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Researchers from the University of Toronto and the Hospital for Sick Children (SickKids) have collaborated with educators, public health practitioners and grade 7 students from Ontario to develop and implement a new school-based vaccine delivery approach that improves student experience.
The CARD system (Comfort, Ask, Relax, Distract) is a fact-based approach that can be implemented as a clbadroom game to help students better prepare for vaccination clinics, thus improving their experiences. The findings were published in the form of a series of studies in a special open source edition of Paediatrics & Child Health, the official journal of the Canadian Pediatric Society.
"Vaccine hesitation has been identified as a major threat to global health," said Anna Taddio, lead author and researcher at the Leslie Dan School of Pharmacy at the University of California. Toronto and Senior Associate Scientist at SickKids.
"While school-based programs are an effective way to provide vaccines that help protect young people and prevent the spread of the disease, many young people have negative experiences because of the fear of pain badociated with the disease. 39; injection ".
"The fear of pain and bites, combined with negative experiences, can lead to vaccine refusal and even a longer-term reluctance to make full use of lifelong health services," says Taddio, expert recognized internationally for pain in children.
The CARD system allows students to select the coping strategies that they wish to use during the vaccination by selecting a letter from the CARD system.
During the immunization day, nurses explicitly ask students about their level of fear and explain what cards they want to play to help them cope and support their choices. For example, a student may wish to play in category "A" and request to be vaccinated in a private place, or "D" and bring an electronic device to serve as a distraction.
This approach was implemented as part of a controlled clinical trial involving 10 schools in the Niagara region. The results showed improved student symptoms and increased use of CARD tools. The students, educators and public health nurses involved were satisfied with the approach and expressed their support for continuing to use CARD beyond the study. The Niagara Region has now implemented the CARD system in all schools in their area.
"CARD is the first knowledge translation tool incorporating all that is known about reducing pain, fear and fainting into a simple, inexpensive and attractive training approach for young people," he said. Taddio.
Involving young people in the design and development of CARD was crucial because it allowed the tools to be developed according to the needs and preferences of the students.
"The CARD system is a highly intuitive and intentional approach to vaccination that enhances the vaccination experience of students," said Leslie Alderman, Vaccine Preventable Disease Supervisor at Niagara Public Health and a member of the Public Health Agency. Go Away Pain Pain project team who oversaw the implementation project.
Earlier this year, the World Health Organization (WHO) had identified vaccine reluctance as one of the top ten threats to global health, alongside climate change, antimicrobial resistance and Ebola. Taddio believes that recognizing barriers to immunization, such as fear and pain, and then designing approaches to overcome them, should help to improve vaccine hesitancy over time. Talking to students about their needles and fears did not make them more frightened or did not want to be vaccinated.
The pilot implementation project has shown a reduction in fear and vertigo, as well as a reduced number of children returning to the clinic after their vaccination with badociated symptoms. However, the pilot project did not show badimilation of vaccinations by students.
"This is not totally surprising," says Taddio. "CARD represents a major shift in the way we provide school-based vaccines and it will take some time before we can begin to measure the impact of CARD on vaccination rates." But it's also important to note that we have not seen a drop in vaccination rates, either. "
CARD tools are now available to educators, public health practitioners, students and families at http://www.aboutkidshealth.ca/CARD
This project was funded by the Knowledge to Action Grant of the Canadian Institutes of Health Research
Source: Hospital for Sick Children
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