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Abramsohn EM, De Ornelas M, Borson S, Frazier CRM, Fuller CM, Grana M, Huang ES, Jagai JS, Makelarski JA, Miller D, Schulman-Green D, Shiu E, Thompson K, Winslow V, Wroblewski K, Lindau ST. CommunityRx, a social care assistance intervention for family and friend caregivers delivered at the point of care: two concurrent blinded randomized controlled trials. Trials 2023; 24:681. [PMID: 37864258 PMCID: PMC10624358 DOI: 10.1186/s13063-023-07697-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 10/03/2023] [Indexed: 10/22/2023] Open
Abstract
BACKGROUND CommunityRx is an evidence-based social care intervention delivered to family and friend caregivers ("caregivers") at the point of healthcare to address health-related social risks (HRSRs). Two CommunityRx randomized controlled trials (RCTs) are being fielded concurrently on Chicago's South Side, a predominantly African American/Black community. CommunityRx-Hunger is a double-blind RCT enrolling caregivers of hospitalized children. CommunityRx-Dementia is a single-blind RCT enrolling caregivers of community-residing people with dementia. RCTs with caregivers face recruitment barriers, including caregiver burden and lack of systematic strategies to identify caregivers in clinical settings. COVID-19 pandemic-related visitor restrictions exacerbated these barriers and prompted the need for iteration of the protocols from in-person to remote operations. This study describes these protocols and methods used for successful iteration to overcome barriers. METHODS AND FINDINGS CommunityRx uses individual-level data to generate personalized, local community resource referrals for basic, health and caregiving needs. In early 2020, two in-person RCT protocols were pre-tested. In March 2020, when pandemic conditions prohibited face-to-face clinical enrollment, both protocols were iterated to efficient, caregiver-centered remote operations. Iterations were enabled in part by the Automated Randomized Controlled Trial Information-Communication System (ARCTICS), a trial management system innovation engineered to integrate the data collection database (REDCap) with community resource referral (NowPow) and SMS texting (Mosio) platforms. Enabled by engaged Community Advisory Boards and ARCTICS, both RCTs quickly adapted to remote operations. To accommodate these adaptations, launch was delayed until November (CommunityRx-Hunger) and December (CommunityRx-Dementia) 2020. Despite the delay, 65% of all planned participants (CommunityRx-Hunger n = 417/640; CommunityRx-Dementia n = 222/344) were enrolled by December 2021, halfway through our projected enrollment timeline. Both trials enrolled 13% more participants in the first 12 months than originally projected for in-person enrollment. DISCUSSION Our asset-based, community-engaged approach combined with widely accessible institutional and commercial information technologies facilitated rapid migration of in-person trials to remote operations. Remote or hybrid RCT designs for social care interventions may be a viable, scalable alternative to in-person recruitment and intervention delivery protocols, particularly for caregivers and other groups that are under-represented in traditional health services research. TRIAL REGISTRATION ClinicalTrials.gov: CommunityRx-Hunger (NCT04171999, 11/21/2019); CommunityRx for Caregivers (NCT04146545, 10/31/2019).
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Affiliation(s)
- Emily M Abramsohn
- University of Chicago, 5841 S. Maryland Ave., MC 2050, Chicago, IL, 60637, USA.
| | | | - Soo Borson
- University of Southern California, 1975 Zonal Ave, Los Angeles, CA, 90033, USA
| | | | - Charles M Fuller
- University of Chicago, 5841 S. Maryland Ave., MC 2050, Chicago, IL, 60637, USA
| | - Mellissa Grana
- University of Chicago, 5841 S. Maryland Ave., MC 2050, Chicago, IL, 60637, USA
| | - Elbert S Huang
- University of Chicago, 5841 S. Maryland Ave., MC 2050, Chicago, IL, 60637, USA
| | - Jyotsna S Jagai
- University of Chicago, 5841 S. Maryland Ave., MC 2050, Chicago, IL, 60637, USA
| | | | - Doriane Miller
- University of Chicago, 5841 S. Maryland Ave., MC 2050, Chicago, IL, 60637, USA
| | | | - Eva Shiu
- University of Chicago, 5841 S. Maryland Ave., MC 2050, Chicago, IL, 60637, USA
| | - Katherine Thompson
- University of Chicago, 5841 S. Maryland Ave., MC 2050, Chicago, IL, 60637, USA
| | - Victoria Winslow
- University of Chicago, 5841 S. Maryland Ave., MC 2050, Chicago, IL, 60637, USA
| | - Kristen Wroblewski
- University of Chicago, 5841 S. Maryland Ave., MC 2050, Chicago, IL, 60637, USA
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Abramsohn EM, De Ornelas M, Borson S, Frazier CR, Fuller CM, Grana M, Huang ES, Jagai JS, Makelarski JA, Miller D, Schulman-Green D, Shiu E, Thompson K, Winslow V, Wroblewski K, Lindau ST. Two concurrent randomized controlled trials of CommunityRx, a social care intervention for family and friend caregivers delivered at the point of care. RESEARCH SQUARE 2023:rs.3.rs-2464681. [PMID: 36909590 PMCID: PMC10002827 DOI: 10.21203/rs.3.rs-2464681/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
Background CommunityRx is an evidence-based social care intervention delivered to family and friend caregivers ("caregivers") at the point of healthcare to address health-related social risks (HRSRs). CommunityRx-Hunger is a double-blind randomized controlled trial (RCT) that enrolls caregivers of hospitalized children. CommunityRx-Dementia is a single-blind RCT that enrolls caregivers of community-residing people with dementia. Clinical trials that enroll caregivers face recruitment barriers, including caregiver burden and lack of systematic strategies to identify and track caregivers. COVID-19 pandemic-related visitor restrictions exacerbated these barriers and prompted the need for iteration of the CommunityRx protocols from in-person to remote operations. This study describes the novel methods used to iterate existing RCT protocols and factors contributing to their successful iteration. Methods CommunityRx uses individual-level data to generate personalized community resource referrals for basic, health and caregiving needs. Our research program uses an asset-based, community-engaged approach including study-specific community advisory boards (CABs). In early 2020, both RCT protocols were pre-tested in-person. In March 2020, when pandemic conditions prohibited enrollment during clinical encounters, both protocols were iterated to efficient, caregiver-centered remote operations. Iterations were enabled in part by the Automated Randomized Controlled Trial Information-Communication System (ARCTICS), a trial management system innovation engineered to integrate the data collection database (REDCap) with community resource referral (NowPow) and SMS texting (Mosio) platforms. Results Enabled by engaged CABs and ARCTICS, both RCTs quickly adapted to remote operations. Designed before the pandemic, we had planned to launch both trials by March 2020 and complete enrollment by December 2021. The pandemic postponed launch until November (CommunityRx-Hunger) and December (CommunityRx-Dementia) 2020. Despite the delay, 65% of all planned participants (CommunityRx-Hunger n = 417/640; CommunityRx-Dementia n = 222/344) were enrolled by December 2021, halfway through our projected enrollment timeline. Both trials enrolled 13% more participants in 12 months than originally projected in-person. Conclusions Our asset-based, community-engaged approach combined with widely accessible institutional and commercial information technologies facilitated rapid migration to remote trial operations. Remote or hybrid RCT designs for social care interventions may be a viable, scalable alternative to in-person recruitment and intervention delivery protocols, particularly for caregivers and other groups that are under-represented in traditional health services research. Trial Status Both studies are registered on ClinicalTrials.gov: CommunityRx-Hunger (NCT04171999); CommunityRx for Caregivers (NCT04146545); My Diabetes My Community (NCT04970810).
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Affiliation(s)
- Emily Marie Abramsohn
- University of Chicago Biological Sciences Division: University of Chicago Division of the Biological Sciences
| | - MariaDelSol De Ornelas
- University of Chicago Biological Sciences Division: University of Chicago Division of the Biological Sciences
| | | | - Cristianne Rm Frazier
- University of Chicago Biological Sciences Division: University of Chicago Division of the Biological Sciences
| | - Charles M Fuller
- University of Chicago Biological Sciences Division: University of Chicago Division of the Biological Sciences
| | - Mellissa Grana
- University of Chicago Biological Sciences Division: University of Chicago Division of the Biological Sciences
| | - Elbert S Huang
- University of Chicago Biological Sciences Division: University of Chicago Division of the Biological Sciences
| | - Jyotsna S Jagai
- University of Chicago Biological Sciences Division: University of Chicago Division of the Biological Sciences
| | - Jennifer A Makelarski
- University of Chicago Biological Sciences Division: University of Chicago Division of the Biological Sciences
| | - Doriane Miller
- University of Chicago Biological Sciences Division: University of Chicago Division of the Biological Sciences
| | | | - Eva Shiu
- University of Chicago Biological Sciences Division: University of Chicago Division of the Biological Sciences
| | - Katherine Thompson
- University of Chicago Biological Sciences Division: University of Chicago Division of the Biological Sciences
| | - Victoria Winslow
- University of Chicago Biological Sciences Division: University of Chicago Division of the Biological Sciences
| | - Kristen Wroblewski
- University of Chicago Biological Sciences Division: University of Chicago Division of the Biological Sciences
| | - Stacy Tessler Lindau
- University of Chicago Biological Sciences Division: University of Chicago Division of the Biological Sciences
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Abu Jawdeh EG, Hunt CE, Eichenwald E, Corwin MJ, McEntire B, Heeren T, Crowell LM, Ikponmwonba C, Saroufim A, Kerr S. Adverse effects of COVID-19 pandemic on a multicenter randomized controlled trial. J Perinatol 2022; 43:653-658. [PMID: 36581761 PMCID: PMC9798371 DOI: 10.1038/s41372-022-01592-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 12/12/2022] [Accepted: 12/16/2022] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Describe the effects of the COVID-19 pandemic on subject enrollment in a multicenter randomized controlled trial. STUDY DESIGN We assessed the number of eligible infants approached and consented for enrollment over five separate epochs including baseline, peak pandemic, and gradual but incomplete recovery. RESULT The pandemic had a major effect on ability to approach parents for consent. Parents approached dropped from 95.4% baseline to 13.1% in the peak pandemic epoch and has not recovered to baseline even in the just-completed post-pandemic epoch (84.9%). Despite the decrease in subjects approached, there was no significant change in the overall consent rate for the study CONCLUSION: The pandemic has significantly limited ability to approach parents of eligible infants for consent, with only partial recovery. Opportunities for interactions of investigators and study coordinators with parents continue to present challenges limiting full recovery.
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Affiliation(s)
- Elie G. Abu Jawdeh
- grid.266539.d0000 0004 1936 8438University of Kentucky, Lexington, KY USA
| | - Carl E. Hunt
- grid.265436.00000 0001 0421 5525Uniformed Services University, Bethesda, MD USA
| | - Eric Eichenwald
- grid.239552.a0000 0001 0680 8770Children’s Hospital of Philadelphia and University of Pennsylvania, Philadelphia, PA USA
| | | | | | - Timothy Heeren
- grid.189504.10000 0004 1936 7558Boston University, Boston, MA USA
| | - Lisa M. Crowell
- grid.189504.10000 0004 1936 7558Boston University, Boston, MA USA
| | | | - Ariana Saroufim
- grid.189504.10000 0004 1936 7558Boston University, Boston, MA USA
| | - Stephen Kerr
- grid.189504.10000 0004 1936 7558Boston University, Boston, MA USA
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Herpertz J, Richter MF, Barkhau C, Storck M, Blitz R, Steinmann LA, Goltermann J, Dannlowski U, Baune BT, Varghese J, Dugas M, Lencer R, Opel N. Symptom monitoring based on digital data collection during inpatient treatment of schizophrenia spectrum disorders - A feasibility study. Psychiatry Res 2022; 316:114773. [PMID: 35994863 DOI: 10.1016/j.psychres.2022.114773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 08/04/2022] [Accepted: 08/05/2022] [Indexed: 10/15/2022]
Abstract
Digital acquisition of patients' self-reports on individual risk factors and symptom severity represents a promising, cost-efficient, and increasingly prevalent approach for standardized data collection in psychiatric clinical routine. Yet, studies investigating digital data collection in patients with a schizophrenia spectrum disorder (PSSDs) are scarce. The objective of this study was to explore the feasibility of digitally acquired self-report assessments of risk and symptom profiles at the time of admission into inpatient treatment in an age-representative sample of hospitalized PSSDs. We investigated the required support, the data entry pace, and the subjective user experience. Findings were compared with those of patients with an affective disorder (PADs). Of 82 PSSDs who were eligible for inclusion, 59.8% (n=49) agreed to participate in the study, of whom 54.2% (n=26) could enter data without any assistance. Inclusion rates, drop-out rates, and subjective experience ratings did not differ between PSSDs and PADs. Patients reported high satisfaction with the assessment. PSSDs required more support and time for the data entry than PADs. Our results indicate that digital data collection is a feasible and well-received method in PSSDs. Future clinical and research efforts on digitized assessments in psychiatry should include PSSDs and offer support to reduce digital exclusion.
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Affiliation(s)
- Julian Herpertz
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Maike Frederike Richter
- Institute for Translational Psychiatry, University of Münster, Münster, Germany; Department of Psychiatry, Jena University Hospital/Friedrich-Schiller-University Jena, Jena, Germany
| | - Carlotta Barkhau
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Michael Storck
- Institute of Medical Informatics, University of Münster, Münster, Germany
| | - Rogério Blitz
- Institute for Translational Psychiatry, University of Münster, Münster, Germany; Institute of Medical Informatics, University of Münster, Münster, Germany; Department of Psychiatry, Jena University Hospital/Friedrich-Schiller-University Jena, Jena, Germany
| | - Lavinia A Steinmann
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Janik Goltermann
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Udo Dannlowski
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Bernhard T Baune
- Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Melbourne, Australia; The Florey Institute of Neuroscience and Mental Health, The University of Melbourne Parkville, Melbourne, Australia; Department of Psychiatry, University of Münster, Münster, Germany
| | - Julian Varghese
- Institute of Medical Informatics, University of Münster, Münster, Germany
| | - Martin Dugas
- Institute of Medical Informatics, University of Münster, Münster, Germany; Institute of Medical Informatics, Heidelberg University Hospital, Heidelberg, Germany
| | - Rebekka Lencer
- Institute for Translational Psychiatry, University of Münster, Münster, Germany; Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - Nils Opel
- Institute for Translational Psychiatry, University of Münster, Münster, Germany; Interdisciplinary Centre for Clinical Research Münster, University of Münster, Münster, Germany; Department of Psychiatry, Jena University Hospital/Friedrich-Schiller-University Jena, Jena, Germany.
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Conducting Neonatal Intensive Care Unit Research During a Pandemic: Challenges and Lessons Learned. Nurs Res 2022; 71:147-152. [PMID: 35212498 PMCID: PMC8881673 DOI: 10.1097/nnr.0000000000000564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND The coronavirus pandemic disrupted normal clinical operations and research. Nurse scientists conducting research studies in the neonatal intensive care unit experienced significant challenges to continuing their research studies amid national lockdowns and hospital visitation restrictions. OBJECTIVES The purpose of this article is to describe the challenges encountered by nurse scientists conducting research studies in the neonatal intensive care unit during the pandemic, the creative solutions devised to overcome these barriers, and the lessons learned during this unprecedented time. METHODS Using our pandemic area studies as exemplars, we highlight the barriers encountered in continuing our research in the intense environment of the neonatal intensive care unit. RESULTS Visitor restrictions limited the presence of parents and researchers in the neonatal intensive care unit during the pandemic, causing disruptions to participant recruitment and data collection. Laboratory closures further limited research activities during the pandemic. Strategies to overcome these barriers include building formal collaborations among researchers and clinicians, creating the infrastructure to support virtual recruitment and electronic consent, and developing contingency plans for studies involving the analysis of biological samples. DISCUSSION The neonatal intensive care unit is a unique environment because of vulnerable patient population and need for researchers to interact with parents to recruit study participants. Implementing the strategies developed during the coronavirus pandemic may allow for the continuation of research activities during future public health crises.
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Molloy EJ, Bearer CB. Pediatric Research and COVID-19: the changed landscape. Pediatr Res 2022; 92:618-619. [PMID: 34887524 PMCID: PMC8656136 DOI: 10.1038/s41390-021-01857-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 11/03/2021] [Indexed: 11/09/2022]
Affiliation(s)
- E. J. Molloy
- grid.8217.c0000 0004 1936 9705Paediatrics, School of Medicine, Trinity College, , The University of Dublin, Dublin, Ireland ,Trinity Research in Childhood Centre (TRICC), Dublin, Ireland ,grid.411886.20000 0004 0488 4333Neonatology, Coombe Women’s and Infant’s University Hospital, Dublin, Ireland ,grid.413305.00000 0004 0617 5936Childrens Hospital Ireland (CHI) at Tallaght, Tallaght University Hospital, Dublin, Ireland ,Neonatology, CHI at Crumlin, Dublin, Ireland
| | - C. B. Bearer
- grid.415629.d0000 0004 0418 9947Rainbow Babies & Children’s Hospital, Cleveland, OH USA ,grid.67105.350000 0001 2164 3847Case Western Reserve University School of Medicine, Cleveland, OH USA
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Unintended consequences of restrictive visitation policies during the COVID-19 pandemic: implications for hospitalized children. Pediatr Res 2021; 89:1333-1335. [PMID: 33654277 PMCID: PMC7922702 DOI: 10.1038/s41390-021-01439-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Accepted: 01/25/2021] [Indexed: 11/08/2022]
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