An interactive web cartoon titled "Welcome to the Radiology Center" teaches sick children what to expect before undergoing an MR, CT, or chest x-ray study. It also gives them a sense of mastery and adventure while enhancing compliance with the procedures.

Developed by the Starlight Children's Foundation in Los Angeles with a grant from the Ronald MacDonald Foundation, the animation was initially available only in CD-ROM format. Hospira, a specialty pharmaceutical and drug delivery company, provided funding to get it online. It is now available for free on the Internet at www.starlight.org/radiology. As of July, the site was receiving between 300 and 400 hits each day.

"The script is based on what young children said that they most wanted to know and what health professionals and parents said seemed to be the most distressing or frightening," said Joan Ford, Starlight's vice president of technology and strategic initiatives.

Starlight interviewed children with serious medical conditions to see what worried them most and what additional information they wanted. The foundation then shared the children's concerns with healthcare professionals and parents in crafting the script. Starlight also commissioned children to review the script, artwork, and outline to ensure that the animation engaged them, was comprehensive, and used kid-friendly language. The program is aimed at introducing children ages six to 10 to the radiology center.

Children meet Justin, Kyle, and April in the radiology waiting room outside doors to the MR, CT, and chest x-ray areas. They click on the characters or radiology rooms to familiarize themselves with the procedures.

Justin has bad stomachaches and has been losing weight. He has already had x-rays, but now he is here for his first CT scan.

"Even though I told everyone at school I was not afraid, now that I am here, I am kind of scared," he said.

Kyle has a bad cough, a fever, and trouble breathing. He is here for a chest x-ray.

April is here for a brain MR. She tells us that she has had headaches and lots of tests, including ones that hurt. Yet she proudly adds that she had a brain MR before.

When a child clicks on each room to enter, a guide gets the appropriate character ready for the test, explaining why a lead apron is needed, why it is important to stand still, that it won't hurt. Unlike passive learning, children click-navigate their way through the stories. They can click the mouse to drink contrast, remove metal, and turn on the machine. The characters interact with the guide and give their opinions about what they are asked to do. Sounds mimic what they would hear when they undergo each test.

According to Rita Goshert, clinical operations manager of the Child Life Program at Miller Children's Hospital in Long Beach, CA, kids often have fears of separation, claustrophobia, and huge machinery.

"When kids learn what to expect, they feel that they can master it," she

said "Play opportunities make the child more comfortable."

—By Laura Newman