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A Parent-Targeted and Mediated Video Intervention to Improve Uptake of Pain Treatment for Infants During Newborn Screening

A Pilot Randomized Controlled Trial

Lavin Venegas, Carolina, MSc, BScN; Taljaard, Monica, PhD; Reszel, Jessica, MScN, RN; Dunn, Sandra, PhD, RN; Graham, Ian D., PhD; Harrold, JoAnn, MD, FRCPC; Larocque, Catherine, BScN, RN; Nicholls, Becky; Nicholls, Stuart, PhD; O'Flaherty, Pat, MEd, MN, RN-NNP; Squires, Janet, PhD, RN; Stevens, Bonnie, PhD, RN; Trépanier, Marie-Josée, MEd, BScN, RN, PNC(C); Harrison, Denise, PhD, RN

The Journal of Perinatal & Neonatal Nursing: January/March 2019 - Volume 33 - Issue 1 - p 74–81
doi: 10.1097/JPN.0000000000000386
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Most newborns undergo newborn screening blood tests. Breastfeeding, skin-to-skin care, and sweet solutions effectively reduce pain; however, these strategies are inconsistently used. We conducted a 2-armed pilot randomized controlled trial in a mother-baby unit to examine the feasibility and acceptability of a parent-targeted and -mediated video demonstrating use of these pain-reducing strategies and to obtain preliminary effectiveness data on uptake of pain management. One hundred parent-newborn dyads were randomized to view the video or receive usual care (51 intervention and 49 control arm). Consent and attrition rates were 70% and 1%, respectively. All participants in the intervention arm received the intervention as planned and reported an intention to recommend the video and to use at least 1 pain treatment with breastfeeding or skin-to-skin care preferred over sucrose. In the intervention arm, 60% of newborns received at least 1 pain treatment compared with 67% in the control arm (absolute difference, −7%; 95% confidence interval, −26 to 12). The video was well accepted and feasible to show to parents. As there was no evidence of effect on the use of pain management, major modifications are required before launching a full-scale trial. Effective means to translate evidence-based pain knowledge is warranted.

University of Ottawa, Ottawa, Ontario, Canada (Ms Lavin Venegas and Dr Harrison); Ottawa Hospital Research Institute (OHRI), Ottawa, Ontario, Canada (Drs Taljaard, Graham, Nicholls, and Squires); Children's Hospital of Eastern Ontario (CHEO) Research Institute (RI), Ottawa, Ontario, Canada (Mss Reszel and Larocque); Better Outcomes Registry & Network (BORN) Ontario, Ottawa, Ontario, Canada (Dr Dunn); CHEO, Ottawa, Ontario, Canada (Drs Harrold and Harrison); Ottawa, Ontario (Ms Nicholls); Champlain Maternal Newborn Regional Program (CMNRP), Ottawa, Ontario, Canada (Mss O'Flaherty and Trépanier); and The University of Toronto and The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada (Dr Stevens).

Corresponding Author: Denise Harrison, PhD, RN, Children's Hospital of Eastern Ontario and University of Ottawa, 401 Smyth Rd, Ottawa, ON K1H 8L1, Canada (denise.harrison@uottawa.ca).

This study was funded by the University of Ottawa Research Development Program (RDP). The authors thank Amanda Bowman for her assistance with recruitment and data collection. The authors also thank the families who kindly volunteered their time to participate in this study and the nursing staff at the participating unit for supporting all aspects of the study.

Disclosure: The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article.

Each author has indicated that he or she has met the journal's requirements for Authorship.

Submitted for publication: March 7, 2018; accepted for publication: November 11, 2018.

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