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Grant Proposal 2-18-02
General Aim: We are searching for ways to provide radiological procedural information to children and their families that is useful, accurate, and reassuring. Specific Aims: We intend to provide a web site that offers self-instruction and interactive video to parents and children interested in exploring radiological procedures they may be scheduled to undergo. Better understanding will lead to decreased apprehension and increased compliance. 1,2,3 Such a website could be used to assess the effectiveness of websites dedicated to preparing children and parents for scheduled radiological procedures. Following completion of the video and once it is available for use on the World Wide Web we plan to assess the video's effectiveness in allaying anxiety as explained briefly below. This project will be carried out in conjunction with representatives from the departments of Public Health and Division of Child and Adolescent and Psychiatry under separate funding from the current grant application. A randomized clinical trial of the effect of a web-based video intervention versus usual care on pre-exam anxiety will be undertaken to measure the effect of a web-based video explaining a radiological examination on anxiety surrounding the examination in the pediatric clinic population. Children who have these examinations will be randomized into intervention and usual care groups at the time of scheduling. At their appointment, they will complete a validated instrument designed to assess anxiety in children. Overall levels will be compared between the two groups in order to assess the video's effect on anxiety. Background and Significance: Parents and children scheduled for radiological procedures should be aware of the environment and the mechanics involved in a radiological procedure. Such preparation may help parents and children understand and foresee expected "invasive" and uncomfortable events. Pediatric Radiologists are sensitive to parents and children's needs. We are searching for ways to provide information to parents and children that is useful, accurate and reassuring. A study by Joy Goldberger, MS, CCLS, demonstrates that children who are "psychologically prepared for medical procedures recover faster with less emotional stress." 1 This is the aim of our project. The World Wide Web is an ideal place to convey medical information for patients because it fulfills three essential criteria:
Preparing videos to be downloaded from the web has been a successful venture for both commercial and non-profit companies. In recent years, as internet connections have grown faster, multimedia capable computers have become more prevalent, the capacity for video and audio on the web to reach a wide audience has increased tremendously. With an educational research grant, the possibilities to benefit the community with this project are ample. We will attempt to make the procedures less frightening for our youngest patients through sensitive, child-friendly communication. Currently, there are many web sites, which give specific information on pediatric radiological examinations 4,5,6,7. They do not, however, include video as a means of explaining the information and also, to our knowledge, have not used cartoons to enhance communication. Using "child actors" will also serve to demystify the process. Our project is a work in progress that can be viewed on the internet at: http://www.newyearvideo.com/designs/pediatricradiology 8 Experimental design: One anticipated difficulty with a streaming video is the capability of the user's computer. Not everyone has a computer with the capacity to run a video satisfactorily. The web page will cover procedures including:
Human and/or animal subjects: No patients will be involved with the project and thus no IRB approval is required. We will, however, verify this with the IRB at our institution. Two pediatric radiologists, a pediatric oncologist, a child and adolescent psychiatrist and radiologic technologists will participate in the videos and do the voice-overs. References:
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