Best Practices fo Early Diagnosis of Cerebral Palsy
NCT Number: NCT06537622
Acronym: CP
Status: NOT_YET_RECRUITING
Study Type: INTERVENTIONAL
Phases: NA
Conditions: Cerebral Palsy|Prematurity
Interventions: OTHER: Implementation group|OTHER: Standard of care
Sponsor: St. Justine's Hospital
Collaborators: IWK Health Centre|St. Boniface Hospital|Sunnybrook Health Sciences Centre|Montreal Children's Hospital of the MUHC|Harvard University|University of British Columbia|Queen Alexandra Centre for Children's Health, Victoria|Jewish General Hospital|CHU de Quebec-Universite Laval|BC Women's Hospital & Health Centre|Dr. Everett Chalmers Hospital|Janeway Children's Health and Rehabilitation Centre|Centre de recherche du Centre hospitalier universitaire de Sherbrooke|Horizon Health Network|Moncton hospital|Windsor Regional Hospital|Maisonneuve-Rosemont Hospital|The Hospital for Sick Children|MOUNT SINAI HOSPITAL|Health Sciences Centre, Winnipeg, Manitoba|Glenrose Foundation|Hamilton Health Sciences Centre|London Health Sciences Centre|Children's Hospital of Eastern Ontario|Queen's University|Foothills Medical Centre|Island Health, Victoria, BC|Canadian Premature babies Foundation
Sex: ALL
Age: CHILD
Enrollment: 2000
Study Design: Allocation: RANDOMIZED|Intervention Model: PARALLEL|Masking: NONE|Primary Purpose: SCREENING
Start Date: 2024-11-01
Completion Date: 2028-11-01
Locations: CHU Sainte-Justine, Montreal, Quebec, H3T 1C5, Canada

Summary:
In this research, the investigators are using an implementation science approach to enhance the uptake of a clinical practice guideline for earlier diagnosis of cerebral palsy (i.e. what is being implemented) in neonatal follow-up clinics across Canada. This clinical practice guideline should be part of what neonatal follow-up specialists do in their routine clinical work with children born preterm. However, there is a wide variability in practice. The goal of this project is to harmonize practices in the neonatal follow-up community in agreement with international recommendations for earlier diagnosis of cerebral palsy. This research will measure if clinicians are truly following the clinical practice guideline. If not, implementation strategies that address barriers and leverage on facilitators will be deployed for successful uptake of the clinical practice guideline. This research will also assess whether implementation of the clinical practice guideline is associated with better patient outcomes.

Primary Outcome Measures: Intervention : corrected age at detection of early signs of CP., This is calculated from the date at which the clinician identifies early signs of CP and shares this diagnosis with family. This diagnosis must be followed by an immediate action i.e., referral for CP-targeted intervention and/or evaluation. Outcome data will be collected through retrospective chart review., Birth to 18-24 months CA|Intervention : Developmental functioning at 18-24 month CA, Evaluation of the developmental functioning using the Bayley Scales of Infant and Toddler Development, 4th edition (Bayley-4), a widely used, standardized, norm-referenced instrument for direct assessment of children aged 1-42 mo. Cognition, language, and motor composite scores are obtained (mean 100±15)., Birth to 18-24 months CA
Secondary Outcome Measures: Implementation : RE-AIM framework - Reach, Effectiveness, Adoption, Reach of the intervention strategies to the target audience of clinicians participating in the CNFUN., Up to 48 months|Implementation : RE-AIM framework - Implementation, Implementation fidelity to the CPG-CP and the implementation strategies., Up to 48 months|Implementation : RE-AIM framework - Maintenance, Maintenance of the practice of CPG-CP over time., Up to 48 months