Jeffs 2007.

Study characteristics
Methods	RCT. 3 arms.
Participants	Number of children: 8 control, 19 distraction (10 = investigator‐selected and 9 = self‐selected) Sex of children: 17 M, 15 F Age range of children: 11 ‐ 17 years Mean age of children: 14.06 ± 2.31 years Needle procedure: phase II of allergy testing involving injection Diagnosis of child: none reported Inclusion criteria: 11 ‐ 17 years old, required environmental or food allergen testing, parental presence, ability to read and write in English Exclusion criteria: bee venom allergy testing, cognitive and developmental disability Setting: outpatient allergy testing clinic within large medical centre located in a moderate‐size metropolitan area of the northeastern United States
Interventions	1. Distraction (investigator‐selected): Children watched a nursing recruitment video targeting an adolescent audience prior to and during allergy testing. 2.Distraction (self‐selected): Children selected 1 distracter from collection of music, audio books, or videos. 3.Usual care control: Received no intervention and consisted of typical communication between children and the nurse
Outcomes	Pain measure: Child self‐report: Adolescent Pediatric Pain Tool (APPT) Child self‐report: Wong Baker FACES scale (0 ‐ 10) Adverse events: none mentioned
Notes	Phase I allergy testing was used to determine the presence of non‐reactive allergens. Distraction was resumed during Phase 2 testing, so only Phase II testing was used in the analyses for this review. Phase 1 involved an N of 32, while Phase 2 involved and N of 27; therefore, the total N reported for this study is 27. Study dates: study dates not reported Funding: grant funding was provided by the Foundation of the New York State Nurses Association and the Delta Pi chapter of Sigma Theta Tau International Conflicts of interest: none declared
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Participants randomly assigned "using a computer‐generated random numbers table" (p. 175 Par 2)
Allocation concealment (selection bias)	Unclear risk	Unclear if all appropriate safeguards taken with assignment envelopes (i.e. sequentially numbered or opaque)
Blinding of participants and personnel (performance bias) All outcomes	High risk	Quote: "unblinded experimental design" (p. 172 Par 7)
Blinding of outcome assessment (detection bias) All outcomes	High risk	Quote: "unblinded experimental design" and no blinding of self‐report of outcome assessment (p. 172 Par 7)
Incomplete outcome data (attrition bias) All outcomes	Low risk	No missing data for phase included in current review
Selective reporting (reporting bias)	Unclear risk	Insufficient information to permit judgment of 'low' or 'high' risk
Other bias	High risk	Multiple potential sources of bias related to study design and other problems (e.g. low statistical power)