Evidence map›Paper›PMID 41514379›Full record

ArticleImplementation science communications2026

Enhancing infant pain assessment and treatment: investigating barriers, facilitators, and implementation outcomes with the ImPaC Resource.

Mariana Bueno, Kate Pearson, Melanie A Barwick, Marsha Campbell-Yeo, Christine Chambers, Carole Estabrooks, Rachel Flynn, Sharyn Gibbins, Denise Harrison, Wanrudee Isaranuwatchai and 8 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Implementation science communications, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors.

Mariana BuenoLawrence Bloomberg Faculty of Nursing, University of Toronto, 155 College Street, Suite 232, Toronto, Ontario, M5T 1P8, Canada. mariana.bueno@utoronto.ca.ORCID http://orcid.org/0000-0002-1470-1321
Kate PearsonThe Hospital for Sick Children, Toronto, Ontario, Canada.
Melanie A BarwickThe Hospital for Sick Children, Research Institute, Child Health and Evaluative Sciences, Toronto, Ontario, Canada.
Marsha Campbell-YeoSchool of Nursing, Faculty of Health, and Departments of Pediatrics and Psychology & Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada.
Christine ChambersIWK Health Centre, Centre for Pediatric Pain Research, Halifax, Nova Scotia, Canada.
Carole EstabrooksFaculty of Nursing, University of Alberta, Edmonton Health Clinic Academy, Edmonton, Alberta, Canada.
Rachel FlynnSchool of Nursing and Midwifery, Brookfield Health Sciences Complex, University College Cork, Cork, Ireland.
Sharyn GibbinsProfessional Practice, Trillium Health Partners, Mississauga, Ontario, Canada.
Denise HarrisonDepartment of Nursing, School of Health Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC, Australia.
Wanrudee IsaranuwatchaiHealth Intervention and Technology Assessment Program (HITAP) Foundation, Nonthaburi, Thailand.
Sylvie LeMayFaculty of Nursing, and Researcher, Université de Montréal, CHU Sainte-Justine Research Center, TransMedTech Institute and Institut Universitaire en Santé Mentale de Montréal, Montreal, Quebec, Canada.
Melanie NoelDepartment of Psychology, University of Calgary, Calgary, Alberta, Canada.
Jennifer StinsonLawrence Bloomberg Faculty of Nursing, University of Toronto, 155 College Street, Suite 232, Toronto, Ontario, M5T 1P8, Canada.
Anne SynnesDivision of Neonatology, BC Children's Hospital Research Institute, BC Women's Hospital, Vancouver, BC, Canada.
Charles VictorInstitute for Clinical Evaluative Sciences (ICES), Management and Evaluation, University of Toronto, The Institute of Health Policy, Toronto, Ontario, Canada.
Janet YamadaToronto Metropolitan University, Cockwell School of Nursing, DaphneToronto, Ontario, Canada.
Shirine RiahiThe Hospital for Sick Children, Toronto, Ontario, Canada.
Bonnie StevensThe Hospital for Sick Children, Research Institute, Child Health and Evaluative Sciences, Toronto, Ontario, Canada.

Funding

Canadian Institutes of Health Research (CIHR) FDN-148452
6 · The paper itself

Abstract

introductionThe Implementation of Infant Pain Practice Change (ImPaC) Resource is a 7-step, multifaceted, web-based implementation strategy to improve pain assessment and treatment in Neonatal Intensive Care Units (NICUs). We explored facilitators and barriers to implementing ImPaC and their relationship to implementation outcomes.

methodA hybrid type 1 effectiveness-implementation study was conducted using a cluster randomized controlled trial (reported elsewhere) and a mixed-method exploratory study design. Level 2 and 3 Canadian NICUs with >15 beds were invited to participate and were randomized to intervention (INT, n=12) or usual care (UC, n=11) groups. INT NICUs recruited a change team who accessed ImPaC for 6 months; UC NICUs were waitlisted for 6 months and then offered ImPaC. Focus groups were conducted with all change teams following ImPaC completion. The Consolidated Framework for Implementation Research (CFIR) guided interview questions and analyses. Professionally transcribed interview data were coded and analysed using directed content analysis. Valence (+/-) and strength (-2, -1, 0, +1, +2) were assigned for each CFIR construct/subconstruct. Inductive codes were identified. Relationships between CFIR constructs/subconstructs and ImPaC implementation outcomes (feasibility and fidelity) were determined.

results83 NICU change team members (median 4/site) participated in focus groups; 1,105 discrete codes relating to 31 CFIR constructs/subconstructs were identified. The most frequent facilitator constructs were Design Quality and Packaging, Compatibility, Available Resources, Champions, Implementation Climate, and Engaging Key Stakeholders. Complexity and Reflecting and Evaluating were salient in 21 transcripts, and Patient Needs and Resources was identified in 20 NICUs. Available Resources and Relative Priority were barriers. A positive association existed between the feasibility of implementing ImPaC and Engaging Key Stakeholders (0.46, p=0.041), Champions (0.82, p=0.001), Relative Priority (0.75, p=0.001) and Networks and Communication (0.60, p=0.023). There was a positive relationship between Engaging Key Stakeholders (0.42, p=0.048), Relative Priority (0.85, p=0.002), Patient Needs and Resources (0.46, p=0.049) and Fidelity.

conclusionSite-specific tailoring to enhance facilitators (e.g., champions, implementation climate) and mitigate local barriers (e.g., resources, relative priority) will provide a viable influence on optimizing implementation outcomes.

Indexed as

Consolidated Framework for Implementation ResearchImplementationImplementation DeterminantsImplementation OutcomesInfantPain

Identifiers

PMID41514379
PMCPMC12882200

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

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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.