Needle fear exists upon a spectrum ranging from mild fear, which is considered normative, to high and clinically significant levels of fear (McMurtry et al., 2015).  High levels of needle fear are associated with longer procedure times, distressing memories related to the procedure, and ineffective pain management (McMurtry et al., 2015; Noel et al., 2012a; Noel et al., 2012b; Taddio et al., 2012). Highly fearful children may also grow up and become parents who model needle fear to their own children (McMurtry et al., 2015). As such, equipping children and their parents with strategies to manage both their needle pain and fear is integral to “breaking the cycle” and ensuring that important needles (e.g., vaccinations) are not delayed or avoided. There is a critical need for interventions targeting children ages 5 to 9, in particular given the frequency of vaccinations recommended during this time frame.

Title of Project Picturing Bravery: Evaluation of an Evidence Informed E-Resource for Children with Needle Fear
Objective The aim is to reduce needle pain and fear in children with moderate to high levels of needle fear using an e-resource intervention.
Criteria Children (ages 5 – 9 years old) with moderate to high levels of needle fear and their parents/caregivers are being sought. Parents/caregivers must be 18 or above, reside in Canada or the US, and speak sufficient English to review the e-resource and answer simple questions via online surveys.
Potential Risks There may be mild discomfort for parents/children with high needle fear during certain online survey items.  To mitigate this risk, participants will have reviewed the e-resource and have learned coping strategies to manage any distress. During consent, participants are reminded they can skip questions/end the survey.
End Date January 31, 2025
Time Required Total time required for the study is 1-2 hours, as follows:

a.     Consent: 5-10 mins

b.    Screening Call: 5 mins

c.     Pre-intervention survey: 10-20 mins

d.    Review of E-Resource: 30-60 mins

e.     Screening Call: 5 mins

f.      Post-intervention survey: 15-20 mins
How to Participate Click here to see if you’re eligible to participate in the study
Participation Gift All participants will receive an honorarium.
Contact Please email us at [email protected] if you would like further information or if you have any questions.

Background

The use of books as a tool to help gain insight into personal challenges (Heath et al., 2005) has been known in the literature as “bibliotherapy”. In fact, children’s books have been found to be a promising method for treating anxiety in a format that is engaging for children (McLellan et al., 2019, Lewis et al., 2015). While there may presently be other picture books that intend to prepare children for needle procedures, no existing studies have reviewed or examined their role in managing children’s needle fear and pain (Tsao et al., 2017).

Our goal is to reduce needle pain and fear in children with needle fear by providing families with a free and accessible “e-resource” that supports them in managing needle fear independently. We first conducted a rapid review of children’s picture books depicting needle procedures and identified gaps in content, which informed the development of a children’s book and accompanying educational online resource for parents and caregivers (i.e., the “e-resource). The children’s book and caregiver guide were reviewed by relevant health care professionals as well as children with needle fear and their parents to provide feedback to inform changes (Phase 1). We are now using a pre-post study design to evaluate the effectiveness of the revised e-resource (children’s book + caregiver guide) in reducing needle fear and anticipated pain in children with moderate to high levels of fear (Phase 2).

The purpose of the study is to evaluate a free online “e-resource” that consists of:

  • A children’s book for kids to learn about needles, why they are important, and what coping strategies can be used.
  • A caregiver resource with evidence-informed tools and strategies for parents to independently manage their child’s needle-related pain and fear.