Technical Reports

CROUP

Croup is a common viral illness affecting 80,000 children annually in Canada. Between 7-31% of children seen in an ED for croup are admitted to hospital due to health care provider apprehension. However, over 60% of children with croup experience mild symptoms that can be safely managed at home. Emerging evidence suggests that initiatives targeting healthcare consumers (i.e., patients, parents, families) can inform decision making and shape treatment expectations. Previous research demonstrates that innovative media are superior to traditional standard health sheets for transferring information to consumers. The purpose of this project was to develop, refine, and test the usability of a whiteboard animation video for parents about childhood croup. Parents rated the tools highly across all usability items, suggesting that creative tools developed using multi-method development processes can help facilitate the uptake of health information in parents.

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PEDIATRIC ACUTE GASTROENTERITIS

Characterized by vomiting, fever, abdominal pain and diarrhea, acute gastroenteritis (AGE) is a common illness in pediatric populations. In Canada, pediatric AGE accounts for 200,000 emergency visits, 20,000 hospital admissions, and 30 deaths a year. Yet, there continues to be significant practice variations in the treatment of AGE. Knowledge translation (KT) can help close the research-practice gap. In particular, art and stories are powerful mediums that cut across age, culture, language, literacy, and gender barriers. The purpose of this study was to work with parents to develop an e-Book and whiteboard animation video for parents on pediatric AGE. Using a multi-method research process, we developed a 2 minute 57 second video and 39-page e-Book for pediatric AGE. Both tools underwent usability testing with parents in three Canadian emergency department waiting rooms in urban, rural, and remote regions. Focus groups were also conducted with parents in each of the three regions. Overall, parents felt that digital and paper-based KT tools would be beneficial knowledge dissemination mediums. Our study showed that parents positively rated an e-Book and whiteboard animation video for pediatric AGE. These findings demonstrate how working together with key stakeholders can facilitate the development of KT tools for parents that are usable, relevant, and increase parental confidence. Furthermore, the type of KT tool developed is an important decision that may depend on parental preferences as well as when and where parents access the tools.

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PEDIATRIC FEVER

Fever is defined as an elevated body temperature greater or equal to 38 degrees celsius when measured via the ear canal. It is a common bodily response in children and is typically a benign process that is self-limiting. However, fever can be an anxiety provoking event for some parents because their child can look unwell and become irritable as a result. Past attempts at translating medical knowledge about fever and its management strategies into parent-friendly formats exist; however, parent misperceptions about definition and management persist despite these educational tools.

Our research team employs patient engagement techniques to develop resources for parents to enhance the uptake of complex medical knowledge. First, our research group conducts qualitative interviews and knowledge synthesis of the literature. Following analysis, salient themes are used to develop a script and skeleton for our videos and infographics, respectively. Employing this same process, this paper discusses the development and usability testing of two digital tools for fever. Prototypes for the video and infographic were tested by parents in urban and remote emergency department (ED) waiting rooms. A total of 58 surveys were completed by parents. Overall, parents rated both the fever video and infographic favourably, suggesting that patient engaged research methods and digital formats are mediums that can facilitate knowledge transfer.

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PROCEDUAL PAIN

Procedures carried out in acute care settings, such as emergency departments (EDs), are among the most common sources of acute pain experienced by children. Such procedures may include intravenous insertions (IVs), venipuncture, and wound irrigation and repair. Inadequately managed procedural pain can cause negative short-term and long-term implications for children, ranging from anxiety to aversion to healthcare. Parents have repeatedly expressed that they do not have the necessary tools to comfort or distract their child during uncomfortable medical procedures. As such, the purpose of this study was to work with parents to develop and evaluate two digital tools for pediatric procedural pain.

A whiteboard animation video and interactive infographic were developed following a systematic review and interview with parents. Prototypes were tested in five ED waiting rooms in two Canadian provinces. Sites included those in urban, rural, and remote settings. Overall, parents rated the tools highly, suggesting that engaging with parents to develop arts-based digital tools is a highly effective method in ensuring that parents can understand and utilize complex health information. 

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BRONCHIOLITIS

Bronchiolitis is an acute infection of the lower respiratory tract that predominantly affects children less than two years old. Although self-limiting, symptoms of bronchiolitis can be distressing for young children. Research has demonstrated that parents may not have the necessary information to be able to identify bronchiolitis symptoms, resulting in emergency department (ED) visits and hospitalizations. Parents have expressed that they feel unprepared, afraid, and that they lack information on their child’s condition. Digital knowledge translation (KT) tools have the potential to convey complex health information to parents.

We worked with parents of children with bronchiolitis to develop and evaluate three digital tools on bronchiolitis (whiteboard animation video, infographic, and e-Book). Following prototype completion, usability testing was conducted using iPads in two Alberta ED waiting rooms. Parents were randomized to one out of the three tools. Overall, the tools were highly rated, suggesting that artsbased digital tools are useful in delivering complex health information to parents to support their healthcare decision-making needs.

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URINARY TRACT INFECTIONS

Urinary tract infections (UTI) are a common source of acute illness for infants and children. Approximately 7-8% of girls and 2% of boys will experience a UTI before they are 8 years old. UTIs may be difficult to identify and treat as symptoms in children are different from expected adult symptoms. A previously conducted systematic review identified four common information needs expressed by parents. More specifically, the research identified that parents had difficulty recognizing signs and symptoms of UTIs, felt disappointed by health care provider’s responses, needed timely and relevant information, and feared the unknown due to lack of UTI knowledge. This demonstrates that more effective knowledge translation tools are needed to satisfy parent information needs.

The purpose of this research was to work with parents to develop and test the usability of an interactive infographic and video about UTIs in children. Prototypes were evaluated by parents through usability testing in two Alberta emergency department waiting rooms. Results were positive and overall, the tools were highly rated across all usability items, suggesting that arts-based digital tools are useful mediums for sharing health information with parents.

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