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Month: March 2020

Implementing E-Training for Geriatric and End-of-Life Care in Corrections

Implementing E-Training for Geriatric and End-of-Life Care in Corrections

Dr. Susan Loeb from The Pennsylvania State University College of Nursing is presenting on the creation of a computer-based learning (CBL) program for corrections staff at the 32nd Annual Scientific Sessions virtual conference of the Eastern Nursing Research Society on March 26-27, 2020. Klein Buendel Senior Scientist, Dr. Valerie Myers, is a co-author on the presentation.

Experts in corrections have identified the care of older individuals who are incarcerated as a high priority area for research and policy. Therefore, there is a need to provide evidence-based training tailored to frontline corrections personnel who are charged with the care and oversight of aged and dying incarcerated individuals. In response, the research team developed, implemented, and tested a CBL program that aligned with contextual environment constraints and the infrastructure-specific needs of corrections.

The virtual presentation will describe how the adoption mechanisms and support systems were integrated from set up to full-scale usability testing of the CBL program, Enhancing Care for the Aged and Dying in Prison (ECAD-P) for corrections staff. Specifically, factors that affect adoption and support systems were identified, examined and implemented at each phase of the development and implementation process of ECAD-P. In the Set-Up phase, the format of a paper-pencil toolkit was not sustainable for long-term, broad dissemination of the program, so support systems were evaluated to determine the capabilities of CBL. Throughout the development, Expert and Community Advisory Boards critically examined the content and programming measures of the product to ensure the product complied with usual practices and institutional constraints.

During testing, small scale usability-testing was conducted to determine human capacity, infrastructure capabilities, reporting systems, and program design and function. In going to full-scale, large-scale usability testing provided valuable insights on implementation considerations, such as leadership, communication, policy, and culture of institution. Consideration of adoption mechanisms and support systems ultimately allowed for researchers to refine ECAD-P for future, effective, large-scale dissemination.

This research was funded by a Small Business Technology Transfer grant to Klein Buendel from the National Institute on Aging at the National Institutes of Health (AG049570; Dr. Susan Loeb and Dr. Valerie Myers, Multiple Principal Investigators). Collaborators on the work presented include Dr. Erin Kitt-Lewis and Kaléi Kowalchik from The Pennsylvania State University College of Nursing; Dr. Rachel Wion from Indiana University School of Nursing; Julie Murphy from King College Nursing Program; and Dr. Valerie Myers and Tiffany Jerrod from Klein Buendel.

Factors Impacting Sun Protection in California Schools

Factors Impacting Sun Protection in California Schools

Findings from a school-based sun safety study, Sun Safe Schools, were published recently in the Journal of School Health. The research team from Klein Buendel, Claremont Graduate University, the Kaiser Permanente Center for Health Research, and Sun Safety for Kids examined the correlates of sun safety policy implementation in California public school districts.

In 2002, California was the first state to enact legislation governing sun protection for students. It is California Education Code Section 35183.5. In 2005, the Sun Safe Schools research team collaborated with California Schools Board Association to develop a comprehensive Sample Board Policy for sun safety (BP 5141.7) based on California law and recommendations from the U.S. Centers for Disease Control and Prevention. The study included California public school districts that had already adopted the board-approved sun safety policy.

For the study, principals and teachers completed an online survey about sun protection policies and practices. Respondents reported on the implementation of ten school practices related to BP 5141.7 and indicated which practices, if any, were implemented in their school. Years in public education, years worked in the current district, perception that parents should take action to protect children from the sun, and respondents’ personal skin types were associated with the number of practices implemented in the school.

A full description of the methods, analyses, results, conclusions, and limitations can be found in the publication. In summary, the authors concluded that policy implementation is more likely among schools with experienced faculty, when parents are seen as important partners in student skin cancer prevention, and when school principals and teachers have a personal skin type at lower risk for melanoma.

The Sun Safe Schools program was a collaborative research effort of Claremont Graduate University (CGU), the Kaiser Permanente Center for Health Research, and Klein Buendel. The research was funded by a grant from the Eunice Kennedy Shriver National Institute of Child Health and Human Development at the National Institutes of Health (HD074416; Dr. Kim Reynolds, CGU, and Dr. David Buller, Klein Buendel, Multiple Principal Investigators). Collaborators included Dr. Richard Meenan from the Kaiser Permanente Center for Health Research; Dr. Jeff Ashley from Sun Safety for Kids in Los Angeles, California; Kim Massie previously from CGU; and Julia Berteletti, Xia (Lucia) Liu, and Mary Buller from Klein Buendel.

A Tablet-delivered Intervention to Reduce Risky Behavior in Adolescents

A Tablet-delivered Intervention to Reduce Risky Behavior in Adolescents

Klein Buendel collaborator, Dr. Christopher Houck from Rhode Island Hospital, will present findings from Project TRAC at the Society of Research on Adolescence Biennial Meeting in San Diego, California, March 19-21, 2020. His presentation will also include a demonstration of the targeted games used in the intervention.

The team initially developed and validated an Emotion Regulation (ER) intervention for reducing risk behaviors among early adolescents. Project TRAC showed that adolescents who learned about sexual health information with ER content were significantly less likely to transition to sexual activity. Despite the promise of targeting ER during early adolescence to prevent risk behaviors, discussions with community partners suggest that the original facilitator-led small-group format is difficult to sustain. Disseminating this prevention approach required a format that was less reliant on specialized training that could be easily implemented to an individual format. Therefore, through advisory panels of early adolescents and consultation from a group of experts in the field, Project TRAC was translated from a small-group format to a tablet-delivered, game-based program.

Acceptability testing took place with ten adolescents followed by 85 adolescents who participated in a small randomized pilot trial to assess the feasibility of the digital intervention as well as preliminary assessment of short-term changes in ER. Those randomized to the intervention condition completed four computerized modules that taught emotion concepts through games and instructional videos. Control participants were waitlisted to complete the intervention at the end of the study and all adolescents completed surveys at baseline and one month later.

Participants positively rated the intervention with a majority completing all four modules. Intervention participants self-reported significant improvements, including emotional awareness, perceived access to ER strategies, use of the strategies taught in the intervention, intentions to use these strategies, emotional knowledge, and perceptions that emotions are changeable. They also reported a moderate effect of poorer perceptions of abilities to manage positive emotions.

Results suggest that a tablet-based intervention providing ER training was able to affect adolescents’ use of ER behaviors, understanding of emotions, and perceptions of emotional competence. Linking ER training to specific areas of risk (sexual health, substance use, or violence prevention) in the developmental window when risk behaviors are beginning, such as early adolescence, may prevent risk behaviors for many young people. Dissemination of evidence-based interventions through tablet formats may also improve the reach of effective interventions.

This research is funded by a grant from the National Institute of Child Health and Human Development (HD089979; Dr. Christopher Houck, Principal Investigator). Other collaborators include Wendy Hadley from the University of Oregon; Crosby Modrowski and Kelsey Bala from Brown University; Brittany Wickham from Villanova University; and Dr. Valerie Myers and Tiffany Jerrod from Klein Buendel.