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Development of a Self‐ Management Program for Parents With Spinal Cord Injury and Disease

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ClinicalTrials.gov Identifier: NCT03985553
Recruitment Status : Completed
First Posted : June 13, 2019
Last Update Posted : June 20, 2019
Sponsor:
Collaborator:
Paralyzed Veterans of America
Information provided by (Responsible Party):
Washington University School of Medicine

Brief Summary:
The purpose of this project was to develop and pilot test a self-management program targeted toward individuals with Spinal Cord Injury/Disease (SCI/D) who are current parents or who are considering becoming parents. This Parenting Self-Management Program (PSMP) will allow parents to identify their goals for successful family participation and provide a structure for professionals to use when working with parents with SCI/D to best meet their needs. A draft PSMP was assembled by members of the research team. This draft was reviewed by experienced parents with SCI/D and professionals who work with individuals who have SCI/D through key informant interviews or focus groups. The feedback was used to modify the draft program and the PSMP was pilot tested with a group of 10 individuals with SCI/D who are new parents, newly injured or who want to improve their participation in parenting activities.

Condition or disease Intervention/treatment Phase
Spinal Cord Injuries Behavioral: Parenting Self-Management Program Not Applicable

Detailed Description:

The project used a self-management approach grounded in self-efficacy theory to increase parenting self-efficacy among persons with spinal cord injury/disease (SCI/D). Program content focused on skill building through opportunities to master techniques and strategies; role modeling, problem solving, decision making, goal setting, and provision of reliable information. The use of a self-management program may also place parents with SCI/D at ease in sharing needs, as it is not an expert model by which a professional is passing judgment on their ability to care for their children. Many parents with disabilities are hesitant to seek professional services for fear of negative consequences such as losing custody of their children. Developing a program that is conducted as a partnership whereby parents direct much of the pace and content may be considered less threatening and more beneficial to those who have experienced distrust of the healthcare system.

There are no other self-management programs that specifically address the needs of parents with SCI/D. The project created a self-management program that was piloted in the St. Louis region and can be replicated across the country among other communities. While the national coordination center for families with disabilities, Through the Looking Glass, provides resource materials to parents across the country, they do not provide a structure for individual problem solving and to meet the needs of parents SCI/D on an individualized level. Providing a format for parents with SCI/D to successfully fulfill their parenting roles has a highly significant social implication; parents will be equipped to meet potential challenges and enjoy participation in their families. Limiting discrimination in the courts, seeking school accessibility, or simply decreasing pain while holding an infant are all worthy goals that could be achieved through a self-management parenting program.

Project Aims

  1. To develop a four-week self-management program for parents with SCI/D to meet their needs in the parenting role and the needs of their families
  2. To aid parents with SCI/D in building the skills and resources needed to continue or begin parenting in a successful manner
  3. To disseminate the PSMP content to other regions, disability organizations, Paralyzed Veterans of America (PVA) chapters, healthcare organizations, and parenting groups to be replicated
  4. To build a sustainable format for meeting the needs of parents with SCI/D that can be replicated and continued across the U.S.

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 10 participants
Intervention Model: Single Group Assignment
Intervention Model Description: Parents/grandparents/potential parents with SCI/D had the opportunity to attend and participate in a 4 week self-management program once a week related to parenting with a disability. The self-management sessions lasted approximately 2 hours once a week and were led by an occupational therapist. There was no control group or alternate intervention.
Masking: None (Open Label)
Primary Purpose: Supportive Care
Official Title: Development of a Self‐ Management Program for Parents With Spinal Cord Injury and Disease
Actual Study Start Date : November 3, 2015
Actual Primary Completion Date : June 29, 2016
Actual Study Completion Date : June 29, 2016

Resource links provided by the National Library of Medicine


Arm Intervention/treatment
Parenting Self-Management Program
Participants were provided a Parenting Self -Management Program booklet with the twenty-four fact sheets at the beginning of the four-week program on topics such as adaptive babycare techniques, advocacy in the courts, emergency planning, safety in the community, talking to children about disability, managing pain/fatigue, connecting to other parents with SCI/D, and wheelchair adjustment/management during and after pregnancy. Sessions included topic introduction, participant interaction, goal setting, resource utilization, and program evaluation. Participants were allowed to choose which resources they wanted and what tips to incorporate into their parenting roles. Participants were asked to develop a weekly goal to encourage achievement, allowing individuals to identify what they wanted or decided to do that could be related to parenting directly or indirectly, such as health and wellness goals that gave them more energy or strength to complete parenting tasks.
Behavioral: Parenting Self-Management Program



Primary Outcome Measures :
  1. Change in participation using the Participation Survey- Mobility (PARTS-M) [ Time Frame: Prior to first session of the PSMP group and 4 weeks after the initial session of the PSMP group. ]
    The PARTS/M is a reliable and valid self-report survey that assesses the participation of people with mobility limitations in various life activities and the impact of common environmental factors on participation (Gray, Hollingsworth, Stark, & Morgan, 2006). For the purposes of the PSMP, a modified version of the Parenting section of the PARTS/M was used. Participants were asked how often they participate in parenting activities, their evaluation of their participation (importance, choice, satisfaction, and control), the number and value of supports they may use, and the influence of pain and fatigue on their participation in parenting activities.

  2. Change in self-efficacy using the General Self-Efficacy Scale (GSE) [ Time Frame: Prior to first session of the PSMP group and 4 weeks after the initial session of the PSMP group. ]
    The GSE was used to determine any influence of the program on participants' self-efficacy. Total score ranges from 10-40 with higher values indicating better outcome.


Secondary Outcome Measures :
  1. Demographic items [ Time Frame: Prior to first session of the PSMP group and 4 weeks after the initial session of the PSMP group as needed. ]
    Age, gender, race, marital status, education level, living situation, income, benefits received, diagnosis associated with SCI/D, time with disability, additional impairments, secondary conditions (pain & fatigue), health status, mobility device use, personal assistance use

  2. Parenting tasks [ Time Frame: Prior to first session of the PSMP group ]
    Asked about number of children, ages, ages when acquired disability and open ended questions about most important and most difficulty task, use of strategies and assistance received when children were at various stages.

  3. Skills and Knowledge [ Time Frame: Prior to first session of the PSMP group and 4 weeks after the initial session of the PSMP group. ]
    Participants were asked to rate their knowledge of topics that were going to be included in the PSMP on a 0-10 scale.



Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Age 18 or older, parent/guardian/grandparent with diagnosis of SCI/D, community dwelling, able to read at or above sixth grade level and either newly injured (sustained SCI in last year) or self-identified as being less experienced in their parenting role.

Exclusion Criteria:

  • Individuals were excluded if they were under age 18, did not have SCI/D, were not a parent/guardian/grandparent or lived in an institution.

A convenience sampling method was used to recruit participants through distribution of flyers at rehabilitation facilities, independent living centers and word of mouth


Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03985553


Locations
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United States, Missouri
Washington University
Saint Louis, Missouri, United States, 63108-2212
Sponsors and Collaborators
Washington University School of Medicine
Paralyzed Veterans of America
Investigators
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Principal Investigator: Jessica Dashner, OTD Washington University Program in Occupational Therapy

Publications:

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Responsible Party: Washington University School of Medicine
ClinicalTrials.gov Identifier: NCT03985553     History of Changes
Other Study ID Numbers: 201501151
First Posted: June 13, 2019    Key Record Dates
Last Update Posted: June 20, 2019
Last Verified: June 2019
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No
Plan Description: Results may be shared in the future following publication acceptance in peer reviewed journal. Individual data requests from researchers will be considered as needed at that time.

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No

Keywords provided by Washington University School of Medicine:
Parenting
Spinal Cord Injuries
Self-Management
Occupational Therapy

Additional relevant MeSH terms:
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Spinal Cord Injuries
Wounds and Injuries
Spinal Cord Diseases
Central Nervous System Diseases
Nervous System Diseases
Trauma, Nervous System