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| ID | Type | Description | Link |
|---|---|---|---|
| 200 2012 53663 0013 | Other Grant/Funding Number | CDC |
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| Name | Class |
|---|---|
| Centers for Disease Control and Prevention | FED |
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This is a randomized controlled open-label trial. During the study, adolescents scheduled to receive at least one intramuscular (IM) vaccine will receive either Buzzy®, Music, or Buzzy® and Music intervention(s) in addition to standard care to evaluate the feasibility and acceptability of these interventions prior to being used in a larger study to assess the effectiveness of the interventions in preventing post-vaccination presyncope and syncope. Feasibility will be assessed according to study staff ability to successfully administer the protocol specified clinic-based interventions and per both study staff and healthcare provider responses to written feasibility assessments. Acceptability will be assessed according to the participant's self-report. In addition, baseline needle phobia and anxiety, post-vaccination pain and presyncope symptoms, and pre- and post- vaccination state anxiety will be assessed per participant written self-report to standardized survey questions.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Buzzy® | Active Comparator | Buzzy® Drug Free Pain Relief which is a medical device designed to reduce vaccination pain when applied to the arm prior to and during a vaccination. |
|
| Music | Active Comparator | Music will be selected and listened to as a distraction before and during vaccination. |
|
| Buzzy® and Music | Active Comparator | Buzzy® will be applied to the arm prior to and during vaccination and music will be selected and listened to before and during vaccination. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Buzzy® | Device | Buzzy® Drug Free Pain Relief which is a medical device designed to reduce vaccination pain when applied to the arm prior to and during a vaccination. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Number of Subjects Who Have Buzzy® Applied to and Kept at Vaccination Site/s for ≥ 30 Seconds Prior to Vaccination | Buzzy® will be applied to and kept on the subjects arm for a minimum of 30 seconds prior to vaccination. | Day1 |
| Number of Subjects Who Have Buzzy® Kept on Vaccination Arm/s During the Entire Vaccination Procedure | Buzzy® will be applied to and kept on the subjects arm for the duration of the vaccination procedure. | Day1 |
| Number of Subjects Who Have Music Playing for ≥ 3 Minutes Prior to Vaccination | Music will be played over speakers for a minimum of 3 minutes prior to vaccination | Day1 |
| Number of Subjects Who Have Music Playing for 10 Minutes Post Vaccination | Music will be played over speakers through the 10 minute post vaccination pain assessment | Day1 |
| Number of Subjects Who Complete the Pre-vaccination Anxiety Assessment | Subjects will be asked to complete an anxiety assessment prior to vaccination | Day1 |
| Number of Subjects Who Complete the Pre-vaccination Needle Phobia Assessment | Subjects will be asked to complete a needle phobia assessment pre-vaccination | Day1 |
| Number of Subjects Who Complete the Post-vaccination Pain Assessment at 1 Minute. | Subjects will complete a post vaccination pain assessment within one minute of their final vaccination |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Emmanuel "Chip" B Walter, MD, MPH | Duke Univeristy | Principal Investigator |
| Theresa Harrington, MD, MPH&TM | Centers for Disease Control and Prevention | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Centers for Disease Control and Prevention | Atlanta | Georgia | 30333 | United States | ||
| Duke University |
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| ID | Title | Description |
|---|---|---|
| FG000 | Buzzy® | Buzzy® Drug Free Pain Relief which is a medical device designed to reduce vaccination pain when applied to the arm prior to and during a vaccination. Buzzy®: Buzzy® Drug Free Pain Relief which is a medical device designed to reduce vaccination pain when applied to the arm prior to and during a vaccination. |
| FG001 | Music | Music will be selected and listened to as a distraction before and during vaccination. Music: Music will be selected and listened to as a distraction before and during vaccination. |
| FG002 | Buzzy® and Music | Buzzy® will be applied to the arm prior to and during vaccination and music will be selected and listened to before and during vaccination. Buzzy®: Buzzy® Drug Free Pain Relief which is a medical device designed to reduce vaccination pain when applied to the arm prior to and during a vaccination. Music: Music will be selected and listened to as a distraction before and during vaccination. |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
Adolescents randomized to intervention
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| ID | Title | Description |
|---|---|---|
| BG000 | Buzzy® | Buzzy® Drug Free Pain Relief which is a medical device designed to reduce vaccination pain when applied to the arm prior to and during a vaccination. Buzzy®: Buzzy® Drug Free Pain Relief which is a medical device designed to reduce vaccination pain when applied to the arm prior to and during a vaccination. |
| BG001 |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Customized | Count of Participants |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Number of Subjects Who Have Buzzy® Applied to and Kept at Vaccination Site/s for ≥ 30 Seconds Prior to Vaccination | Buzzy® will be applied to and kept on the subjects arm for a minimum of 30 seconds prior to vaccination. | Participants randomized to intervention and vaccinated | Posted | Count of Participants | Participants | Day1 |
|
Data were collected for 20 minutes post-vaccination.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Buzzy® | Buzzy® Drug Free Pain Relief which is a medical device designed to reduce vaccination pain when applied to the arm prior to and during a vaccination. Buzzy®: Buzzy® Drug Free Pain Relief which is a medical device designed to reduce vaccination pain when applied to the arm prior to and during a vaccination. |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Presyncope | Vascular disorders | Non-systematic Assessment | Air conditioning in room not working. The patient felt better after being fanned for five minutes. Symptoms lasted between 1 and 5 minutes. |
Not provided
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Kristen Gunnell | Duke Vaccine and Trials Unit | 9196848891 | kristen.gunnell@duke.edu |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Apr 17, 2018 | Jul 9, 2019 | Prot_SAP_000.pdf |
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| ID | Term |
|---|---|
| D019462 | Syncope, Vasovagal |
| D013575 | Syncope |
| ID | Term |
|---|---|
| D054971 | Orthostatic Intolerance |
| D054969 | Primary Dysautonomias |
| D001342 | Autonomic Nervous System Diseases |
| D009422 | Nervous System Diseases |
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| ID | Term |
|---|---|
| D009147 | Music Therapy |
| ID | Term |
|---|---|
| D026421 | Sensory Art Therapies |
| D000529 | Complementary Therapies |
| D013812 | Therapeutics |
| D012046 | Rehabilitation |
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| Music | Behavioral | Music will be selected and listened to as a distraction before and during vaccination. |
|
| Day1 |
| Number of Subjects Who Complete the Post-vaccination Pain Assessment at 10 Minutes | Subjects will complete a post vaccination pain assessment at 10 minutes after their final vaccination | Day1 |
| Number of Subjects Who Complete the Post-vaccination Presyncope Symptom Assessment | Subjects will complete a questionnaire about presyncope symptoms after their vaccination/s | Day1 |
| Number of Subjects Who Complete the Post Vaccination Anxiety Assessment | Subjects will complete a post vaccination anxiety assessment | Day1 |
| Number of Subjects Who Complete the Acceptability Assessment | Subjects will be given a questionnaire about the acceptability of their intervention. | Day1 |
| Number of Reports From Coordinators That Indicated Having Music Playing During the Vaccine Administration Was Somewhat Easy or Very Easy | Coordinators will answer a questionnaire about the feasibility of the music intervention after each encounter with a subject | Day1 |
| Number of Reports From Coordinators That Indicated Having Music Playing During the Vaccine Administration Was Somewhat Assistive or Very Assistive | Coordinators will answer a questionnaire about the feasibility of the music intervention after each encounter with a subject | Day1 |
| Number of Reports From Coordinators That Indicated Having Buzzy® Applied in Conjunction With the Vaccination Was Somewhat Easy or Very Easy | Coordinators will answer a questionnaire about the feasibility of the Buzzy® intervention after each encounter with a subject | Day1 |
| Number of Reports From Coordinators That Indicated Having Buzzy® Applied in Conjunction With the Vaccination Was Somewhat Assistive or Very Assistive | Coordinators will answer a questionnaire about the feasibility of the Buzzy® intervention after each encounter with a subject | Day1 |
| Number of Reports From Providers That Indicated Having Music Playing During the Vaccine Administration Was Somewhat Easy or Very Easy | Providers will answer a questionnaire about the feasibility of the music intervention after each encounter with a subject | Day1 |
| Number of Reports From Providers That Indicated Having Music Playing During the Vaccine Administration Was Somewhat Assistive or Very Assistive | Providers will answer a questionnaire about the feasibility of the music intervention after each encounter with a subject | Day1 |
| Number of Reports From Providers That Indicated Having Buzzy® Applied in Conjunction With the Vaccination Was Somewhat Easy or Very Easy | Providers will answer a questionnaire about the feasibility of the Buzzy® intervention after each encounter with a subject | Day1 |
| Number of Reports From Providers That Indicated Having Buzzy® Applied in Conjunction With the Vaccination Was Somewhat Assistive or Very Assistive | Providers will answer a questionnaire about the feasibility of the Buzzy® intervention after each encounter with a subject | Day1 |
| Number of Subjects Who Like Having Music Play During Their Shot/s a Little or Very Much | Subjects will complete a survey about the acceptability of the music intervention during their vaccinations | Day1 |
| Number of Subjects Who Felt Having Music Play During Their Shot/s Was Somewhat Easy or Easy | Subjects will complete a survey about the acceptability of the music intervention during their vaccinations | Day1 |
| Number of Subjects Who Found Music Playing While Receiving Their Shots to be Somewhat Comfortable or Very Comfortable | Subjects will complete a survey about the acceptability of the music intervention during their vaccinations | Day1 |
| Number of Subjects Who Found the Music Playing While They Got Their Shot/s to be Just Right | Subjects will complete a survey about the acceptability of the music intervention during their vaccinations | Day1 |
| Number of Subjects Who Would be Somewhat Likely or Very Likely to Want to Listen to Music Again While Receiving Shot/s | Subjects will complete a survey about the acceptability of the music intervention during their vaccinations | Day1 |
| Number of Subjects Who Found the Music App Sufficient or Somewhat Sufficient to Selecting the Music They Like | Subjects will complete a survey about the acceptability of the music intervention during their vaccinations | Day1 |
| Number of Subjects Who Either Like a Little or Very Much Liked Having Buzzy® on Their Arm/s During Shot/s | Subjects will complete a survey about the acceptability of the Buzzy® intervention during their vaccinations | Day1 |
| Number of Subjects Who Found Having Buzzy® on Their Arm/s During Shot/s Somewhat Easy or Very Easy | Subjects will complete a survey about the acceptability of the Buzzy® intervention during their vaccinations | Day1 |
| Number of Subjects Who Found Having Buzzy® on Their Arm/s During Shot/s Somewhat Comfortable or Very Comfortable | Subjects will complete a survey about the acceptability of the Buzzy® intervention during their vaccinations | Day1 |
| Number of Subjects Who Were Not Bothered by the Cold Temperature of Buzzy® on Their Arm/s During Shot/s | Subjects will complete a survey about the acceptability of the Buzzy® intervention during their vaccinations | Day1 |
| Number of Subjects Who Were Not Bothered by the Vibration of Buzzy® on Their Arm/s During Shot/s | Subjects will complete a survey about the acceptability of the Buzzy® intervention during their vaccinations | Day1 |
| Number of Subjects Who Would Choose to Have Buzzy® on Their Arm/s During Shot/s Again | Subjects will complete a survey about the acceptability of the Buzzy® intervention during their vaccinations | Day1 |
| Durham |
| North Carolina |
| 27705 |
| United States |
| Music |
Music will be selected and listened to as a distraction before and during vaccination. Music: Music will be selected and listened to as a distraction before and during vaccination. |
| BG002 | Buzzy® and Music | Buzzy® will be applied to the arm prior to and during vaccination and music will be selected and listened to before and during vaccination. Buzzy®: Buzzy® Drug Free Pain Relief which is a medical device designed to reduce vaccination pain when applied to the arm prior to and during a vaccination. Music: Music will be selected and listened to as a distraction before and during vaccination. |
| BG003 | Total | Total of all reporting groups |
| Participants |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Ethnicity (NIH/OMB) | Count of Participants | Participants |
|
| Race/Ethnicity, Customized | Count of Participants | Participants |
|
| Region of Enrollment | Count of Participants | Participants |
|
Music will be selected and listened to as a distraction before and during vaccination.
Music: Music will be selected and listened to as a distraction before and during vaccination.
| OG002 | Buzzy® and Music | Buzzy® will be applied to the arm prior to and during vaccination and music will be selected and listened to before and during vaccination. Buzzy®: Buzzy® Drug Free Pain Relief which is a medical device designed to reduce vaccination pain when applied to the arm prior to and during a vaccination. Music: Music will be selected and listened to as a distraction before and during vaccination. |
|
|
| Primary | Number of Subjects Who Have Buzzy® Kept on Vaccination Arm/s During the Entire Vaccination Procedure | Buzzy® will be applied to and kept on the subjects arm for the duration of the vaccination procedure. | Participants randomized to intervention and vaccinated | Posted | Count of Participants | Participants | Day1 |
|
|
|
| Primary | Number of Subjects Who Have Music Playing for ≥ 3 Minutes Prior to Vaccination | Music will be played over speakers for a minimum of 3 minutes prior to vaccination | Participants randomized to intervention and vaccinated | Posted | Count of Participants | Participants | Day1 |
|
|
|
| Primary | Number of Subjects Who Have Music Playing for 10 Minutes Post Vaccination | Music will be played over speakers through the 10 minute post vaccination pain assessment | Participants randomized to intervention and vaccinated | Posted | Count of Participants | Participants | Day1 |
|
|
|
| Primary | Number of Subjects Who Complete the Pre-vaccination Anxiety Assessment | Subjects will be asked to complete an anxiety assessment prior to vaccination | Participants randomized to intervention and vaccinated | Posted | Count of Participants | Participants | Day1 |
|
|
|
| Primary | Number of Subjects Who Complete the Pre-vaccination Needle Phobia Assessment | Subjects will be asked to complete a needle phobia assessment pre-vaccination | Participant randomized to intervention and vaccinated | Posted | Count of Participants | Participants | Day1 |
|
|
|
| Primary | Number of Subjects Who Complete the Post-vaccination Pain Assessment at 1 Minute. | Subjects will complete a post vaccination pain assessment within one minute of their final vaccination | Participants randomized to intervention and vaccinated. | Posted | Count of Participants | Participants | Day1 |
|
|
|
| Primary | Number of Subjects Who Complete the Post-vaccination Pain Assessment at 10 Minutes | Subjects will complete a post vaccination pain assessment at 10 minutes after their final vaccination | Participants randomized to intervention and vaccinated. | Posted | Count of Participants | Participants | Day1 |
|
|
|
| Primary | Number of Subjects Who Complete the Post-vaccination Presyncope Symptom Assessment | Subjects will complete a questionnaire about presyncope symptoms after their vaccination/s | Participants randomized to intervention and vaccinated. | Posted | Count of Participants | Participants | Day1 |
|
|
|
| Primary | Number of Subjects Who Complete the Post Vaccination Anxiety Assessment | Subjects will complete a post vaccination anxiety assessment | Participant randomized to intervention and vaccinated | Posted | Count of Participants | Participants | Day1 |
|
|
|
| Primary | Number of Subjects Who Complete the Acceptability Assessment | Subjects will be given a questionnaire about the acceptability of their intervention. | Participant randomized to intervention and vaccinated | Posted | Count of Participants | Participants | Day1 |
|
|
|
| Primary | Number of Reports From Coordinators That Indicated Having Music Playing During the Vaccine Administration Was Somewhat Easy or Very Easy | Coordinators will answer a questionnaire about the feasibility of the music intervention after each encounter with a subject | Participant randomized to intervention and vaccinated | Posted | Count of Participants | Participants | Day1 |
|
|
|
| Primary | Number of Reports From Coordinators That Indicated Having Music Playing During the Vaccine Administration Was Somewhat Assistive or Very Assistive | Coordinators will answer a questionnaire about the feasibility of the music intervention after each encounter with a subject | Participant randomized to intervention and vaccinated | Posted | Count of Participants | Participants | Day1 |
|
|
|
| Primary | Number of Reports From Coordinators That Indicated Having Buzzy® Applied in Conjunction With the Vaccination Was Somewhat Easy or Very Easy | Coordinators will answer a questionnaire about the feasibility of the Buzzy® intervention after each encounter with a subject | Participant randomized to intervention and vaccinated | Posted | Count of Participants | Participants | Day1 |
|
|
|
| Primary | Number of Reports From Coordinators That Indicated Having Buzzy® Applied in Conjunction With the Vaccination Was Somewhat Assistive or Very Assistive | Coordinators will answer a questionnaire about the feasibility of the Buzzy® intervention after each encounter with a subject | Participant randomized to intervention and vaccinated | Posted | Count of Participants | Participants | Day1 |
|
|
|
| Primary | Number of Reports From Providers That Indicated Having Music Playing During the Vaccine Administration Was Somewhat Easy or Very Easy | Providers will answer a questionnaire about the feasibility of the music intervention after each encounter with a subject | Participant randomized to intervention and vaccinated. One participant did not complete the assessment. | Posted | Count of Participants | Participants | Day1 |
|
|
|
| Primary | Number of Reports From Providers That Indicated Having Music Playing During the Vaccine Administration Was Somewhat Assistive or Very Assistive | Providers will answer a questionnaire about the feasibility of the music intervention after each encounter with a subject | Participant randomized to intervention and vaccinated. One participant did not complete the assessment. | Posted | Count of Participants | Participants | Day1 |
|
|
|
| Primary | Number of Reports From Providers That Indicated Having Buzzy® Applied in Conjunction With the Vaccination Was Somewhat Easy or Very Easy | Providers will answer a questionnaire about the feasibility of the Buzzy® intervention after each encounter with a subject | Participant randomized to intervention and vaccinated. One participant did not complete the assessment. | Posted | Count of Participants | Participants | Day1 |
|
|
|
| Primary | Number of Reports From Providers That Indicated Having Buzzy® Applied in Conjunction With the Vaccination Was Somewhat Assistive or Very Assistive | Providers will answer a questionnaire about the feasibility of the Buzzy® intervention after each encounter with a subject | Participant randomized to intervention and vaccinated | Posted | Count of Participants | Participants | Day1 |
|
|
|
| Primary | Number of Subjects Who Like Having Music Play During Their Shot/s a Little or Very Much | Subjects will complete a survey about the acceptability of the music intervention during their vaccinations | Participant randomized to intervention and vaccinated | Posted | Count of Participants | Participants | Day1 |
|
|
|
| Primary | Number of Subjects Who Felt Having Music Play During Their Shot/s Was Somewhat Easy or Easy | Subjects will complete a survey about the acceptability of the music intervention during their vaccinations | Participant randomized to intervention and vaccinated | Posted | Count of Participants | Participants | Day1 |
|
|
|
| Primary | Number of Subjects Who Found Music Playing While Receiving Their Shots to be Somewhat Comfortable or Very Comfortable | Subjects will complete a survey about the acceptability of the music intervention during their vaccinations | Participants randomized to intervention and vaccinated. One participant did not complete the assessment. | Posted | Count of Participants | Participants | Day1 |
|
|
|
| Primary | Number of Subjects Who Found the Music Playing While They Got Their Shot/s to be Just Right | Subjects will complete a survey about the acceptability of the music intervention during their vaccinations | Participants randomized to intervention and vaccinated | Posted | Count of Participants | Participants | Day1 |
|
|
|
| Primary | Number of Subjects Who Would be Somewhat Likely or Very Likely to Want to Listen to Music Again While Receiving Shot/s | Subjects will complete a survey about the acceptability of the music intervention during their vaccinations | Participants randomized to intervention and vaccinated | Posted | Count of Participants | Participants | Day1 |
|
|
|
| Primary | Number of Subjects Who Found the Music App Sufficient or Somewhat Sufficient to Selecting the Music They Like | Subjects will complete a survey about the acceptability of the music intervention during their vaccinations | Participant randomized to intervention and vaccinated | Posted | Count of Participants | Participants | Day1 |
|
|
|
| Primary | Number of Subjects Who Either Like a Little or Very Much Liked Having Buzzy® on Their Arm/s During Shot/s | Subjects will complete a survey about the acceptability of the Buzzy® intervention during their vaccinations | Participants randomized to intervention and vaccinated | Posted | Count of Participants | Participants | Day1 |
|
|
|
| Primary | Number of Subjects Who Found Having Buzzy® on Their Arm/s During Shot/s Somewhat Easy or Very Easy | Subjects will complete a survey about the acceptability of the Buzzy® intervention during their vaccinations | Participant randomized to intervention and vaccinated | Posted | Count of Participants | Participants | Day1 |
|
|
|
| Primary | Number of Subjects Who Found Having Buzzy® on Their Arm/s During Shot/s Somewhat Comfortable or Very Comfortable | Subjects will complete a survey about the acceptability of the Buzzy® intervention during their vaccinations | Participants randomized to intervention and vaccinated | Posted | Count of Participants | Participants | Day1 |
|
|
|
| Primary | Number of Subjects Who Were Not Bothered by the Cold Temperature of Buzzy® on Their Arm/s During Shot/s | Subjects will complete a survey about the acceptability of the Buzzy® intervention during their vaccinations | Participants randomized to intervention and vaccinated | Posted | Count of Participants | Participants | Day1 |
|
|
|
| Primary | Number of Subjects Who Were Not Bothered by the Vibration of Buzzy® on Their Arm/s During Shot/s | Subjects will complete a survey about the acceptability of the Buzzy® intervention during their vaccinations | Participants randomized to intervention and vaccinated | Posted | Count of Participants | Participants | Day1 |
|
|
|
| Primary | Number of Subjects Who Would Choose to Have Buzzy® on Their Arm/s During Shot/s Again | Subjects will complete a survey about the acceptability of the Buzzy® intervention during their vaccinations | Participants randomized to intervention and vaccinated | Posted | Count of Participants | Participants | Day1 |
|
|
|
| 0 |
| 10 |
| 0 |
| 10 |
| 0 |
| 10 |
| EG001 | Music | Music will be selected and listened to as a distraction before and during vaccination. Music: Music will be selected and listened to as a distraction before and during vaccination. | 0 | 10 | 0 | 10 | 1 | 10 |
| EG002 | Buzzy® and Music | Buzzy® will be applied to the arm prior to and during vaccination and music will be selected and listened to before and during vaccination. Buzzy®: Buzzy® Drug Free Pain Relief which is a medical device designed to reduce vaccination pain when applied to the arm prior to and during a vaccination. Music: Music will be selected and listened to as a distraction before and during vaccination. | 0 | 10 | 0 | 10 | 0 | 10 |
|
Not provided
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| D014474 | Unconsciousness |
| D003244 | Consciousness Disorders |
| D019954 | Neurobehavioral Manifestations |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D000359 |
| Aftercare |
| D003266 | Continuity of Patient Care |
| D005791 | Patient Care |
| D011613 | Psychotherapy |
| D004191 | Behavioral Disciplines and Activities |