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Ciptaningtyas VR, Sumekar TA, de Mast Q, de Jonge MI, Margawati A. Parental engagement in research on paediatric lower respiratory tract infections in Indonesia. BMC Pediatr 2024; 24:165. [PMID: 38459462 PMCID: PMC10921691 DOI: 10.1186/s12887-024-04648-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Accepted: 02/15/2024] [Indexed: 03/10/2024] Open
Abstract
BACKGROUND Lower respiratory tract infections (LRTIs) in children are a major concern in Indonesia as it is the leading cause of morbidity and mortality. Therefore, research on LRTIs is crucial to improve children's health. However, clinical research in children is challenging due to parental concerns. This study aims to understand parental considerations for taking part in clinical studies on LRTI in the Indonesian context. METHODS A cross-sectional study using a validated online questionnaire was conducted from November 2021 to March 2022. This study included parents from two public elementary schools and two private primary schools in Semarang, Indonesia. A total of 1236 responses were analysed. RESULTS There was a significant association between educational attainment and willingness to participate in general health and LRTI-related research requiring specimen collection; respondents with an advanced educational level were more likely to refuse participation in research. A similar pattern was observed among respondents with smaller families and younger children against participation in LRTI research. Most respondents who indicated not to participate explained that they did not perceive the necessity to take part and expressed their concerns about endangering their child's health as a consequence of the specimen collection. Most respondents expected a personal benefit and prioritized access to the study results for their child. CONCLUSION Parents' educational background and family composition are important determinants of parental engagement in research on LRTI in Indonesia. Notably, parents with a lower educational level, having large families, and older children were more inclined to participate. The emphasis on concerns about potential harm and personal benefit underscores the need for a targeted communication strategy.
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Affiliation(s)
- Vincentia Rizke Ciptaningtyas
- Department of Microbiology, Faculty of Medicine, Universitas Diponegoro, Jl. Prof. H. Soedarto, Semarang, SH, Tembalang, Semarang, 50275, Indonesia.
- Diponegoro National Hospital, Semarang, Indonesia.
- Department of Laboratory Medicine, Laboratory of Medical Immunology, Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, the Netherlands.
| | - Tanjung Ayu Sumekar
- Diponegoro National Hospital, Semarang, Indonesia
- Department of Psychiatry, Faculty of Medicine, Universitas Diponegoro, Semarang, Indonesia
- Center for Biomedical Research, Faculty of Medicine, Universitas Diponegoro, Semarang, Indonesia
| | - Quirijn de Mast
- Department of Internal Medicine, Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Marinus Isaäk de Jonge
- Department of Laboratory Medicine, Laboratory of Medical Immunology, Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Ani Margawati
- Department of Public Health, Faculty of Medicine, Universitas Diponegoro, Semarang, Indonesia
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Amin S, Sangadi I, Allman-Farinelli M, Badve SV, Boudville N, Coolican H, Coulshed S, Foster S, Fernando M, Haloob I, Harris DC, Hawley CM, Holt J, Howell M, Kumar K, Johnson DW, Lee VW, Mai J, Rangan A, Roger SD, Sud K, Torres V, Vilayur E, Rangan GK. Participant Perceptions in a Long-term Clinical Trial of Autosomal Dominant Polycystic Kidney Disease. Kidney Med 2023; 5:100691. [PMID: 37602144 PMCID: PMC10432794 DOI: 10.1016/j.xkme.2023.100691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/22/2023] Open
Abstract
Rationale & Objective The development of new therapies for autosomal dominant polycystic kidney disease requires clinical trials to be conducted efficiently. In this study, the factors affecting the recruitment and retention of participants enrolled in a 3-year randomized controlled trial in autosomal dominant polycystic kidney disease were investigated. Study Design Qualitative study. Setting & Participants All participants (N=187) were invited to complete a 16-item questionnaire at the final study visit of the primary trial. Participants were recruited to complete a semistructured interview using purposeful sampling according to age, self-reported gender, and randomization group. Analytical Approach Descriptive statistics were used for demographic data and questionnaires. The interview transcripts underwent inductive thematic coding. Results One hundred and forty-six of the 187 randomized participants (79%) completed the post-trial questionnaire, and 31 of the 187 participants (21%) completed the interview. Most participants (94%) rated their global satisfaction with the trial as high (a score of 8 or more out of 10). Altruism, knowledge gain, and access to new treatments were the main motivators for recruitment. The main reasons for considering leaving the study were concerns about the risk of intervention and family or work issues. Strategies that favored retention included flexibility in attending different study sites, schedule flexibility, staff interactions, and practical support with parking and reminders. The main burden was time away from work with lost wages, and burden associated with magnetic resonance imaging scans and 24-hour urine output collections. Limitations The study population was restricted to participants in a single nondrug clinical trial, and the results could be influenced by selection and possible social desirability bias. Conclusions Participants reported high levels of satisfaction that occurred as a function of the trial meeting participants' expectations. Furthermore, retention was a balance between the perceived benefits and burden of participation. Consideration of these perspectives in the design of future clinical trials will improve their efficiency and conduct. Plain-Language Summary Advances in the clinical practice of autosomal dominant polycystic kidney disease (ADPKD) require affected individuals to voluntarily participate in long-term multicenter randomized controlled trials (RCTs). In this qualitative post hoc study of a 3-year RCT of increased water intake in ADPKD, altruism, knowledge gain, and access to a nondrug treatment positively influenced the decision to volunteer. Ongoing participation was enabled by building flexibility into the study protocol and staff prioritizing a participant's needs during study visits. Although participants completed the required tests, most were considered burdensome. This study highlights the importance of incorporating protocol flexibility into trial design; the preference for interventions with a low risk of adverse effects; and the urgent requirement for robust surrogate noninvasive biomarkers to enable shorter RCTs in ADPKD.
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Affiliation(s)
- Sneha Amin
- Michael Stern Laboratory for Polycystic Kidney Disease, Westmead Institute for Medical Research, The University of Sydney, Sydney, Australia
| | - Irene Sangadi
- Michael Stern Laboratory for Polycystic Kidney Disease, Westmead Institute for Medical Research, The University of Sydney, Sydney, Australia
- Department of Renal Medicine, Westmead Hospital, Western Sydney Local Health District, Sydney, Australia
| | | | - Sunil V. Badve
- St George Hospital, Sydney, Australia
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - Neil Boudville
- Sir Charles Gairdner Hospital, Perth, Australia
- Medical School, University of Western Australia, Perth, Australia
| | - Helen Coolican
- Polycystic Kidney Disease Australia, Roseville, Australia
| | | | - Sheryl Foster
- Department of Radiology, Westmead Hospital, Western Sydney Local Health District, Sydney, New South Wales
- Discipline of Medical Imaging Science, Sydney School of Health Sciences, The University of Sydney, Sydney, Australia
| | - Mangalee Fernando
- Department of Renal Medicine, Prince of Wales Hospital, Sydney, Australia
| | - Imad Haloob
- Department of Renal Medicine, Bathurst Hospital, Bathurst, Australia
| | - David C.H. Harris
- Michael Stern Laboratory for Polycystic Kidney Disease, Westmead Institute for Medical Research, The University of Sydney, Sydney, Australia
- Department of Renal Medicine, Westmead Hospital, Western Sydney Local Health District, Sydney, Australia
| | - Carmel M. Hawley
- Australasian Kidney Trials Network, University of Queensland at Princess Alexandra Hospital, Brisbane, Australia
- Translational Research Institute, Brisbane, Australia
- Department of Kidney and Transplant Services, Princess Alexandra Hospital, Brisbane, Australia
| | - Jane Holt
- Department of Renal Medicine, Wollongong Hospital, Wollongong, Australia
| | - Martin Howell
- School of Public Health, The University of Sydney, Sydney, NSW, Australia
| | | | - David W. Johnson
- Australasian Kidney Trials Network, University of Queensland at Princess Alexandra Hospital, Brisbane, Australia
- Translational Research Institute, Brisbane, Australia
- Department of Kidney and Transplant Services, Princess Alexandra Hospital, Brisbane, Australia
| | - Vincent W. Lee
- Michael Stern Laboratory for Polycystic Kidney Disease, Westmead Institute for Medical Research, The University of Sydney, Sydney, Australia
- Department of Renal Medicine, Westmead Hospital, Western Sydney Local Health District, Sydney, Australia
| | - Jun Mai
- Department of Renal Medicine, Liverpool Hospital, Southwestern Sydney Local Health District, Sydney, Australia
| | - Anna Rangan
- School of Nursing, The University of Sydney, Sydney, Australia
| | | | - Kamal Sud
- Department of Renal Medicine, Nepean Kidney Research Centre, Nepean Hospital and Nepean Clinical School, The University of Sydney, Sydney, Australia
| | - Vicente Torres
- Translational Polycystic Kidney Disease Center, Mayo Clinic, Rochester, MN
| | - Eswari Vilayur
- Department of Nephrology, John Hunter Hospital, Newcastle, Australia
| | - Gopala K. Rangan
- Michael Stern Laboratory for Polycystic Kidney Disease, Westmead Institute for Medical Research, The University of Sydney, Sydney, Australia
- Department of Renal Medicine, Westmead Hospital, Western Sydney Local Health District, Sydney, Australia
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Lee SKM, Smith L, Tan ECK, Cairns R, Grunstein R, Cheung JMY. Melatonin use in children and adolescents: A scoping review of caregiver perspectives. Sleep Med Rev 2023; 70:101808. [PMID: 37451058 DOI: 10.1016/j.smrv.2023.101808] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 06/08/2023] [Accepted: 06/11/2023] [Indexed: 07/18/2023]
Abstract
Despite melatonin's popularity as a pediatric sleep-aid, little has been investigated around caregivers' understanding and perception of melatonin use for their dependent. This scoping review analyzes the current literature on pediatric melatonin use, to understand how caregivers' perceptions around melatonin are shaped by their illness/medication-related beliefs, treatment experience and preferences. A literature search was conducted across Embase, Medline, PsycINFO, PubMed and Scopus, generating 184 results for screening against the inclusion criteria. Nineteen studies were retrieved, comprising of 1561 children and adolescents, aged 8.7 ± 2.3 years (range: 0-44 years), conducted primarily in the United States of America (n = 6), Canada (n = 3) and the Netherlands (n = 3). Studies were evaluated for their study design and caregiver-centered outcomes, encompassing: 1) illness/treatment-related beliefs, 2) treatment satisfaction/effectiveness, 3) treatment preference/acceptability, and 4) impact of child's sleep disturbance on caregivers' quality-of-life. Sleep disturbances necessitating melatonin use occurred alongside congenital/neurodevelopmental comorbidities in 18 studies (95%). Melatonin was commonly associated with "naturalness" and "safety". Concepts of treatment satisfaction versus effectiveness were minimally differentiated within included studies. Caregivers preferred concurrent use of melatonin and behavioral interventions for management of their dependents' sleep. Improved sleep in the dependent generally led to better quality-of-life for caregivers and their family.
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Affiliation(s)
- Samantha K M Lee
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia; Sleep and Circadian Research Group, Woolcock Institute of Medical Research, Sydney, Australia
| | - Lorraine Smith
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Edwin C K Tan
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Rose Cairns
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia; New South Wales Poisons Information Center, The Children's Hospital at Westmead, Sydney, Australia
| | - Ronald Grunstein
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia; Sleep and Circadian Research Group, Woolcock Institute of Medical Research, Sydney, Australia; CIRUS Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, Sydney, Australia; Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Janet M Y Cheung
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia; Sleep Research Group, Charles Perkins Center, The University of Sydney, Sydney, Australia.
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Rae S, Maguire J, Aglipay M, Barwick M, Danavan K, Haines J, Jenkins J, Klaassen M, Moretti ME, Ong F, Persaud N, Porepa M, Straus S, Tavares E, Willan A, Birken C. Randomized controlled trial evaluating a virtual parenting intervention for young children at risk of obesity: study protocol for Parenting Addressing Early Years Intervention with Coaching Visits in Toronto (PARENT) trial. Trials 2023; 24:8. [PMID: 36600302 PMCID: PMC9811050 DOI: 10.1186/s13063-022-06947-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 11/22/2022] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND The prevalence of overweight (15%) and obesity (6%) in children under 5 years of age in Canada are high, and young children with overweight and obesity are at increased risk of the development of chronic disease(s) in adulthood. Prior research has demonstrated very few published trials on effective obesity prevention interventions in young children at risk of obesity, within primary healthcare settings. The aim of this study is to determine if 18-48-month-old children at risk for obesity, who are randomized to receive the Parents Together program (i.e., intervention group), have reduced body mass index z-score (zBMI), compared to those not receiving the intervention, at a 12-month follow-up. Secondary clinical outcomes between the intervention and control groups will be compared at 12 months. METHODS A pragmatic, parallel group, 1:1, superiority, randomized control trial (RCT) through the TARGetKids! Practice Based Research Network will be conducted. Young children (ages 18-48 months) who are at increased risk for childhood obesity will be invited to participate. Parents who are enrolled in the intervention group will participate in eight weekly group sessions and 4-5 coaching visits, facilitated by a trained public health nurse. Children and parents who are enrolled in the control group will receive the usual health care. The primary outcome will be compared between intervention arms using an analysis of covariance (ANCOVA). Feasibility and acceptability will be assessed by parent focus groups and interviews, and fidelity to the intervention will be measured using nurse-completed checklists. A cost-effectiveness analysis (CEA) will be conducted. DISCUSSION This study will aim to reflect the social, cultural, and geographic diversity of children in primary care in Toronto, Ontario, represented by an innovative collaboration among applied child health researchers, community health researchers, and primary care providers (i.e., pediatricians and family physicians in three different models of primary care). Clinical and implementation outcomes will be used to inform future research to test this intervention in a larger number, and diverse practices across diverse geographic settings in Ontario. TRIAL REGISTRATION ClinicalTrials.gov NCT03219697. Registered on June 27, 2017.
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Affiliation(s)
- Sarah Rae
- grid.17063.330000 0001 2157 2938Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON Canada ,grid.42327.300000 0004 0473 9646Child Health Evaluative Sciences, The Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, ON Canada
| | - Jonathon Maguire
- grid.415502.7Li Ka Shing Knowledge Institute, St Michael’s Hospital, Toronto, ON Canada ,grid.34429.380000 0004 1936 8198Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, ON Canada
| | - Mary Aglipay
- grid.415502.7Li Ka Shing Knowledge Institute, St Michael’s Hospital, Toronto, ON Canada
| | - Melanie Barwick
- grid.42327.300000 0004 0473 9646Child Health Evaluative Sciences, The Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, ON Canada ,grid.17063.330000 0001 2157 2938Dalla Lana School of Public Health, University of Toronto, Toronto, ON Canada ,grid.17063.330000 0001 2157 2938Department of Psychiatry, University of Toronto, Toronto, ON Canada
| | - Karoon Danavan
- grid.17063.330000 0001 2157 2938Department of Pediatrics, Department of Medicine, University of Toronto, Toronto, ON Canada
| | - Jess Haines
- grid.34429.380000 0004 1936 8198Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, ON Canada
| | - Jennifer Jenkins
- grid.17063.330000 0001 2157 2938Applied Psychology and Human Development, University of Toronto, Toronto, ON Canada
| | - Marie Klaassen
- grid.417191.b0000 0001 0420 3866Toronto Public Health, Toronto, ON Canada
| | - Myla E. Moretti
- grid.17063.330000 0001 2157 2938Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, ON Canada ,grid.42327.300000 0004 0473 9646Clinical Trials Unit, Ontario Child Health Support Unit, The Hospital for Sick Children, Toronto, ON Canada
| | - Frank Ong
- grid.42327.300000 0004 0473 9646Child Health Evaluative Sciences, The Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, ON Canada
| | - Nav Persaud
- grid.415502.7Li Ka Shing Knowledge Institute, St Michael’s Hospital, Toronto, ON Canada ,grid.415502.7Department of Family and Community Medicine, Centre for Urban Health Solutions and Department of Family and Community Medicine, University of Toronto, St. Michael’s Hospital, Toronto, ON Canada
| | - Michelle Porepa
- grid.17063.330000 0001 2157 2938Department of Pediatrics, Department of Medicine, University of Toronto, Toronto, ON Canada
| | - Sharon Straus
- grid.415502.7Department of Pediatrics, St Michael’s Hospital, Pediatric Research, Toronto, ON Canada
| | - Erika Tavares
- grid.42327.300000 0004 0473 9646Genetics and Genome Biology, The Hospital for Sick Children, Toronto, ON Canada
| | - Andrew Willan
- grid.42327.300000 0004 0473 9646Child Health Evaluative Sciences, The Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, ON Canada ,grid.17063.330000 0001 2157 2938Dalla Lana School of Public Health, University of Toronto, Toronto, ON Canada
| | - Catherine Birken
- grid.17063.330000 0001 2157 2938Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON Canada ,grid.42327.300000 0004 0473 9646Child Health Evaluative Sciences, The Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, ON Canada ,grid.17063.330000 0001 2157 2938Department of Pediatrics, Department of Medicine, University of Toronto, Toronto, ON Canada ,grid.17063.330000 0001 2157 2938Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, ON Canada
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Wood MD, West NC, Sreepada R, Loftsgard KC, Petersen L, Robillard J, Page P, Ridgway R, Chadha NK, Portales-Casamar E, Görges M. Identifying risk factors, patient reported experience and outcome measures, and data capture tools for an individualized pain prediction tool in pediatrics: a focus group study (Preprint). JMIR Perioper Med 2022; 5:e42341. [DOI: 10.2196/42341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 10/25/2022] [Accepted: 10/27/2022] [Indexed: 11/05/2022] Open
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