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Health Misinformation in Participant Comments in a Facebook-Delivered Cancer Risk Reduction Intervention

Health Misinformation in Participant Comments in a Facebook-Delivered Cancer Risk Reduction Intervention

Little is known about how how participants in a health intervention share health misinformation via social media platforms. The Health Chat research team published insights from their Facebook-delivered cancer risk reduction intervention and randomized trial with mothers and teen daughters as an abstract for the Society of Behavioral Medicine (SBM). The lead author, Kelsey Arroyo, from the University of Connecticut, would have presented the work at the 41st Annual Meeting and Scientific Sessions of the Society of Behavioral Medicine in San Francisco, had the conference been held as planned.

For this study, the researchers examined 175 comments made to 42 randomly-selected Facebook posts on different health topics such as substance use, indoor tanning, vaccines, mental health by study participants. The Facebook groups were moderated by health professionals. The participant comments were coded as sharing an opinion, a personal experience, an intention, or information. Comments were analyzed for whether misinformation was conveyed. According to the authors, “misinformation was defined as a fact, belief, opinion, or action that is not supported by scientific evidence.”

Analysis showed that more than three-quarters of comments shared a personal experience. Overall, less than one-fifth of the comments conveyed misinformation, and more than half of the misinformation was conveyed in comments that shared a personal experience.

This research is funded by a grant from the National Cancer Institute (CA192652; Dr. David Buller, Klein Buendel, and Dr. Sherry Pagoto, University of Connecticut, Multiple Principal Investigators). Collaborators and co-authors on the SBM abstract include Kelsey Arroyo, Jared Goetz, and Dr. Molly Waring from the University of Connecticut; Dr. Katie Baker and Dr. Joel Hillhouse from East Tennessee State University; Dr. Kim Henry from Colorado State University; Dr. Jerod Stapleton formerly from the Rutgers Cancer Institute of New Jersey; and Julia Berteletti and Dr. Barbara Walkosz from Klein Buendel.

Lessons Learned: Accessing Sites for Correctional Research

Lessons Learned: Accessing Sites for Correctional Research

Dr. Erin Kitt-Lewis from Penn State University presented insights into accessing correctional facilities for research 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, was a co-author on the presentation.

Despite the imperative to engage in research in corrections, researchers face many challenges due to the restrictive nature of this setting. Dr. Kitt-Lewis shared many of the lessons learned by this collaborative research team as they worked to secure diverse prison and jail settings to research, develop, and test the Enhancing Care for the Aged and Dying in Prison program.

Lessons learned included the discovery of contextually-specific constraints such as the closing or consolidating of services or facilities, managing staffing constraints, relocating staff, ascertaining and adhering to policies and administrative directives, and working within the guidelines of the review board of the correctional system.

Establishing and maintaining relationships with key stakeholders in corrections were also important aspects of this research. In her presentation, Dr. Kitt-Lewis discussed developing networking opportunities such as connecting via social media like LinkedIn, attending corrections conferences, and discussing potential research opportunities to help build relationships with key stakeholders and decision-makers. Additional perceptions from the field included identifying potential barriers or constraints to accessing correctional sites, and sustaining relationships post-research via ongoing communication such as sharing periodic updates, final reports, and publications with partners.

The correctional system has often been called a “closed” system due to the difficulty faced by researchers in attempting to access and conduct research. However, establishing well-defined strategies to conduct research in the system appears to create efficiency and promote much needed health-related research in the correction setting. Research outcomes that are contextually-specific can support and foster equitable care for people who are incarcerated.

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, in addition to Dr. Erin Kitt-Lewis, include Dr. Susan Loeb and Kaléi Kowalchik from Penn State University; 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.

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.

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.

Klein Buendel’s 2019 Research Highlights

Klein Buendel’s 2019 Research Highlights

In our 17th year, Klein Buendel scientists and staff continue to conduct rigorous behavioral science research with numerous collaborators from across the country. In 2019, our investigators published 15 new research manuscripts in peer-reviewed journals and presented their research findings via 18 posters and presentations at 10 local, national, and international conferences and expert meetings. One of our posters was nominated for Best Poster in the Prevention and Public Health division at the Science of Dissemination and Implementation in Health annual conference, and one of our papers was selected by its journal to be included in their December 2019 Continuing Medical Education (CME) exam.

In April 2019, KB opened a new satellite research office in Albuquerque, New Mexico. The office is led by Dr. Gill Woodall, KB Senior Scientist, and conducts research projects with southwestern populations. 

Dr. Valerie Myers, KB Senior Scientist, was appointed this year by the Board of Directors of the Society of Behavioral Medicine to serve as the Education, Training, and Career Development Committee Chair. Her three-year term will begin in April of 2020.

In March of 2019, Dr. Barbara Walkosz, KB Senior Scientist, lectured on Media Literacy and Health Communication at Beijing Normal University in China. Dr. Walkosz also serves as an appointed Commissioner for Denver Mayor Michael Hancock’s Commission on Aging, part of the Agency for Human Rights and Community Partnerships.

In April of 2019, Dr. David Buller, KB Director of Research, lectured on KB’s occupational sun protection research (Sun Safe Workplaces) in a class at the University of Colorado School of Medicine. And in December, he presented initial findings from an ongoing social media campaign for mothers to improve adolescent health and reduce indoor tanning (Health Chat) via webinar to the Health Communication and Informatics Research Branch of the National Cancer Institute.

In product news, we licensed our Train to Tend® responsible marijuana vendor training program to Avid Will LLC for marketing and sales have started to take off. Also, sales of the very successful Way To Serve® responsible alcoholic beverage server training program continue to accelerate. And in September, we made one of our long-time products – the Grow, Eat Thrive elementary school nutrition and gardening curriculum – available for free online.

Lastly, KB was recognized in 2019 as #47 on Colorado Biz Magazine’s Top 100 Woman-Owned Companies list, and was #130 on their Top 200 Private Companies list.

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

Publications

  • 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. Psychol Addict Behav. 2019 Feb;33(1):1-14. doi: 10.1037/adb0000442.
  • 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. 1 Apr 2019;34(2):145-158.
  • Kitt-Lewis E, Loeb SJ, Myers VH, Wion RK, Baney B, Strickfaden S. Developing educational modules to enhance care of aged and dying inmates: Set-up phase. Public Health Nurs. 2019;36(11): 401-410.
  • Buller DB, Walkosz BJ, Berteletti J, Pagoto SL, Bibeau J, Baker K, Hillhouse J, Henry KL. Insights on HPV vaccination in the United States from mothers’ comments on Facebook posts in a randomized trial. Hum Vaccin Immunother. 2019;15(7-8):1479-1487.
  • Buller DB, Walkosz BJ, Woodall WG. Use of media and social media in the prevention of substance abuse. In: Sloboda Z, Petras H, Robertson E, Hingson R, eds. Prevention of Substance Use. Cham, Switzerland: Springer Nature Switzerland AG; 2019 pp 319-334.
  • Newton RL Jr, Carter L, St. Romain J, Jerrod T, Griffith D, Myers V. Development of a mobile phone app to maintain physical activity in African American men: MobileMen. mHealth. 2019 Jun 13;5:16. doi: 10.21037/mhealth.2019.05.03. eCollection 2019.
  • Kitt-Lewis E, Loeb SJ, Wion RK, Myers VH, Jerrod T, Strickfaden S. Developing Computer-Based Learning on Care of Aged and Dying Incarcerated People. J Forensic Nurs. 2019 Jul 9. doi: 10.1097/JFN.0000000000000248. [Epub ahead of print]
  • Byrnes HF, Miller BA, Bourdeau B, Johnson MB, Buller DB, Berteletti J, Rogers VA. Prevention of alcohol and other drug overuse among nightclub patrons: a randomized trial of a group-based mobile intervention at nightclubs. J Stud Alcohol Drugs. 2019 Jul;80(4):423-430.
  • Walkosz B, Buller D, Buller M, Wallis A, Liu X. Senior managers’ awareness of sun protection policy predicts implementation of worksite sun safety in a randomized trial. Am J Ind Med. 2019 Oct;62(10):893-900.
  • Meenan RT, Walkosz BJ, Buller DB, Eye R, Buller MK, Wallis AD, Olivas S. Economic evaluation of an intervention promoting adoption of occupational sun protection policies. J Occup Environ Med. 2019 Dec 6;61(12):978-983.*

*The above paper was selected by JOEM as an article to be included in their December 2019 CME exam.

  • Gonzalez CD, Rundle CW, Pona A, Walkosz BJ, Dellavalle RP. Ultraviolet radiation may cause premature fading of colored tattoos. Photodermatol Photoimmunol Photomed. 2019 Aug 28. doi: 10.1111/phpp.12509. [Epub ahead of print]
  • Buller DB, Woodall WG, Saltz R, Buller MK. Compliance with ID regulations by recreational marijuana stores in two US states. J Stud Alcohol Drugs. J Stud Alcohol Drugs. 2019 Nov;80(6):679-686.
  • White KAM, Dailey YT, Guest DD, Zielaskowski K, Robers E, Sussman A, Hunley K, Hughes CR, Schwartz MR, Kaphingst KA, Buller DB, Hay JL, Berwick M. MC1R variation in a New Mexico opulation. Cancer Epidemiol Biomarkers Prev. 2019 Nov;28(11):1853-1856.
  • Gonzalez CD, Pona A, Walkosz BJ, Dellavalle RP. Hispanic Tattoo Artists Could Provide Skin Cancer Prevention via Aftercare and Social Media. J Drugs Dermatol. ; 2019 Dec 1;18(12):1237-1243.
  • Glynn NW, Gmelin T, Santanasto AJ, Lovato LC, Lange‐Maia BS, Nicklas BJ, Fielding RA, Manini TM, Myers VH, de Rekeneire N, Spring BJ, Pahor M, King AC, Rejeski WJ, Newman AB; for the Lifestyle Interventions and Independence for Elders Study Group. Impact of baseline fatigue on a physical activity intervention to prevent mobility disability. J Am Geriatr Soc. 2019 Dec 22. doi:10.1111/jgs.16274. [Epub ahead of print]

Conference Presentations

Society of Behavioral Medicine Annual Meeting: March 6-9 in Washington, DC

  • Berteletti J, Buller DB, Pagoto S, Walkosz B, Bibeau J, Baker K, Hillhouse J, Henry K. Mothers’ beliefs about adolescent marijuana use: insights from a Facebook-delivered intervention and randomized trial. Oral presentation.
  • Reynolds KD, Buller DB, Buller MK, Massie K, Berteletti J, Ashley J, Meenan RT. Randomized trial evaluating an intervention supporting implementation of sun safety policies in public elementary schools. Oral presentation.
  • Myers VH, Loeb SJ, Kitt-Lewis E, Wion R, Murphy J, Jerrod T, Carter M. E-training of Inmate Peer Caregivers for Enhancing Geriatric and End-of-Life Care in Prisons. Oral presentation.
  • Bibeau JL, Berteletti J, Goetz JM, Massie K. Using project management skills in behavioral research. Pre-conference workshop presentation.

American Society of Preventive Oncology Annual Meeting: March 10-12 in Tampa, Florida

  • Myers V. Technology and Health Behavior: Crossing the Digital Divide. Oral presentation.

Eastern Nursing Research Society Annual Meeting: April 3-5 in Providence, Rhode Island

  • Loeb SJ, Kitt-Lewis E, Myers VH, Wion R, and Murphy J, Jerrod T, Carter M. Inmate Caregiver Training in Geriatrics and End-Of-Life. Oral presentation.

DC Health Communication Conference: April 25-27 in Fairfax, Virginia

  • Buller D. Grant Writing 101: Boot Camp with NIH. Pre-conference workshop presentation.

Society for Prevention Research Annual Meeting: May 28-31 in San Francisco, California

  • Byrnes H, Miller B, Bourdeau B, Johnson MB, Buller DB, Berteletti J, and Rogers V. Group cohesion among social drinking groups at nightclubs and risk from alcohol and other drug use. Poster presentation.
  • Miller B, Byrnes H, Rogers V, Bourdeau B, Grube J, Johnson MB, Buller DB, Berteletti J. Group-based intervention for overuse of alcohol in a high-risk context: Examining the influence of group gender composition on outcomes. Poster presentation.
  • Saltz R, Buller D, Woodall WG, Grayson A. Refusal of pseudo-intoxicated customers by retail marijuana outlets in three U.S. states. Poster presentation.

Kettil Bruun Society Annual Meeting: June 3-7 in Utrecht, Netherlands

  • Woodall WG, Buller DB, Saltz R, Perez F, Chacon-Silva A, Sanchez V, Reither J, Starling R, Diaz L. WayToServe Español: A web-based responsible beverage service training for Spanish-speaking alcohol servers. Oral presentation.

National Research Society on Alcoholism Annual Scientific Meeting: June 22-26 in Minneapolis, Minnesota

  • Woodall WG, Saltz R, Buller D, Perez F, Chacon Silva A, Sanchez V, Starling R. Refusal of alcohol sales to pseudo-intoxicated patrons in primarily Spanish-speaking premises: A tale of two states. Oral presentation.

North American Association of Transportation Safety and Health Officials Annual Conference: September 8-12 in New Orleans, Louisiana

  • Grayson A. Go sun smart at work. Oral presentation.

European Society for Prevention Research Conference: September 16-18 in Ghent, Belgium

  • Buller D, Woodall WG, Saltz R, Grayson A, Svendsen S, Buller M. Effects of an online responsible vendor training for recreational cannabis stores on sales to pseudo-intoxicated customers: need for increased deterrence. Oral presentation. 
  • Miller B, Byrnes H, Rogers V, Bourdeau B, Grube J, Buller D, Woodall WG, Berteletti J. A family-based program to reduce teen alcohol use and risky sexual behavior. Oral presentation. 
  • Woodall WG, Miller B, Buller D, Byrnes H, Bourdeau B, Grube J, Rogers V, Berteletti J. Effect of teen engagement with a family-based online intervention on reduction in alcohol use by teens. Poster presentation.

The Science of Dissemination & Implementation in Health Conference: December 4-6 in Washington, DC

  • Buller DB, Reynolds KD, Buller MK, Meenan R, Ashley J, Berteletti J, Massie K. An implementation intervention for school sun safety policies increased parents’ reports of sun safety communication from schools and children’s sun protection. Oral presentation.
  • Buller DB, Walkosz B, Buller M, Meenan R, Eye R, Grayson A, Olivas S. An Implementation Model for the Cost-effective Scale-up of the Sun Safe Workplaces Program. Poster presentation.*

*The above poster was nominated for Best Poster in the division of Prevention and Public Health at the Science of Dissemination & Implementation in Health Conference.

Parents’ Reports of School Communication on Sun Safety

Parents’ Reports of School Communication on Sun Safety

The U.S. Surgeon General and the Centers for Disease Control and Prevention have called on the nation’s schools to help prevent skin cancer by implementing sun safety practices and policies. The Sun Safe Schools program was designed by Klein Buendel researchers and collaborators in response to those calls to action. The program was implemented and evaluated with 118 public elementary schools in California.

Dr. David Buller, Klein Buendel Director of Research, presented data on the impact of the Sun Safe Schools intervention on parents’ reports of sun safety communication from schools and children’s sun protection behavior at the 12th Annual Conference on the Science of Dissemination and Implementation in Health in Washington, DC, December 4-6, 2019.

Schools randomized to the Sun Safe Schools intervention group (N=58) received support for implementing school sun safety practices by trained coaches over 20 months. Based on Diffusion of Innovations Theory, support and resources for implementation were tailored to school principals’ readiness to implement. Parents completed an online posttest survey through invitations sent by principals or while attending parent-oriented school events. Parents were surveyed to test the hypothesis that parents would report more communication about sun safety at schools receiving the intervention than at control schools.

The Sun Safe Schools program appeared to increase communication on sun safety and the use of student sun protection. Parents in intervention schools were more likely to report receiving information about sun safety from the school and that their children wore sun-protective clothing than in control schools. The improvement in sun safety appeared to result from policy implementation. In schools where principals reported implementing sun safety practices at posttest, parents reported that children spent less time outdoors and had fewer sunburns than at non-implementing schools. Further, parents who received information about sun safety from the school reported more sun protection for their child than parents not receiving the information.

In summary, a school district-level policy, combined with active technical support for schools within the district, appears to be effective at increasing implementation of school sun safety practices to help protect children from solar ultraviolet radiation, the primary risk factor for the development of skin cancer.

The Sun Safe Schools program is a joint 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, Multiple Principal Investigators). Other collaborators included Dr. Richard Meenan from the Kaiser Permanente Center for Health Research in Portland, Oregon; Dr. Jeff Ashley from Sun Safety for Kids in Los Angeles, California; Kim Massie previously from Chapman University; and Julia Berteletti and Mary Buller from Klein Buendel.

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
Alcohol Sale Refusals to Pseudo-Intoxicated Patrons In Primarily Spanish-Speaking Premises

Alcohol Sale Refusals to Pseudo-Intoxicated Patrons In Primarily Spanish-Speaking Premises

Klein Buendel Senior Scientist Dr. W. Gill Woodall presented data on alcohol over-service from the WayToServe-Español project on a panel discussion at the 42nd Annual Scientific Meeting of the Research Society on Alcoholism held in Minneapolis, Minnesota on June 22-26, 2019.

The over-service of alcohol to individuals who show signs of intoxication is problematic for public health because it contributes to drunk driving and alcohol-related injury and death. In addition, little is known about alcohol over-service in premises where business is conducted primarily in Spanish because these alcohol service situations have been understudied.

Dr. Woodall presented data from a baseline assessment of a randomized trial that investigated Responsible Beverage Service (RBS) training in predominately Spanish-speaking premises in Texas and New Mexico. The research provides a unique opportunity to contrast two states and communities with similar populations, but different alcohol policies and practices.

Hispanic confederates were trained to enact evidence-based signs of intoxication while attempting to purchase an alcoholic beverage in Spanish. Over-service was measured using a pseudo-intoxicated patron protocol. Baseline refusal rates were 12% in Texas and 34% in New Mexico. On the panel, Dr. Woodall discussed the implications of these baseline data for RBS training in minority communities and alcohol policy.

This research is funded by the National Institute of Minority Health and Health Disparities at the National Institutes of Health (MD010405; Dr. W. Gill Woodall, Klein Buendel, Principal Investigator). Collaborating co-authors on the presentation included Dr. Robert Saltz from the Pacific Institute for Research and Evaluation, Dr. David Buller from Klein Buendel, Dr. Victoria Sanchez and Dr. Randall Starling from the University of New Mexico, and Dr. Areli Chacon Silva and Dr. Frank Perez from the University of Texas at El Paso.

Refusal of Pseudo-intoxicated Customers at Retail Marijuana Stores

Refusal of Pseudo-intoxicated Customers at Retail Marijuana Stores

Klein Buendel Senior Scientist, Dr. David Buller presented a poster at the Society for Prevention Research Annual Meeting in San Francisco, California in May. The poster presented insights on whether personnel in recreational marijuana stores refuse sales to buyers who appear to be intoxicated.

Recreational marijuana is sold by state-licensed stores in seven U.S. states. Like alcohol, sales are prohibited to persons younger than age 21 and sometimes to persons who are apparently intoxicated. A sample of 150 licensed retail stores in Colorado, Oregon, and Washington were selected from state regulatory agency lists. A majority of stores sold both recreational and medical marijuana. The sample was stratified between the largest metropolitan area in each state (Denver, Portland, and Seattle) and nearby regions with smaller cities.

Pseudo-patron assessment teams comprised of a ‘buyer’ and an ‘observer’, visited each store once from August to October 2018. Buyers attempted to enter the premises while feigning obvious signs of intoxication (for example: slurred speech, stumbling, dropped change or ID) and attempted to purchase a low-cost cannabis product. Observers recorded whether buyers gained entry and if the clerk offered to sell marijuana (no actual purchases were made).

Refusal rates were rare. Overall, refusal rates were slightly higher in the states of Colorado and Oregon than in Washington. A state law that explicitly prohibited sales in Oregon may have slightly decreased sales there, while refusals in Colorado may be attributed to the wide-scale use of security guards checking IDs at entrances. These high rates of sales to apparently intoxicated customers are a cause for concern, especially in light of research indicating that the combination of alcohol and marijuana intoxication appears to severely impair driver performance.

This research project is funded by a grant from the National Institute on Drug Abuse at the National Institutes of Health (DA038933; Dr. David Buller, Principal Investigator). Additional collaborators include Dr. Robert Saltz from the Pacific Institute for Research and Evaluation in Oakland, California; and Dr. Gill Woodall and Andrew Grayson from Klein Buendel.