Perceived Barriers to Clinical Trials Participation: A Survey of Pediatric Caregivers

Introduction. Pediatric clinical trials are difficult to conduct, leading to off-label use of medication in children based on results of trials with adults. As a unique population, children deserve to have appropriately tested therapies. The purpose of this study was to evaluate pediatric caregivers’ beliefs and perceived barriers to participation in clinical trials. Methods. The study was completed within the Sunflower Pediatric Clinical Trials Research Extension (SPeCTRE), an affiliate of the IDeA States Pediatric Clinical Trials Network (ISPCTN). This was a cross-sectional survey, adapted from the Pediatric Research Participation Questionnaire. A convenience sample of pediatric caregivers was recruited in three areas of a highly rural Midwestern state between 2017 and 2018. Results.  A total of 159 caregivers completed surveys; the majority (72.3%) were previously familiar with clinical trials, but <20% had ever been invited to participate. Caregivers were willing to consider enrolling their child if a physician in whom they had high trust recommended the trials (H=10.1, p=0.04) and if there were perceived benefits, such as access to tests and medications not covered by insurance (correlation coefficient [CC]=0.4, p<0.01) and compensation for time and travel (CC=0.3, p=0.04). Conclusions. Trust in their physician highly influences likelihood of a caregiver consenting to have their child participate in a clinical trial. Therefore, to facilitate opportunities for children to participate in clinical trials, physicians need to be trained so they can offer trials locally. In addition, trials need to offer benefits, such as increased access to tests and medications as well as appropriate compensation

The Relationship of Personality Style and Attention Deficit Hyperactivity Disorder in Children

Introduction. This study was to identify personality correlates ofchildren with a diagnosis of Attention Deficit Hyperactive Disorder(ADHD). The Jungian Personality Type dimensions primarilyconsidered were Sensing/Intuiting and Perceiving/Judging.A Sensing child is likely to be very present-centered. A Perceivingchild tends to be curious and resist order and structure. Methods. Children attending a general pediatric clinic with a diagnosisof ADHD were eligible to participate. Enrolled childrenwere administered the Murphy-Meisgeier Type Indicator forChildren. Binomial tests were performed comparing Perceivingand Sensing personality components to accepted population rates. Results. Participants (n = 117) were predominantly male(78%) with a median age of 10 years. The Sensing trait (72%)was more prevalent than expected, though prevalence for thePerceiving trait (44%) did not differ from population rates. Conclusions. Personality types occasioned with the diagnosisof ADHD could be useful in establishing/normalizingtreatment regimens and approaches to assist thesechildren and their families better. KS J Med 2017;10(2):26-29

Perceived Barriers to Pediatric Clinical Trials Implementation: A Survey of Health Care Staff

Introduction. Clinical trials are the gold standard for assessing the effectiveness and safety of treatments. The objective of the current study was to assess provider opinions regarding implementing pediatric clinical trials in various practice settings across Kansas.   Methods. The study was completed within the Sunflower Pediatric Clinical Trials Research Extension (SPeCTRE), an affiliate of the IDeA States Pediatric Clinical Trials Network (ISPCTN). A cross-sectional, 36-item survey was administered to a state-wide convenience sample targeting health care providers and clinic staff.   Results. A total of 119 health care providers and clinic staff completed surveys; 31% were physicians. Physicians were more likely than other clinic staff to have experience with clinical trials (correlation coefficient [CC]=0.270, p=0.004). When compared to urban respondents, rural providers were less supportive of recruitment for clinical trials in their practices (CC=-0.251, p=0.008) and more likely to feel comfortable referring patients for clinical trials involving treatments that their insurance did not cover (CC=0.302, p=0.001).  Conclusions. A range of rural and urban health care professionals support the performance of pediatric clinical trials but identify several barriers as well. These results will support future pediatric clinical trials across the country including Kansas.

A Comparison of Community and Clinic Baby Showers to Promote Safe Sleep for Populations at High Risk for Infant Mortality

Community baby showers have provided education and free portable cribs to promote safe sleep for high-risk infants. We evaluated knowledge gained at these showers and the effectiveness of holding baby showers at a primary care clinic as an alternative to traditional community venues. Participants at the community venue were more likely to exhibit risk factors associated with unsafe sleep and to report an unsafe sleep location for their infant without the provided portable crib. Following the showers, both groups showed improvement in knowledge and intentions regarding safe sleep. However, to connect with the highest risk groups, showers held at community venues appeared to be preferable to those held at high-risk clinics