title: Educational outreach to reduce immunization pain in office settings.
abstract: OBJECTIVE
  The goal was to examine the impact of a teaching module on immunization pain reduction practices in pediatric offices 1 and 6 months after the intervention.
  
  
  METHODS
  Fourteen practices were selected randomly to receive a 1-hour teaching session on immunization pain reduction techniques, and 13 completed the study. Before the intervention, telephone interviews were conducted with parents concerning their children's recent immunization experiences. At 1 and 6 months after the intervention, parents of children who had recent immunizations were interviewed by using the same questionnaires. Clinicians also were surveyed at baseline and at 6 months.
  
  
  RESULTS
  A total of 839 telephone interviews and 92 clinician surveys were included. Significant changes from baseline were identified at 1 and 6 months after the intervention. At 1 month, parents were more likely to report receiving information (P = .04), using strategies to reduce pain (P < .01), learning something new (P < .01), using a ShotBlocker (P < .01), using sucrose (P < .01), and having higher levels of satisfaction (P = .015). At 6 months, all rates remained significantly higher than baseline findings (all P < .01) except for satisfaction. Clinician surveys revealed significant increases in the use of longer needles, sucrose, pinwheels, focused breathing, and ShotBlockers at 6 months.
  
  
  CONCLUSIONS
  A 1-hour teaching session had measurable effects on the use of pain-reducing strategies at 1 and 6 months after the intervention. This research supports the hypothesis that small-group teaching sessions at the site of care can be associated with changes in practice behaviors.
authors.affiliation: Children's Hospital Boston, Department of Anesthesia, Perioperative and Pain Medicine, 300 Longwood Ave, Boston, MA 02115, USA. neil.schechter@childrens.harvard.edu
authors.forename: Neil L
authors.initials: NL
authors.lastname: Schechter
authors.forename: Bruce A
authors.initials: BA
authors.lastname: Bernstein
authors.forename: William T
authors.initials: WT
authors.lastname: Zempsky
authors.forename: Nancy S
authors.initials: NS
authors.lastname: Bright
authors.forename: Alice K
authors.initials: AK
authors.lastname: Willard
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007114:Immunization; D007223:Infant; D008297:Male; D010146:Pain / Q000175:diagnosis* / Q000453:epidemiology; D010147:Pain Measurement; D010353:Patient Education as Topic; D011320:Primary Health Care / Q000592:standards*; D011795:Surveys and Questionnaires