Encopresis
Conditions
Keywords
Encopresis, Internet, Web, Treatment, Intervention
Brief summary
Encopresis, also known as fecal incontinence, is the voluntary or involuntary passage of stools causing soiling of clothes by a child over 4 years of age. The purpose of this study is to evaluate an Internet intervention for the treatment of encopresis.
Detailed description
An estimated 2.3% of children suffer from encopresis. Enhanced Toilet Training (ETT) is one of the most effective ways of treating this disorder. When delivered by skilled and knowledgeable clinicians, ETT is twice as effective as intensive medical management alone. Although ETT is effective in treating encopretic children, there are six major barriers to its implementation: 1) availability of a knowledgeable and skilled clinician; 2) parental acceptance of referral to a mental health professional; 3) expense of service; 4) burden of time and distance to access such specialty services; 5) child resistance to disclosure of embarrassing material; and 6) willingness of the child and parent to follow treatment recommendations. This project will circumvent these barriers by developing an interactive Internet-based ETT program. The study will then assess the feasibility of the program by determining the acceptance, function, and effectiveness of the intervention. This project will have four phases. Phase 1 will identify optimal Internet and treatment elements as well as issues in need of experimental investigation. Phase 2 will investigate how to enhance Internet interventions. Phase 3 will evaluate the relative benefit of adding the Internet treatment to clinical services provided by clinicians in the fields of medicine and mental health. Phase 4 will investigate the relative long-term benefits of adding such an Internet-based intervention to professional care to determine its impact on symptom improvement, relapse prevention, quality of life, and its cost-effectiveness. Phase 4 will also assess to what extent the program is disseminated worldwide when made available on the Internet.
Interventions
BEHAVIORALInternet-based intervention UCanPoopToo
Internet-based intervention to administer Enhanced Toilet Training (ETT).
BEHAVIORALtreatment as usual
Routine clinical care.
Sponsors
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
University of Virginia
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
6 Years to 12 Years
Healthy volunteers
Yes
Inclusion criteria
* Child seen by pediatrician, family physician, or psychologist for the treatment of encopresis * Access to the Internet, either through a family computer or a community computer
Exclusion criteria
* Diagnosis of either mental retardation (IQ \< 85) or * A primary illness responsible for fecal soiling (e.g., spina bifida)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Fecal accident outcomes with online diary data | Pre, Post (4-6 weeks), and one year Post after the intervention period (4-6 weeks) | Number of accidents per 2 week period |
| Success and cure rates | Post (4-6 weeks) and one year Post after the intervention period (4-6 weeks) | Success rate as defined by having zero or one fecal accident over a two week period. Cure rate as defined by having zero accidents over the previous two weeks. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Parent knowledge of encopresis | Pre, Post (4-6 weeks), and one year Post after the intervention period (4-6 weeks) | Parent knowledge of encopresis was assessed on a revised version of the Encopresis Knowledge Scale (EKS). |
| Encopresis Cost Analysis | Pre and Post (4-6 weeks) | Participants quantified items and events that occurred which contribute to the cost of encopresis such as number of diapers used, number of school days missed, number of parent trips to school, and clean-out procedures then cost estimates were applied to each. |
| Virginia Encopresis Constipation Apperception Test (VECAT) | Pre, Post (4-6 weeks), and one year Post after the intervention period (4-6 weeks) | Parent assessment of child's bowel specific problems related to encopresis and constipation. |
| Fecal accident outcomes with retrospective data | Pre, Post (4-6 weeks), and one year Post after the intervention period (4-6 weeks) | Number of accidents per 2 week period |
Other
| Measure | Time frame | Description |
|---|---|---|
| Usage patterns of the Internet intervention | Post (4-6 weeks) | Usage (number of Cores completed; number of Follow-ups completed and Modules assigned) |
| Internet Intervention Utility Measure of Satisfaction | Post (4-6 weeks) | Parent and child rated their satisfaction with the Internet intervention using the Internet Intervention Utility Questionnaire. |
Countries
United States
Outcome results
None listed