The 130th Annual Meeting of APHA

Abstract #40435

Sarah Santana, MPH, DrPH(ABD), James Yuan, Rachel Bernstein, and Vanessa Conrad. Division of Epidemiology and Data Services, Maricopa County Department of Public Health Services, 1825 E. Roosevelt St, Phoenix, AZ 85006, 602 506 6801, sarahsantana@mail.maricopa.gov

The Maricopa County Department of Public Health conducted a large, double-blinded study to test the effectiveness of ethyl-chloride spray in reducing pain among children receiving immunizations. Several previous studies suggested that topical pain relievers reduced pain among children. However, most of these studies were conducted in private providers’ offices.

The study was conducted among 1,136 children attending public health clinics. Three measures were used to assess degree of pain: a child self-reported scale, a parental expectation scale, and a neutral observer scale. Study participants were divided into three cells: those who received the ethyl-chloride, those who received an alcohol spray, and those receiving no treatment. Results showed that the ethyl-chloride spray did not reduce pain.

A number of methodological challenges arose during the study. First, volunteers, rather than well-trained staff, were used as observers. Trained staff might have been more sensitive to subtle differences in reactions. Second, the control group had to be tested on a separate day than the test groups so that parents did not feel that they were receiving substandard treatment. Third, the scale used for the study did not distinguish between anxiety and pain. Ideally, participants should have been screened for anxiety. Fourth, personnel at one clinic distributed popsicles to children before the final questionnaires, which may have influenced outcomes at that site. The first challenge was a result of limited funds available for the study. The second, third, and fourth challenges highlight the difficulties in conducting a study in a public health setting.

Learning Objectives:

• Participants will learn a) the results of a large, controlled study that tested the effectiveness of a pain-reducing spray (ethyl-chloride) used prior to immunizations, and b) the methodological challenges of conducting the study in a public health environment.

Keywords: Methodology, Public Health Research

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.