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Trial registered on ANZCTR
Registration number
ACTRN12615000397516
Ethics application status
Approved
Date submitted
2/04/2015
Date registered
29/04/2015
Date last updated
29/04/2015
Type of registration
Retrospectively registered
Titles & IDs
Public title
A cluster randomised trial to evaluate the effectiveness of a telephone based coaching program in reducing excessive gestational weight gain amongst pregnant women
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Scientific title
Evaluation of a telephone based information and coaching program to reduce excessive gestational weight gain amongst pregnant women
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Secondary ID [1]
286471
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Nil
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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:
Gestational weight gain
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Condition category
Condition code
Public Health
294959
294959
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0
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Health promotion/education
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Reproductive Health and Childbirth
294960
294960
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0
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Antenatal care
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Diet and Nutrition
295006
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0
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Obesity
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Women in the intervention group will be enrolled in a coaching program run by the Get Healthy Service which has been adapted specifically for pregnant women (the GWG module). The coaching program comprises up to 10 calls between 15 - 40 minutes in duration by university qualified coaches (8 during pregnancy and 2 after birth). The length is directed by the participant, and can be flexible. Similar to the standard GHS, the calls are aimed at healthy eating, physical activity and achieving healthy weight gain during pregnancy. Calls are based on behaviour change principles designed to help with goal setting, maintaining motivation, overcoming barriers and making sustainable life changes. The timing of calls is designed to be flexible based on participant preferences. Generally, the schedule for calls pre-delivery: 3 calls in the first 3 weeks, followed by a call every 2-3 weeks, unless requested otherwise from the participant. For post pregnancy calls: 1 call at 10 weeks, 1 call at 14 weeks post delivery, unless requested otherwise by the participant.
Participants in the coaching arm will receive 10 calls: 8 during pregnancy, 2 post pregnancy. Fewer calls may be conducted if the woman withdraws from the Service, or delivers before her 7th call.
Compliance to the study will be monitored by recording the number and dates of coaching calls received by a participant and recording reason for withdrawing from the Service in the case of withdrawals
Participants in the coaching program will also be provided with evidence based materials including pregnancy specific fact sheets, the Having a Baby Book published by NSW Health and the Get Healthy Information booklet which includes generic advice on healthy eating, physical activity and achieving and maintaining a healthy weight. All pregnancy specific content is developed based on nationally and internationally endorsed guidelines such as the Australian Dietary Guidelines and US Institute of Medicine Weight Gain during Pregnancy guidelines.
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Intervention code [1]
291559
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Lifestyle
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Comparator / control treatment
In additional to usual care provided by the antenatal clinic, women in the control group will receive the evidence based package of materials described above, including advice on healthy eating, physical activity and achieving healthy weight gain during pregnancy. Usual care for this study is the routine care women receive as part of their antenatal appointments in the hospitals.
Participants will receive 1 coaching and information call from the Get Healthy Service coach in addition to their usual care, after referral from her midwife (at or before 22 weeks gestation). It is anticipated that the duration of the call will be between 30 to 40 minutes.
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Control group
Active
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Outcomes
Primary outcome [1]
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Weight, self reported by participants.
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Assessment method [1]
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Timepoint [1]
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Baseline when intervention starts, 36 weeks of pregnancy and 12 months post birth
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Secondary outcome [1]
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Overall fruit and vegetable intake, self-reported during telephone interview
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Assessment method [1]
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Timepoint [1]
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Baseline when intervention starts, 36 weeks of gestation and 12 months post birth
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Secondary outcome [2]
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Perception of the service by participants (continuing and non-continuing), midwives, nursing unit managers and medical practitioners. Interviews will be conducted with purposefully selected participants.
The composite outcomes from the interviews will be used to further enhance the program.
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Assessment method [2]
314001
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Timepoint [2]
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Ongoing as appropriate during the study period.
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Eligibility
Key inclusion criteria
Pregnant women
Women with conditions that may potentially require minor adaptation of the standard dietary or physical activity to participate in the program safely will require clearance from a medical practitioner. All conditions are listed in the protocol.
Some examples of conditions that require medical clearance include:
Hypertension
Epilepsy
Asthma Moderate (women requiring daily bronchodilators and steroid inhalers)
Type 2 diabetes (diet controlled)
Musculo-skeletal problems
Previous pre-term birth
Recurrent miscarriage
(Note that this is not an exhaustive list)
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Females
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
1. Pre-pregnancy BMI < 18.5 kg/m2;
2. Gestation of over 18 weeks;
3. Non English speaking;
4. Multiple pregnancy; and
5. Women with complex medical conditions
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Study design
Purpose of the study
Prevention
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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)
This study will be a stratified cluster randomised trial, with stratification by pre-pregnancy BMI (normal and overweight/obese) and clustering by hospital. Pregnant women at each hospital recruited into the trial on their first booking visit in the relevant arms.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Hospitals within geographic classification (rural or metropolitan) will be randomised into either the control and intervention arm using excel random number generator function.
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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
The sample size has been calculated based on the ability to detect a difference of 3 kgs in gestational weight gain between intervention and control groups, at 80% power and with expected attrition rate of 30%. Of the 640 women, approximately 165 in total would fall into the normal category and 475 into the overweight/obese category.
Differences between the two groups in mean weight gain will be tested using the independent samples t-test, and the proportion returning to their pre-pregnancy weight 12 months post birth will be analysed using the X2 test.
Multivariate regression models will be used to estimate odds ratios for gestational weight gain with age, pre-pregnancy BMI, dietary and physical activity scores, weight gain during pregnancy and the type of intervention as independent variables.
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
2/09/2014
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Actual
2/09/2014
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Date of last participant enrolment
Anticipated
31/12/2015
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
640
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
NSW
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Recruitment hospital [1]
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Liverpool Hospital - Liverpool
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Recruitment hospital [2]
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Dubbo Base Hospital - Dubbo
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Recruitment hospital [3]
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Orange Health Service - Orange
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Recruitment hospital [4]
3653
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Lismore Base Hospital - Lismore
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Recruitment hospital [5]
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Blacktown Hospital - Blacktown
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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NSW Office of Preventive Health
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Address [1]
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Liverpool Hospital, Don Everett Building.
Locked Bag 7103
Liverpool BC
1871 NSW
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Country [1]
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Australia
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Primary sponsor type
Government body
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Name
NSW Office of Preventive Health
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Address
Liverpool Hospital, Don Everett Building.
Locked Bag 7103
Liverpool BC
1871 NSW
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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]
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NA
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Address [1]
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NA
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Country [1]
289722
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Other collaborator category [1]
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Government body
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Name [1]
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NSW Kids and Families
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Address [1]
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73 Miller Street
North Sydney
2060 NSW
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Country [1]
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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SWSLHD Human Research Ethics Committee
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Ethics committee address [1]
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Liverpool Hospital Locked Bag 7103 Liverpool BC 1871 NSW
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
292623
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Approval date [1]
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26/06/2014
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Ethics approval number [1]
292623
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HREC/14/LPOOL/131
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Summary
Brief summary
Excessive gestational weight gain (EGWG) or weight gain during pregnancy is associated with poor child and maternal health outcomes, including preeclampsia, gestational diabetes, complications with labour and delivery, and babies who are born either small or large for gestational age. There is also an increased likelihood of postpartum obesity in both mothers and their children, which in turn leads to an increased risk of chronic disease later in life. Estimates from one off studies indicate the prevalence of EGWG in Australia could lie between 38 and 67%. The NSW Get Healthy Service (GHS) is a telephone based coaching service available to all adults in NSW aged 18 years and over. The NSW Office of Preventive Health (OPH) and NSW Kids and Families have collaborated to develop a service enhancement or “module” for the GHS specifically aimed at supporting pregnant women to achieve appropriate gestational weight gain. An initial pilot phase for the module is proposed to assess effectiveness of the coaching program, through conduct of a randomised controlled trial. This RCT will compare the effectiveness of a telephone based coaching program versus provision of information alone in supporting pregnant women to achieve appropriate gestational weight gain and prevent postpartum weight retention. The hypothesis is that compared with participants who only receive information, pregnant women enrolled in the coaching program will be less likely to achieve excessive gestational weight, and be more likely to have returned to their prepregnancy weight 12 months after giving birth. A stratified cluster randomised design will be used, with stratification by prepregnancy BMI (normal and overweight/obese) and clustering by hospital. Four hospitals will be invited to participate, with two allocated to the control arm and two to the intervention arm. Pregnant women will be invited to participate in the trial on their first booking visit with a midwife, and allocated to an arm depending on the hospital they attend. Anthropometric (e.g. weight gain or retention) and behavioural (e.g. fruit and vegetable consumption) outcomes for each group will be compared at 36 weeks gestation and 12 months post birth. Additionally, qualitative feedback on the feasibility and acceptability of the module (information and coaching components) will be sought from participants and midwives.
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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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Ms Michelle Maxwell
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Address
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Liverpool Hospital, Don Everett Building.
Locked Bag 7103
1871 NSW
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Country
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Australia
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Phone
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+61 2 8738 6503
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Michelle Maxwell
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Address
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Liverpool Hospital, Don Everett Building.
Locked Bag 7103
1871 NSW
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Country
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Australia
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Phone
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+61 2 8738 6503
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Santosh Khanal
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Address
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Liverpool Hospital, Don Everett Building.
Locked Bag 7103
1871 NSW
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Country
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Australia
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Phone
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+61 2 8738 7231
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Fax
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
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.
Download to PDF