Childhood immunisation is a critically important public health initiative. However, since most vaccines are administered by injection, it is associated with considerable pain and distress. Despite evidence demonstrating the efficacy of various pain management strategies, the frequency with which these are used during routine infant vaccinations in UK practice is unknown.

This study aimed to explore primary care practice nurses’ (PNs) use of evidence-based pain management strategies during infant immunisation, as well as barriers to evidence-based practice.

A questionnaire was developed and distributed to nurses throughout the UK via convenience sampling in paper and online formats. Questions assessed the frequency of pain management intervention use during infant immunisation and barriers to their use.

A total of 255 questionnaire responses were received. Over 90% (n = 226) of respondents never used topical anaesthetics or sweet solutions during immunisations, while 41.9% advised breastfeeding occasionally (n = 103). Parent-/caregiver-led distraction was the most frequently used intervention, with most nurses using it occasionally (47.9%, n = 116) or often (30.6%, n = 74). Most practices had no immunisation pain management policy (81.1%, n = 184), and most PNs’ previous training had not included pain management (86.9%, n = 186). Barriers to intervention use included lack of time, knowledge and resources. Excluding distraction, pain management strategies were infrequently or never used during infant immunisation. Key barriers to using evidence-based strategies were lack of time, knowledge and resources.

Behavioural activation (BA) is recommended by the National Institute for Health and Care Excellence guidelines for the treatment of perinatal depression; however, there is limited evidence about whether it is effective when delivered by non-mental health specialists (NMHS) in a perinatal setting in the UK.

This study aimed to adapt a BA intervention manual and guided self-help booklet intended for delivery by NMHSs for the treatment of perinatal depression.

Interviews were conducted with 15 women and 19 healthcare professionals (HCP) within the first study element. Four experience-based co-design (EBCD) workshops were held, with the involvement of 14 women and three HCPs, to modify the BA documents for the specific needs of perinatal women. Thematic analysis was used to analyse the data.

The findings from the study elements were presented with themes. The co-designers (women and HCPs) pointed out that having sleeping problems, changes in appetite, feeling exhausted and feeling emotional, may be experienced by non-depressed mothers as well during pregnancy or in the postpartum period, especially around the fourth day after giving birth. Therefore, it was important to differentiate these feelings from depression. The women also wanted to see an example for each activity before being asked to do it. Having examples would help them to see the possibilities before creating their own diary sheets or tables of activities.

Aside of the tool adaptation, the findings of this study provide a foundation to assess the effectiveness of the adapted intervention in a subsequent feasibility trial.

This study explored health visitors’ perception of their role in the universal childhood immunisation programme with particular emphasis on influencing factors and communication strategies.

The majority of parents’ consent to immunisation, but some find decision-making in this area difficult and have unmet information needs. In the United Kingdom, health visitors routinely provide immunisation information for parents, whereas general practitioners (GPs) and practice nurses tend to administer vaccines and respond to parents/carers’ questions. Research has investigated health professionals’ views and knowledge about immunisation, but less is understood about health visitors’ role and how they communicate with parents.

Following the Local Research Ethics and Research Governance permissions, all health visitors (n = 120) working in one county in the United Kingdom were invited to participate in the study. Semistructured interviews (n = 22) were undertaken using a prompt guide. The interviews were transcribed verbatim. Thematic analysis using an iterative approach was used to explore the data facilitated by NVIVO™ software.

Five themes emerged from the interviews. These were health visitors’ professional role; identity and perceived barriers and communication strategies, parents’ right to choose, confidence in measles, mumps, and rubella (MMR) vaccination and communicating with migrant families about immunisation. There were differences between the health visitors in their perceptions of their roles, skills and knowledge and communication strategies. Health visitors perceived that GPs and practice nurses took a paternalistic approach to the provision of immunisation information, while they used a parental decision-making model. Health visitors reported a loss of professional confidence following the MMR crisis.

Given the evidence that some parents find it difficult to gain the information they need about immunisation and health visitors’ acknowledgement that their usual communication models were not effective during the MMR crisis, we feel specific communication skills training is needed to enable health professionals to provide parents with appropriate decision support.