NCT06989593

Brief Summary

The goal of this clinical trial is to learn whether a journaling intervention can reduce stress and anxiety in parents of children with urogenital conditions (such as differences of sex development and hypospadias). The main questions it aims to answer are:

  • Does guided journaling help to reduce anxiety levels in parents of children with urogenital conditions?
  • What are parents' perspectives on group-based writing interventions for future support programs? Participants will:
  • Complete a short anxiety questionnaire (the General Anxiety Disorder-7 scale) at the beginning of the study
  • Receive a physical journal with 5 writing prompts designed to help process emotions related to their child's condition
  • Complete 5 journal entries over several weeks, writing about their experiences and feelings
  • Complete the same anxiety questionnaire again after finishing the journal entries
  • Participate in a 45-minute interview to discuss how the journaling affected their stress levels and gather feedback on potential group-based writing programs

Trial Health

57
Monitor

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Trial has exceeded expected completion date
Enrollment
20

participants targeted

Target at below P25 for not_applicable

Timeline
Completed

Started Oct 2025

Shorter than P25 for not_applicable

Geographic Reach
1 country

1 active site

Status
recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

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Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

May 22, 2025

Completed
3 days until next milestone

First Posted

Study publicly available on registry

May 25, 2025

Completed
5 months until next milestone

Study Start

First participant enrolled

October 10, 2025

Completed
7 months until next milestone

Primary Completion

Last participant's last visit for primary outcome

May 1, 2026

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

May 1, 2026

Completed
Last Updated

October 23, 2025

Status Verified

May 1, 2025

Enrollment Period

7 months

First QC Date

May 22, 2025

Last Update Submit

October 22, 2025

Conditions

Keywords

Disorders of Sex DevelopmentHypospadiasAnxietyStress, PsychologicalParentsPsychological AdaptationWritingNarrative TherapyQualitative ResearchPatient ParticipationSocial SupportMental HealthInterpersonal RelationsParent-Child RelationsUrogenital AbnormalitiesFemale Urogenital DiseasesUrogenital DiseasesPenile DiseasesGenital Diseases, MaleGenital DiseasesMale Urogenital DiseasesCongenital AbnormalitiesGonadal DisordersEndocrine System Diseases

Outcome Measures

Primary Outcomes (1)

  • Change in GAD-7 Anxiety Scores

    Change from baseline in General Anxiety Disorder-7 (GAD-7) scores. The GAD-7 is a validated 7-item self-report questionnaire used to assess anxiety symptom severity. Scores range from 0-21, with higher scores indicating greater anxiety symptoms.

    Change from baseline (pre-intervention) to approximately 6 weeks post-intervention initiation

Secondary Outcomes (4)

  • Qualitative Assessment of Anxiety Related to Child's Diagnosis

    Measured at one follow-up interview, approximately 6 weeks after intervention initiation

  • Changes in Parental Coping Strategies

    Measured at one follow-up interview, approximately 6 weeks after intervention initiation

  • Interest in Group-Based Writing Interventions

    Approximately 6 weeks after intervention initiation

  • Feasibility and Acceptability of Journaling Intervention

    Approximately 6 weeks after intervention initiation

Study Arms (1)

Narrative Medicine Journaling Intervention

EXPERIMENTAL

All participants in this single-arm pilot study will complete baseline GAD-7 anxiety assessments, participate in a guided journaling program, complete follow-up GAD-7 assessments, and take part in a qualitative interview. Parents of children with urogenital conditions (differences of sex development and hypospadias) will receive the narrative medicine intervention over a period of several weeks, with pre- and post-intervention anxiety measurements and interview assessments.

Behavioral: Narrative Medicine Journaling Intervention

Interventions

Participants will complete the GAD-7 anxiety assessment at baseline. They will then receive a physical journal containing 5 structured, therapeutic writing prompts designed to help process emotions related to their child's diagnosis. Prompts focus on processing experiences with diagnosis, addressing uncertainty, coping with stigma, and developing resilience. Parents will be instructed to complete the 5 journal entries, spending 15-20 minutes on each writing session at least once per week. Following completion of the journaling intervention, participants will complete a follow-up GAD-7 assessment and take part in a 30-45 minute qualitative interview to further assess perceived changes in anxiety, stress, and coping strategies, and to gather feedback on potential group-based writing programs.

Also known as: Therapeutic Writing, Reflective Journaling, Guided Narrative Intervention, Narrative Medicine
Narrative Medicine Journaling Intervention

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersYes
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Parent or legal guardian of a child (age 0-17 years) diagnosed with a urogenital condition (differences of sex development and/or hypospadias)
  • Able to read and understand English
  • Child receives care at Boston Children's Hospital
  • Willing to complete a guided journaling intervention (through writing or dictation) over a period of approximately 5 weeks
  • Willing to participate in a 45 minute follow-up interview
  • Able to provide informed consent

You may not qualify if:

  • Parent/guardian with severe psychiatric disorder that would interfere with participation as determined by referring physician
  • Parent/guardian unable to complete either written journaling activities or dictation
  • Inability to provide informed consent

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Boston Children's Hospital

Boston, Massachusetts, 02115, United States

RECRUITING

MeSH Terms

Conditions

HypospadiasDisorders of Sex DevelopmentAnxiety DisordersStress, PsychologicalPatient ParticipationPsychological Well-BeingUrogenital AbnormalitiesFemale Urogenital DiseasesUrogenital DiseasesPenile DiseasesGenital Diseases, MaleGenital DiseasesMale Urogenital DiseasesCongenital AbnormalitiesGonadal DisordersEndocrine System Diseases

Condition Hierarchy (Ancestors)

Female Urogenital Diseases and Pregnancy ComplicationsCongenital, Hereditary, and Neonatal Diseases and AbnormalitiesMental DisordersBehavioral SymptomsBehaviorPatient Acceptance of Health CareTreatment Adherence and ComplianceHealth BehaviorPersonal Satisfaction

Central Study Contacts

Study Design

Study Type
interventional
Phase
not applicable
Allocation
NA
Masking
NONE
Purpose
SUPPORTIVE CARE
Intervention Model
SINGLE GROUP
Sponsor Type
OTHER
Responsible Party
SPONSOR INVESTIGATOR
PI Title
Attending Physician in Endocrinology, Instructor of Pediatrics

Study Record Dates

First Submitted

May 22, 2025

First Posted

May 25, 2025

Study Start

October 10, 2025

Primary Completion

May 1, 2026

Study Completion

May 1, 2026

Last Updated

October 23, 2025

Record last verified: 2025-05

Data Sharing

IPD Sharing
Will not share

Individual participant data (IPD) will not be shared because this pilot study primarily collects sensitive qualitative data through personal narratives and interviews concerning parents' experiences with their children's urogenital conditions. The small sample size and detailed personal accounts could potentially lead to participant identification even if de-identified, raising significant confidentiality and privacy concerns. Additionally, during the informed consent process, participants will not have been specifically asked for permission to share their raw data beyond the research team. The study will instead focus on sharing aggregate findings and thematic analyses while protecting participants' confidentiality. If future researchers are interested in the data, specific requests may be considered by the IRB on a case-by-case basis with appropriate data use agreements.

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