Knowledge translation of the HELPinKIDS clinical practice guideline for managing childhood vaccination pain: usability and knowledge uptake of educational materials directed to new parents

Abstract

BackgroundAlthough numerous evidence-based and feasible interventions are available to treat pain from childhood vaccine injections, evidence indicates that children are not benefitting from this knowledge. Unrelieved vaccination pain puts children at risk for significant long-term harms including the development of needle fears and subsequent health care avoidance behaviours. Parents report that while they want to mitigate vaccination pain in their children, they lack knowledge about how to do so. An evidence-based clinical practice guideline for managing vaccination pain was recently developed in order to address this knowledge-to-care gap. Educational tools (pamphlet and video) for parents were included to facilitate knowledge transfer at the point of care. The objectives of this study were to evaluate usability and effectiveness in terms of knowledge acquisition from the pamphlet and video in parents of newly born infants.MethodsMixed methods design. Following heuristic usability evaluation of the pamphlet and video, parents of newborn infants reviewed revised versions of both tools and participated in individual and group interviews and individual knowledge testing. The knowledge test comprised of 10 true/false questions about the effectiveness of various pain management interventions, and was administered at three time points: at baseline, after review of the pamphlet, and after review of the video.ResultsThree overarching themes were identified from the interviews regarding usability of these educational tools: receptivity to learning, accessibility to information, and validity of information. Parents’ performance on the knowledge test improved (p≤0.001) from the baseline phase to after review of the pamphlet, and again from the pamphlet review phase to after review of the video.ConclusionsUsing a robust testing process, we demonstrated usability and conceptual knowledge acquisition from a parent-directed educational pamphlet and video about management of vaccination pain. Future studies are planned to determine the impact of these educational tools when introduced in clinical settings on parent behaviors during infant vaccinations.

Minimizing pain during childhood vaccination injections: improving adherence to vaccination schedules

“…The search terms included immune pain, vaccine pain, pain relief, pain strategies, and pain techniques. Additionally, the references found in Taddio et al 6 were investigated for further research not found on the initial electronic search. Inclusion criteria consisted of studies investigating non-pharmacological pain-relieving strategies for vaccination-related pain in children aged 0-18 years.…”

“…6 Further research is needed to identify specific barriers and HCP hesitancy to implement pain control with vaccinations in the outpatient setting. Discovering the gaps of implementing research into practice will assist with improved recommendations and provider education.…”

“…Because there can be long-term sequelae from childhood painful procedures, 6 HCPs should implement measures to reduce vaccination-related pain. Some HCPs may view pain from vaccinations as benign and unavoidable, 7 thus thoughts of implementing measures to reduce pain during vaccinations may be cumbersome and timeconsuming.…”

“…1 A few of the common parental reasons for refusing childhood vaccinations include questioning vaccination safety, distrust of the government, concern about contraindications with a child's underlying medical condition, as well as the pain and anxiety associated with needle puncture. 1,6 Unfortunately, vaccinations are the most common painful and anxiety producing procedures to take place in the outpatient health care clinic, although health care providers (HCPs) usually consider vaccinations to be a benign procedure 7 requiring little intervention. 8 Nevertheless, some children experience intense anxiety regarding vaccinations, a reaction that may result in non-adherence to the recommended vaccination schedule.…”

“…9,10 Vaccination-related pain and anxiety is most often associated with a fear of Despite the fact that needle-associated pain during vaccinations is a surmountable barrier, it is still a main reason for noncompliance to the vaccination schedule. 6,12 Thus, HCPs should be aware of these issues and employ techniques to reduce anxiety and pain during vaccinations, 13 an act that may promote adherence to the vaccination schedule.…”