Grant: Foundation Grant

Not just a poke, needle pain and related fear are in fact major health concerns. All Canadian children undergo painful needle procedures; hospitalized children undergo multiple procedures daily. Pain causes unnecessary suffering, fear, procedure complications (e.g., fainting, failed procedures), and avoidance behaviours. An alarming 20% of unvaccinated 6- 18-year-old children (herein called youth) refuse vaccination due to fear of needle-related pain. This leaves them at risk of acquiring and spreading disease. My vision is to make children all over the world healthier by improving their experiences during needle procedures which will increase needle procedure acceptance. In previous work, I led the creation of a Clinical Practice Guideline (CPG) to address pain and fear and documented gaps for youth. The current project has been developed with key user groups to address these gaps using real-world solutions. Over 7 years, I will build on my successes with my CIHR-funded Help ELiminate Pain in Kids & Adults (HELPinKids&Adults) team to address key unanswered questions. Specifically, to help close the pain care gap for youth, I will: 1) identify best practices for injection techniques, 2) implement and evaluate a novel tool/game developed by youth teaching youth how to reduce pain, fear and fainting, and 3) create both an updated CPG that incorporates this new evidence and a national plan to facilitate integration into healthcare systems. I expect improvements in patient-prioritized outcomes (pain, fear, fainting and needle procedure acceptance); I estimate a 5% absolute increase in school-based vaccine uptake alone. Long-term, I expect improved health outcomes and health cost savings due to improved compliance and efficiency. Importantly, this research program engages youth and other stakeholders to address youth's most pressing concern about healthcare - the needle - and fulfills our ethical obligation to first, do no harm.