Name [5]
279464
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Celia Godfrey
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Address [5]
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Royal Children's Hospital, 50 Flemington Rd, Parkville VIC 3052, Australia
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Country [5]
279464
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Australia
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Other collaborator category [6]
279468
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Individual
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Name [6]
279468
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Stephen Hearps
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Address [6]
279468
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Royal Children's Hospital, 50 Flemington Rd, Parkville VIC 3052, Australia
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Country [6]
279468
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Australia
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Other collaborator category [7]
279665
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Individual
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Name [7]
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Roberto Gomez Raygoza
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Address [7]
279665
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Centro Medico Nacional, Siglo XXI. Avenida Cuauhtemoc 330, Doctores, 06720 Cuauhtemoc, Ciudad de Mexico
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Country [7]
279665
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Mexico
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
297091
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The University of Melbourne Human Research Ethics Sub-Committee
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Ethics committee address [1]
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Parkville, Melbourne, Victoria, 3010
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
297091
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28/10/2015
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Approval date [1]
297091
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18/02/2016
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Ethics approval number [1]
297091
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1545487.1
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Summary
Brief summary
Children with acquired brain injury (ABI) present with challenging behavior. and their families present with high levels of stress. Poor self regulation is the core deficit of challenging behavior. The aims of this study are to investigate the effectiveness and feasibility of an intervention (Signposts for building better behavior) which has been adapted to Mexican population in improving behavior and self-regulation (SR) in Mexican children with ABI compared to telephone support. To investigate the effectiveness and feasibility of the intervention in improving parenting skills, parent self-efficacy, quality of parent child-relationship and decreasing parental stress in parents of children with ABI compared to telephone support. Our secondary aims are (1) to explore the impact that parent characteristics (depressive and anxiety symptoms, social risk, family burden and self-regulation) have on the intervention outcomes; (2) to investigate if parenting and child-behavior changes are maintained 3 months after the intervention. We hypothesize that on completion of the Signposts intervention, and at 3-months post-intervention: (i) parents of children with ABI will report improved child behavior and SR compared to those in the telephone support group; (ii) parents of children with ABI will report reduced stress, improved parenting skill and parent self-efficacy compared to the telephone support group; (iii)parenting and child-behavior changes will be maintained. This is the first study that will evaluate the efficacy and feasibility of a parenting program for Mexican parents of children with ABI.
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Trial website
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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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Prof Vicki Anderson
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Address
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Royal Children's Hospital, 50 Flemington Rd, Parkville VIC 3052, Australia
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Country
72950
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Australia
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Phone
72950
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+61383416200
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Fax
72950
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Email
72950
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[email protected]
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Contact person for public queries
Name
72951
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Clara Luz Chavez Arana
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Address
72951
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Royal Children's Hospital, 50 Flemington Rd, Parkville VIC 3052, Australia
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Country
72951
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Australia
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Phone
72951
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+525573711007
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Fax
72951
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Email
72951
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[email protected]
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Contact person for scientific queries
Name
72952
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Cathy Catroppa
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Address
72952
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Royal Children's Hospital, 50 Flemington Rd, Parkville VIC 3052, Australia
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Country
72952
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Australia
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Phone
72952
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+61383416200
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Fax
72952
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Email
72952
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
Type
Is Peer Reviewed?
DOI
Citations or Other Details
Attachment
Plain language summary
No
Signposts was effective in reducing dysfunctional ...
[
More Details
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Study results article
Yes
Chavez-Arana, C., Catroppa, C., Hearps, S. J.C., Y...
[
More Details
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372473-(Uploaded-11-09-2019-02-31-04)-Journal results publication.pdf
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
Parenting program versus telephone support for Mexican parents of children with acquired brain injury: A blind randomized controlled trial.
2017
https://dx.doi.org/10.1016/j.conctc.2017.06.007
N.B. These documents automatically identified may not have been verified by the study sponsor.
Download to PDF