CARD (Comfort Ask Relax Distract) and community pharmacy vaccinations: Evaluation of implementation outcomes from a cluster randomized trial
The CARD system (Comfort Ask Relax Distract) is a protocol for vaccine delivery that includes interventions that facilitate vaccine recipient coping and improve the vaccination experience. CARD was compared to control (usual care) in a pragmatic hybrid effectiveness-implementation cluster randomized...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2025-12-01
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| Series: | Human Vaccines & Immunotherapeutics |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/21645515.2025.2503524 |
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| author | Anna Taddio James Morrison Charlotte Logeman Victoria Gudzak Lucie M Bucci C. Meghan McMurtry Molly Yang Mike Folinas Rahim Moineddin Noni E. MacDonald |
| author_facet | Anna Taddio James Morrison Charlotte Logeman Victoria Gudzak Lucie M Bucci C. Meghan McMurtry Molly Yang Mike Folinas Rahim Moineddin Noni E. MacDonald |
| author_sort | Anna Taddio |
| collection | DOAJ |
| description | The CARD system (Comfort Ask Relax Distract) is a protocol for vaccine delivery that includes interventions that facilitate vaccine recipient coping and improve the vaccination experience. CARD was compared to control (usual care) in a pragmatic hybrid effectiveness-implementation cluster randomized trial. Of 25 participating community pharmacies, 12 were randomized to CARD and 13 to control for all vaccines administered between November 2023 and January 2024. Implementation strategies planned to support CARD integration included an educational webinar, customized implementation recommendations, change equipment, online chat group, and audit and feedback. Educational outreach was added to improve intervention fidelity. This paper reports on implementation outcomes of the trial. Provider surveys and focus groups revealed acceptability and feasibility of CARD and implementation strategies. Vaccinators in CARD pharmacies (vs. control) reported higher satisfaction with vaccine recipient interactions and that overall, CARD was time neutral. They also reported higher utilization of some CARD-recommended injection techniques. Administrative data verified utilization of the CARD coping checklist, which solicits vaccine recipient coping preferences, in 96% of vaccine recipients that participated. Post-vaccination feedback surveys were available for 90% of vaccine recipients that participated. Implementation results were aligned with trial effectiveness outcomes, and support routine use of CARD in community pharmacies.Trial registration : NCT06098703 |
| format | Article |
| id | doaj-art-a6c5df0be62443689d4d2ee897d9054a |
| institution | Kabale University |
| issn | 2164-5515 2164-554X |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Human Vaccines & Immunotherapeutics |
| spelling | doaj-art-a6c5df0be62443689d4d2ee897d9054a2025-08-20T03:59:25ZengTaylor & Francis GroupHuman Vaccines & Immunotherapeutics2164-55152164-554X2025-12-0121110.1080/21645515.2025.2503524CARD (Comfort Ask Relax Distract) and community pharmacy vaccinations: Evaluation of implementation outcomes from a cluster randomized trialAnna Taddio0James Morrison1Charlotte Logeman2Victoria Gudzak3Lucie M Bucci4C. Meghan McMurtry5Molly Yang6Mike Folinas7Rahim Moineddin8Noni E. MacDonald9Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, CanadaWholehealth Pharmacy Partners, Markham, ON, CanadaThe Hospital for Sick Children, Toronto, CanadaLeslie Dan Faculty of Pharmacy, University of Toronto, Toronto, CanadaBucci-Hepworth Health Services Inc, Pincourt, CanadaDepartment of Psychology, University of Guelph, Guelph, CanadaWholehealth Pharmacy Partners, Markham, ON, CanadaLeslie Dan Faculty of Pharmacy, University of Toronto, Toronto, CanadaFaculty of Medicine, University of Toronto, Toronto, CanadaFaculty of Medicine, Dalhousie University, Halifax, CanadaThe CARD system (Comfort Ask Relax Distract) is a protocol for vaccine delivery that includes interventions that facilitate vaccine recipient coping and improve the vaccination experience. CARD was compared to control (usual care) in a pragmatic hybrid effectiveness-implementation cluster randomized trial. Of 25 participating community pharmacies, 12 were randomized to CARD and 13 to control for all vaccines administered between November 2023 and January 2024. Implementation strategies planned to support CARD integration included an educational webinar, customized implementation recommendations, change equipment, online chat group, and audit and feedback. Educational outreach was added to improve intervention fidelity. This paper reports on implementation outcomes of the trial. Provider surveys and focus groups revealed acceptability and feasibility of CARD and implementation strategies. Vaccinators in CARD pharmacies (vs. control) reported higher satisfaction with vaccine recipient interactions and that overall, CARD was time neutral. They also reported higher utilization of some CARD-recommended injection techniques. Administrative data verified utilization of the CARD coping checklist, which solicits vaccine recipient coping preferences, in 96% of vaccine recipients that participated. Post-vaccination feedback surveys were available for 90% of vaccine recipients that participated. Implementation results were aligned with trial effectiveness outcomes, and support routine use of CARD in community pharmacies.Trial registration : NCT06098703https://www.tandfonline.com/doi/10.1080/21645515.2025.2503524Pharmacyvaccinationpain managementthe CARD systemvaccination servicesimplementation science |
| spellingShingle | Anna Taddio James Morrison Charlotte Logeman Victoria Gudzak Lucie M Bucci C. Meghan McMurtry Molly Yang Mike Folinas Rahim Moineddin Noni E. MacDonald CARD (Comfort Ask Relax Distract) and community pharmacy vaccinations: Evaluation of implementation outcomes from a cluster randomized trial Human Vaccines & Immunotherapeutics Pharmacy vaccination pain management the CARD system vaccination services implementation science |
| title | CARD (Comfort Ask Relax Distract) and community pharmacy vaccinations: Evaluation of implementation outcomes from a cluster randomized trial |
| title_full | CARD (Comfort Ask Relax Distract) and community pharmacy vaccinations: Evaluation of implementation outcomes from a cluster randomized trial |
| title_fullStr | CARD (Comfort Ask Relax Distract) and community pharmacy vaccinations: Evaluation of implementation outcomes from a cluster randomized trial |
| title_full_unstemmed | CARD (Comfort Ask Relax Distract) and community pharmacy vaccinations: Evaluation of implementation outcomes from a cluster randomized trial |
| title_short | CARD (Comfort Ask Relax Distract) and community pharmacy vaccinations: Evaluation of implementation outcomes from a cluster randomized trial |
| title_sort | card comfort ask relax distract and community pharmacy vaccinations evaluation of implementation outcomes from a cluster randomized trial |
| topic | Pharmacy vaccination pain management the CARD system vaccination services implementation science |
| url | https://www.tandfonline.com/doi/10.1080/21645515.2025.2503524 |
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