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NCT Number: NCT07531862

Spina Bifida Healthcare Navigator Program

Many adults with spina bifida experience difficulties managing their health-such as coordinating care across multiple providers, keeping up with medications, and navigating insurance systems. These tasks require strong thinking skills like planning, organizing, and problem-solving, which are often called "executive functions." Many adults with spina bifida have challenges with these skills due to differences in brain development associated with the condition. When a person's thinking abilities do not match the demands placed on them by their healthcare and daily routines, health problems often follow. Despite this, very few programs exist to help adults with spina bifida address this gap.

This study tests a new program called ALIGN (Navigating Life with Spina Bifida), developed at the UPMC Adult Spina Bifida Clinic. ALIGN was co-designed with a healthcare provider who is also an adult living with spina bifida. The program helps participants improve the fit between their abilities and their environment through two approaches: building personal skills and strategies, and arranging supports and routines to make demands more manageable. ALIGN includes six virtual group sessions and one individual session with a clinician.

Participants will be adults (age 18 or older) with spina bifida. They will complete questionnaires before and after the program measuring confidence in managing health, mood, and ability to participate in daily activities. A separate group of participants who do not take part in ALIGN will complete the same questionnaires for comparison. The main goals are to determine whether ALIGN is practical to deliver, acceptable to participants, and associated with early signs of benefit.

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This study is active but is not currently recruiting participants.

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Key information

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

University of Pittsburgh/UPMC

Pittsburgh, Pennsylvania, 15219, United States

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Adults (18 years or older) diagnosed with spina bifida (SB), including any type (e.g., myelomeningocele, meningocele, lipomyelomeningocele).
  • Individuals who are able to participate in educational and interactive sessions (in-person at UPMC Mercy or remotely via secure teleconferencing).
  • English fluency

Exclusion criteria

  • Under 18 years of age
  • Non-English fluency

Treatment and study plan

Behavioral Treatment

Behavioral

The intervention being tested in this study (ALIGN) is designed to improve the fit between an individual's abilities and their environment. This is accomplished through two complementary approaches: building personal skills and strategies ("build"), and arranging supports and routines to make demands more manageable ("scaffold"). ALIGN includes six virtual group sessions and one individual session with a clinician. The intervention fits within the broad umbrella of "third-wave" cognitive-behavioral therapies. It emphasizes psychological flexibility as an important treatment component.

Other names: Spina Bifida Healthcare Navigator Program

Primary outcomes

  1. Acceptability of Intervention Measure (AIM)

    Time frame: post-intervention (approximately two months after enrollment; administered only to participants assigned to the intervention group)

    This measure assesses perceived acceptability of an intervention. The scale consists of 4 items, each rated on a 5-point Likert scale (1 = completely disagree to 5 = completely agree). Scores are calculated as the mean of all items, yielding a score range of 1 to 5. Higher scores indicate greater perceived acceptability. No items are reverse scored.

  2. Intervention Appropriateness Measure (IAM)

    Time frame: post-intervention (approximately two months after enrollment; administered only to participants assigned to the intervention group)

    This measure assesses perceived appropriateness of an intervention, defined as its perceived fit, relevance, or compatibility for a given context or population. The scale consists of 4 items, each rated on a 5-point Likert scale (1 = completely disagree to 5 = completely agree). Scores are calculated as the mean of all items, yielding a score range of 1 to 5. Higher scores indicate greater perceived appropriateness. No items are reverse scored.

  3. Feasibility of Intervention Measure (FIM)

    Time frame: post-intervention (approximately two months after enrollment; administered only to participants assigned to the intervention group)

    This measure assesses perceived feasibility of implementing an intervention within a given setting. The scale consists of 4 items, each rated on a 5-point Likert scale (1 = completely disagree to 5 = completely agree). Scores are calculated as the mean of all items, yielding a score range of 1 to 5. Higher scores indicate greater perceived feasibility. No items are reverse scored.

Secondary outcomes

  1. Change in PROMIS Depression Measure

    Time frame: Enrollment to approximately two months

    This measure assesses severity of depressive symptoms, including affective and cognitive components of depression. Scores are reported as T-scores standardized to the U.S. general population (mean = 50, standard deviation = 10). Higher T-scores indicate greater depressive symptom severity. Scores are generated using PROMIS computer adaptive testing algorithms; raw item scores are not summed.

  2. Change in Partners in Health (PIH) Scale

    Time frame: Enrollment to approximately two months

    The PIH Scale assesses self-management capacity in individuals with chronic health conditions, including knowledge, treatment adherence, symptom monitoring, and management of physical, emotional, and social impacts. The scale includes 12 items, each rated from 0 to 8, producing a total score range of 0-96. Higher scores indicate greater self-management capacity. Item scores are summed to compute the total score; subscale scores (e.g., condition and treatment knowledge, coping, condition management, treatment adherence) may also be examined descriptively but are not required for total score computation.

  3. Change in Acceptance and Action Questionnaire-2 (AAQ-2)

    Time frame: Enrollment to approximately two months

    The AAQ-2 measures psychological inflexibility and experiential avoidance, core constructs within Acceptance and Commitment Therapy. The scale contains 7 items, each rated on a 7-point Likert scale (1-7), yielding a total score range of 7-49. Higher total scores indicate greater psychological inflexibility and experiential avoidance, whereas lower scores indicate greater psychological flexibility. Items are summed after required reverse scoring to produce the total score.

  4. Change in PROMIS Self-Efficacy (Managing Daily Activities)

    Time frame: Enrollment to approximately two months

    This measure assesses perceived confidence in performing various activities of daily living related to chronic health conditions, such as routine tasks, exercise, and managing activities in challenging situations. Scores are reported as T-scores standardized to a calibration population (mean = 50, standard deviation = 10). Higher T-scores indicate greater self-efficacy in managing daily activities. Scores are generated using PROMIS computer adaptive testing algorithms based on item response theory; raw item scores are not summed.

  5. Change in PROMIS Participation Measure

    Time frame: Enrollment to approximately two months

    This measure assesses perceived ability to participate in social roles and activities, including work, family, and community functioning. Scores are reported as T-scores standardized to the U.S. general population (mean = 50, standard deviation = 10). Higher T-scores indicate greater ability to participate in social roles and activities. Scores are generated using PROMIS computer adaptive testing algorithms based on item response theory; raw item scores are not summed.

  6. Change in PROMIS Anxiety Measure

    Time frame: Enrollment to approximately two months

    This measure assesses severity of anxiety symptoms, including fear, worry, and physiological arousal. Scores are reported as T-scores standardized to the U.S. general population (mean = 50, standard deviation = 10). Higher T-scores indicate greater anxiety symptom severity. Scores are generated using PROMIS computer adaptive testing algorithms; raw item scores are not summed.

  7. Change in PROMIS Self-Efficacy (Managing Symptoms)

    Time frame: Enrollment to approximately two months

    This measure assesses perceived confidence in the ability to manage and control symptoms associated with chronic health conditions across a variety of settings and situations. Scores are reported as T-scores standardized to a calibration population (mean = 50, standard deviation = 10). Higher T-scores indicate greater self-efficacy in managing symptoms. Scores are generated using PROMIS computer adaptive testing algorithms based on item response theory; raw item scores are not summed.

  8. Change in PROMIS Self-Efficacy (Managing Medications and Treatments)

    Time frame: Enrollment to approximately two months

    This measure assesses perceived confidence in managing medication regimens and treatment-related tasks associated with chronic health conditions, including adherence, scheduling, and navigating treatment decisions. Scores are reported as T-scores standardized to a calibration population (mean = 50, standard deviation = 10). Higher T-scores indicate greater self-efficacy in managing medications and treatments. Scores are generated using PROMIS computer adaptive testing algorithms based on item response theory; raw item scores are not summed.

  9. Change in PROMIS Self-Efficacy (Managing Emotions)

    Time frame: Enrollment to approximately two months

    This measure assesses perceived confidence in managing emotional responses related to living with chronic health conditions, including worry, frustration, and discouragement. Scores are reported as T-scores standardized to a calibration population (mean = 50, standard deviation = 10). Higher T-scores indicate greater self-efficacy in managing emotions. Scores are generated using PROMIS computer adaptive testing algorithms based on item response theory; raw item scores are not summed.

  10. Change in PROMIS Self-Efficacy (Managing Social Interactions)

    Time frame: Enrollment to approximately two months

    This measure assesses perceived confidence in managing social situations and interpersonal interactions related to living with chronic health conditions, including communicating needs and participating in social activities. Scores are reported as T-scores standardized to a calibration population (mean = 50, standard deviation = 10). Higher T-scores indicate greater self-efficacy in managing social interactions. Scores are generated using PROMIS computer adaptive testing algorithms based on item response theory; raw item scores are not summed.

Other outcomes

  1. Change in Grit-12

    Time frame: Enrollment to approximately two months

    The Grit-12 measures perseverance of effort and consistency of interests toward long-term goals. It contains 12 items rated on a 5-point Likert scale, producing a total score range of 1-5 when averaged. Higher scores indicate greater grit. Items are averaged after appropriate reverse scoring to compute the total score; subscale scores for perseverance and consistency may also be derived.

  2. Change in Interpersonal Support Evaluation List-12 (ISEL-12)

    Time frame: Enrollment to approximately two months

    The ISEL-12 assesses perceived availability of social support, including appraisal, belonging, and tangible support. The scale includes 12 items rated on a 4-point Likert scale, yielding a total score range of 12-48. Higher scores indicate greater perceived social support. Item scores are summed to produce the total score; subscale scores (e.g., appraisal, belonging, tangible support) can also be computed.

Sponsors and collaborators

Lead sponsor

University of Pittsburgh

Other

Collaborators

  • Fisa Foundation

Registry information

Official study title

Spina Bifida Healthcare Navigator Program: A Pilot Trial of the ALIGN Contextual-Behavioral Intervention

Acronym: ALIGN

Important dates

Study start
2026
Primary completion
2026
Study completion
2026
First posted
Apr 15, 2026
Registry last updated
Jun 4, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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