Examining the Effectiveness of the CARD (Comfort, Ask, Relax, Distract) System on Improving Student Experiences during School-based Vaccination Clinics: Results of a Randomized Cluster Trial
Bibliographic record
Abstract
Background: Needle fear and pain can be exacerbated in school-based vaccination clinics when students are unprepared and fear cues are not systematically minimized. The CARD system (Comfort, Ask, Relax, Distract) incorporates evidence-based strategies to mitigate fear and pain. We examined CARD’s effectiveness in reducing student fear, pain and related symptoms during school vaccinations. Methods: Randomized cluster trial in 40 Wellington-Dufferin-Guelph schools during fall 2019. Schools were randomly assigned (1:1) to CARD or control. Students reported fear, pain and dizziness scores. Nurses reported coping tools used and post-vaccination reactions. Results: 1424 of 1919 students across participating schools were vaccinated at school. Fear and pain were lower in CARD vs. control: OR 0.65 (95% CI 0.47-0.90) and OR 0.62 (95% CI 0.50-0.77), respectively. No CARD students fainted compared to 0.8% control (p=0.02). Dizziness or post-vaccination reactions did not differ. Coping tools were used more frequently in CARD schools. Discussion: CARD reduced stress-related symptoms during school-based vaccinations.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.008 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.008 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".