Responsible Marijuana Vendor Training

Responsible Marijuana Vendor Training

Dr. David Buller, Klein Buendel Senior Scientist and Director of Research, presented recent work by his research team at the Tenth European Society for Prevention Research (EUSPR) Conference and Members’ Meeting in Ghent, Belgium in September. His presentation, “Effects of an Online Responsible Vendor Training for Recreational Cannabis Stores on Sales to Pseudo-intoxicated Customers: Need for Increased Deterrence,” was coauthored by Dr. Gill Woodall, Mr. Andrew Grayson, Ms. Sierra Svendsen, and Ms. Mary Buller from Klein Buendel; and Dr. Robert Saltz from the Pacific Institute for Research and Evaluation.

The advent of recreational cannabis in Canada, Uruguay, and several U.S. states raises the risk of polysubstance-impaired driving. In alcohol markets, training in responsible sales practices is an intervention to reduce sales to intoxicated patrons and thus prevent impaired driving and other harms. Similar training may benefit communities with recreational cannabis sales.

An online responsible marijuana vendor (RMV) training, Train To Tend, was developed with input from state regulators and store personnel. Among its five modules, learning elements taught store personnel to recognize signs of alcohol impairment and intoxication, refuse sales, and understand the risks of driving under the influence of cannabis. A sample of 150 recreational cannabis stores in Colorado, Oregon, and Washington State, USA were enrolled in a randomized controlled trial, half of which were randomly assigned to use the RMV training. Stores were posttested using a pseudo-intoxicated patron (PiP) protocol in which confederate buyers feigned obvious signs of intoxication.

Sales of cannabis to PiPs were refused at only 16 of 144 stores across the three states. There was no difference in refusal rates between intervention and control stores or between stores that used the RMV training or not. In 11 visits, store personnel commented on the buyers’ behavior or expressed concern/suspicion about buyers but sold to them anyway.

Training in responsible sales practices alone did not appear to reduce sales to intoxicated customers. Legal deterrence from making these sales may be insufficient or nonexistent for store management to support adherence to this responsible sales practice. Regulatory actions (such as swift, severe, and certain penalties) may be needed to increase perceived risk with such sales  to achieve training’s benefits.

This research was sponsored by a grant from the National Institute on Drug Abuse at the National Institutes of Health (DA038933; Dr. David Buller, Principal Investigator). Train To Tend was programmed by the Creative Team at Klein Buendel.

Dr. David Buller presenting the RMV training program
Smart Choices 4 Teens

Smart Choices 4 Teens

Three Klein Buendel researchers were part of a team that gave two presentations at the Tenth European Society for Prevention Research (EUSPR) Conference and Members’ Meeting in Ghent, Belgium in September. Dr. David Buller, Dr. W. Gill Woodall, and Ms. Julia Berteletti were part of the Smart Choices 4 Teens research team led by Dr. Brenda Miller from the Prevention Research Center at the Pacific Institute for Research and Evaluation (PIRE).

Smart Choices 4 Teens is an online, interactive, family-based program for parents and older teens designed to reduce teen alcohol use and risky sexual behaviors. The program features three sequential components (parent-teen communication, teen alcohol prevention, and teen romantic relationships) that parents and teens complete separately before working together through a discussion activity at the end of each component. A randomized controlled trial with 411 families found significantly better outcomes for teens in the experimental condition as compared to controls in terms of decreased alcohol use and decreased sexual risk behaviors.

Oral Presentation

Dr. Brenda Miller’s presentation focused on the design of the Smart Choices 4 Teens alcohol prevention component. This module targeted eleven topics: (1) the decision to drink or not drink, (2) social host laws, (3) physical effects of alcohol, (4) signs of alcohol poisoning, (5) social consequences of alcohol, (6) an interactive Blood Alcohol Calculator, (7) myths about alcohol, (8) creating a safety plan for parties, (9) parental influences, (10) refusal skills, and (11) defining a drinking problem. The module incorporated four different activity formats — video narratives, info-gadgets, interactive activities, and structured discussions. Parents and teens engaged in the same materials but did so separately, coming together to choose and discuss hypothetical scenarios that guided the discussion offline. A “nudge” feature was embedded to allow teens to prompt their parent to finish a module and move to the end-of-module offline discussion or vice versa. The nudge feature was used 561 times by 218 users.

Dr. Miller reported that 86% of experimental families began the intervention and 50% of families completed the teen alcohol prevention component. The average time needed to complete the alcohol component was 16 minutes. Parents and teens reported learning new lessons and becoming more comfortable discussing alcohol use together. Barriers to completion included limited understanding of some content and needing additional instructions.

Poster Presentation

Dr. David Buller presented a poster, with analysis led by Dr. W. Gill Woodall, on the effect of teen engagement with Smart Choices 4 Teens. Teens and parents (411 dyads) completed an online baseline survey prior to being assigned to either the intervention or control conditions. Follow-up online surveys were completed 6, 12, and 18 months later. The teen sample was 55% female and 72% non-Hispanic White. The parent sample was comprised predominately of mothers (84.7%).

The Smart Choices 4 Teens website tracked duration of time spent using each of the web-based components. In an analysis of teens who completed the program in the intervention group (n=142), linear regressions tested duration of teens’ time in each online component in the entire program as predictors of teens’ past 30-day alcohol use at the 6-month follow-up. More time spent by teens using interactive activities negatively predicted later alcohol use, as did teens’ time spent viewing videos. Also, teens’ time spent using info-gadget activities had a negative relationship with alcohol use.

The researchers report that activities with interactivity, animations, and video content may produce stronger preventive effects on alcohol use because teens prefer this format over written text in the info-gadgets, have more involvement with them, and/or find characters relatable. These reactions may stimulate deep processing of prevention content.

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 Dr. Miller’s research team included Dr. Hilary Byrnes, Ms. Veronica Rogers, and Dr. Joel Grube from PIRE; Dr. Beth Bourdeau from the University of California San Francisco; and Dr. David Buller, Dr. W. Gill Woodall, and Ms. Julia Berteletti from Klein Buendel. Smart Choices 4 Teens was programmed by the Creative Team at Klein Buendel.

Dr. Brenda Miller viewing Smart Choices 4 Teens
Project STRONG Expands into Spanish

Project STRONG Expands into Spanish

Ms. Julia Berteletti, Klein Buendel Research Program Manager, is a Co-Investigator on a new research project aimed at teaching adolescent boys, with their parents, skills on regulating their emotions and how to communicate their feelings.

Emotional regulation is the ability to successfully understand and express one’s emotions (1). The large empirical literature links violent behavior and adolescents who lack this ability. Furthermore, numerous studies show that parental involvement is crucial to offsetting dating violence risk (2).

Northeastern University, in collaboration with Klein Buendel, conducted a pilot study which was funded by the National Institute of Justice and titled “Partner Violence Prevention for Middle School Boys: A Dyadic Web-Based Intervention” (2014-MU-CX-4002). The aim of the study was to develop a web-based intervention to reduce the risk of dating violence among middle-school aged males. The engaging web program was used by parents and adolescents together, with both the parent and the child choosing an avatar, playing games together, and being prompted to discuss the content.

Results showed that families generally found the program helpful and useful (3). Adolescents randomized to the STRONG condition were less likely to report dating violence perpetration events and victimization events when compared to the control group (3). Additionally, adolescents in the STRONG condition reported an increase in a number of emotional regulation measures compared to control participants (3).

The new Project STRONG R01 study will be conducted in a larger randomized controlled trial titled “Project STRONG: A Web-Based Dating Violence Prevention Program for Parents and Middle School Boys”. The web-based program will be translated and developed in Spanish and will be tested for its ability to reduce the risk of dating violence among both English- and Spanish-speaking middle-school aged males. Again, parents and their sons will complete the program together.

The research is funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development at the National Institutes of Health (HD097126; Dr. Chris Houck and Dr. Christine Rizzo, Principal Investigators). Ms. Berteletti will be collaborating with Dr. Chris Houck of Rhode Island Hospital and Dr. Christine Rizzo of Brown University.

References

1. Houck CD, Hadley W, Barker D, Brown LK, Hancock E, Almy B. An emotion regulation intervention to reduce risk behaviors among at-risk early adolescents. Prev Sci. 2016;17(1):71-82. doi: 10.1007/s11121-015-0597-0
2. Lundgren R, Amin A. Addressing intimate partner violence and sexual violence among adolescents: emerging evidence of effectiveness. J Adolesc Health. 2015;56(1 Suppl):S42-S50. doi: 10.1016/j.jadohealth.2014.08.012
3. National Criminal Justice Reference Service; Rizzo CJ, Houck C. Summary Report: Partner Violence Prevention for Middle-School Boys: A Dyadic Web-Based Intervention Study (Project STRONG). Available at: https://www.ncjrs.gov/pdffiles1/nij/grants/252517.pdf. Published January 2019. Accessed August 21, 2019.

The Grow, Eat, Thrive School Gardening Curriculum is Now Free

The Grow, Eat, Thrive School Gardening Curriculum is Now Free

September is National Childhood Obesity Month because increasing awareness about how to prevent overweight and obesity children is a public health priority. To help with the effort, Klein Buendel is making its Grow, Eat, Thrive elementary school curriculum available to teachers for free online. Grow, Eat, Thrive pairs nutrition and physical activity education with container gardening for children in grades Kindergarten through 5. It teaches students about the benefits of eating fruits and vegetables and engaging in daily exercise for overall good health.

Grow, Eat, Thrive can stand alone or complement a teacher’s existing lesson plans. While completing lessons, students plant their own container or outdoor garden, care for it, and harvest what they have grown. This hands-on approach provides students with a sense of where fresh produce comes from, an appreciation for healthy foods and daily activity, and a connection to making healthy life choices. The lessons are age and grade level appropriate, and relate to a variety of content standards for easy implementation.

The evidence-based curriculum was created and tested by Klein Buendel with students at six Colorado elementary schools and was found to increase knowledge of a healthy diet in all grades. In younger grades, the curriculum improved attitudes toward a healthy diet and increased intake of healthier foods.

“As obesity rates continue to rise, education that addresses nutrition and physical activity in elementary schools is essential,” said Ms. Mary Buller, one of the curriculum collaborators from Klein Buendel. “Grow, Eat, Thrive helps makes that education easy and fun for everyone.”

Grow, Eat, Thrive was created with a grant from the U.S. Department of Agriculture (USDA 2005-33610-16469; Ms. Lee Stiffler-Myer, Principal Investigator). To access the free lesson plans, visit the Grow, Eat, Thrive website.

Using Panel Vendors to Recruit Research Participants

Using Panel Vendors to Recruit Research Participants

It has become more common to recruit research study participants through online panel vendors, such as GfK or Qualtrics. In a publication made available recently in PubMed Central from Evaluation and the Health Professions, Dr. Meme Wang-Schweig from the Prevention Research Center at the Pacific Institute for Research and Evaluation (PIRE) and her coauthors (including Dr. David Buller from Klein Buendel), report on the use of panel vendors for recruiting research participants into a randomized controlled trial. The research study was testing an online, family-based alcohol prevention program for parents and older teens, called Smart Choices 4 Teens.

Panel vendors are hired to recruit and match potential research participants to a target population for data collection.  Most panel vendors use non-probability sampling which does not involve random selection. People opt in to participate. The vendors advertise for panelists using website banner ads, emails, direct mail, etc. Panelists are paid but may also enjoy contributing their opinions to a research study. Panel vendors can recruit a potential research sample quickly.

Dr. Wang-Schweig’s paper endeavors to answer two methodological questions: (1) how well do panel vendors provide a sample of families to participate in a trial who meet specific inclusion criteria, and (2) how well do panel vendors provide a sample of families to participate in a trial who reflect the make-up of the general population? Using the Smart Choice 4 Teens project’s experience as a real-world example, the authors describe the process of working with panel vendors, the sample’s match to the intended target population, and the additional screening they employed to ensure the quality of the sample. Several recommendations are made for other research teams looking to use panel vendors to recruit study participants.

Smart Choice 4 Teens was supported by a grant from the National Institute on Alcohol Abuse and Alcoholism (AA020977; Dr. Brenda Miller, PIRE, Principal Investigator). Dr. Wang-Schweig’s coauthors for this publication included Dr. Brenda Miller, Dr. Hilary Byrnes, Dr. Beth Bourdeau, and Ms. Veronica Rogers from PIRE; and Dr. David Buller from Klein Buendel.

The Importance of Managers’ Awareness of Sun Protection Policy

The Importance of Managers’ Awareness of Sun Protection Policy

Improving occupational sun protection is a priority in the United States, as The Surgeon General’s Call to Action to Prevent Skin Cancer highlights. Klein Buendel and its collaborators responded to the call by launching a randomized trial to evaluate the effectiveness of a workplace sun protection program for outdoor workers. The program, Sun Safe Workplaces, was implemented with 98 public employers in Colorado, a state with high ultraviolet radiation due to its high elevation and sunny climate. The intervention promoted the adoption or strengthening of sun safety policy and the implementation of employee sun protection training. A two-year follow-up study also was completed with 68 of the 98 public sector employers.

In a recent publication in the American Journal of Industrial Medicine, Dr. Barbara Walkosz, Klein Buendel Senior Scientist, and her coauthors reported results related to the hypothesis that senior managers’ awareness of sun protection policy in the workplace would predict increased sun safety practices by employers and employees who work outdoors.

A full description of the methods (questionnaires and on-site observations), results, conclusions, and limitations of the research can be found in the American Journal of Industrial Medicine publication. In general, more sun safety messages, manager-employee communication, sun safety practices, and sun protection equipment (sunscreen, hats, etc. ) were evident when senior managers were more aware of their organization’s sun protection policy.

Overall, the authors found that occupational sun protection programs can be more effective on the “front line” (with people who work outdoors) when the “back office” (senior management) is aware of and can, therefore, support and encourage their organization’s sun safety policies and practices.

This analysis was funded by a grant from the National Cancer Institute at the National Institutes of Health (CA134705; Dr. David Buller and Dr. Barbara Walkosz, Principal Investigators). Dr. Walkosz’s coauthors on this paper included Dr. David Buller, Ms. Mary Buller, and Ms. Xia (Lucia) Liu from Klein Buendel, and Dr. Allan Wallis from the University of Colorado Denver.

Train To Tend Licensed to Avid Will LLC

Train To Tend Licensed to Avid Will LLC

Klein Buendel has licensed its online responsible vendor training program for recreational marijuana stores, Train To Tend®, to Avid Will LLC for sales and marketing. Senior Scientists, Dr. David Buller and Dr. W. Gill Woodall, and their collaborators created Train To Tend to provide retail staff with knowledge and skills to sell recreational marijuana responsibly in an effort to keep their communities safe. Avid Will LLC will make Train to Tend available immediately to retail recreational marijuana stores in Colorado. State-specific versions for Oregon, Washington State, Massachusetts, and California will be launched this year, as well.

In 2017 and 2018, Train To Tend was tested using a random sample of state-licensed recreational marijuana stores (n=225) in Colorado, Oregon, and Washington State. One hundred twenty-five stores were randomly selected to receive the Train To Tend training while the remaining stores received the usual and customary training in their state. Post-training surveys were administered to Train To Tend trainees to gauge their perceptions of self-efficacy toward responsible vending practices, as well as their ratings of usability for Train To Tend.

The training improved trainees’ ability to check IDs, and their confidence in using their state’s inventory tracking system and identifying intoxicated customers. Trainees rated the training as user-friendly and thought that the information and skills learned in the training would help keep their communities safe. In a recent review, Danielle, an Instructional Designer for Native Roots, a Colorado retail chain, said “Train To Tend has been effective and engaging for our employees, and we are thankful for the Train To Tend team and their online responsible vendor program.”

The development and evaluation of Train to Tend was funded by a grant from the National Institute on Drug Abuse at the National Institutes of Health (DA038933; Dr. David Buller, Principal Investigator). Additional scientific collaborators include Dr. W. Gill Woodall from Klein Buendel and Dr. Robert Saltz from the Pacific Institute for Research and Evaluation in California.

Collaborator Spotlight:
Dr. Christopher Houck

Collaborator Spotlight:
Dr. Christopher Houck

Christopher Houck, PhD, is an Associate Professor in the Pediatrics and Psychiatry and Human Behavior departments at Brown University. He currently works with Dr. Valerie Myers on a project titled, “An Emotion Regulation Intervention for Early Adolescent Risk Behavior Prevention” which is funded by the Eunice Kennedy Shriver National Institute of Child Health and Development (HD089979).

The program, Project Trac, originally geared toward educating adolescents on sexual health, was proven effective at targeting emotional regulation and reducing sexual risk among middle schoolers and high schoolers. Through tablet-based gaming, the current intervention focuses on teaching adolescents’ skills for managing their emotions to reduce poor decision-making that can lead to engaging in a variety of risky behaviors, like substance use or fighting. The overall goal of the current study is to provide an engaging, digital format to deliver the effective emotional regulation program; delivering the intervention through this technology reduces implementation costs and allows for flexibility in order to reach a wider audience.

Dr. Houck has also collaborated with Klein Buendel as a Co-Investigator on a project funded by the National Institute of Justice titled “Partner Violence Prevention for Middle School Boys: A Dyadic Web-Based Intervention” (2014-MU-CX-4002). The aim of the study was to develop a web-based intervention to reduce the risk of dating violence among middle-school aged males. The engaging, web-based intervention, to be used by parents and adolescents together, was based on the large empirical literature linking emotion regulation deficits to violent behavior as well as numerous studies showing that parental involvement is crucial to offset dating violence risk. The results from the pilot-testing were promising and a larger randomized controlled trial will begin in the fall.

In addition to adolescent emotional regulation and risky behaviors research, Dr. Houck is a licensed psychologist and provides services to children and adolescents at Rhode Island Hospital in the Department of Child and Adolescent Psychiatry. He works with patients affected by family illness and dealing with both psychological and medical problems. Dr. Houck completed his postdoctoral fellowship in pediatric psychology at Brown University in Rhode Island. He received the Psychology Research Mentor Awards from the Alpert Medical School at Brown University Department of Psychiatry and Human Behavior in 2017. In addition to his work at Rhode Island Hospital and Brown University, he is also on the editorial board of the Journal of Pediatric Psychology.

Computer-based Learning for End-of-Life Care in Prisons

Computer-based Learning for End-of-Life Care in Prisons

In a recent publication in the Journal of Forensic Nursing, authors from The Pennsylvania State University and Klein Buendel describe, in detail, the design and development of a computer-based learning program for geriatric and end-of-life (EOL) care for incarcerated people. The program, called Enhancing Care for the Aged and Dying in Prison (ECAD-P), was funded by a Small Business Technology Transfer (STTR) grant to Klein Buendel from the National Institute on Aging.

Content creation was based on the Phase I Principal Investigators’ paper-based EOL Toolkit. The systematic design and development of the training program was guided by the Institute for Healthcare Improvement’s Framework for Going to Full Scale. The Journal of Forensic Nursing paper describes the painstaking processes of designing a program logo, recording video testimonials, creating graphic novels, incorporating visually-stimulating images, confirming reading level, and programming the functionality of the media-rich, interactive computer-based training program. The final ECAD-P program has six modules which take approximately 2.5 hours to complete in one or more sessions.

The STTR Phase I and Phase II projects were funded by a grant from the National Institute on Aging (AG049570). The Phase I Multiple Principal Investigators, Dr. Janice Penrod and Dr. Susan Loeb, are from The Pennsylvania State University. The Phase II Multiple Principal Investigators, Dr. Susan Loeb and Dr. Valerie Myers, are from The Pennsylvania State University and Klein Buendel, respectively. Other paper coauthors include Rachel Wion from The Pennsylvania State University, Tiffany Jerrod from Klein Buendel, and Sophia Strickfaden from Johnson & Wales University. ECAD-P was programmed by the Creative Team at Klein Buendel.

Physical Activity Maintenance in African American Men

Physical Activity Maintenance in African American Men

In a recent publication in mHealth, Dr. Robert Newton, Dr. Valerie Myers, and their coauthors describe the development of a smartphone app to help African American men maintain physical activity. The formative research was funded by a Small Business Technology Transfer (STTR) grant to Klein Buendel from the National Institute of Minority Health and Health Disparities.

African American men experience higher rates of morbidity and mortality from several chronic diseases that have low physical activity as a modifiable risk factor. For example, increased levels of physical activity have been shown to reduce the risk of developing obesity, cardiovascular disease, and diabetes. Yet, African American men’s levels of regular physical activity remain low.

The study set out to develop and test the feasibility of a prototype smartphone app to promote physical activity maintenance in African American men. The publication describes formative research (focus groups), user-centered design, and evaluation (usability testing and one-month beta testing) of the MobileMen app through an iterative process with participants from the target population.

MobileMen and its learning activities were designed with a Social Cognitive Theory framework. The programmed app included a dashboard, learning activities, a prompting system, an activity tracker, and rewards.

Users reported above average satisfaction with the app. They also rated the app as user-friendly, helpful, enjoyable, and culturally relevant. The participants reported willingness to use the app to improve their physical activity. Rates of app use and other data are reported in the paper. A full description of the methods, results, conclusions, strengths, and limitations of the feasibility study, as well as a discussion on the inclusion of nutrition information, can be found in the mHealth publication.

The STTR Phase I project was funded by grant number MD010304 (Dr. Robert Newton, Pennington Biomedical Research Center, Principal Investigator). Coauthors include Dr. Valerie Myers and Tiffany Jerrod from Klein Buendel, Leah Carter and Jessica Romain from the Pennington Biomedical Research Center, and Dr. Derek Griffith from Vanderbilt University.