Promoting medication safety in community spaces
In our outreach to parents of children under 6, we have visited different community groups to promote medication safety with respect to non-prescription cough and cold products. It’s been truly fascinating to interact with parents and their children in diverse community settings and to learn how the audience and context impact our message and its delivery. So far we’ve done 20 talks to 185 parents of over 200 children under 6 years of age. What’s amazing is that only 24 (13%) parents were aware of the important message that: over the counter cough & cold products are not safe. Those who were aware learned through the media (7), doctor’s office (6), day-care (1) pharmacist (5), relatives who are health professionals (4), community centre (1)
Some of the places we have been to include:
- Community drop-in programs where parent groups drop in to learn about community resources. Some of these have been excellent because they offer child-minding thus allowing parents to focus on the presentation. Mobile child minding has been extremely valuable in these venues. In some of the programs, the children are in the same room but on the side. Some parents even bring a grand-parent to mind the children so that they can focus on the talk.
- Diverse language programs: it was a really rewarding experience to present to three Chinese speaking groups. The translation factor may be challenging but overall, it was clear that they understood and valued the message. We verified that there is a Chinese word that distinguishes viruses from bacteria – which was excellent. It was particularly helpful to learn about the medication practices in the Chinese community and the need to promote safety through culturally sensitive workshops.
- Preschool oriented programs aimed at children: these have been a really effective way to connect with the parents. It is quite possible that the parents who are aware of this programs and motivated to bring their children may not be typical parents. They have proven knowledgeable and engaged in learning about their children’s health. This makes us wonder about the characteristics of parents that we are not reaching through these venues.
- Community health centres: these are groups facilitated by a nurse. These have been excellent because the facilitator is a health professional who can prompt us to address the questions that matter to the parents. For example, one nurse asked us to come back and address the topic of drugs and breastfeeding – an excellent topic for her group.
- Libraries: These have been really interesting because they are key centres of learning in the community. One approach has been to visit story-telling programs that libraries organize for families. The story-time is based on a health theme after which we talk to the parents. The challenge here of course is to engage both the young ones, who are the central audience and the parents. Children’s librarians can help us with creative ideas to keep the little one’s interested in our message as well. The other approach has been to organize a standalone program aimed at parents of young children. Where well promoted in advance, this has been very successful as parents come eager to listen to the message and able to stay for the entire length of the presentation. Less successful has been the attempt to offer our presentation in the place of a story program. Since not all parents attend all the sessions, they were not aware that we were offering a different presentation from their regular program.
- Given the alarmingly small proportion of parents who are aware of this message, it is clear that a multi-pronged strategy is required to reach parents with this important information. The message needs to be available in languages other than English and French (Canada’s official languages).
- To simplify things, we emphasized the message: most colds are caused by viruses and there is therefore no cure; over the counter cough & cold medications are not safe and it is safe to give plain pain-killers only (not combination products) to manage fever. However, parents wanted to know the reason why these products were no longer safe for children under 6. Particularly concerned, were those who had older children and had used these products before. It was important to explain that these drugs were released back in the 60s and 70s and since then, there had been no evidence to support their effectiveness. At the same time, there was clear data to show that children metabolized these drugs differently from adults and there were reports of serious side effects not only in Canada but in Europe, US and elsewhere. This reinforces the value of understanding how adults learn and supporting that when conveying messages.
- The discussion of non-medicinal remedies was essential for supporting actionable behavioural change. It would have been unrealistic to expect parents to follow this recommendation without a clear alternative for handling cough and cold symptoms. Encouraging parents to share their own experiences of successful remedies was empowering and effective. Many of them were knowledgeable and played the role of peer educators.
- The parents posed thought-provoking questions some of which were based on their cultural background and traditional practices. Others sought clarification while some stemmed from common beliefs and conceptions that need to be validated by evidence. For example, how do I tell the difference between a bacterial and viral infection? Are there safe homeopathic remedies? Are these effective? Does applying alcohol on the child’s body bring down fever? Does massage therapy help with cold symptoms? Is it okay to cut an adult’s Tylenol pill into half for a child? My child is x pounds. How much of drug y should I give him? Are antihistamines okay for allergies? Why call it baby aspirin and yet it’s not safe for kids under 20?
- Our Fortune Teller was very popular as it was a lot of fun: everyone enjoys folding it and we can’t keep up with the demand.
- The most valuable information we can give consumers is how to find health reliable information – such sources as BC health guide.