Using the card (comfort ask relax distract) system for vaccination delivery: Review of tools, implementation approaches, and positive impact on vaccination safety and experiences
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University of Toronto 144 College Street, Toronto, Ontario, M5S 3M2 Canada
Bucci-Hepworth Health Services Inc., Québec, Canada
Brock University, Canada
Publication date: 2023-04-26
Popul. Med. 2023;5(Supplement):A2072
Around the world, fear, pain and other immunization stress-related responses (e.g., dizziness, fainting) are common adverse reactions during vaccine injections, and contribute to needless suffering, complications, and dissatisfaction with care. Across the lifespan, concerns about such stress-related responses account for vaccine refusals in about 1 out of 10 individuals. There are effective interventions; yet they are not systematically incorporated into vaccination delivery systems. The CARD (Comfort-Ask-Relax-Distract) system is a new vaccine delivery framework that was developed to address this knowledge-to-care gap. Developed from a 2015 Canadian clinical practice guideline endorsed by the World Health Organization (WHO), CARD incorporates evidence-based interventions before, during and after vaccination that together improve the safety of vaccination delivery and lead to more positive vaccination experiences in vaccine recipients, vaccinators and onlookers (e.g., parents, clinic staff). Interventions are included in each letter category (C-A-R-D) that address the psychological, biological and social factors contributing to an individuals risk of experiencing immunization stress-related responses. These interventions include increasing knowledge and preparedness, mitigating pain and fear, and promoting trusting relationships with vaccinators, which in turn, can have a positive impact on vaccination acceptance, compliance and confidence. During the COVID-19 pandemic, priority funding was provided by the Public Health Agency of Canada to support creation of tools and implementation approaches that allow CARD to be integrated across diverse vaccination settings delivering vaccinations to children and adults, in order to support public COVID-19 vaccination. Both English and French tools were created and are freely available online for anyone to use. The specific objectives of this workshop are to: 1) describe the importance of including patient experiences as a quality indicator of vaccination programs; 2) introduce the CARD system as a framework for providing vaccinations to an international public health audience; 3) share key CARD tools (e.g., child web game, training e-module) for implementation; and 4) describe implementation approaches used across diverse vaccination settings (mass clinics, pharmacies, hospitals, long-term care) and the successes achieved, in order to stimulate global interest and adoption. There are 3 workshop speakers: Anna Taddio, Lucie Marisa Bucci, and Angelo Ilersich. Speakers will engage the audience with questions throughout the presentation to stimulate discussion. Videos and other tools will be demonstrated. The audience will be asked for feedback and to describe their needs to support broad implementation across health care settings. Key questions that the workshop will address:Why are immunization stress-related responses important to track for vaccination delivery programs?How can the CARD system improve the safety of vaccination delivery and improve patient-centredness in health care delivery?What are the key CARD tools and how can they be feasibly integrated across diverse vaccination settings?What are the expected benefits of implementing CARD as a vaccination delivery framework?
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