Clinical trial NCT02589132: Mobile-Thrive - A Family Self-Management Approach to Failure to Thrive
Official title: Mobile-Thrive - A Family Self-Management Approach to Failure to Thrive
Study type: INTERVENTIONAL
Overall status: TERMINATED
Phase: NA
Conditions: Failure to Thrive
Lead sponsor: Medical College of Wisconsin
Sponsor class: OTHER
Collaborators: name: Children's National Research Institute
First posted: 2015-10-28
Enrollment: 10
Sex: ALL
Minimum age (years): 4
Maximum age (years): 4
Standard ages: CHILD
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: Failure to Thrive negatively affects growth, cognition, behavior, and quality of life (QoL), which can be devastating and enduring. These outcomes are high-cost and lead to increased family stress and negatively affect the caregiver-child relationship. Therefore, families need increased access to materials that will help them understand their child's health and help them use new feeding behaviors to improve the child's nutrition and growth. Standard care with the addition of Mobile Thrive (M-Thrive), our innovative smart phone-based mobile app, is intended to demonstrate the clinical advantages of using mobile health technology (mHealth) in comparison to standard care alone.

Detailed description: Families will be randomly assigned to either the Standard Care plus access to the Mobile-Thrive (M-Thrive) application or Standard Care alone. All families will complete a 24-hour dietary recall, Feeding Strategies Questionnaire (FSQ), PedsQL Family Impact Module (PedsQL FIM), and Pediatric Inventory for Parents (PIP) at pre/post treatment. It will take about 45 minutes to complete these measures. Anthropometric measurements will be collected at pretreatment, 6 weeks, and 3 months. Families receiving standard care alone will have regularly scheduled visits in the Nutritional Care Program and will have access to standard care resources, including phone contacts and electronic access through the CHW hospital portal. Specifically, standard care treatment provides dietary and behavioral instructions on appropriate beverage intake, appropriate feeding regimen, advice on limiting low-calorie foods, and multivitamin supplementation, if appropriate. Families in the standard care plus the M-Thrive application will receive the standard care treatment that is described above, as well as on-demand resources, daily educational text messages, and family self-management push notifications through the M-Thrive application. The research team will train families on the use of the M-Thrive application and families in the standard care plus M-Thrive application can contact their provider through the application with questions and/or concerns. At the conclusion of the intervention, qualitative data regarding the participants' experience will be collected. Specifically, 90-minute focus group sessions will occur within 2 weeks of concluding the 3 month active phase of treatment. Families will be asked to discuss factors that affected their ability to sustain condition management recommendations, their efforts to access health care resources, factors that affect family quality of life and caregiver stress, and family impressions of what else would help to build support for families managing FTT. All sessions will be transcribed and coded for content analysis.

Eligibility criteria: Inclusion Criteria:

* Parents of children ages 4 months to 4 years old with a medical diagnosis of failure to thrive.
* English speaking.

Exclusion Criteria:

* Parents of children who do not meet the inclusion criteria.
* Non- english speaking.

Primary outcomes:
measure: Weight z score
timeFrame: 3 months
Secondary outcomes:
Other outcomes:
measure: Calorie intake
timeFrame: 3 months
Locations:
city: Milwaukee
country: United States
facility: Children's Hospital of Wisconsin
state: Wisconsin
Study officials:
affiliation: Medical College of Wisconsin
name: Praveen Goday, MD
role: PRINCIPAL_INVESTIGATOR
affiliation: Medical College of Wisconsin
name: Alan Silverman, PhD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Jaffe AC. Failure to thrive: current clinical concepts. Pediatr Rev. 2011 Mar;32(3):100-7; quiz 108. doi: 10.1542/pir.32-3-100. No abstract available.
citation: Mitchell WG, Gorrell RW, Greenberg RA. Failure-to-thrive: a study in a primary care setting. Epidemiology and follow-up. Pediatrics. 1980 May;65(5):971-7.
citation: Berwick DM, Levy JC, Kleinerman R. Failure to thrive: diagnostic yield of hospitalisation. Arch Dis Child. 1982 May;57(5):347-51. doi: 10.1136/adc.57.5.347.
citation: Skuse DH. Non-organic failure to thrive: a reappraisal. Arch Dis Child. 1985 Feb;60(2):173-8. doi: 10.1136/adc.60.2.173.
citation: Block RW, Krebs NF; American Academy of Pediatrics Committee on Child Abuse and Neglect; American Academy of Pediatrics Committee on Nutrition. Failure to thrive as a manifestation of child neglect. Pediatrics. 2005 Nov;116(5):1234-7. doi: 10.1542/peds.2005-2032.
citation: Black MM, Krishnakumar A. Predicting longitudinal growth curves of height and weight using ecological factors for children with and without early growth deficiency. J Nutr. 1999 Feb;129(2S Suppl):539S-543S. doi: 10.1093/jn/129.2.539S.
citation: Dowdney L, Skuse D, Morris K, Pickles A. Short normal children and environmental disadvantage: a longitudinal study of growth and cognitive development from 4 to 11 years. J Child Psychol Psychiatry. 1998 Oct;39(7):1017-29.
citation: Dykman RA, Casey PH, Ackerman PT, McPherson WB. Behavioral and cognitive status in school-aged children with a history of failure to thrive during early childhood. Clin Pediatr (Phila). 2001 Feb;40(2):63-70. doi: 10.1177/000992280104000201.
citation: Drotar D, Sturm L. Prediction of intellectual development in young children with early histories of nonorganic failure-to-thrive. J Pediatr Psychol. 1988 Jun;13(2):281-96. doi: 10.1093/jpepsy/13.2.281. No abstract available.
citation: Skuse D, Pickles A, Wolke D, Reilly S. Postnatal growth and mental development: evidence for a "sensitive period". J Child Psychol Psychiatry. 1994 Mar;35(3):521-45. doi: 10.1111/j.1469-7610.1994.tb01738.x.
citation: Mendez MA, Adair LS. Severity and timing of stunting in the first two years of life affect performance on cognitive tests in late childhood. J Nutr. 1999 Aug;129(8):1555-62. doi: 10.1093/jn/129.8.1555.
citation: Yang S, Tilling K, Martin R, Davies N, Ben-Shlomo Y, Kramer MS. Pre-natal and post-natal growth trajectories and childhood cognitive ability and mental health. Int J Epidemiol. 2011 Oct;40(5):1215-26. doi: 10.1093/ije/dyr094. Epub 2011 Jul 15.
citation: Crookston BT, Penny ME, Alder SC, Dickerson TT, Merrill RM, Stanford JB, Porucznik CA, Dearden KA. Children who recover from early stunting and children who are not stunted demonstrate similar levels of cognition. J Nutr. 2010 Nov;140(11):1996-2001. doi: 10.3945/jn.109.118927. Epub 2010 Sep 15.
citation: Atalay A, McCord M. Characteristics of failure to thrive in a referral population: implications for treatment. Clin Pediatr (Phila). 2012 Mar;51(3):219-25. doi: 10.1177/0009922811421001. Epub 2011 Oct 12.
citation: Garro A, Thurman SK, Kerwin ME, Ducette JP. Parent/caregiver stress during pediatric hospitalization for chronic feeding problems. J Pediatr Nurs. 2005 Aug;20(4):268-75. doi: 10.1016/j.pedn.2005.02.015.
citation: Rumberger JS, Dansky K. Is there a business case for telehealth in home health agencies? Telemed J E Health. 2006 Apr;12(2):122-7. doi: 10.1089/tmj.2006.12.122.
citation: Gazmararian JA, Elon L, Yang B, Graham M, Parker R. Text4baby program: an opportunity to reach underserved pregnant and postpartum women? Matern Child Health J. 2014 Jan;18(1):223-232. doi: 10.1007/s10995-013-1258-1.
citation: Ryan P, Sawin KJ. The Individual and Family Self-Management Theory: background and perspectives on context, process, and outcomes. Nurs Outlook. 2009 Jul-Aug;57(4):217-225.e6. doi: 10.1016/j.outlook.2008.10.004.
citation: Black MM, Dubowitz H, Hutcheson J, Berenson-Howard J, Starr RH Jr. A randomized clinical trial of home intervention for children with failure to thrive. Pediatrics. 1995 Jun;95(6):807-14.
citation: Black MM, Dubowitz H, Krishnakumar A, Starr RH Jr. Early intervention and recovery among children with failure to thrive: follow-up at age 8. Pediatrics. 2007 Jul;120(1):59-69. doi: 10.1542/peds.2006-1657.
citation: Hutcheson JJ, Black MM, Talley M, Dubowitz H, Howard JB, Starr RH Jr, Thompson BS. Risk status and home intervention among children with failure-to-thrive: follow-up at age 4. J Pediatr Psychol. 1997 Oct;22(5):651-68. doi: 10.1093/jpepsy/22.5.651.
citation: Raynor P, Rudolf MC, Cooper K, Marchant P, Cottrell D. A randomised controlled trial of specialist health visitor intervention for failure to thrive. Arch Dis Child. 1999 Jun;80(6):500-6. doi: 10.1136/adc.80.6.500.
citation: Wright CM, Callum J, Birks E, Jarvis S. Effect of community based management in failure to thrive: randomised controlled trial. BMJ. 1998 Aug 29;317(7158):571-4. doi: 10.1136/bmj.317.7158.571.
citation: Rotheram-Borus MJ, Tomlinson M, Swendeman D, Lee A, Jones E. Standardized functions for smartphone applications: examples from maternal and child health. Int J Telemed Appl. 2012;2012:973237. doi: 10.1155/2012/973237. Epub 2012 Dec 13.
citation: Klesges RC, Klesges LM, Brown G, Frank GC. Validation of the 24-hour dietary recall in preschool children. J Am Diet Assoc. 1987 Oct;87(10):1383-5.
citation: Berlin KS, Davies WH, Silverman AH, Rudolph CD. Assessing family-based feeding strategies, strengths, and mealtime structure with the Feeding Strategies Questionnaire. J Pediatr Psychol. 2011 Jun;36(5):586-95. doi: 10.1093/jpepsy/jsp107. Epub 2009 Dec 7.
citation: Davies WH, Satter E, Berlin KS, Sato AF, Silverman AH, Fischer EA, Arvedson JC, Rudolph CD. Reconceptualizing feeding and feeding disorders in interpersonal context: the case for a relational disorder. J Fam Psychol. 2006 Sep;20(3):409-17. doi: 10.1037/0893-3200.20.3.409.
citation: Varni JW, Sherman SA, Burwinkle TM, Dickinson PE, Dixon P. The PedsQL Family Impact Module: preliminary reliability and validity. Health Qual Life Outcomes. 2004 Sep 27;2:55. doi: 10.1186/1477-7525-2-55.
citation: Panepinto JA, Hoffmann RG, Pajewski NM. A psychometric evaluation of the PedsQL Family Impact Module in parents of children with sickle cell disease. Health Qual Life Outcomes. 2009 Apr 16;7:32. doi: 10.1186/1477-7525-7-32.
citation: Streisand R, Braniecki S, Tercyak KP, Kazak AE. Childhood illness-related parenting stress: the pediatric inventory for parents. J Pediatr Psychol. 2001 Apr-May;26(3):155-62. doi: 10.1093/jpepsy/26.3.155.