From Evidence to Practice: Implementing the 2026 Canadian Clinical Practice Guideline Update on Vaccination-Related...

Area of Science:

• Public Health
• Psychology
• Implementation Science

Background:

• Vaccination-related distress (VRD) includes pain, needle fear, and stress, acting as a barrier to immunization.
• VRD contributes to vaccination refusal, particularly in under-vaccinated populations, and can have long-term consequences.
• Evidence-based guidelines exist, but adapting interventions like the Canadian CARD system to new cultural contexts is essential.

Purpose of the Study:

• To describe the cultural adaptation process of the Canadian CARD system for the Dutch National Immunization Program.
• To outline the engagement of user groups and preparation for pilot testing using the EPIS framework.
• To ensure effective VRD mitigation strategies are implemented in the Dutch vaccination setting.

Main Methods:

• Utilized the EPIS (Exploration-Preparation-Implementation-Sustainment) framework for systematic adaptation.
• Engaged relevant user groups, including children, support persons, and healthcare professionals.
• Culturally adapted the CARD (Comfort-Ask-Relax-Distract) system for the Dutch context.

Main Results:

• The study details experiences with adapting the CARD system for Dutch users.
• Preparation for pilot testing of a Dutch version of the CARD system is underway.
• The EPIS framework guided the systematic implementation approach.

Conclusions:

• Cultural adaptation and systematic implementation are necessary for introducing multicomponent interventions like the CARD system in new settings.
• The adapted CARD system shows promise for reducing VRD in the Dutch vaccination context.
• Further pilot testing is required to validate the intervention's efficacy in the Netherlands.