ArticleCanadian pharmacists journal : CPJ = Revue des pharmaciens du Canada : RPC
Integration of CARD (Comfort Ask Relax Distract) for COVID-19 community pharmacy vaccination in children: Effect on implementation outcomes.
Article in Canadian pharmacists journal : CPJ = Revue des pharmaciens du Canada : RPC. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
17 citing papers in PubMed, 2 syntheses or guidelines pooled it, 15 citations in OpenAlex.
- Reducing distress during vaccine injections: 2026 clinical practice guideline update.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2026Guideline
- A Systematic Review and Meta-Analysis of the Effectiveness of Process Interventions for Reducing Distress During Vaccine Injections.The Clinical journal of pain · 2026Pooled it
- CARD (Comfort Ask Relax Distract) and community pharmacy vaccinations: Evaluation of implementation outcomes from a cluster randomized trial.Human vaccines & immunotherapeutics · 2025Trial
- CARD (Comfort Ask Relax Distract) and community pharmacy vaccinations: Evaluation of effectiveness outcomes from a cluster randomized trial.Human vaccines & immunotherapeutics · 2025Trial
- "It Could Become a Standard"-A Qualitative Study of the CARDChildren (Basel, Switzerland) · 2026Article
- Coping with Pokes: Child, Caregiver, and Clinician Feedback on a Caregiver-Led Educational Resource for Managing Children's Needle Fear.Nursing reports (Pavia, Italy) · 2026Article
- Using the CARD system for university-based pop-up vaccination clinics: A two-stage hybrid effectiveness-implementation study.Human vaccines & immunotherapeutics · 2025Article
- Development and refinement of an online CARD (Comfort Ask Relax Distract) course for organizations and providers delivering vaccinations and other needle procedures.Human vaccines & immunotherapeutics · 2025Article
- Playing CARD (Comfort Ask Relax Distract): Upping our game on the quality of vaccine delivery.Human vaccines & immunotherapeutics · 2025Article
- Picturing Bravery: A Rapid Review of Needle Procedures Depicted in Children's Picture Books.Children (Basel, Switzerland) · 2023Article
- COVID-19 Vaccination Delivery in Long-Term-Care using the CARD (Comfort Ask Relax Distract) System: Mixed Methods study of Implementation Drivers.Canadian journal of pain = Revue canadienne de la douleur · 2022Article
- Experiences of community pharmacists administering COVID-19 vaccinations: A qualitative study.Canadian pharmacists journal : CPJ = Revue des pharmaciens du Canada : RPCArticle
- Perceptions of pharmacy technician students of the CARD (Comfort Ask Relax Distract) e-module introduced as part of vaccine injection training.Canadian pharmacists journal : CPJ = Revue des pharmaciens du Canada : RPCArticle
- CARD (Comfort Ask Relax Distract) for community pharmacy vaccinations in children: Effect on immunization stress-related responses and satisfaction.Canadian pharmacists journal : CPJ = Revue des pharmaciens du Canada : RPCArticle
- CARD (Comfort Ask Relax Distract) integration guide for community pharmacies administering vaccinations: How to playCanadian pharmacists journal : CPJ = Revue des pharmaciens du Canada : RPCArticle
- Community pharmacists' perceptions of the CARD (Comfort Ask Relax Distract) system for use during vaccinations.Canadian pharmacists journal : CPJ = Revue des pharmaciens du Canada : RPCArticle
- Introducing CARD (Comfort Ask Relax Distract) as a vaccine delivery program for community pharmacy-based vaccinations.Canadian pharmacists journal : CPJ = Revue des pharmaciens du Canada : RPCArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 6 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Introduction: Community pharmacists report that providing vaccinations can be challenging, particularly if the vaccine recipient is a child, because of heightened levels of fear. The objective of this study was to determine acceptability and feasibility of the CARD (Comfort Ask Relax Distract) system as a vaccination delivery framework for children receiving COVID-19 vaccinations in a community pharmacy setting. CARD incorporates evidence-based interventions that reduce fear and immunization stress-related responses in vaccine recipients and was demonstrated to be effective and feasible in other vaccination settings providing vaccinations to children and adults. Methods: This mixed-methods study involved 5 independent pharmacies (with 6 vaccinators) offering COVID-19 vaccinations to children between 5 and 11 years of age. Vaccinating staff and implementation leads from the pharmacy organization participated in a small-scale CARD implementation project (before-and-after design). Afterwards, they filled in quantitative surveys and provided qualitative feedback about their perceptions and experiences in focus group discussions. Qualitative data were analyzed deductively, using the Consolidated Framework for Implementation Research (CFIR). Results: The study was conducted between January 16 and March 20, 2022. Across both quantitative and qualitative measures, vaccinating staff reported positive attitudes about CARD and alignment with their professional roles. They reported that CARD reduced children's fear and improved the vaccination experiences in children and parents and for themselves. Vaccinators reported increased confidence due to CARD. They reported compatibility of CARD interventions within their practice and that it was time neutral. They maintained use of some interventions after the study. They also provided suggestions and shared concerns about fidelity and future feasibility of continuing various components of the program. Conclusion: CARD was demonstrated to be acceptable and feasible by vaccinators performing vaccinations in children in community pharmacies.
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.