Development of Educational Modules to Enhance Care of Aged and Dying Inmates

Development of Educational Modules to Enhance Care of Aged and Dying Inmates

The United States has the highest rate of incarceration in the world and the demographics of the prison inmate population are shifting and aging. Many older adults are serving extended sentences and will age and die in place — making geriatric and end-of-life care an essential educational foci for prison staff. Consequently, resources are needed to adequately prepare prison staff to address this growing concern.

In a recent publication in Public Health Nursing, a research team led by Dr. Susan Loeb from Penn State University and including Klein Buendel (KB) Senior Scientist, Dr. Valerie Myers, reports on the development of educational modules to enhance the care of aged and dying inmates in prisons. The article describes the strategies used to “set-up” the Enhancing Care for the Aged and Dying in Prisons (ECAD-P) educational modules. “Set-up” is the first of four phases in the Institute for Healthcare Improvement (IHI) Framework for Going to Full Scale, which served as the conceptual framework for this study. Objectives achieved during the Set-up phase include: (a) establishing an approach for infusing the intervention into the target system; (b) identifying the product that needs scaling-up; and (c) determining what will be accomplished in the full-scale phase. Also, program buy-in within the given context and identification of the test sites, as well as support by early adopters, are essential.

The design approach for the educational modules included an environmental scan, a modified Delphi study, and a usability study.

An environmental scan provided a foundational understanding of the complex, contextual factors that impact correctional settings in the United States. Specifically, the environmental scan of diverse correctional settings helped to determine current educational approaches, education and learning preferences of personnel, and the technological capacity to deliver computer-based educational modules. Gaining knowledge was essential for the targeted development of modules that are tailored to address the health needs of the growing numbers of older inmates, many of whom will remain incarcerated through their end of life.

The Delphi process uses iterative group facilitation to forge reliable consensus on the opinion of experts through a series of structured questionnaires or rounds. The goal is to secure expert judgment based on experience. A Delphi survey was conducted early in the Set-Up phase to identify essential geriatric content for integration into the new prototype learning modules. The outcome was a reliable consensus on essential geriatric content for inclusion into the newly rebranded ECAD-P modules. An Expert Advisory Board reviewed the findings and validated the results.

For the usability assessment, the research team collaborated to design and program three media-rich, interactive computer-based prototype modules designed for the corrections context. The prototype, containing three modules, was built using Axure development software. The prototype was self-contained on a laptop computer. Each module had learning objectives, content delivered through multiple interactive features (for example: drag and drop, hover, click and reveal, video) and a final comprehension check quiz. Usability and acceptability testing were assessed following an established protocol examine navigability, detect problems, observe time spent solving problems, identify problem severity, and develop recovery strategies. After usability testing, the participants completed the System Usability Scale, a validated tool for assessing the usability and acceptability of technology-based products. Testing was conducted with 16 participants at two state correctional institutions in one mid-Atlantic state.

A full description of the methods, results, conclusions, and limitations of this study, as well as the implications for public health nursing, can be found in Public Health Nursing. This research was funded by a Small Business Technology Transfer (STTR) grant to KB from the National Institute on Aging at the National Institutes of Health (AG049570; Dr. Susan Loeb, Principal Investigator). Other collaborators/coauthors include Dr. Janice Penrod, Dr. Erin Kitt-Lewis, Dr. Rachel Wion, and Brenda Baney from Penn State University; and Sophia Strickfaden from Johnson & Wales University. KB’s Creative Team produced the ECAD-P prototype modules.

Skin Cancer Awareness for Winter Enthusiasts

Skin Cancer Awareness for Winter Enthusiasts

Last month, Klein Buendel (KB) teamed up with the Colorado Skin Cancer Task Force (CSCTF) and Rocky Mountain Sunscreen (RMS) at the Annual Outdoor Retailer and Snow Show to spread skin cancer awareness to outdoor winter enthusiasts.

Per their website, the Outdoor Retailer Snow Show is the largest outdoor snow sports industry gathering in North America. The trade show brings outdoor industry brands, suppliers, retailers, and leaders together for a three-day expo at the Colorado Convention Center. Although the trade show is closed to the public, last year the event attracted over 29,000 attendees with representatives from over 1,000 brands.

The extensive Snow Show provides the opportunity to reach thousands of individuals who work and recreate outdoors. Every year, for over a decade, KB has partnered with the CSCTF and RMS to raise awareness about UV radiation and skin cancer prevention at the event. We stress the importance of practicing sun safety at high elevation during the winter months when UV can reach very high levels.

Specifically, KB increases people’s awareness of their personal risk for skin cancer by taking individual’s UV photographs using a Reveal Imager. The imager by Canfield, has the ability to capture and expose a lifetime of sun damage in a single image of someone’s face that is otherwise invisible to the naked eye. From the image, KB staff point out problem areas that have received damage from the sun and suggested simple sun safety practices for people to better protect themselves from accruing further UV damage.

Other members of the CSTF, including Colorado dermatologists and dermatology interns, were also present to help field questions and to perform free skin examinations on request.

African Heritage and Health Week

African Heritage and Health Week

The first week of February is African Heritage and Health Week – a celebration of the flavors and healthy cooking techniques that were central and vital to the well-being of African ancestors from Africa, South America, the Caribbean, and the American South. February is the perfect time to honor and explore this healthy culinary history because it is also Black History Month.

African Heritage and Health Week was pioneered by Oldways to promote healthier, happier living through cultural food traditions. Studies have shown that many chronic conditions such as diabetes, heart disease, and obesity, now prevalent in African American communities, tend to appear in populations as traditional diets are changed or abandoned. The program is designed to raise awareness about the health benefits and exciting flavors of traditional African heritage cuisines, and to invite people everywhere to taste these traditional foods, whether at a restaurant, a community event, or at home with friends and family.

Klein Buendel’s Real Health Photos® can help increase the effectiveness of health campaigns – such as those promoting healthy cultural cooking in African American communities – by providing photographs for print and digital media that represent and appeal to the target population. This unique stock photography enterprise includes numerous images of people shopping, cooking, and eating in healthy ways. Real Health Photos show diversity of gender, race, ethnicity, age, income level, and health condition.

Real Health Photos is a stock photography service owned and operated by Klein Buendel. It was developed with a research grant (MD003338, Mary Buller, Principal Investigator) from the National Institute of Minority Health and Health Disparities at the National Institutes of Health. Real Health Photos is designed to capture the diversity of health through photography and promote the inclusion of all populations in health promotion materials and media – and the effectiveness of the intended health message.

For more images, visit Real Health Photos.

Ms. Mary Buller, President and Owner of Klein Buendel, and her coauthors recently published a paper on their photographic research in the Journal of Health Communication.

Collaborator Spotlight:
Dr. Frank Pérez

Collaborator Spotlight:
Dr. Frank Pérez

Image courtesy of UTEP

Frank G. Pérez, Ph.D., is an Associate Professor of Communication and Research at the University of Texas at El Paso (UTEP). He is currently a collaborator working with Klein Buendel scientists, Dr. Gill Woodall and Dr. David Buller, on WayToServe® Español: A Culturally-Appropriate Online Responsible Beverage Service Training for Spanish-Speaking Servers project, funded by the National Institute on Minority Health and Health Disparities. Dr. Pérez will assist with the creation of culturally-appropriate content and the translation of the WayToServe online training program into Spanish and to ensure the translation is compatible with the needs and values of alcohol servers in Spanish language-dominant bars and restaurants. The randomized control trial will take place at Spanish-dominant businesses in the Southwestern region of the United States.

At UTEP Dr. Pérez ’s research includes Intercultural communication, popular culture, Chicano studies, identity issues and the Master of Leadership Studies programs. He also conducts research in intercultural health with a focus on Latina/Latino populations in relation to alcohol use. He is also the lead instructor of the UTEP-Rare Mater of Arts program, an internationally based program that allows environmental conservation professionals from throughout the developing world to earn a Master of Arts. Students first complete a year of coursework in communication followed by the development, implementation, management, and evaluation of a one-year environmental conservation campaign, often in a rural community.

Dr. Pérez has recently completed a book-length manuscript on the fantasy heritage of Spanish colonizer Juan de Oñate in Southwest tourism. The manuscript examines tourism and how it erases and/or marginalizes Mexican/Americans from memory at popular tourism sites in the Southwest. Dr. Pérez’s research has also appeared in Communication for Development and Social Change Journal, Western Journal of Communication, Communication Yearbook, Aztlán: A Journal of Chicano Studies, and other scholarly outlets.

Implementation of Occupational Sun Safety at a 2-Year Follow-Up in a Randomized Trial

Implementation of Occupational Sun Safety at a 2-Year Follow-Up in a Randomized Trial

The American Academy of Dermatology acknowledges that outdoor workers receive more UV radiation exposure and are at a higher risk for skin cancer than other workers.1 In a recent article e-published in the American Journal of Health Promotion, KB’s Dr. David Buller, Dr. Barbara Walkosz, and Mary Buller, along with multiple collaborators, evaluated the implementation of sun protection policies two years after the initial intervention, called Sun Safe Workplaces (SSW), in cities, counties, and special districts in Colorado with workers in public works, public safety, and parks and recreation. Authors were also interested in whether or not the organizational characteristics had an effect on the implementation of the sun safety policies.

In the original 24-month long study, 98 government organizations in Colorado were enrolled in 2010 and 2011 and half were randomly selected to receive the SSW intervention, where the primary outcome was adoption of a sun protection policy. Each of the organizations’ written workplace policies were assessed and senior managers completed surveys before and after the intervention. In 2015 and 2016, two years after the intervention was completed, the organizations were contacted for a second follow-up and 63 of the original 98 agreed to participate. Self-administered surveys were given to frontline supervisors and employees who worked outdoors by key contact managers. Project staff visited each organization to conduct semi structured interviews with key managers and complete an audit of the workplace for sun protection messages and items.

Implementation of sun protection policies was measured in three ways: 1) inspection of the workplace for sun protection messages and personal sun protection items, such as shade structures or sunscreen; 2) reports from frontline supervisors on whether the organization communicated with employees about sun safety, had unwritten standard operating procedures on sun safety, or provided personal sun protection equipment for employees, such as wide-brimmed hats, sunscreen, long-sleeved shirts, long pants, etc.; and 3) reports from employees on whether they had received any training on sun safety at the workplace or sun safety communication from the organization or a coworker.

Results showed that two years after the initial intervention, sun protection messages and sun protection items were used more often in organizations that were originally part of the intervention group compared to the control group. Survey responses from frontline supervisors at intervention organizations also showed more communication about sun protection to employees, more standard operating procedures on sun safety and more free/reduced cost sunscreen than those from control organizations. Sun protection training and sun safety communication from coworkers and the employer was higher in intervention organizations when compared to control organizations. Additionally, organizations with a sun protection policy implemented more sun safety actions (communication about sun safety and provided personal sun protection equipment) than organizations without a policy.

The authors conclude that the SSW intervention appeared to increase local government organizations’ sun safety actions over time. Authors state that formal policies on sun protection and training together appear to be an important part of occupational sun protection efforts. A full description of the methods, results, conclusions, and limitations of this study can be found in the publication in the American Journal of Health Promotion.

This research was funded by the National Cancer Institute (CA187191; Dr. David Buller and Dr. Barbara Walkosz, Principal Investigators). Collaborators/coauthors include Mary Buller from Klein Buendel, Dr. Allan Wallis from the University of Colorado Denver, Dr. Peter Andersen from San Diego State University, Dr. Michael Scott from Mikonics, Inc., Dr. Richard Meenan from Kaiser Permanente’s Center for Health Research, and Dr. Gary Cutter from the University of Alabama at Birmingham.

Reference

  1. Outdoor workers and skin cancer. Safety+Health. September 23, 2018. Available at: https://www.safetyandhealthmagazine.com/articles/17480-outdoor-workers-and-skin-cancer. Accessed January 14, 2019.

Developing Geriatric and End-of-Life E-training For Inmate Peer Caregivers

Developing Geriatric and End-of-Life E-training For Inmate Peer Caregivers

Dr. Susan Loeb from Penn State University presented on the development of computer-based learning modules for caregivers of the aged and dying in prisons at the 11th Annual Conference on the Science of Dissemination and Implementation in Health in Washington DC, December 3-5, 2018. This research is being conducted with Dr. Valerie Myers at Klein Buendel (KB), a co-author on the presentation.

The increasing numbers and complex needs of aged and dying inmates intensifies the burden of care and costs incurred by prisons. In an initial study (NR011874), best practices in the community were adapted in the Toolkit for Enhancing End-of-Life Care (EOL) in Prisons to train prison staff in EOL care. The print-based Toolkit was well received; however, not well suited for dissemination and lacked geriatric content. The Toolkit was transformed and expanded into Enhancing Care of the Aged and Dying in Prisons (ECAD-P) computer-based learning (CBL) modules in a second study (AG049570). ECAD-P development revealed the need to develop e-training for inmates to assist staff as caregivers for aged and dying inmates.

The purpose of the third study, which was presented at the D&I Conference, is to transform best practices in inmate peer caregiving into a comprehensive training program  that consists of media-rich and interactive computer-based learning modules for providing geriatric and EOL care to peers (i.e., prisoner to prisoner). Focus groups with inmate caregivers, prison staff, and training staff were conducted to determine a menu of CBL modules. An Advisory Board of experts in EOL care, geriatrics, ethics, and corrections health informed the selection of modules for development. Usability testing will soon be conducted in one men’s and one women’s prison with inmates who are experienced in providing mental health peer support, but have not been caregivers for their aged and dying peers. Focus group data will be analyzed using thematic analysis. Usability data will be analyzed using descriptive statistics and content analysis. Data are currently being collected. Analysis will be complete in October and the presentation completed by November.

The Prisoner to Prisoner (P2P) project allows the creation of innovative technology while being mindful of security and safety concerns regarding prisoners. Expanded testing of the P2P product will optimize the scalable unit for broader dissemination, establish the effectiveness of the training, provide critical insights relevant to dissemination of the commercial product, and position the research team to study broad dissemination and implementation outcomes.

This research was funded by a Small Business Technology Transfer (STTR) grant to KB from the National Institute on Aging at the National Institutes of Health (AG057239; Dr. Susan Loeb, Principal Investigator) and Dr. Valerie Myers, Co-Investigator. Additional collaborators on the work presented at the conference include Dr. Erin Kitt-Lewis and Dr. Rachel Wion from the Penn State University College of Nursing, and Tiffany Jerrod and Morgan Carter from KB. The technology is being developed by the KB Creative Team.

A Year of Research and Outreach

A Year of Research and Outreach

This was a very productive year for Klein Buendel (KB). In 2018, our scientists and staff:

  • Competed successfully for 4 new prime grant and subcontract research awards;
  • Completed 7 prime and subcontract research projects;
  • Presented research findings at 17 local, national, and international conferences and expert meetings; a total of 34 presentations, panel discussions, and posters; and
  • Published 20 research manuscripts in peer-reviewed journals.

It was also a very exciting year because KB was one of three North American sponsors and organizers of the 4th International Conference on UV and Skin Cancer Prevention. KB co-sponsored the conference with Ryerson University in Toronto, Ontario, Canada and the Canadian Dermatology Society. The conference was held in Toronto on May 1-4, 2018.

And KB celebrated it’s Sweet 16th Birthday in June!

Additional highlights of our 2018 research publications, conference presentations, and outreach activities are listed below. Publications may include manuscripts that were in press or published in electronic format last year. The names of KB investigators and staff are bolded.

Publications

Loeb SJ, Penrod J, Myers VH, Baney BL, Strickfaden SM, Kitt-Lewis E, Wion RK. Enhancing Care of Aged and Dying Prisoners: Is e-Learning a Feasible Approach? J Forensic Nurs. 2017 Dec;13(4):178-185.

Cochrane SK, Chen SH, Fitzgerald JD, Dodson JA, Fielding RA, King AC, McDermott MM, Manini TM, Marsh AP, Newman AB, Pahor M, Tudor-Locke C, Ambrosius WT, Buford TW; LIFE Study Research Group. Association of Accelerometry-Measured Physical Activity and Cardiovascular Events in Mobility-Limited Older Adults: The LIFE (Lifestyle Interventions and Independence for Elders) Study. J Am Heart Assoc. 2017 Dec 2;6(12).

Wang-Schweig M, Miller BA, Buller DB, Byrnes HF, Bourdeau B, Rogers V. Using panel vendors for recruitment into a web-based family prevention program: methodological consideration. Evaluation and the Health Professions. 2017 Jan 1: 163278717742189. doi: 10.1177/0163278717742189. [Epub ahead of print]

Berteletti J, Buller DB, Massie K, Ashley J, Liu X, & Reynolds, KR. Sun protection policies in public school districts with elementary schools in California. JAMA Dermatol. 2018 Jan 1;154(1):103-105.

Buller DB, Reynolds KD, Berteletti J, Massie K, Ashley J, Buller MK, Meenan RT. Accuracy of principal and teacher knowledge of school district policies on sun protection in California elementary schools. Prev Chronic Dis. 2018 Jan 18;15:E07. doi: 10.5888/pcd15.170342.

Gellar AC, Jablonski NG, Pagoto SL, Hay JL, Hillhouse J, Buller DB, Kenney L, Robinson JK, Weller RB, Moreno MA, Gilchrest BA, Sinclair C, Arndt J, Taber JM, Morris KL, Dwyer LA, Perna FM, Klein WMP, Suls J. Interdisciplinary perspectives on sun safety. JAMA Derm. 2018; 154(1):88-92.

Buller DB, Heckman CJ, Manne SL. The potential of behavioral counseling to prevent skin cancer. JAMA Dermatol. 2018 May;154(5):516-521.

Buller DB, Walkosz BJ, Buller MK, Wallis A, Andersen PA, Scott MD, Eye R, Liu X, & Cutter GR. Results of a randomized trial on an intervention promoting adoption of occupational sun protection policies. Am J of Health Promot. 2018 May;32(4):1042-1053.

Hay JL, Zielaskowski K, White KM, Kaphingst K, Robers E, Guest D, Sussman A, Talamantes Y, Schwartz M, Rodriguez VM, Li Y, Schofield E, Bigney J, Hunley K, Buller D, Berwick M. Interest and uptake of MC1R testing for melanoma risk in a diverse primary care population: a randomized clinical trial. JAMA Dermatol. 2018 Jun 1;154(6):684-693.

Walkosz BJ, Buller D, Buller M, Wallis A, Meenan R, Cutter G, Anderson P, Scott M. Sun Safe Workplaces: effects of an occupational skin cancer prevention program in employee sun safety practices. J Occup Environ Med. 2018 Nov;60(11):900-997.

Buller DB, Woodall WG, Saltz R, Grayson A, Buller MK. Implementation and Effectiveness of an Online Responsible Vendor Training for Recreational Marijuana Stores in Colorado, Oregon, and Washington State. J Public Health Manag Pract. 2018 Aug 31. [Epub ahead of print]

Nostrati A, Pimentel MA, Falzone A, Hegde R, Goel S, Chren M, Eye R, Linos E, Pagoto S, Walkosz BJ. Skin cancer prevention messages on Facebook: likes, shares and comments. J Am Acad Dermatol. 2018 Sep;79(3):582-585.

Kasting ML, Christy SM, Sutton SK, Lake P, Malo TL, Roetzheim RG, Schechtman T, Zimet GD, Walkosz BJ, Salmon D, Kahn JA, Giuliano AR, Vadaparampil ST. Florida Physicians’ Reported use of AFIX-Based Strategies for Human Papillomavirus Vaccination. Prev Med. 2018 Sep 13. pii: S0091-7435(18)30282-2. doi: 10.1016/j.ypmed.2018.09.004. [Epub ahead of print]

Buller MK, Andersen P, Bettinghaus EP, Liu X, Slater MD, Henry K, Fluharty L, Fullmer S, Buller DB. Randomized Trial Evaluating Targeted Photographic Health Communication Messages in Three Stigmatized Populations: Physically-disabled, Senior, and Overweight/Obese Individuals. Journal of Health Communication. 2018;23(10-11):886-898.

Woodall WG, Starling R, Saltz RF, Buller DB, Stanghetta P. Results of a randomized trial of web-based retail onsite responsible beverage service training: Waytoserve.org. Journal of Studies on Alcohol and Drugs. 2018 Sept;79(5):672-679.

Woodall WG, Starling R, Saltz RF, Buller DB, Stanghetta P. Responses to Commentaries by Miller (2018) and Buvik and Rossow (2018). J Stud Alcohol Drugs. 2018 Sep;79(5):684-685.

Buller DB, Walkosz BJ, Buller MK, Wallis A, Andersen PA, Scott MD, Meenan RT, Cutter GR. Implementation of occupational sun safety at a two-year follow-up in a randomized trial: comparison of sun safe workplaces policy intervention to attention control. American Journal of Health Promotion. 2018 Nov 26:890117118814398. doi: 10.1177/0890117118814398. [Epub ahead of print]

Kitt-Lewis E, Loeb SJ, Myers VH, Wion RK, Baney B, Strickfaden S. Developing training to enhance care of aged and dying inmates: set-up phase. Public Health Nursing. In press.

Byrnes HF, Miller BA, Grube JW, Bourdeau B, Buller DB, Wang-Schweig M, Woodall WG. Prevention of alcohol use in older teens: A randomized trial of an online family prevention program. Psychology of Addictive Behaviors. In press.

Buller MK, Bettinghaus EP, Fluharty L, Andersen PA, Slater MD, Henry KL, Liu X, Fullmer S, Buller DB. Improving health communication with photographic images that increase identification in three minority populations. Health Ed Res. In press.

Conference Presentations

NASPA Well-being and Health Promotion Leadership Conference — January 18-20 in Portland, Oregon
Myers VH, Newton RL, Jerrod T. Healthy Detours: A location-based services app to promote healthy choices among college students. (presentation)

University of Alabama Birmingham School of Medicine Center for Exercise Medicine’s Distinguished Lecture Series — March 13 in Birmingham, Alabama
Myers V. Caminemos Juntas: A Location-Based Smartphone App for Latinas to Connect with Nearby Walking Partners. (presentation)

Eastern Nursing Research Society Annual Meeting — April 11-13 in Newark, New Jersey
• Loeb SJ, Kitt-Lewis E, Myers VH. Development of Computer-based Training for Inmate Caregivers through Nursing Science and Technological Innovations. (presentation)

Society of Behavioral Medicine Annual Meeting — April 11-14 in New Orleans, Louisiana
Berteletti J, Strickfaden S, Woodall WG, Starling R, Zimet G, Stupiansky N, Chilton L. BeVaccinated: Designing a web app to promote teen vaccination uptake. (poster)
Buller D, Walkosz B, Buller MK, Wallis A, Meenan R, Liu X. Moderators of implementation of occupational sun protection policy by public-sector employers in a randomized trial. (presentation)
• Goldstein C, Alshurafa N, Spruijt-Metz D, Thomas G, Jake Schoffman D, Goldstein S, Wac K, Myers V. The Digital Health Council & ETCD present perspectives on effective digital health training in behavioral medicine. (panel discussion)
• Jackson J, Castro Sweet C, Coa K, Foster G, Matacotta J, Myers V, Place S, Keefe B, Osborn C, Wolin K. Speed networking your career options: Non-academic paths for behavior scientists. (panel discussion)
• McLeod D, Myers V, Stetson B, Sheean P. Nuts and Bolts: A practical Q&A about your education and career trajectory. (panel discussion)
Myers V, Loeb SJ, Kitt-Lewis E, Jerrod T, Strickfaden S, Wion RK. What works in corrections: Front-line insights on computer-based training. (poster)
Myers VH, Hudson H, Jerrod T, Strickfaden S, Buller M, Lippert M. Pinpoint: Gaming technology to engage adolescent sickle cell patients in precision pain management. (poster)
• Pagoto S, Berteletti J, Walkosz B, Oleski J, Palumbo A, Baker K, Hillhouse J, Henry K, Buller D. Delivering health promotion interventions on social media: Engagement and methodological considerations. (panel discussion)
• Reynolds K, Buller D, Berteletti J, Massie K, Ashley J, Buller MK, Meenan R. Correlates of sun safe policy implementation among elementary schools. (poster)
• Newton RL, Myers V, Carter L, Griffith D. A Mobile Phone-based physical activity maintenance app for African American men: MobileMen. (presentation)

Patient Centered Outcomes Research 8th Annual Symposium – April 24-25 2018 in St. Louis, Missouri
Buller DB. Precision Skin Cancer Prevention: A Sun Safety Mobile App. (presentation)

4th International Conference on UV and Skin Cancer Prevention – May 1-4, 2018 in Toronto, Ontario, Canada
Buller D. A Facebook Intervention to Reduce mothers’ Permissiveness for Indoor Tanning: Health Chat. (presentation)
• Meenan RT, Buller DB, Reynolds KD, Massie K, Berteletti J, Buller MK, Ashley J. Costs of Sun Protection Policy Implementation in California School Districts. (presentation)
• Meenan R, Buller D, Walkosz B, Eye R, Buller M, Wallis A. Estimated Cost of Occupational Sun Protection Policy Intervention Delivery to Public-Sector Employers. (presentation)
• Massie K, Berteletti J, Freeth B, Ashley J, Buller MK, Buller DB, Reynolds KD. Implementation Strategies: Review of a Sun Safety Program in California. (poster)
Walkosz B, Dellavalle R, Buller M, Buller D, Eye R, Olivas S. Formative Research to Develop Sun Safety Ink!, a Skin Cancer Prevention Training Program for Tattoo Artists. (presentation)

International Communication Association Annual Meeting — May 24-28 in Prague, Czech Republic
Woodall WG, Berteletti J, Starling R, Zimet G, Stupainsky N, Kong A, Chilton L. Usability testing of a web app to improve adolescent vaccination: Be Vaccinated. (presentation)
Walkosz B, Buller D, Buller MK, Wallis A, Meenan R, Scott M, Andersen P, Cutter G. Sun Safe Workplaces: Effect of a communication theory-based occupational skin cancer prevention program on employee sun safety practices. (presentation)

UNESCO International Conference on the Tangible and Intangible Impact of Information and Communication in the Digital Age — June 4-8 in Khanty-Mansiysk, Russia
Walkosz B. Emerging Issues in Media Literacy in the 21st Century. (presentation)

National Cancer Institute Cancer Center HPV Vaccination Meeting – June 7-8 in Washington, DC
• Kong A, Woodall WG, Zimet G, Reither J, Myers V, Buller D, Starling R, Chilton L, Ginossar T. Improving HPV Vaccine Uptake with Digital Interventions. (presentation)

National Research Society on Alcoholism Annual Scientific Meeting – June 16-20 in San Diego, California
• Sanchez V, Chacon A, Perez F, Reither J. WayToServe-Español: Adapting an Evidence-Based Online Responsible Beverage Server (RBS) Training for Spanish Language Populations in the US Southwest. (poster)

National Cancer Institute Exercise Science and Skin Cancer Prevention Research Meeting — September 26-27 in Washington, DC
Buller D, Walkosz B. Translational Research in Sun Safety in Sports Settings. (presentation)

National Commission on Correctional Health Care Conference – October 12-16 in Fort Lauderdale, Florida
• Loeb S, Myers V, Kitt-Lewis E. Developing and Testing E-Training to Enhance Care of Aged and Dying Prisoners. (poster)

EUSPR Conference and Members’ Meeting – October 24-29 in Lisbon, Portugal
• Miller BA, Rogers V, Byrnes H, Johnson M, Buller DB, Grube J, Berteletti J. Influences of Personal Characteristics on Group-based Club Intervention Outcomes. (presentation)

Colorado Cancer Coalition Annual Symposium — November 8-9 in Lakewood, Colorado
Myers V. Caminemos Juntas: Using Technology and Social Media to Advance Your Mission. (presentation)

American Public Health Association Annual Meeting — November 10-14 in San Diego, California
Buller DB, Woodall WG, Saltz R, Grayson A, Buller MK, Svendsen S. Implementation and Effectiveness of an Online Responsible Vendor Training for Recreational Marijuana Stores in Colorado, Oregon, and Washington State. (presentation)

EUROGIN International Multidisciplinary HPV Congress – December 2-5 in Lisbon, Portugal
Woodall WG. Digital Interventions to Improve HPV Vaccine Uptake: Results and Issues. (presentation)
Woodall WG, Zimet G, Reither J, Kong A, Buller DB, Chilton L, Myers V, Starling R, Ginossar T. Vacteens: Results from Ongoing Trials of Mobile Web Apps to Improve HPV Vaccine Uptake. (poster)
Buller DB, Walkosz B, Berteletti J, Pagoto S, Oleski J, Baker K. Insights on HPV Vaccination from Mothers’ Comments on Facebook Posts in a Randomized Trial. (poster)

The Science of Dissemination & Implementation in Health Annual Conference – December 3-5 in Washington, DC
• Meenan R, Reynolds K, Buller D, Massie K, Berteletti J, Buller MK, Ashley J. Economic evaluation of a sun protection promotion program in California elementary schools. (presentation)
• Loeb S, Myers V, Kitt-Lewis E, Wion RK, Jerrod T, Carter M. Developing Geriatric and End-of-Life E-training For Inmate Peer Caregivers (poster)

Other Highlights & Recognitions

In February, Dr. Valerie Myers, began her tenure as a mentor for the SPRINT program at the National Cancer Institute. She also began serving as a mentor on Dr. Seth Creasy’s K Award entitled, “Linking Temporal Pattern of Modifiable Behaviors to Weight Loss Outcomes”.

Dr. David Buller was a co-author on a chapter in a book that was selected as the 2018 recipient of the Gerald R. Miller Boo Award for Interpersonal Communication from the National Communication Association:

    The book is: D.O. Braithwaite and P. Schrodt (Eds.), Engaging theories in interpersonal communication: Multiple perspectives, 2nd edition (pp. 343-356). Thousand Oaks, CA: Sage.
    The chapter is: Burgoon, J. K., & Buller, D. B. (2015). Interpersonal deception theory: Purposive and interdependent behavior during deceptive interpersonal communication.

Dr. Susan Loeb and Dr. Valerie Myers’ Phase I STTR Project, E-training of Inmate Peer Caregivers for Enhancing Geriatric and End-of-Life Care in Prisons, was selected for inclusion in the NIH Niche Assessment Program for small businesses.

KB received trademark registration through the U.S. Patent and Trademark Office for Train To Tend®.

Way To Serve®, the licensed evidence-based online responsible alcohol server training program owned by KB and its research collaborators, achieved a significant milestone by selling 75,000 trainings since it entered the market.

KB, along with Rocky Mountain Sunscreen and the Colorado Skin Cancer Task Force, offered free UV camera photographs and skin cancer prevention education to attendees at the Snowsports Industries of America Snow Show in January and the Outdoor Retailer Summer Market in July. Both trade shows were held at the Colorado Convention Center in Denver, Colorado.

Beginning in September, KB made its Grade K-5 sun safety curriculum, Sunny Days Healthy Ways®, available free to the public in response to the Surgeon General’s Call to Action to Prevent Skin Cancer.

KB was recognized on Colorado Biz Magazine’s Top 100 Woman-Owned Companies list. KB landed at #48 for 2018. Colorado Biz Magazine ranked Klein Buendel #142 of Top 250 Private Companies for 2018.

Here’s to a Very Healthy and Happy New Year!

Cost Analysis of a Sun Safety Program at California Elementary Schools

Cost Analysis of a Sun Safety Program at California Elementary Schools

The Surgeon General’s 2014 Call to Action to Prevent Skin Cancer emphasized the importance of sun safety for schools. However, limited cost data exist to inform implementation decisions regarding school sun safety practices. In response, Dr. Richard Meenan from the Kaiser Permanente Center for Health Research (KPCHR), presented data on the costs of delivering a sun protection policy intervention to public elementary schools in California at the 11th Annual Conference on the Science of Dissemination and Implementation in Health in Washington DC, December 3-5, 2018.

The Sun Safe Schools (SSS) program, a joint research effort of Claremont Graduate University (CGU), KPCHR, and Klein Buendel (KB), provided technical assistance to California public elementary schools interested in implementing sun safety practices consistent with their district board policy for sun safety. The research design included a randomized trial of SSS that assessed its effectiveness in promoting implementation and an economic evaluation of the SSS program.

Fifty-eight intervention schools and 60 controls participated. Principals at intervention schools received regular phone and email contact from trained SSS coaches over 20 months to support implementation of selected sun safety practices. Rolling recruitment and intervention occurred over 47 months (2014-18). Study outcome data are from a posttest survey of school principals. Intervention delivery costs were virtually all labor (SSS coach and principal time). Implemented practices were organized into ten categories (such as student education and outdoor shade) and micro-costed using a project-developed template. Required school labor and non-labor resources for implementation were estimated for each practice. Three elementary school principal consultants reviewed the template for appropriateness.

Intervention delivery costs and costs of implemented practices for intervention schools and control schools were presented and are being submitted for publication. Principals’ beliefs about the importance of sun protection were positively correlated with policy implementation, both in numbers of implemented policies and overall dollars invested. Results indicated that a low-cost program of regular phone and email coaching of school administrators can successfully stimulate implementation of sun safety practices in elementary schools at a reasonable cost. Costs per student were similar to other school health practices. These findings can assist administrators with selecting and implementing appropriate sun safety practices for their schools.

This research was supported by a grant from the Eunice Kennedy Shriver National Institute for Child Health and Human Development (HD074416; Dr. Kim Reynolds, Claremont Graduate University, Principal Investigator). Collaborators in addition to Dr. Reynolds and Dr. Meenan include Kim Massie from Claremont Graduate University in California; Dr. David Buller, Julia Berteletti, and Mary Buller from Klein Buendel; and Dr. Jeff Ashley from Sun Safety for Kids in Los Angeles, California.

Vacteens: A Mobile Web App to Improve HPV Vaccine Uptake

Vacteens: A Mobile Web App to Improve HPV Vaccine Uptake

Dr. W. Gill Woodall from Klein Buendel (KB) and the University of New Mexico and Jeanny Reither from KB presented findings from the Vacteens Project at the Eurogin International Multidisciplinary HPV Congress in Lisbon, Portugal, December 2-5, 2018. Eurogin is one of the most important conferences on Human Papillomavirus (HPV) infection and related cancers. It aims to raise the public health profile of HPV, increase the need for responsible health services, and examine the cost-effectiveness of risk-based screening to pave the way for the development of new strategies for the prevention of HPV-induced cancers.

The uptake of the HPV vaccine in the United States remains significantly below the Healthy People 2020 goal of 80% series completion, and this is particularly so for the young adolescent age range, when the immunogenic response to the vaccine is stronger. While a number of factors may account for this less than desirable vaccine uptake, parental concerns and misinformation about the efficacy and safety of HPV vaccine remain barriers to reaching public health vaccination goals. Physician and clinic-based interventions have shown some limited positive effect on vaccine uptake. However, parental barriers to HPV vaccination may ideally be addressed by digital interventions (in this case, smartphone applications) that are tailored to their concerns. Specifically, research indicates there is a great deal of: (1) confusion and uncertainty about HPV vaccine, and (2) concomitant misinformation about HPV vaccine, who it is meant for, and the conditions under which it is maximally effective.

With funding from the Patient Centered Outcomes Research Institute (PCORI) and the National Cancer Institute, Dr. Woodall’s team systematically developed a set of mobile web app tools to prompt the informed adoption of HPV vaccination. They used Diffusion of Innovations Theory and related research on Informed Decision Making to guide the iterative development of mobile apps for parents of young female and male adolescents.

Ms. Reither presented a poster that reported the results of developmental research and early trial findings from two smartphone web app projects — one focused on parents and adolescent girls (ages 11-14) and the other on parents and adolescent boys in the same age range. The objective of these investigations is to develop and evaluate a mobile web app to encourage HPV vaccination in New Mexico, an ethnically-diverse state. Current ongoing randomized controlled efficacy trials with parents and their adolescent children in New Mexico clinics provide data to determine the impact of these mobile web apps on informed decision making and uptake for the HPV vaccine.

Dr. Woodall participated in a panel session entitled “Uses of New Technologies in HPV Vaccine Behavioral Science Research.” He gave a presentation on the design, development, and testing of the innovative Vacteens web app. New technologies and social networking sites like this can be used to understand sources of information and misinformation about HPV vaccination, engage parents and youth, and encourage HPV vaccination.

The progress and initial results of these ongoing research efforts will have implications for reaching HPV vaccine uptake goals set by Healthy People 2020 in the United States. Mobile web-based interventions show promise for reaching HPV vaccine uptake goals. A mobile web app can make decision-making tools widely available on popular mobile platforms such as tablet computers and smartphones, as well as personal computers.

This research was funded by grants from PCORI and the National Cancer Institute (CA210125; Dr. W. Gill Woodall, Principal Investigator). Collaborators included Dr. Alberta Kong, Dr. Randall Starling, Dr. Lance Chilton, and Dr. Tamar Ginossar from the University of New Mexico; Dr. Greg Zimet from Indiana University; and Dr. David Buller and Jeanny Reither from KB. 


Dr. W. Gill Woodall and Jeanny Reither from Klein Buendel
INSIGHTS ON HPV VACCINATION FROM MOTHERS’ COMMENTS ON FACEBOOK POSTS IN A RANDOMIZED TRIAL

INSIGHTS ON HPV VACCINATION FROM MOTHERS’ COMMENTS ON FACEBOOK POSTS IN A RANDOMIZED TRIAL

HPV vaccine uptake among adolescent girls in the United States remains below the national goal of 80%. Parent decisions to vaccinate daughters can be impeded by confusion, uncertainty, and misinformation about the Human Papilloma Virus (HPV) vaccine. Dr. David Buller from Klein Buendel (KB) presented an analysis of mothers’ beliefs about vaccinating their adolescent daughters for HPV at the Eurogin International Multidisciplinary HPV Congress in Lisbon, Portugal, December 2-5, 2018.

Mothers with adolescent daughters from 34 states (n=880) were recruited to participate in a randomized controlled trial evaluating a social media campaign on adolescent health. The mothers’ beliefs were expressed in comments to posts on HPV vaccination in a social media campaign on adolescent health. Participants were recruited through Qualtrics survey panels or local efforts at the Tennessee study site. Eligibility criteria were: having a daughter aged 14-17, living in one of 34 states without a complete ban on indoor tanning for minors, using a Facebook account 1+ times a week, being able to read English, consenting to participate, completing the baseline survey, and willing to join the Facebook group. The campaign, implemented through Facebook private groups, included posts on HPV vaccination, as one of seven general health topics. The experimental manipulation varied posts on indoor tanning versus prescription drug abuse prevention. Posts on HPV vaccination and reactions and comments from mothers were extracted.

Mothers had a mean age of 43.1 years; 6.5% were Hispanic and 86.6% white; and 63.1% reported that their daughter had been vaccinated for HPV (17.8% receiving two shots and 31.5% three shots). HPV vaccination posts received on average 1.3 reactions and 3.3 comments from mothers. Comments often formed a dialogue among mothers. More than half of the comments (52.8%) were favorable, indicating that the daughter had been vaccinated and HPV vaccination reduced mothers’ anxiety, HPV infection rates, and related disease risk. However, 45.3% were unfavorable, citing safety concerns, lack of efficacy, unknown long-term consequences, inappropriate age for the vaccine, apprehension by other mothers, fears of vaccine tampering, lack of physician support, and sexual activity issues (for example, plans to wait until daughter becomes sexually active or using vaccine to guard against unprotected sex). Some commented, mostly favorably, on the need to vaccinate boys.

Facebook comments indicated both support for and resistance to HPV vaccination by mothers in the United States. Reasons for not vaccinating girls were similar to barriers expressed in other research and reflected negative media coverage of HPV vaccination. Effective strategies are needed in social media to counter misinformation on and resistance to HPV vaccines.

This research was funded by a grant from the National Cancer Institute (CA192652; Dr. David Buller, Principal Investigator). Collaborators include Dr.Barbara Walkosz and Julia Berteletti from KB; Dr. Sherry Pagoto and Jessica Oleski from the University of Connecticut, and Dr. Katie Baker from East Tennessee State University.

Eurogin is one of the most important conferences in the world on HPV infection and related cancers. The international gathering examines public health, health services, screening, and prevention of HPV-induced cancers.