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Bowel and Bladder Continence Among Children with Spina Bifida: A Prospective Study
The lack of effective bladder and/or bowel control is a significant barrier to the normal social and emotional development of children and adolescents with Spina Bifida. The study proposed in this application will employ a standard, systematic protocol for assessing continence, bowel/bladder regimen performance, regimen adherence, and specific barriers to adherence. This protocol will result in the individually tailored use of a standard approach to continence training including:
- Behavioral skills training (e.g., clean intermittent catherization (CIC), toilet schedule, medication and dietary regimen management) and timed toileting.
- An individually programmed Medical Digital Assistant (pager system) for organizing and prompting critical bowel/bladder management and other medical self-care tasks.
The specific aims of the study are:
- To determine the effects of a behavioral intervention protocol implemented to identify and modify barriers to neurogenic bowel/bladder management adherence for individuals with spina bifida.
- To evaluate the effects of the behavioral intervention on adherence with the prescribed medical regimen.
- To determine if a behavioral intervention can have a significant impact on measures of continence, quality of life, and secondary medical complications related to neurogenic bowel and bladder.
Hypothesis I: The provision of a state-of-the-art Behavioral Intervention Protocol for assessing and modifying barriers to medical regimen adherence will significantly increase rates of partial and complete continence in children with SB compared to a Usual Care control group.
Hypothesis II: The provision of a state-of-the-art Behavioral Intervention Protocol for assessing and modifying barriers to medical regimen adherence will significantly increase health-related quality of life in children with SB compared to a Usual Care control group.