A clinic-based behavioral intervention to reduce CMV transmission in pregnancy

描述(申请人提供)：巨细胞病毒(CMV)感染是最常见的宫内传播病毒感染，是导致永久性残疾的重要原因，如听力损失、视力丧失、脑瘫和/或儿童认知障碍。在美国，先天性巨细胞病毒感染率从活产儿的0.5%到0.7%不等，在世界许多地区超过1%。鉴于这些事实，重要的是找到预防或降低母体CMV感染风险的策略，从而减少先天性CMV感染。然而，目前还没有预防产妇感染和先天性巨细胞病毒感染的疫苗。我们的目标是开发产前筛查和短暂干预(SBI)，重点是 在先天性巨细胞病毒感染风险增加的人群中，促进降低巨细胞病毒母婴传播风险的行为。我们将通过衡量CMV传播和预防措施的知识增加，洗手和清洁环境表面等防护行为的增加，以及共用幼儿使用的食物、饮料或餐具等危险行为的减少来评估干预的效果。登记参加产前护理的孕妇将被选为行为干预组或对照组，接受标准的产前护理。我们还将评估这一方法的可行性和可接受性。一项可广泛应用于其他临床环境的成功干预措施，不仅对妇女的知识和行为产生影响，而且对降低孕妇及其后代的CMV感染率也具有非常重要的意义。有效和可接受的巨细胞病毒相关行为干预的最终目标将是显著降低美国先天性巨细胞病毒感染的发生率和负担。

DESCRIPTION (provided by applicant): Cytomegalovirus (CMV) infection represents the most common viral infection transmitted in-utero and is a significant cause of permanent disabilities such as hearing loss, vision loss, cerebral palsy and /or cognitive impairment in children. The rate of congenital CMV infection ranges from 0.5-0.7% of live births in the US and exceeds 1% in many parts of the world. In light of these facts, it is important to find strategies that will ether prevent or reduce the risk of maternal, and thereby congenital, CMV infection. However, vaccines to prevent maternal infections and congenital CMV infections are not currently available. Our goal is to develop a prenatal screening and brief intervention (SBI) that will focus on the promotion of behaviors that reduce child- to-mother CMV transmission risk among pregnant women in a population that is at increased risk for congenital CMV infection. We will evaluate the efficacy of the intervention by measuring increased knowledge of CMV transmission and prevention measures, increased use of protective behaviors such as hand washing and cleaning environmental surfaces, and decreased practice of risk behaviors such as sharing food, drink or eating utensils used by young children. Pregnant women who are enrolled in prenatal care will be selected to participate in the behavioral intervention group or a comparison group which will receive standard prenatal care. We will also assess the feasibility and acceptability of this approach. A successful intervention that is adaptable on a larger scale to other clinic settings will be invaluable not only for the impact on women's knowledge and behaviors, but also for decreasing CMV infection rates in pregnant women and their offspring. The ultimate goal of an efficacious and acceptable CMV-related behavioral intervention would be to significantly reduce the incidence and burden of congenital CMV infection in the US.