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Inmate Caregiver Training in Geriatrics and End-Of-Life

Inmate Caregiver Training in Geriatrics and End-Of-Life

Dr. Susan Loeb from Penn State University presented on the development of computer-based learning modules for caregivers of the aged and dying in prisons at the 31st Annual Scientific Sessions of the Eastern Nursing Research Society (ENRS) held in Providence, RI on April 3-5, 2019. This research is being conducted with Klein Buendel Senior Scientist, Dr. Valerie Myers, a co-author on the presentation.

More men and women are aging and facing end-of-life (EOL) while incarcerated. Early research by this research team found that computer-based training for inmates assisting staff in geriatric and EOL care was feasible. This collaborative team of nurse scientists, small business partners, and the correctional community are working to advance the quality of care provided for those aging and dying in our nations’ correctional institutions. Specifically, the purpose of the research presented at ENRS was to identify inmate peer caregiver training needs, and discover priority content areas and core values for inmate computer-based modules with the help of stakeholders and experts.

Six focus groups were conducted with stakeholders at one men’s and one women’s state correctional institution in a Mid-Atlantic state. Stakeholders included information technology and human resources staff, interdisciplinary front line staff who oversee inmate peer caregivers, and inmate peer caregivers. A content analysis identified content areas and core values. An Advisory Board of experts in EOL and geriatric care, corrections health, and corrections training, suggested combining some of the priority content areas. The resulting priority content areas for the initial Inmates Care modules were Universal Precautions, Role of the Inmate Caregiver in the Final Hours, and Loss and Grief. The core values identified for the inmates training were respect, dignity, and compassion. The next steps of the research project include completing three prototype modules, testing them for usability, and developing a specifications document for technology programming and production congruent with correctional facility security precautions.

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

Implementation of Sun Safety Policies in Public Elementary Schools

Implementation of Sun Safety Policies in Public Elementary Schools

Klein Buendel Research Program Manager, Julia Berteletti, presented insights from a randomized controlled trial that tested a technical assistance program designed to help principals implement district sun safety policies in elementary schools at the 40th Annual Meeting and Scientific Sessions of the Society of Behavioral Medicine, March 6-9, 2019 in Washington, DC.

The Centers for Disease Control and Prevention (CDC) and U.S. Surgeon General have advised the nation’s schools to adopt and implement sun protection policy to reduce children’s exposure to solar ultraviolet radiation to prevent skin cancer. A total of 118 elementary schools from 40 California public school districts that had adopted a school board-approved policy for sun safety were recruited and the principal and a teacher at each school reported on school sun protection practices at baseline and posttest.

Half of the schools were randomly assigned to receive the 20-month Sun Safe Schools intervention, delivered by trained Sun Safety Coaches who met with principals, described the district policy, helped them select and plan implementation of sun safety practices, and provided support and resources matched to the principal’s readiness to implement practices based on Diffusion of Innovation Theory. Control schools received a minimal information treatment containing basic school sun safety information from the CDC, the National Association of State Boards of Education, and U.S. Surgeon General.

Compared to controls, principals at intervention schools reported implementing more sun safety practices in general, whether present in the district’s written policy or not. Similarly, teachers at intervention schools reported implementing a larger number of sun safety practices in general, including practices in their district’s written policy or not, compared with control schools. Overall, the intervention was effective at increasing sun safety practices in public elementary schools. However, convincing school districts to adopt policies may be only the first step in improving sun safety practices becasue districts need to actively disseminate the new policy to schools and provide assistance and materials to facilitate implementation.

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

Mothers’ Beliefs about Adolescent Marijuana Use

Mothers’ Beliefs about Adolescent Marijuana Use

Marijuana laws are changing rapidly in the United States, which poses potential challenges for parent-child communication about avoiding marijuana use during adolescence. Klein Buendel Research Program Manager, Julia Berteletti, presented insights from a Facebook-delivered intervention and randomized trial with mothers and teen daughters at the 40th Annual Meeting and Scientific Sessions of the Society of Behavioral Medicine (SBM), March 6-9, 2019 in Washington, DC.

Baseline survey responses, a sample of posts on preventing marijuana use, and comments were analyzed for understanding mothers’ and daughters’ marijuana use and beliefs about marijuana. The research was testing mothers’ engagement with a social media campaign on adolescent health delivered via private Facebook groups. The sample was comprised of over 800 mothers with adolescent daughters aged 14-17 from 34 U.S. states. As the primary trial purpose was to prevent indoor tanning, eligibility included residing in one of 34 states without a complete ban on indoor tanning for minors. Of these states, 15 have legalized medical marijuana sales, three have legalized medical and recreational sales, and 16 have not legalized sales of marijuana.

Both mothers and daughters completed a baseline survey. Overall, mothers believed that marijuana is harmful for adolescents. Fewer daughters used marijuana than mothers, and daughters felt marijuana use was less harmful than mothers. Both mothers and daughters who used marijuana found it less harmful than non-users. Compared to non-recreational states, mothers in states with recreational marijuana sales felt it was more harmful, but state laws did not significantly affect use by mothers or daughters.  

Facebook comments supporting marijuana use from mothers pertained to benefits of cannabinoids over opioids and providing daughters with information to make their own choices, for example. Negative comments included adverse effects on developing brains, lack of research, and dangers of it being “laced” with other drugs. Mothers also shared reasons to say “no” and how to discuss long-term effects with their daughters.

This research project is funded by a grant from the National Cancer Institute (CA192652; Dr. David Buller, Klein Buendel, Principal Investigator). Collaborators include Dr. Barbara Walkosz and Julia Berteletti from Klein Buendel, Dr. Sherry Pagoto and Jessica Bibeau from the University of Connecticut, Dr. Katie Baker and Dr. Joel Hillhouse from East Tennessee State University, and Dr. Kim Henry from Colorado State University.

Using E-Training to Enhance Geriatric and End-of-Life Care in Prisons

Using E-Training to Enhance Geriatric and End-of-Life Care in Prisons

Klein Buendel Senior Scientist, Dr. Valerie Myers, presented preliminary findings from a project that provides e-training of inmate peer caregivers to enhance geriatric and end-of-life (EOL) care in prisons at the 40th Annual Meeting and Scientific Sessions of the Society of Behavioral Medicine (SBM), March 6-9, 2019 in Washington, DC.

The United States has an incarceration rate of 655 people per 100,000, making it the highest globally. The older adult segment of the prison population has more than tripled since 1990 and their health issues are comparable to those of free people who are 10-15 years their senior. Inmates over the age of 55 have a death rate that is 10 times that of prisoners aged 25-34. United States prison systems are facing increased demands in caring for aged and dying inmates. A systematic review revealed that inmate peer caregivers can figure prominently in delivery of EOL care in prison. However, the degree of training received by inmate peer caregivers varies widely.

The lack of consistent training points to a need for evidence-based, current, and readily accessible training for this population to mitigate the growing need for EOL care in United States prisons. In response to this need, the E-training of Inmate Peer Caregivers for Enhancing Geriatric and End-of-Life Care in Prisons project, will demonstrate the scientific merit and feasibility of developing cutting edge, media-rich learning modules to train inmate peer caregivers in geriatric and EOL care. The aims of the project are to: (1) transform best practices in inmate peer caregiving into a comprehensive training program that consists of media-rich and highly interactive computer-based learning modules for providing geriatric and EOL care to their peers; and (2) conduct in-person usability testing of the media-rich and highly interactive web-based prototypes with inmates who are currently Mental Health Peer Support Specialists (that is, prisoners who are experienced caregivers, but naïve to geriatric and EOL care) and prison staff to evaluate the user interface, ease of use, and perceived barriers in order to refine and optimize the product.

Focus groups were conducted with three different groups, inmates, IT staff, and interdisciplinary staff, at a men’s and a women’s state correctional institution to inform content and program development of the training modules. Focus group participants prioritized the Universal Precautions, Loss/Grief, and Role of Inmate Caregivers in the Final Hours modules. These modules will be programmed and tested in state prisons in a mid-Atlantic state. The System Usability Scale, a validated tool for assessing the usability and acceptability of technological products, will serve as the primary outcome.

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

Using Project Management Skills in Behavioral Research

Using Project Management Skills in Behavioral Research

Research projects have various moving parts throughout their lifespan needing to be completed within a certain time frame and budget as outlined in the grant awarded. Project management skills are crucial in ensuring all phases, tasks, and logistics of a research project are organized and completed within deadline and scope.

The workload of a project is driven by how each aim breaks down into a phase, each with its own specific deliverables to be fulfilled and unique timeline to be met. As each phase of a project moves forward, the responsibilities are often compounded due to overlapping timelines, creating an increased need to think ahead and utilize efficient multi-tasking and organizational skills.

Research Project Management Phases

  • Determining and communicating the scope derived from the grant aims and methods;
  • Developing timelines;
  • Protocol development (such as recruitment, screening, data entry, intervention, data management, and adverse event processing);
  • Obtaining necessary institutional approvals;
  • Staff identification/hiring, training, and evaluation;
  • Goal setting including incremental goals as well as larger overarching goals;
  • Project implementation;
  • Delivering objectives including communication of progress toward objectives;
  • Tracking budgeted and expended costs;
  • Required reporting to aid in communicating progress; and
  • Problem-solving as issues inevitably arise.

Communication is a key component to ensuring a smooth flow of the deliverables throughout the project. All personnel on a project need to maintain the same vision and goals. This can often be accomplished using regular meetings, phone calls, emails, and reports. Beyond the regular means of communication, a more comprehensive system such as project management software can be used to keep track of deliverables and deadlines.

Klein Buendel Research Program Manager, Julia Berteletti, organized and participated in a research project management Pre-Conference Workshop at the 40th Annual Meeting and Scientific Sessions of the Society of Behavioral Medicine (SBM), March 6-9, 2019 in Washington, DC. Co-presenters included Jessica Bibeau and Jared Goetz from the University of Connecticut, and Kim Massie from Chapman University in California. The presenters have been coordinating multi-site research projects from coast-to-coast with each other for several years. Ms. Berteletti explained, “Our projects run on effective partnerships. Facilitating teamwork is one of my favorite parts of my job. It meant a lot to me for us to share our methods for effective collaboration and project management with other research teams.”

The SBM seminar provided a guide for managing a research project using a project management approach which included: (a) understanding the scope, (b) setting goals, (c) considering the costs, (d) implementation (intervention/data collection), and (e) close-out. A hypothetical project was used to present each part of the approach. Team organization, communication, important considerations, timelines, charts, and reports were reviewed to aid in organization, and project management software ideas were provided along with a tutorial of the Basecamp software.

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

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

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

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

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

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

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

A Year of Research and Outreach

A Year of Research and Outreach

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

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

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

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

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

Publications

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Conference Presentations

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Other Highlights & Recognitions

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

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

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

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

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

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

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

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

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

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

Cost Analysis of a Sun Safety Program at California Elementary Schools

Cost Analysis of a Sun Safety Program at California Elementary Schools

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

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

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

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

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

Vacteens: A Mobile Web App to Improve HPV Vaccine Uptake

Vacteens: A Mobile Web App to Improve HPV Vaccine Uptake

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

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

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

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

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

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

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


Dr. W. Gill Woodall and Jeanny Reither from Klein Buendel
Developing and Testing E-Training to Enhance Care of Aged and Dying Prisoners

Developing and Testing E-Training to Enhance Care of Aged and Dying Prisoners

Klein Buendel (KB) collaborator, Susan Loeb, PhD, RN, described the development and testing of computer-based training for corrections staff on caring for aged and dying prisoners in a poster she presented at the National Commission on Correctional Health Care (NCCHC). The conference was held in Las Vegas, NV from October 20-24, 2018.

The Enhancing Care of the Aged and Dying in Prisons (ECAD-P) training program is a collaboration between KB and Penn State University. The research team, which includes KB Senior Scientist, Dr. Valerie Myers and KB’s Creative Team, built upon electronic file training materials that had been developed at Penn State University, and transformed them into interactive computer-based training that is relevant to a broad spectrum of correctional staff.

Approaches employed in an earlier phase of this research included: (a) engagement with an Expert Advisory Board, including representatives from corrections, geriatrics, and hospice; (b) a Community Advisory Board constituted by corrections officials and returning citizens; (c) an environmental scan conducted with corrections training officers and information technology staff; (d) a modified Delphi survey with geriatric and corrections nurses; and (e) initial in-person usability testing of an early version of three training modules. In a second phase, usability testing of six modules was conducted in a large jail in the Northeast and a State Correctional Institution in the Midwest.

Analytic approaches employed throughout this research included content analysis, geriatric content identification, and acceptability, feasibility, and usability evaluation using qualitative observation approaches and the System Usability Scale. The Phase I study established proof of concept, produced three prototypical modules, a drafted a detailed specifications document for full program development in Phase II. Phase II included refinement of Phase I learning modules and development of three additional modules. Phase II assessments showed that the program is acceptable, feasible, and usable in corrections.

The NCCHC poster concluded that correctional settings across the United States face growing demands to better address the health care and management needs of aged, chronically ill, and dying inmates. The ECAD-P computer-based training holds promise to contribute to better preparation of correctional staff to effectively care for these populations.

This research was funded by a Small Business Technology Transfer (STTR) grant to KB from the National Institute on Aging at the National Institutes of Health (AG049570; Dr. Susan Loeb and Dr. Valerie Myers, Multiple Principal Investigators). Collaborators/coauthors in addition to Dr. Loeb and Dr. Myers include Dr. Erin Kitt-Lewis from the Penn State University College of Nursing.