title: Teaching parents to manage pain during infant immunizations: laying the foundation for better pain management practices.
abstract: OBJECTIVE
  To evaluate knowledge uptake from a parent-directed factsheet about managing pain during infant vaccinations, and the added influence of a pretest.
  
  
  METHODS
  Solomon 4-group randomized controlled trial. New mothers hospitalized after the birth of an infant were randomized to 1 of 4 groups: 2 included the intervention (factsheet about pain management) and 2 included the control (information on another topic). A pretest was given to 1 intervention and 1 control group. Following maternal review of allocated information, posttests were administered in all groups. Both control groups received the information after posttesting. A follow-up telephone survey after 2 months measured knowledge retention and utilization of pain management interventions.
  
  
  RESULTS
  A total of 120 mothers participated (July, 2012 to February, 2013); demographics did not differ among groups. The 2 factsheet groups demonstrated more knowledge (P<0.05) about effective pain management (mean without pretest: 5.6 [SD=2.0]; with pretest: 6.9 [1.6]) compared with the 2 control groups (without pretest: 3.2 [2.2]; with pretest: 3.4 [2.5]) immediately after review; and the factsheet and pretest group scored higher than the factsheet only group. In groups with a prefactsheet baseline knowledge test, knowledge was higher at follow-up compared with baseline. Follow-up knowledge and utilization of pain management interventions did not differ among groups.
  
  
  CONCLUSIONS
  The factsheet led to acute gains in knowledge and knowledge gains persisted after 2 months. Acutely, knowledge was bolstered by the pretest. These results can be used to guide future research and implementation of the factsheet.
authors.affiliation: *Clinical, Social and Administrative Pharmacy, Leslie Dan Faculty of Pharmacy, University of Toronto †Child Health Evaluative Sciences, The Hospital for Sick Children §Department of Pediatrics, Mount Sinai Hospital ‡Department of Pediatrics, The Hospital for Sick Children, Toronto, ON, Canada.
authors.forename: Anna
authors.initials: A
authors.lastname: Taddio
authors.forename: Moshe
authors.initials: M
authors.lastname: Ipp
authors.forename: Charmy
authors.initials: C
authors.lastname: Vyas
authors.forename: Chaitya
authors.initials: C
authors.lastname: Parikh
authors.forename: Sarah
authors.initials: S
authors.lastname: Smart
authors.forename: Suganthan
authors.initials: S
authors.lastname: Thivakaran
authors.forename: Ali
authors.initials: A
authors.lastname: Jamal
authors.forename: Derek
authors.initials: D
authors.lastname: Stephens
authors.forename: Vibhuti
authors.initials: V
authors.lastname: Shah
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D019317:Evidence-Based Medicine; D005260:Female; D005500:Follow-Up Studies; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009035:Mothers; D059408:Pain Management / Q000379:methods*; D010290:Parents; D010353:Patient Education as Topic / Q000379:methods*; D014611:Vaccination / Q000009:adverse effects* / Q000379:methods*