Abstract
Background: Students experience fear, pain, and fainting during vaccinations at school. While evidence-based interventions exist, no Knowledge Translation (KT) interventions have been developed to mitigate these symptoms. A multidisciplinary team-the Pain Pain Go Away Team- was assembled to address this knowledge-to-care gap. This manuscript provides an overview of the methodology, knowledge products, and impact of an evidence-based KT program developed and implemented to improve the vaccination experience at school. Methods: We adapted knowledge and assessed the barriers to knowledge use via focus group interviews with key stakeholder groups involved in school-based vaccinations: Students, nurses, school staff, and parents. Next, we developed project-specific goals and data collection tools and collected baseline data. We then created a multifaceted KT intervention called The CARDTM System (C-Comfort, A-Ask, R-Relax, D-Distract) to provide a framework for planning and delivering vaccinations using a studentcentred approach. Selected KT tools from this framework were reviewed in additional focus groups held in all stakeholder groups. The multifaceted KT intervention was then finalized and implemented in stages in two projects including grade 7 students undergoing school vaccinations and impact on student outcomes (e.g., symptoms of fear, pain, dizziness) and process outcomes (e.g., utilization of interventions that reduce student symptoms, vaccination rate) were assessed. Results: Participants reported that improving the vaccination experience is important. Based on participant feedback, an evidence-based multifaceted KT intervention called The CARDTM System was developed that addresses user needs and preferences. Selected KT tools of this intervention were demonstrated to be acceptable and to improve knowledge and attitudes about vaccination in the stakeholder groups. In two separate implementation projects, CARDTM helped grade 7 students prepare for vaccinations and positively impacted on their vaccination experiences. CARDTM improved vaccination experiences for other stakeholder groups as well. There was no evidence of an impact on school vaccination rates. Conclusion: We developed and implemented a promising multifaceted KT intervention called The CARDTM System to address vaccination-associated pain, fear, and fainting. Future research is recommended to determine impact in students of different ages and in different geographical regions and clinical contexts.
| Original language | English |
|---|---|
| Pages (from-to) | S3-S18 |
| Journal | Paediatrics and Child Health |
| Volume | 24 |
| DOIs | |
| Publication status | Published - Mar 29 2019 |
Bibliographical note
Funding Information:The authors thank the students and parents who participated in this project. We also thank the staff at Niagara Region Public Health and The Niagara Catholic District School Board for their commitment to improving the quality of care provided at their respective organizations. FundingInformation: This project was funded by the Canadian Institutes of Health Research Knowledge to Action Grant (KAL-147564). Potential Conflicts of Interest: AT reports Section 9 Trademark No. 924835 for CARD. LMB reports that Immunize Canada received grants from Pfizer Canada, Merck Canada, GSK Canada, Seqirus Canada and Sanofi Pasteur outside the submitted work. There are no other disclosures. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed. Pain Pain Go Away Team: Tamlyn Freedman BAS1, Tori McDowall RN6, Horace Wong MSc1, Kate Robson7, Christine Halpert RN MA8, Evelyn Wilson MAEd BPHE9, Jocelyn Cortes RN10, M. Mustafa Hirji MD MPH6, Cathryn Schmidt2, Srdjana Filipovic PhD2, Melanie Badali PhD11 1Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario; 2The Hospital for Sick Children, Toronto, Ontario; 6Niagara Region Public Health & Emergency Services, Thorold, Ontario; 7Canadian Family Advisory Network; 8British Columbia Centre for Disease Control; 9Ontario Institute for Studies in Education, University of Toronto; 10Ontario Ministry of Health and Long-Term Care; 11AnxietyBC, Vancouver, British Columbia
Publisher Copyright:
© The Author(s) 2019.
ASJC Scopus Subject Areas
- Pediatrics, Perinatology, and Child Health
