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Mutual Influences of Mothers’ and Daughters’ Mental Health on the Closeness of their Relationship

Mutual Influences of Mothers’ and Daughters’ Mental Health on the Closeness of their Relationship

A Health Chat study published in the Journal of Child and Family Studies examined intra- and interpersonal associations between poor mental health and mother–daughter relationship closeness in a sample of 467 dyads. Health Chat was a social media intervention designed to reduce mothers’ permissiveness toward their teen daughters’ indoor tanning behavior. It also addressed other adolescent health topics, such as vaccination, alcohol, and physical activity.

An Actor–Partner Interdependence Model was used to examine bidirectional processes between mothers and their teenage daughters. The independent variable was self-reported poor mental health and the dependent variable was relationship closeness. Communication satisfaction was also examined as a potential interpersonal mediator of the pathway between poor mental health and relationship closeness.

Daughters’ self-reported poor mental health negatively predicted their own perception of closeness as well as mothers’ perception of closeness. In addition, there was evidence that perceived communication may help explain both the actor effect (one’s own poor mental health on one’s own perception of closeness) and the partner effect (partner’s poor mental health on one’s own perception of closeness).

Detailed methods and results are presented in the publication. Results suggest that when daughters’ mental health is poor, relationship closeness as perceived by mother and daughter may be weakened, and that this effect may in part be explained by poor communication between mother and daughter. The authors concluded that strategies to promote family communication, especially for families experiencing mental health problems, may aid in the development of closer mother–daughter relationships.

This research was funded by a grant and supplement from the National Cancer Institute (CA192652; David Buller and Sherry Pagoto, Multiple Principal Investigators). Additional collaborating authors include Hyanghee Lee (lead author) and Kimberly Henry from Colorado State University; Katie Baker and Joel Hillhouse from East Tennessee State University; Jessica Bibeau from the University of Connecticut; and Barbara Walkosz and Julia Berteletti from Klein Buendel. 

Keeping Research Moving During a Pandemic

Keeping Research Moving During a Pandemic

Dr. Susan Loeb, PhD, RN, FGSA, FAAN, from the Pennsylvania State University Ross and Carol Nese College of Nursing – and an active Klein Buendel research collaborator – reflected on her research team’s experience in keeping research productive during the COVID-19 pandemic at the 17th Annual Custody & Caring Conference, November 4-5, 2021. The virtual conference was sponsored by the University of Saskatchewan in Saskatoon, Saskatchewan, Canada. 

The cessation of face-to-face human subjects research by Universities and Departments of Corrections due to the COVID-19 pandemic has challenged researchers to seek alternative approaches for moving their work forward, albeit often not as originally conceived. Dr. Loeb’s presentation, and an accompanying award-winning poster led by Dr. Erin Kitt-Lewis from the Penn State Ross and Carol Nese College of Nursing, reported experiences from the Inmates Care Project,an STTR grant awarded to Klein Buendel by the National Institute on Aging (AG057239; Dr. Susan Loeb and Dr. Barbara Walkosz, Multiple Principal Investigators).

The Inmates Care study served as an exemplar to demonstrate strategies and adaptions employed to forge ahead in modified yet meaningful ways despite a protracted public health emergency. Inmates Care focuses on the research and development of computer-based training to prepare incarcerated persons to assist corrections staff in caring for people who have grown old behind bars and are approaching the end of their lives in prison. Identification of barriers and facilitators, re-envisioning how the team would restructure their day-to-day work, and preparing for the future were a few of the essential steps that were described.  

Key Lessons Learned

  • Seizing the opportunity to make investments in team member development;
  • Writing protocols that detail both in-person and virtual options for data collection to allow the team to pivot quickly when the next challenge arises; and
  • Reaching out to brainstorm with funding agency program officers, Institutional Review Board analysts, advisory board members, and other researchers beyond the team.

Such initiatives can result in scientifically sound, safe, and pragmatic solutions to keep research productive despite public health challenges. Taken together, these approaches can maintain study progress and scientific integrity, as well as identify alternate ways to achieve study aims in a timeline necessarily relaxed, but as close as possible to the original plan.

Co-authors on the presentation and 1st Place poster included Dr. Erin Kitt-Lewis, Sherif Olanrewaju, and Leigh Casey from Penn State University; Dr. Valerie Myers formerly from Klein Buendel; Jeannyfer Reither and Savanna Olivas from Klein Buendel; and Katherine Aiken from the Penn State College of Health and Human Development.

In addition to the paper and poster presentation, Dr. Loeb was also an invited panelist on a Closing Keynote titled, “Reflections on Forensic Mental Health and Correctional Nursing.”

Let’s Talk About Skin Cancer

Let’s Talk About Skin Cancer

Family communication about skin cancer risk may motivate people to put sun protection into practice. However, the availability, distribution, and reach of such communication is not well known.

In a recent publication in the Journal of Health Communication, authors including Dr. David Buller from Klein Buendel, describe prevalence and patterns of family communication about skin cancer across 600 diverse primary care patients. The patients were from Albuquerque, New Mexico, a geographical location with low latitude and significant year-round ultraviolet radiation from the sun.

Over half of the patients reported discussing general cancer and skin cancer risks with their families. The most frequent target of skin cancer risk communication included doctors, followed by friends/coworkers, spouse/partner, other family members, sisters, mothers, daughters, sons, fathers, and brothers. On average, participants reported having talked to three family members about skin cancer risks.

The most frequently discussed skin cancer risk communication topics were the use of sun protection, followed by the personal risk of skin cancer, who had skin cancer in the family, family risk of skin cancer, time of sun exposure, and skin cancer screening. Overall, greater family communication about general cancer and skin cancer risks was associated with a family or personal history of cancer, higher perceived risk, higher health literacy, being non-Hispanic, having higher education or income, and proactive sun protective behavior.

These study findings have implications for developing interventions that encourage family discussions about skin cancer risk, sun protection, and skin cancer screening that may foster the adoption of sun-protective behaviors and reduced exposure to harmful ultraviolet radiation.

This research was supported by a grant from the National Cancer Institute (CA181241; Dr. Jennifer Hay and Dr. Marianne Berwick, Multiple Principal Investigators). Authors in addition to the Principal Investigators include Dr. Smita Banerjee (lead author) and Dr. Elizabeth Schofield from the Memorial Sloan Kettering Cancer Center; Dr. Andrew Sussman, Dr. Dolores Guest, Dr. Yvonne Dailey, Dr. Matthew Schwartz, and Dr. Keith Hunley from the University of New Mexico; Dr. Kimberly Kaphingst from the University of Utah; and Dr. David Buller from Klein Buendel.

STAC-T: Formative Research Results

STAC-T: Formative Research Results

Formative research, such as target population focus groups and usability testing, is essential for the design and development of interactive technology-based programs. Usability testing results of a brief web-based middle school bystander bullying prevention program, STAC-T, were published recently in JMIR Formative Research. The research team was led by Dr. Aida Midgett from Boise State University. Key collaborators included Dr. Diana Doumas from Boise State University and Dr. Valerie Myers, formerly from Klein Buendel.

STAC-T translates four strategies to train bystanders to effectively intervene to reduce bullying into a time- and cost-effective web-based program for middle school students and staff. The four strategies are: “Stealing the show,” “Turning it over,” “Accompanying others,” and “Coaching compassion.”

The main purpose of the formative research was to assess the usability and acceptability of a STAC-T prototype in advance of full-scale development. Other aims included understanding school needs and barriers to program implementation, and assessing differences in usability between middle school staff and students. 

Sixteen participants from three middle schools in rural, low-income communities completed STAC-T usability testing and a qualitative interview. The publication describes the usability testing methods and outcomes of data analyses, including ratings of prototype program satisfaction, acceptability, feasibility, needs, barriers, and recommendations for program adjustments. Overall, school staff and students reported satisfaction with the web-based program. They found it easy to use, acceptable, and feasible. The findings have encouraged the authors to pursue the full-scale development of the STAC-T web-based bullying prevention app for middle schools.

The STAC-T feasibility project was funded by a small business STTR grant to Klein Buendel from the National Institute on Minority Health and Health Disparities at the National Institutes of Health (MD014943; Dr. Aida Midgett, Principal Investigator). The STAC-T prototype was programmed by Klein Buendel’s Creative Team.

FitBrothers

FitBrothers

African American men experience significant health disparities across a number of preventable chronic diseases including cardiovascular disease, strokes, diabetes, and cancer. Physical activity (PA) is a modifiable risk factor for these conditions. However, the limited number of clinic- or community-based PA promotion studies that have included African American men have resulted in successful short-term behavior change for PA levels. Maintenance of increased PA levels over an extended time period is needed for sustained health benefits.

A research team from Klein Buendel, the Pennington Biomedical Research Center (PBRC), and Georgetown University are launching a new research project to address PA maintenance in African American men with technology. The project is: A Smartphone App to Increase and Maintain Physical Activity in African American Men (FitBrothers). The effort is being led by Dr. Robert Newton from PBRC and is being funded by a Fast-Track STTR grant to Klein Buendel from the National Institute of Minority Health and Health Disparities (MD014947; Dr. Robert Newton, Principal Investigator).

Dr. Newton’s preliminary focus group data indicates that African American men would be receptive to maintenance strategies delivered via smartphone. For this new project, the team will develop a prototype smartphone app and conduct usability testing to determine design viability and acceptability among would-be users in Phase I. In Phase II, the team will conduct a comparative effectiveness trial to assess success of the app on the PA maintenance levels of participating African American men.

Dr. Newton is an Associate Professor of Physical Activity and Ethnic Minority Health at PBRC. His research collaborators include Dr. Derek Griffith from Georgetown University and Dr. David Buller from Klein Buendel. Dr. Griffith is the Founding Co-Director of the Racial Justice Institute, Founder and Director of the Center for Men’s Health Equity, and Professor of Health Systems Administration and Oncology at Georgetown. Dr. Buller is the Director of Research at Klein Buendel. The FitBrothers app will be engineered by Klein Buendel’s Creative Team.

Mothers and Teenage Daughters: HPV Vaccination Information via Social Media

Mothers and Teenage Daughters: HPV Vaccination Information via Social Media

Dr. David Buller, Klein Buendel’s Director of Research, and his coauthors have published results from the Health Chat Project in the online journal, Frontiers in Digital Health. Health Chat was designed as a social media intervention to reduce mothers’ permissiveness toward their teen daughters’ indoor tanning behavior. It also addressed other adolescent health topics, including human papillomavirus vaccination.

“Parents acquire information about human papillomavirus (HPV) vaccines online and encounter vaccine-critical content, especially on social media, which may depress vaccine uptake,” according to the authors. To help address vaccine hesitancy and misinformation, the authors employed a Facebook-delivered adolescent health campaign targeting mothers with posts on HPV vaccination. The study examined the relationship between mothers’ comments and reactions to posts about HPV and any change in their self-reports of having their daughters vaccinated.

The online publication describes the study’s hypotheses, social media health intervention, research methods, results, communication strategies, and limitations. The behavioral research was guided by social cognitive theory, transportation theory, and diffusion of innovations theory. In summary, mothers commented both positively and negatively toward HPV vaccine-related posts. Also, vaccinations rates increased from baseline, through 12-month and 18-month follow-up assessments.

This research was funded by a grant and supplement from the National Cancer Institute (CA192652; Dr. David Buller and Dr. Sherry Pagoto, Multiple Principal Investigators). Collaborating authors include Dr. Katie Baker and Dr. Joel Hillhouse from East Tennessee State University; Dr. Kimberly Henry from Colorado State University; Jessica Bibeau from the University of Connecticut; Kelsey Arroyo from the University of Florida; and Dr. Barbara Walkosz and Julia Berteletti from Klein Buendel. 

Skin Cancer Genetic Testing Research

Skin Cancer Genetic Testing Research

Klein Buendel Director of Research, Dr. David Buller, is a co-author on two recent publications reporting the results of studies on genetic testing and treatment decision-making for melanoma patients. Both papers report finding from a study directed by Dr. Jennifer Hay from the Memorial Sloan Kettering Cancer Center in New York and Dr. Marianne Berwick from the University of New Mexico.

Behavioral and Psychological Outcomes Associated with Skin Cancer Genetic Testing

The first paper has been published in the journal Cancer (Basel). The study investigated genomic testing of the common melanocortin-1 receptor (MC1R) gene for skin cancer risk in a randomized controlled trial in primary care settings in Albuquerque, New Mexico. Study participants were randomized 5:1 to a MC1R test invitation or usual care. Three-month sun protection, skin cancer screening, and skin cancer worry outcomes associated with testing, and key effect moderators (such as cancer risk perceptions, and skin cancer risk factors) were assessed.

Full research methods and results are reported in the publication and show that the primary outcomes were unchanged by the MC1R test offer, test acceptance, and level of risk feedback. Moderator analyses results are also presented in the publication. “Risk feedback did not prompt cancer worry, and average risk feedback did not erode existing sun protection,” according to the authors. More study is needed in the understanding and development of tailored strategies to address low skin cancer risk awareness and genetic testing.

This research was supported by the National Cancer Institute (CA181241; Jennifer Hay and Marianne Berwick, Multiple Principal Investigators). Collaborators include Kimberly Kaphingst from the University of Utah; David Buller from Klein Buendel; Elizabeth Schofield and Yuelin Li from the Memorial Sloan Kettering Cancer Center; Kirsten Meyer White from the New Mexico VA Health System; Andrew Sussman, Dolores Guest, Yvonne Dailey, Erika Robers, Matthew Schwartz, and Keith Hunley from the University of New Mexico.

Effect of Superstitious Beliefs and Risk Intuitions on Genetic Test Decisions

The second paper has been published in the journal Medical Decision Making. The study investigated cognitive causation, or superstitious thinking, and negative affect in risk as predictors of MC1R (moderate v. high risk) skin cancer genetic testing and responses to the testing.

Nearly 500 participants completed baseline assessments using validated measures of cognitive causation (beliefs that thinking about cancer risk increases cancer likelihood) and negative affect in risk (negative feelings generated during risk perception) and subsequently received a test offer. Participants could access a website to learn about and request genetic testing. Those who completed genetic testing for skin cancer completed assessments of cognitive and affective reactions two weeks after testing.

Methods, assessment measures, and full results are reported in the publication. In summary, negative affect in risk did not hamper test information seeking, but did inhibit the uptake of genetic testing. Those with higher cognitive causation showed more fear regarding their test result.

This research was supported by the National Cancer Institute (CA181241; Jennifer Hay and Marianne Berwick, Multiple Principal Investigators). Collaborators include Kristen Riley from Rutgers University; Andrew Sussman, Dolores Guest, Yvonne Dailey, Matthew Schwartz, and Keith Hunley from the University of New Mexico; Elizabeth Schofield from the Memorial Sloan Kettering Cancer Center; David Buller from Klein Buendel; and Kimberly Kaphingst from the University of Utah.

Vacteens: A Web App to Boost HPV Vaccine Uptake

Vacteens: A Web App to Boost HPV Vaccine Uptake

Dr. W. Gill Woodall, Klein Buendel Senior Scientist, and his coauthors published the results of the Vacteens Project in the online journal, Frontiers in Digital Health.

The uptake of HPV vaccine in the United States remains lower than preferred by health authorities, particularly for young adolescents, when immunogenic response to the vaccine is strongest. Potential parental barriers to low vaccine uptake include confusion, uncertainty, and misinformation about HPV vaccine schedule, safety, and effectiveness. Dr. Woodall and his collaborators believe that parental barriers to HPV vaccination may be addressed by digital interventions, such as web apps, that are tailored to their concerns.

The Vacteens Project project tested a web app for educating parents. The study was conducted with 82 parent-adolescent (daughter) pairs recruited from in nine pediatric clinics in New Mexico. It tested whether digital information delivered to parents in a community setting may be an effective way to help reach HPV vaccine uptake goals in the United States. Diffusion of Innovations Theory principles were used to guide the development of the Vacteens/Vacunadolescente mobile app in English and Spanish.

Parents were randomized to receive either the Vacteens/VacunaAdolescente mobile web app or the usual and customary online HPV vaccination pamphlet from the U.S. Centers for Disease Control and Prevention (CDC). Parents completed surveys at baseline and month 3, and child vaccine records were collected at month 12. Vaccine uptake results from the study found that parents who received the Vacteens/VacunaAdolescente web app were more likely to have their daughters vaccinated than parents in the control condition. Study methods, results, and limitations are detailed in the online publication.

This research was funded by a grant from the Patient-Centered Outcomes Research Institute (PCORI) to the University of New Mexico (#1511-33018; Dr. W. Gill Woodall, Principal Investigator). Dr. Woodall’s collaborators include Dr. Greg Zimet from Indiana University, Dr. Alberta Kong, Dr. Lance Chilton, and Dr. Randall Starling from the University of New Mexico, and Dr. David Buller, Jeannyfer Reither, and Dr. Valerie Myers from Klein Buendel.

Smart Choices 4 Teens

Smart Choices 4 Teens

Healthy decision-making by older adolescents and young adults can be fostered by active parental relationships and mutual engagement.

Two Klein Buendel Scientists are co-authors on a paper in the journal JMIR Pediatrics and Parenting looking at healthy decision-making. Dr. Gill Woodall and Dr. David Buller are members of a research team led by Dr. Brenda Miller from the Pacific Institute for Research and Evaluation (PIRE). The paper, whose lead author is Dr. Beth Bourdeau from the University of California, San Francisco, reports findings from a study designed to test the efficacy of the Healthy Relationships and Sexual Decision-making component of a web-based intervention for older adolescents and their parents, called Smart Choices 4 Teens.

The paper describes the details of the final segment of a randomized controlled trial conducted with 411 families with adolescents aged 16-17 years. Adolescents and parents worked through the web-based, self-paced program together. “Participation in the relationships component increased the frequency of parental sexual communication and increased the number of dating rules after accounting for other significant adolescent characteristics.” The paper reports that “Smart Choices 4 Teens demonstrated efficacy in increasing the frequency of sexual communication between parents and adolescents in the long term.”

The Smart Choices 4 Teens research was supported by a grant from the National Institute on Alcohol Abuse and Alcoholism (AA020977; Dr. Brenda Miller, PIRE, Principal Investigator). Other authors on this publication include Dr. Hilary Byrnes and Dr. Joel Grube from PIRE; Dr. Beth Bourdeau from the University of California San Francisco; and Dr. Gill Woodall and Dr. David Buller from Klein Buendel. Smart Choices 4 Teens was programmed by the Creative Team at Klein Buendel.

Computer-Based Training for Geriatric and End-of-Life Care in Prisons

Computer-Based Training for Geriatric and End-of-Life Care in Prisons

In a recent publication in the Journal of Correctional Health Care, authors from Penn State University, Indiana University, King’s College, and Klein Buendel share insights into the testing of a computer-based training for peer caregivers (PCs) in prisons to care for aged and dying prisoners. 

As the aged and dying incarcerated population increases, so does the demand on corrections health care. In the publication, the research team describes their process of conducting focus groups and performing usability testing with PCs and corrections staff members who ultimately helped identify the priority training topics.  

The focus groups, in consultation with an Expert Advisory Board, led to the creation of three prototype modules: Standard Precautions; Loss and Grief; and Role of the Inmate Caregiver in the Final Hours. Following the focus groups, face-to-face usability testing was conducted with PCs and staff who confirmed the contextual training relevance and feasibility of the computer-based training program. 

The team concluded that the computer-based training, Inmates Care, provides evidence to complement nurse-led training within the corrections setting with a standardized e-training package. A full description of the methods, results, discussion, strength and limitations, and conclusions can be found in the publication.  

This research was funded by a Phase I grant from the National Institute on Aging (AG057239). The project was led by Principal Investigator Dr. Susan Loeb from Penn State University and Co-Investigator Dr. Valerie Myers from Klein Buendel. Additional authors include Dr. Erin Kitt-Lewis from Penn State University, Tiffany Jerrod from Klein Buendel, Dr. Rachel Wion from Indiana University, and Dr. Julie Murphy from King’s College.