Automated parent-training for preschooler immunization pain relief: a randomized controlled trial

To examine a computerized parent training program, "Bear Essentials," to improve parents' knowledge and coaching to help relieve preschoolers' immunization distress. In a randomized controlled trial, 90 parent-child dyads received Bear Essentials parent training plus distraction, distraction only, or control. Outcomes were parent knowledge, parent and child behavior, and child pain. Bear Essentials resulted in improved knowledge of the effects of parents' reassurance, provision of information, and apologizing on children's procedural distress. Trained parents also engaged in less reassurance and more distraction and encouragement of deep breathing. Children in Bear Essentials engaged in more distraction and deep breathing than children in other groups. There were no effects on measures of child distress or pain. Results suggest that the interactive computer training program impacted parent knowledge, parent behavior, and child behavior as hypothesized, but modifications will be necessary to have more robust outcomes on child procedural distress.