1
|
Smith V, Delaney H, Hunter A, Torgerson D, Treweek S, Gamble C, Mills N, Stanbury K, Dempsey E, Daly M, O'Shea J, Weatherup K, Deshpande S, Ryan MA, Lowe J, Black G, Devane D. The development and acceptability of an educational and training intervention for recruiters to neonatal trials: the TRAIN project. BMC Med Res Methodol 2023; 23:265. [PMID: 37951890 PMCID: PMC10638723 DOI: 10.1186/s12874-023-02086-1] [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: 11/17/2022] [Accepted: 10/28/2023] [Indexed: 11/14/2023] Open
Abstract
BACKGROUND Suboptimal or slow recruitment affects 30-50% of trials. Education and training of trial recruiters has been identified as one strategy for potentially boosting recruitment to randomised controlled trials (hereafter referred to as trials). The Training tRial recruiters, An educational INtervention (TRAIN) project was established to develop and assess the acceptability of an education and training intervention for recruiters to neonatal trials. In this paper, we report the development and acceptability of TRAIN. METHODS TRAIN involved three sequential phases, with each phase contributing information to the subsequent phase(s). These phases were 1) evidence synthesis (systematic review of the effectiveness of training interventions and a content analysis of the format, content, and delivery of identified interventions), 2) intervention development using a Partnership (co-design/co-creation) approach, and 3) intervention acceptability assessments with recruiters to neonatal trials. RESULTS TRAIN, accompanied by a comprehensive intervention manual, has been designed for online or in-person delivery. TRAIN can be offered to recruiters before trial recruitment begins or as refresher sessions during a trial. The intervention consists of five core learning outcomes which are addressed across three core training units. These units are the trial protocol (Unit 1, 50 min, trial-specific), understanding randomisation (Unit 2, 5 min, trial-generic) and approaching and engaging with parents (Unit 3, 70 min, trial-generic). Eleven recruiters to neonatal trials registered to attend the acceptability assessment training workshops, although only four took part. All four positively valued the training Units and resources for increasing recruiter preparedness, knowledge, and confidence. More flexibility in how the training is facilitated, however, was noted (e.g., training divided across two workshops of shorter duration). Units 2 and 3 were considered beneficial to incorporate into Good Clinical Practice Training or as part of induction training for new staff joining neonatal units. CONCLUSION TRAIN offers a comprehensive co-produced training and education intervention for recruiters to neonatal trials. TRAIN was deemed acceptable, with minor modification, to neonatal trial recruiters. The small number of recruiters taking part in the acceptability assessment is a limitation. Scale-up of TRAIN with formal piloting and testing for effectiveness in a large cluster randomised trial is required.
Collapse
Affiliation(s)
- V Smith
- School of Nursing and Midwifery, University of Dublin, Trinity College Dublin, Dublin, Ireland.
- Health Research Board-Trials Methodology Research Network (HRB-TMRN), University of Galway, Galway, Ireland.
| | - H Delaney
- School of Nursing and Midwifery, University of Dublin, Trinity College Dublin, Dublin, Ireland
- Health Research Board-Trials Methodology Research Network (HRB-TMRN), University of Galway, Galway, Ireland
| | - A Hunter
- Health Research Board-Trials Methodology Research Network (HRB-TMRN), University of Galway, Galway, Ireland
- School of Nursing and Midwifery, University of Galway, Galway, Ireland
| | - D Torgerson
- York Trials Unit, University of York, York, YO10 5DD, UK
| | - S Treweek
- Health Services Research Unit, Trial Forge, University of Aberdeen, Aberdeen, UK
| | - C Gamble
- Liverpool Clinical Trials Centre, University of Liverpool, Liverpool, UK
| | - N Mills
- QuinteT, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - K Stanbury
- National Perinatal Epidemiology Unit (NPEU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - E Dempsey
- INFANT Centre, University College Cork, Cork, Ireland
| | - M Daly
- Irish Neonatal Health Alliance, Public and Patient Involvement Contributor, Bray, Co-Wicklow, Ireland
| | - J O'Shea
- Public and Patient Involvement Contributor, Royal Hospital for Children, Glasgow, UK
| | - K Weatherup
- Public and Patient Involvement Contributor, Oxford, UK
| | | | - M A Ryan
- INFANT Centre, University College Cork, Cork, Ireland
| | - J Lowe
- Centre for Trials Research, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
| | - G Black
- Royal Hospital for Children and Young People, Edinburgh, UK
| | - D Devane
- Health Research Board-Trials Methodology Research Network (HRB-TMRN), University of Galway, Galway, Ireland
- School of Nursing and Midwifery, University of Galway, Galway, Ireland
| |
Collapse
|
2
|
Mitchell E, Oddie SJ, Dorling J, Gale C, Johnson MJ, McGuire W, Ojha S. Implementing two-stage consent pathway in neonatal trials. Arch Dis Child Fetal Neonatal Ed 2023; 108:79-82. [PMID: 34949637 PMCID: PMC9763226 DOI: 10.1136/archdischild-2021-322960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 12/02/2021] [Indexed: 11/04/2022]
Abstract
Perinatal trials sometimes require rapid recruitment processes to facilitate inclusion of participants when interventions are time-critical. A two-stage consent pathway has been used in some trials and is supported by national guidance. This pathway includes seeking oral assent for participation during the time-critical period followed by informed written consent later. This approach is being used in the fluids exclusively enteral from day one (FEED1) trial where participants need to be randomised within 3 hours of birth. There is some apprehension about approaching parents for participation via the oral assent pathway. The main reasons for this are consistent with previous research: lack of a written record, lack of standardised information and unfamiliarity with the process. Here, we describe how the pathway has been implemented in the FEED1 trial and the steps the trial team have taken to support sites. We provide recommendations for future trials to consider if they are considering implementing a similar pathway. Trial registration number: ISRCTN89654042.
Collapse
Affiliation(s)
- Eleanor Mitchell
- Nottingham Clinical Trials Unit, School of Medicine, University of Nottingham, Nottingham, UK
| | - Sam J Oddie
- Department of Neonatal Medicine, Bradford Teaching Hospitals NHS Foundation Trust, West Yorkshire, UK
| | - Jon Dorling
- Department of Neonatal Medicine, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Chris Gale
- Neonatal Medicine, School of Public Health, Faculty of Medicine, Imperial College London, London, UK
| | - Mark John Johnson
- Department of Neonatal Medicine, University Hospital Southampton NHS Foundation Trust, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - William McGuire
- Centre for Reviews and Dissemination, University of York, York, UK
| | - Shalini Ojha
- Population and Applied Health Sciences, School of Medicine, University of Nottingham, Nottingham, UK
- Neonatal Unit, University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK
| |
Collapse
|
3
|
Padilla-Sánchez C, Baixauli-Alacreu S, Cañada-Martínez AJ, Solaz-García Á, Alemany-Anchel MJ, Vento M. Delayed vs Immediate Cord Clamping Changes Oxygen Saturation and Heart Rate Patterns in the First Minutes after Birth. J Pediatr 2020; 227:149-156.e1. [PMID: 32710909 DOI: 10.1016/j.jpeds.2020.07.045] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 06/24/2020] [Accepted: 07/10/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To build arterial oxygen saturation (SpO2) and heart rate (HR) percentiles for the first 10 minutes after birth in term infants born after an uneventful gestation, vaginal delivery, and delayed cord clamping (DCC) for ≥60 seconds, and to compare our results with previous ones constructed after immediate cord clamping. STUDY DESIGN Preductal SpO2, HR, and timing of DCC immediately after complete fetal body expulsion were recorded. The pulse-oximeter was adjusted in the right wrist/hand and set at maximal intensity and measurements performed every 2 seconds. RESULTS A total of 282 term newborn infants were included. The definitive data set comprised of 70 257 SpO2 and 79 746 HR measurements. Median and IQR of SpO2 (%) at 1, 5, and 10 minutes after birth were 77 (68-85), 94 (90-96), and 96 (93-98), respectively. HR (beats per minute) median and IQR at 1, 5, and 10 minutes after birth were 148 (84-170), 155 (143-167), and 151 (142-161), respectively. We found significantly higher SpO2 for the 10th, 50th, and 90th percentiles compared with the previous reference ranges for the first 5 minutes and HR for the first 1-2 minutes after birth. CONCLUSIONS Spontaneously breathing term newborn infants born by vaginal delivery who underwent DCC ≥60 seconds achieved higher SpO2 and HR in the first 5 minutes after birth compared with term neonates born under the same conditions but with immediate cord clamping. Further studies in neonates undergoing cesarean delivery are under way.
Collapse
Affiliation(s)
- Celia Padilla-Sánchez
- University and Polytechnic Hospital La Fe, Valencia, Spain; University of Valencia (UV), Spain; Generalitat Valenciana, Consellería de Salut, Unidad Docente de Matronas, Spain
| | - Susana Baixauli-Alacreu
- University and Polytechnic Hospital La Fe, Valencia, Spain; University of Valencia (UV), Spain; Generalitat Valenciana, Consellería de Salut, Unidad Docente de Matronas, Spain
| | | | | | | | - Máximo Vento
- University and Polytechnic Hospital La Fe, Valencia, Spain; Nursing and Midwifery School of the Valencian Community, Spain.
| |
Collapse
|
4
|
Oliver S, Uhm S, Duley L, Crowe S, David AL, James CP, Chivers Z, Gyte G, Gale C, Turner M, Chambers B, Dowling I, McNeill J, Alderdice F, Shennan A, Deshpande S. Top research priorities for preterm birth: results of a prioritisation partnership between people affected by preterm birth and healthcare professionals. BMC Pregnancy Childbirth 2019; 19:528. [PMID: 31888523 PMCID: PMC6938013 DOI: 10.1186/s12884-019-2654-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Accepted: 11/29/2019] [Indexed: 11/10/2022] Open
Abstract
Background We report a process to identify and prioritise research questions in preterm birth that are most important to people affected by preterm birth and healthcare practitioners in the United Kingdom and Republic of Ireland. Methods Using consensus development methods established by the James Lind Alliance, unanswered research questions were identified using an online survey, a paper survey distributed in NHS preterm birth clinics and neonatal units, and through searching published systematic reviews and guidelines. Prioritisation of these questions was by online voting, with paper copies at the same NHS clinics and units, followed by a decision-making workshop of people affected by preterm birth and healthcare professionals. Results Overall 26 organisations participated. Three hundred and eighty six people responded to the survey, and 636 systematic reviews and 12 clinical guidelines were inspected for research recommendations. From this, a list of 122 uncertainties about the effects of treatment was collated: 70 from the survey, 28 from systematic reviews, and 24 from guidelines. After removing 18 duplicates, the 104 remaining questions went to a public online vote on the top 10. Five hundred and seven people voted; 231 (45%) people affected by preterm birth, 216 (43%) health professionals, and 55 (11%) affected by preterm birth who were also a health professional. Although the top priority was the same for all types of voter, there was variation in how other questions were ranked. Following review by the Steering Group, the top 30 questions were then taken to the prioritisation workshop. A list of top 15 questions was agreed, but with some clear differences in priorities between people affected by preterm birth and healthcare professionals. Conclusions These research questions prioritised by a partnership process between service users and healthcare professionals should inform the decisions of those who plan to fund research. Priorities of people affected by preterm birth were sometimes different from those of healthcare professionals, and future priority setting partnerships should consider reporting these separately, as well as in total.
Collapse
Affiliation(s)
- Sandy Oliver
- Social Science Research Unit, UCL Institute of Education, 18 Woburn Square, London, WH10NR, UK
| | - Seilin Uhm
- Social Science Research Unit, UCL Institute of Education, 18 Woburn Square, London, WH10NR, UK
| | - Lelia Duley
- Nottingham Clinical Trials Unit, University of Nottingham, Nottingham, UK.
| | | | - Anna L David
- Institute for Women's Health, University College London, 86-96 Chenies Mews, London, WC1E 6HX, UK
| | - Catherine P James
- Institute for Women's Health, University College London, 86-96 Chenies Mews, London, WC1E 6HX, UK
| | | | - Gill Gyte
- National Childbirth Trust (NCT), 30 Euston Square, London, NW1 2FB, UK
| | - Chris Gale
- Neonatal Medicine, School of Public Health, Faculty of Medicine, Imperial College London, Chelsea and Westminster Hospital campus, London, SW10 9NH, UK
| | - Mark Turner
- Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| | | | | | - Jenny McNeill
- School of Nursing & Midwifery, Queen's University Belfast, Medical Biology Centre, Belfast, BT9 7BL, UK
| | - Fiona Alderdice
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Old Road Campus, Headington, Oxford, OX3 7LF, UK
| | - Andrew Shennan
- Kings College London, St. Thomas Hospital, London, SE1 7EH, UK
| | - Sanjeev Deshpande
- Sanjeev Deshpande, Princess Royal Hospital, Apley Castle, Grainger Drive, Telford, TF1 6TF, UK
| |
Collapse
|