Video Inspired Discussions About Ethical Outcomes in Pediatrics

Trial statusRecruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
AgeNot listed
SponsorMassachusetts General Hospital

About this trial

The goal of this clinical trial is to learn if the VIDEO-PEDS intervention works to improve Goals of Care communication between clinicians and parents of children with cancer.

The main questions it aims to answer are:

Does the intervention improve Goals of Care documentation? Does it improve patient outcomes (including less invasive preferences for resuscitation and interventions, less hospital utilization, and more palliative care and hospice use)? Does it improve parent outcomes (including health satisfaction and feeling heard and understood per survey scores)?

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

Age 0-12 years

Diagnosed with any type or stage of cancer

Receiving cancer directed treatment

Decision maker for the child.

Disqualifiers

Not receiving primary medical care from the cancer clinic (e.g., second-opinion consultations only)

Already referred to and fully consulted by the palliative care team

Prognosis of less than a 2-month life expectancy

Visually impaired beyond 20/200 corrected and unable to view the video (note: hearing impaired is not an exclusion as the videos are closed captioned).

Trial design

Design model

Parallel

Treatments tested in this trial

  • VIDEO-PEDS

    Other intervention

    Following enrollment, parents will receive a link to view the refined video decision aid that is designed to prompt parents to think about their goals of care for their child with cancer, and then to react by engaging in communication with a trained member of the research team called the Navigator and eventually their clinical team over the course of the 9-month study duration.

  • VIDEO-PEDS pilot

    Other intervention

    This is the 3-month pilot version of the intervention, which will be further developed for the eventual RWCT.

  • Focus Group

    Other intervention

    Parents will view the Video aid and provide fascilitated feedback in an audio-recorded virtual group setting.

Treatment groups

567 Participants
are divided into 4 treatment groups
Group A: UH3 RWCT Arm - InterventionExperimental treatment 1 intervention
Group B: UH3 RWCT Arm - ControlNo intervention 0 interventions
Group C: UG3 Pilot InterventionOther 1 intervention
Group D: UG3 Focus GroupOther 1 intervention

Trial outcomes

Primary outcomes

1

Goals-of-Care Discussion

Percentage of parents who held conversations with their medical team about goals, values, or priorities for treatment and outcomes as per documentation in the medical record.

Time frame
At the end of Cycles 1, 2, and 3 (each cycle is 9 months)
2

Code Status Limitation

Percentage of parents who communicate limitations to cardiopulmonary resuscitation and intubation with their medical team as per documentation in the medical record.

Time frame
At the end of Cycles 1, 2, and 3 (each cycle is 9 months)
3

Palliative Care

Percentage of parents who mention a visit with a specialty palliative care clinician, mention of specialist palliative care discussion, or patient preferences regarding seeing a palliative care clinician to their medical team as per documentation in the medical record.

Time frame
At the end of Cycles 1, 2, and 3 (each cycle is 9 months)
4

Time-Limited Trial

Percentage of parents who engage in conversations with their medical team about the use of a treatment or procedure for a set amount of time with a pre-defined goal and plan related to the outcome at the end of the trial as per documentation in the medical record.

Time frame
At the end of Cycles 1, 2, and 3 (each cycle is 9 months)

Secondary outcomes

1

Acceptability themes from qualitative data

For the development phase, qualitative group interviews will yield information about participant preferences. For the pilot phase, qualitative individual interviews will yield information about participant preferences after a 3-month study duration.

Time frame
2 years
2

Feasibility by % of parents

Feasibility will be assessed as ability to identify, recruit, and retain participants as a percentage. 70% of those screened should be eligible for approach after the Validation and Opt-out Steps. 70% approached should agree to participate. 70% should complete the study. (\<30% should be lost to follow-up or withdraw from the study.)

Time frame
2 years
3

Parent Satisfaction scores

A parent survey will measure how parents felt heard and understood by the medical team and how satisfied they were with the care received using five validated items from the measure Feeling Heard and Understood and two items from the Survey about Caring for Children with Cancer (SCCC) all answered on a 5-point Likert Scale. Scores range from 0 to 100 with 0 being the lowest satisfaction.

Time frame
2 years

Other outcomes

Sponsors and contacts

Click on the lead sponsor to view all of their trials.

Massachusetts General Hospital

Lead sponsor

National Cancer Institute (NCI)

Collaborator

Dartmouth-Hitchcock Medical Center

Collaborator

Dana-Farber Cancer Institute

Collaborator

Yale University

Collaborator

Emory University

Collaborator

Children's Healthcare of Atlanta

Collaborator

University of Alabama at Birmingham

Collaborator