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Mini: Sensory Friendly Vaccine Kits · Why We Do What We Do

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Speaker 1: You're listening to Why we do what we do. Welcome
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Speaker 1: to Why we do what we do Mini. I am
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Speaker 1: your host, Abraham, and today we are doing something a
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Speaker 1: little bit different. This will be our first ever Mini
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Speaker 1: with a guest host. As I have described before if
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Speaker 1: you are new to the show, Minis are these short
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Speaker 1: dive episodes that we do once a week. They release
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Speaker 1: on Mondays. We release our full length episodes on Wednesdays,
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Speaker 1: and so we just take these bite sized topics and
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Speaker 1: unpack the psychology of things in the world. And if
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Speaker 1: you like what you hear today, then please like and subscribe,
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Speaker 1: rate and review, join us on Patreon all the things.
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Speaker 1: I'll talk about those at the end and let me
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Speaker 1: introduce my guests. So this is doctor Lauren Brown. She
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Speaker 1: is a research assistant professor at the University of Nevada Reno.
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Speaker 1: Thank you so much for being here.
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Speaker 2: Hello.
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Speaker 1: I asked you to come on today because we're talking
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Speaker 1: about the crossover between sort of the medical field and disabilities.
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Speaker 1: So we're talking about accessibility and you and I had
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Speaker 1: talked about this interesting project that was these vaccine kits
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Speaker 1: for people with disabilities. So if you could just describe
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Speaker 1: sort of what these things are to begin with.
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Speaker 2: We had originally started this project when we received some
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Speaker 2: flow through COVID funding in twenty twenty one, when vaccines
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Speaker 2: were a little more difficult to receive. But we quickly
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Speaker 2: found that a lot of them, the disability community specifically,
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Speaker 2: if they wanted this shot generally, they had it. And
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Speaker 2: so one of the things that we you know, when
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Speaker 2: we kind of surveyed providers and people with lived experience
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Speaker 2: as well as their families, we found that a lot
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Speaker 2: of the issues around getting the vaccine wasn't necessarily that
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Speaker 2: they couldn't go somewhere and find it easily. It was
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Speaker 2: more that they were a little hesitant to get the vaccine.
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Speaker 2: And if you look at data with you know, children
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Speaker 2: as well as especially children with disabilities, you're more likely
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Speaker 2: to see a lot of behaviors around, you know, not
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Speaker 2: a lot of anxiety, fear of the vaccine, some avoidance,
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Speaker 2: a lot of parents, you know, say that they had
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Speaker 2: to hold their kids down, and so there were a
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Speaker 2: lot of things that we were trying to avoid.
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Speaker 1: And was this fear of just shots generally speaking, or
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Speaker 1: the COVID vaccine specifically vaccines in general. Okay, Sony, any
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Speaker 1: kind of shot they might be getting. Yes, So basically
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Speaker 1: you have the issue that people who would benefit from
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Speaker 1: and likely and need these shots like any of us,
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Speaker 1: but getting them to engage in this willingly is is troublesome.
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Speaker 1: So so what was the sort of solution that you
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Speaker 1: that this project was pioneering or exploring.
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Speaker 2: I guess my background is in behavior analysis as well,
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Speaker 2: so you know, kind of combining our expertise in you know,
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Speaker 2: working with people with lived experiences and their families as
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Speaker 2: well as you know, understanding behavior management, we really tried
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Speaker 2: to bridge a lot of distraction techniques as well as
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Speaker 2: coping and calming techniques that could help these medical providers
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Speaker 2: in the moment with their patients and make it more
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Speaker 2: likely that they first off get their vaccines, hopefully that
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Speaker 2: they're doing it a little more willingly, and that they
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Speaker 2: can come back and be less fearful and less anxious
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Speaker 2: in immunization setting.
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Speaker 1: Oh cool, So what was the distraction technique that was
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Speaker 1: involved in this?
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Speaker 2: So in looking at the kind of medical literature and
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Speaker 2: evidence based practices for procedural pain management, So the CDC,
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Speaker 2: so they have seven specific evidence based strategies of ways
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Speaker 2: to reduce that procedural pain cool Those are things like
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Speaker 2: giving sweet tasting liquids orally injecting vaccines rapidly without.
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Speaker 1: Aspiration aspirations the sort of like when they do the
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Speaker 1: little pump on the on the plunger to make sure
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Speaker 1: there's no air in it. I think they use that
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Speaker 1: as sort of a scary image in movies sometimes, like
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Speaker 1: you see they like press the plunger in the little
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Speaker 1: bit of liquid comes out and it's it's an ominous beware,
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Speaker 1: bad things are about to happen signal.
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Speaker 2: So the third one, injecting the most painful vaccine last.
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Speaker 1: Okay, makes sense? Build up to it, yeah.
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Speaker 2: Fourth using tactile stimulation such as rubbing or stroking near
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Speaker 2: the injection site before and during the injection. Then distracting
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Speaker 2: the patient done either by like parent, clinician the patient themselves,
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Speaker 2: having the patient seated rather than laying down, and lastly
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Speaker 2: using topical anesthetics. And so from our perspective, not being
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Speaker 2: medical providers and just trying to offer some evidence based
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Speaker 2: practice around what works or strategies for working with people
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Speaker 2: with lived experience and their families. We focused a lot
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Speaker 2: on numbers four and five. So using some sort of
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Speaker 2: tactile stimulation as well as distraction, and we really focused
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Speaker 2: our kits around those two measures.
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Speaker 1: Awesome. I want to get into some of the details
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Speaker 1: of the features of these kits. But speaking of distraction,
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Speaker 1: here's an unwelcome distraction in the form of ADS. We're
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Speaker 1: back and we were talking about the components of these
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Speaker 1: kits that get to a sensory l element of the
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Speaker 1: experience of receiving a vaccine or a shot of some kind.
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Speaker 1: I'm given to understand there's the piece of a kit
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Speaker 1: that sort of you had mentioned this sort of rubbing
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Speaker 1: the injection site or like providing some stimulation to that.
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Speaker 1: What kind of tool would you use to address that.
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Speaker 2: So one of the things included in these kits is
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Speaker 2: a buzzy stimulator, and what it does is it combines
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Speaker 2: high frequency vibration and cold to really control sharp pain.
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Speaker 2: So it's a little high frequency vibration that looks like
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Speaker 2: a little b and it has its wings are a
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Speaker 2: ice ice pack, and so it can really help with
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Speaker 2: really controlling that sharp pain. Research has shown it's effective
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Speaker 2: at reducing both the pain as well as the fear
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Speaker 2: in the future of getting future injections, and data also
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Speaker 2: indicates that there's a less likelihood of individuals passing out
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Speaker 2: during their vaccination experience.
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Speaker 1: That makes sense. I feel like that would help me.
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Speaker 1: And I'm not even really a person who's afraid of vaccines,
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Speaker 1: but I mean, it doesn't feel very good to get
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Speaker 1: stuck with a needle. And so the way it works
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Speaker 1: basically is you have like a tiny tool I guess
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Speaker 1: you could call it that is cold and it vibrates
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Speaker 1: pretty fast, and you sort of put that on the
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Speaker 1: injection site.
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Speaker 2: The recommendation is between pain and brain. So if the
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Speaker 2: vaccine is on your arm, you're going to put the
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Speaker 2: device just above where you inject the vaccine, again between
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Speaker 2: pain and brain if you are putting it elsewhere. So
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Speaker 2: if you need a shot in the stomach or in
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Speaker 2: the leg, again you're just thinking of right above the
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Speaker 2: area where the shot is, again between pain and brain.
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Speaker 1: Cool.
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Speaker 2: So the other kit items that we included, we did
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Speaker 2: a big box of fidget toys, just because you know,
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Speaker 2: every person has a different preference for things they like
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Speaker 2: to play with. So there's like poppets and some toys
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Speaker 2: that make noise, some that spin and are colorful, all
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Speaker 2: those kind of different things, and.
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Speaker 1: So so the distractions, like give them something else to do.
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Speaker 2: Give them something else to do, something exciting, given that
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Speaker 2: immunization experience should be fairly short. You know, anything that
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Speaker 2: even if it provides a couple minutes of distraction during
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Speaker 2: a stressful time, can be helpful in that environment.
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Speaker 1: Yeah, I think people's phones have sort of served that
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Speaker 1: purpose in their lives, where that becomes a distraction that's
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Speaker 1: like I'm bored, or I don't like this event or something,
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Speaker 1: I have something else to do. It makes a lot
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Speaker 1: of sense then to leverage a tool that serves a
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Speaker 1: similar function.
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Speaker 2: We also included noise canceling headphones in case it's like
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Speaker 2: an environment where it's really a little audit toy over
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Speaker 2: stimulation is happening for the individual. We have a weight
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Speaker 2: to blanket in case that's a preference for an individual.
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Speaker 2: And we have a Coping Skills for Kids workbook that
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Speaker 2: includes a lot of different activities to focus on any
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Speaker 2: sort of calming activities. Like there's a lot of just
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Speaker 2: breathing activities that are very visual that kids can kind
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Speaker 2: of like trace a circle or a square or anything
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Speaker 2: and kind of follow the instructions, like you know, holding
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Speaker 2: their breath for four seconds and then letting it out
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Speaker 2: for four, holding again for four, breathing in for four,
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Speaker 2: just lots of different kind of activities that can help
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Speaker 2: calm the breathing.
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Speaker 1: So you have the sort of stimulatory aspect of this,
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Speaker 1: you have this distraction piece against is all in the
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Speaker 1: service of facilitating access to medical treatments, and so there's
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Speaker 1: also there was some more that you guys were doing
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Speaker 1: that had to do with how you worked with the
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Speaker 1: existing practices in sort of the medical space as well
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Speaker 1: in terms of strategies they use.
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Speaker 2: Yeah, I think that we were mostly trying to take
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Speaker 2: things that have been available and that a lot of
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Speaker 2: medical providers are familiar with. And so there's quite a
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Speaker 2: few different like pain management scales that are you know,
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Speaker 2: have been researched heavily in the medical field, like the
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Speaker 2: Flax scale, for example.
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Speaker 1: It's one of those smiley faces.
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Speaker 2: No, the Flax scale is the it's actually one that
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Speaker 2: they use with babies and other so's. It's often done
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Speaker 2: for people with disabilities.
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Speaker 1: So pretty much, if I'm hearing you correctly, it's like
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Speaker 1: it's people who often have limited ability to communicate their
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Speaker 1: sort of their experience of pain.
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Speaker 2: Yes, yeah, so hence you know why, it's often with
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Speaker 2: younger children who may not be able to you know,
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Speaker 2: identify like on a scale, so like the long Baker
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Speaker 2: Faces scale, for example, that you often see in a
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Speaker 2: lot of hospitals, has like those different faces and they
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Speaker 2: tell you what, you know, what face are you today
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Speaker 2: or what number are you sure, just to get an
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Speaker 2: idea of if things are improving or getting worse. But
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Speaker 2: for yeah, individuals who can't maybe say where they're at,
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Speaker 2: either you know, in that moment or just aren't able
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Speaker 2: to do.
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Speaker 1: That as yeah, they may not understand the question.
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Speaker 2: Yes, there's there's a lot to that, but there there
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Speaker 2: are some scales, so like the Flax scale developed by
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Speaker 2: Merkle and colleagues who it's mostly so flac F l
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Speaker 2: A C C, face, legs, activity, cry, and consolability. And
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Speaker 2: so there's essentially a zero to two rating scale of
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Speaker 2: for example, the face. You know, for a zero, it
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Speaker 2: might be there's no expression or smile. One there's maybe
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Speaker 2: occasional grimace that they frown withdrawn into is you know
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Speaker 2: that there's clenched jaw, frequent to constant frown, and so
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Speaker 2: you're just looking at physical behaviors that you can observe
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Speaker 2: to hopefully measure pain in some capacity. A child obviously
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Speaker 2: screaming and crying is a pretty clear indication of pain
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Speaker 2: and being upset, and so, you know, just one of
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Speaker 2: the reasons we looked at those is mostly to help
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Speaker 2: medical providers who are familiar with these types of skills
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Speaker 2: to have a way to relate to their patience and
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Speaker 2: to utilize some of those coping and calming techniques as
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Speaker 2: needed kind of in the moment.
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Speaker 1: Essentially, it's taking those as you mentioned, the behaviors as
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Speaker 1: an indicator of when someone is has a limited ability
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Speaker 1: to communicate, is very young children, people with limited verbal repertoires,
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Speaker 1: et cetera. That you can just use some guidance to
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Speaker 1: try to generally categorize what their experience of pain might
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Speaker 1: be based on their overt behaviors, right, did I summarize that? Well? Yeah, cool,
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Speaker 1: all right, I mean, so the plan is essentially that
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Speaker 1: you will work with providers who are in sort of
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Speaker 1: the space of providing vaccines and other medical treatment to
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Speaker 1: that population, the people with disabilities or behavioral sort of obstacles,
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Speaker 1: if you will, to receive that sort of treatment.
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Speaker 2: Yes, so the grant funding that we have for these
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Speaker 2: is specifically in the state of Nevada, So we are
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Speaker 2: providing these to our local providers in the state as
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Speaker 2: long as they are providers, immunization providers and not individuals
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Speaker 2: requesting them themselves. We are providing these kits free of
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Speaker 2: charge as a result of that grant funding.
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Speaker 1: Awesome. So to be clear to everyone, these are these
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Speaker 1: products are not commercially available right now. That's not to
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Speaker 1: say that you who couldn't try some sort of fidget
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Speaker 1: distraction technique if that's going to help, Like, there's some
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Speaker 1: evidence already to suggest that that might work for some people.
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Speaker 1: So I think there's some sort of low stakes, non
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Speaker 1: proprietary things out there on the market. But this is
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Speaker 1: sort of some initial investigatory research, if you will, that
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Speaker 1: then might turn into more widespread practice down the road perhaps. Yeah. Cool,
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Speaker 1: All right, well, thank you so much for joining me.
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Speaker 1: For all of those of those of you out there
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Speaker 1: who are interested then just to follow along. Hopefully this
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Speaker 1: will be something that starts to show up in the world,
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Speaker 1: assuming that that we're allowed to get vaccines over the
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Speaker 1: next several years. So anyway, thank you for joining me today.
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Speaker 1: I appreciate all your insights on this topic. Thank you again.
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Speaker 1: Thank you so much to my guest doctor Lauren Brown
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Speaker 1: for joining me today on this mini. If you'd like
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15:10
Speaker 1: What We Do mini is out.
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