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Trial registered on ANZCTR
Registration number
ACTRN12624000736549
Ethics application status
Approved
Date submitted
30/03/2024
Date registered
14/06/2024
Date last updated
14/06/2024
Date data sharing statement initially provided
14/06/2024
Type of registration
Prospectively registered
Titles & IDs
Public title
A Randomized Controlled Trial to Evaluate the Effect of Tailored Behavioral Sleep Interventions for Non-Respiratory Sleep Disorders in Children with Neurodisability Compared to Routine Care
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Scientific title
A Randomized Controlled Trial to Evaluate the Effect of Tailored Behavioral Sleep Interventions for Non-Respiratory Sleep Disorders in Children with Neurodisability Compared to Routine Care
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Secondary ID [1]
311476
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None
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
neurodevelopmental conditions
332796
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Sleep Problems
332797
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Neurodisability
332798
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Paediatric Sleep Issues
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Condition category
Condition code
Neurological
330249
330249
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0
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Other neurological disorders
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Mental Health
330250
330250
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0
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Other mental health disorders
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Physical Medicine / Rehabilitation
330251
330251
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0
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Other physical medicine / rehabilitation
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Participants will be randomised into one of two active intervention groups.:
1) Receive Intervention A- individual eADVICE-online sleep program accessed by parent as many times as they wish (IxA).
2) Receive Intervention B- parent group telehealth delivered by a psychologist or specialist sleep nurse trained in delivery of sleep interventions (IxB).
Intervention group A will be an individualised program for the child accessed by the parent using an electronic device, The interventions will be structured by the initial answers given by parents when completing questions in the introductory part of the program, about their child’s sleep. Answers will lead to a decision tree for treatment advice, based on the problems described. The decision tree will include generic advice regarding sleep hygiene and routines and then lead on to specific treatments for specific sleep problems, funnelling participants to the correct advice according to their responses. For example if a participant reports sensory processing concerns advice will be directed to a module regarding management of sensory issues relating to sleep.
Modules will include: psychoeducation around sleep, bedtime routines, special consideration at bedtime relating to diagnosis (example visual impairment and bedtime), how we change behaviour, specific sleep strategies directly treating a sleep issue (for example: camping out method for a sleep association). Age modules of preschool, school aged and high school aged show adapted content and examples to suit the age.
Participants can choose to receive treatment advice in a printable text format or from an online character (“Dr Sam”) that interacts with them. Printable text will be dependant on how much advice is required, however generally would be 2-3 page handouts. The online interaction will be provided by short 5-10 minute interactions with "Dr Sam" for each strategy/advice. Parents can revisit the program to input additional information, resulting in modification of subsequent treatment advice. Families will be self-directed in their access to the online program, with up to them how often they access it. The families can access the program at any time through the 12-month study, with frequency of access the program logged.
Intervention group B is a parent-based group behavioural intervention based on an intervention found to be effective in children with Attention Deficit and Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD), an important subgroup of the neurodisability (ND) population. For this study the program will be adapted to suit a wider spectrum of ND groups. The intervention will involve two group telehealth sessions (2 hours in duration) conducted 7 days apart. Each group session will involve the Educator (trained professional-sleep clinical nurse or psychologist) and 2-4 parents. Session content will include modules on sleep hygiene, sleep amount/timing/regularity, bedtime routine and finally strategies to minimise bedtime resistance, night wakings and co-sleeping (i.e., graduated extinction, bedtime pass, social story). Homework will involve datasheets to complete each night, including elements discussed in the sessions taking approximately 15-30 minutes to complete. Two follow-up phone calls 2 weeks apart with the educators and each parent will occur to check compliance and completion of homework tasks.
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Intervention code [1]
327930
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Behaviour
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Comparator / control treatment
standard clinical advice
Within the standard clinical advice group, Sleep hygiene advice will be provided to all new patients attending the sleep clinic, including those referred for sleep disordered breathing (SDB). Clinicians will be asked to complete a brief form after the consultation, indicating if they have covered specific areas including (a) Sleep hygiene, (b) Sleep amount/timing/regularity, (c) Bedtime routine and (d) Specific sleep strategies e.g., extinction, graduated extinction, bedtime passes, stimulus control procedures, positive reinforcement, relaxation techniques, social stories, imaginations.
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Control group
Active
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Outcomes
Primary outcome [1]
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Change in Sleep Total Score on Child Sleep Habits Questionnaire from baseline to 6 months and 12 months
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Assessment method [1]
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Child Sleep Habits Questionnaire
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Timepoint [1]
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baseline, 6 months (primary timepoint), 12 months post initiation of intervention
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Secondary outcome [1]
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Change in CHSQ Sleep Subscales (Sleep latency and insomnia)
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Assessment method [1]
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Child Sleep Habits Questionnaire Subscores
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Timepoint [1]
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6 months and 12 months post initiation of intervention
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Secondary outcome [2]
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Change in the Child participant's behaviour and function
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Assessment method [2]
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Child Adjustment and Parent Efficacy Scale- Developmental Disability (CAPES-DD) total problems scale and subscale scores completed by parents
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Timepoint [2]
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6 months and 12 months post initiation of intervention
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Secondary outcome [3]
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Change in self-reported sleep quality
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Assessment method [3]
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Sleep Diary completed by child participant and/or parent
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Timepoint [3]
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6 months and 12 months post initiation of intervention
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Secondary outcome [4]
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Change in Quality of life scores
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Assessment method [4]
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The Pediatric Quality of Life Inventory 4.0 (PedsQL 4.0) questionnaire completed by parents
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Timepoint [4]
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6 months and 12 months post initiation of intervention
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Secondary outcome [5]
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Change in parental mental health scores
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Assessment method [5]
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Depression, Anxiety and Stress Scale (DASS) questionnaire completed by parents
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Timepoint [5]
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6 months and 12 months post initiation of intervention
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Secondary outcome [6]
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Change in functional ability and behaviour of child participant
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Assessment method [6]
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Qualitative semi-structured interview with 1) primary caregiver (parent) and 2) Teacher (if possible). This will be done by a member in the research team training in interviewing.
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Timepoint [6]
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6 months and 12 months post initiation of intervention
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Secondary outcome [7]
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Family feedback on acceptability of the mode of delivery of program
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Assessment method [7]
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Custom designed study questionnaire completed by child participant (where possible) and parent
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Timepoint [7]
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6 months and 12 months post initiation of intervention
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Eligibility
Key inclusion criteria
Children who are new patients to the sleep clinic, with a clinician diagnosed ND aged 2-18 years old, and a non-respiratory sleep issue that has been confirmed by a tertiary sleep specialist and requires treatment. Children and caregivers will be required to speak English to a required level to undertake the intervention. Parents with a child that meets inclusion will be invited to participate.
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Minimum age
2
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Children without a clinician diagnosed ND, under 2 years old or over 18 years old, or without diagnosed sleep issues.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Allocation is not concealed
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Randomisation will be undertaken with a pre-generated random number sequence generated by the trial statistician using block randomisation. The randomisation list will be generated using the R statistical software and imported into REDCap. Randomisation will be stratified according to the developmental age group of children (3-5yr, 6-12yr, 13-16yr- assessed by developmental paediatrician) and by site (3 sites). Allocation to the control arm and two intervention arms will occur at a 1:1:1 ratio.
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
1/08/2024
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Actual
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Date of last participant enrolment
Anticipated
31/07/2025
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Actual
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Date of last data collection
Anticipated
31/07/2026
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Actual
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Sample size
Target
150
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
NSW,QLD,VIC
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Recruitment hospital [1]
26151
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Queensland Children's Hospital - South Brisbane
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Recruitment hospital [2]
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The Royal Childrens Hospital - Parkville
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Recruitment hospital [3]
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The Children's Hospital at Westmead - Westmead
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Recruitment postcode(s) [1]
42012
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4101 - South Brisbane
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Recruitment postcode(s) [2]
42013
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3052 - Parkville
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Recruitment postcode(s) [3]
42014
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2145 - Westmead
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Funding & Sponsors
Funding source category [1]
315762
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Government body
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Name [1]
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Australian Department of Health and Aged Care: Medical Research Future Fund (MRFF)
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Address [1]
315762
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Country [1]
315762
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Australia
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Primary sponsor type
University
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Name
The University of Queensland
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Address
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
317945
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Address [1]
317945
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Country [1]
317945
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Other collaborator category [1]
283075
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Hospital
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Name [1]
283075
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Queensland Children's Hospital
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Address [1]
283075
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Country [1]
283075
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Australia
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Other collaborator category [2]
283078
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Hospital
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Name [2]
283078
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Children's Hospital at Westmead
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Address [2]
283078
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Country [2]
283078
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Australia
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Other collaborator category [3]
283079
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Hospital
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Name [3]
283079
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The Royal Children's Hospital Melbourne
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Address [3]
283079
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Country [3]
283079
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
314623
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Children’s Health Queensland Hospital and Health Service Human Research Ethics Committee
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Ethics committee address [1]
314623
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http://www.childrens.health.qld.gov.au/research/human-research-ethics-committee
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Ethics committee country [1]
314623
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Australia
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Date submitted for ethics approval [1]
314623
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13/01/2024
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Approval date [1]
314623
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21/02/2024
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Ethics approval number [1]
314623
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HREC/23/QCHQ/105383
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Ethics committee name [2]
315017
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The University of Queensland Human Research Ethics Committee A
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Ethics committee address [2]
315017
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https://www.uq.edu.au/research/research-support/ethics-integrity-and-compliance/human-ethics
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Ethics committee country [2]
315017
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Australia
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Date submitted for ethics approval [2]
315017
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02/04/2024
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Approval date [2]
315017
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Ethics approval number [2]
315017
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Summary
Brief summary
The primary purpose of this study to evaluate the effectiveness of behavioural sleep interventions for treatment of non-respiratory sleep disorders in children with ND. Alongside this, we hope to determine the optimal mode of delivery of treatment for non-respiratory sleep disorders in children with ND. Therefore, we developed the following two hypothesis: (i) A structured behavioural sleep intervention program will be more effective than standard clinical treatment for the management of non-respiratory sleep problems in children with ND. and (ii) Group telehealth and app delivery of a behavioural sleep intervention program will be as effective as standard clinical care for the management of non-respiratory sleep problems in children with ND.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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A/Prof Jasneek Chawla
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Address
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QLD Children's Hospital, 501 Stanley St, South Brisbane QLD 4101
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Country
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Australia
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Phone
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+61452662105
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Fax
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Email
132198
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[email protected]
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Contact person for public queries
Name
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Kasey Fullwood
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Address
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Centre for Children's Health Research, 62 Graham Street, South Brisbane QLD 4101
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Country
132199
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Australia
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Phone
132199
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+61 07 3069 7503
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Fax
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Email
132199
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[email protected]
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Contact person for scientific queries
Name
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Kasey Fullwood
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Address
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Centre for Children's Health Research, 62 Graham Street, South Brisbane QLD 4101
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Country
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Australia
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Phone
132200
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+61 07 3069 7503
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Fax
132200
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Email
132200
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
21580
Study protocol
[email protected]
21581
Informed consent form
[email protected]
22012
Ethical approval
[email protected]
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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