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INSIGHTS ON HPV VACCINATION FROM MOTHERS’ COMMENTS ON FACEBOOK POSTS IN A RANDOMIZED TRIAL

INSIGHTS ON HPV VACCINATION FROM MOTHERS’ COMMENTS ON FACEBOOK POSTS IN A RANDOMIZED TRIAL

HPV vaccine uptake among adolescent girls in the United States remains below the national goal of 80%. Parent decisions to vaccinate daughters can be impeded by confusion, uncertainty, and misinformation about the Human Papilloma Virus (HPV) vaccine. Dr. David Buller from Klein Buendel (KB) presented an analysis of mothers’ beliefs about vaccinating their adolescent daughters for HPV at the Eurogin International Multidisciplinary HPV Congress in Lisbon, Portugal, December 2-5, 2018.

Mothers with adolescent daughters from 34 states (n=880) were recruited to participate in a randomized controlled trial evaluating a social media campaign on adolescent health. The mothers’ beliefs were expressed in comments to posts on HPV vaccination in a social media campaign on adolescent health. Participants were recruited through Qualtrics survey panels or local efforts at the Tennessee study site. Eligibility criteria were: having a daughter aged 14-17, living in one of 34 states without a complete ban on indoor tanning for minors, using a Facebook account 1+ times a week, being able to read English, consenting to participate, completing the baseline survey, and willing to join the Facebook group. The campaign, implemented through Facebook private groups, included posts on HPV vaccination, as one of seven general health topics. The experimental manipulation varied posts on indoor tanning versus prescription drug abuse prevention. Posts on HPV vaccination and reactions and comments from mothers were extracted.

Mothers had a mean age of 43.1 years; 6.5% were Hispanic and 86.6% white; and 63.1% reported that their daughter had been vaccinated for HPV (17.8% receiving two shots and 31.5% three shots). HPV vaccination posts received on average 1.3 reactions and 3.3 comments from mothers. Comments often formed a dialogue among mothers. More than half of the comments (52.8%) were favorable, indicating that the daughter had been vaccinated and HPV vaccination reduced mothers’ anxiety, HPV infection rates, and related disease risk. However, 45.3% were unfavorable, citing safety concerns, lack of efficacy, unknown long-term consequences, inappropriate age for the vaccine, apprehension by other mothers, fears of vaccine tampering, lack of physician support, and sexual activity issues (for example, plans to wait until daughter becomes sexually active or using vaccine to guard against unprotected sex). Some commented, mostly favorably, on the need to vaccinate boys.

Facebook comments indicated both support for and resistance to HPV vaccination by mothers in the United States. Reasons for not vaccinating girls were similar to barriers expressed in other research and reflected negative media coverage of HPV vaccination. Effective strategies are needed in social media to counter misinformation on and resistance to HPV vaccines.

This research was funded by a grant from the National Cancer Institute (CA192652; Dr. David Buller, Principal Investigator). Collaborators include Dr.Barbara Walkosz and Julia Berteletti from KB; Dr. Sherry Pagoto and Jessica Oleski from the University of Connecticut, and Dr. Katie Baker from East Tennessee State University.

Eurogin is one of the most important conferences in the world on HPV infection and related cancers. The international gathering examines public health, health services, screening, and prevention of HPV-induced cancers.

Results of Train To Tend Presented at APHA

Results of Train To Tend Presented at APHA

To date, ten U.S. states and the District of Columbia (DC) have legalized the use and/or sale of recreational marijuana. Training in responsible sales practices in the alcohol market has reduced sales to minors and, in some cases, intoxicated patrons. Responsible sales practices training could have similar benefits in the recreational marijuana market.

Dr. David Buller, Director of Research at Klein Buendel (KB) presented the results of the implementation and effectiveness trial of Train To Tend at the Annual Meeting and Expo of the American Public Health Association (APHA) in San Diego, California, November 10-14, 2018. APHA’s annual conference is the largest annual gathering of public health professionals with over 12,000 attendees.

Train To Tend is a unique responsible marijuana vending (RMV) training program developed by KB scientists and staff. The online RMV training was developed through input from state regulators, local law enforcement personnel, Colorado Marijuana Enforcement Division’s curriculum standards, interviews with recreational marijuana store personnel (n=15), and usability testing of a prototype training with store personnel (n=19). The RMV training contained five modules: State laws and regulations, ID checking, health effects of cannabis, customer service practices including recognizing intoxicated patrons, and rules of the trade including inventory tracking.

In a randomized controlled trial enrolling state-licensed retail recreational marijuana stores (n=225) in Colorado, Oregon, and Washington State, 125 stores were randomly assigned to receive the RMV training. Trainees completed pre- and post-training surveys evaluating usability and effects of the training. A total of 459 cannabis store employees completed the online training in 55 stores in the three states between June 2017 and February 2018. The training improved trainees’ ability to check IDs, their confidence to use the state’s inventory tracking system, and their ability to recognize intoxicated customers. Most trainees found the training to be user-friendly (78.4%), were satisfied with it (68.8%), and would recommend it to another employee (91.1%).

Overall, online RMV training was acceptable to retail recreational marijuana personnel and appeared to improve responsible sales practices. Training in responsible sales practices has been a successful policy intervention in the alcohol market that should be considered for the recreational marijuana market.

This research was funded by a grant from the National Institute on Drug Abuse at the National Institutes of Health (DA038933; Dr. David Buller, Principal Investigator). APHA presentation collaborators include Dr. Robert Saltz from the Pacific Institute for Research and Evaluation in Oakland, California; and Dr. Gill Woodall, Andrew Grayson, Mary Buller, and Sierra Svendsen from KB. Research details and more results of this study have been reported in an e-publication in the Journal of Public Health Management and Practice.

Technology, Social Media and Behavior Change

Technology, Social Media and Behavior Change

Klein Buendel (KB) Senior Scientist, Dr. Valerie Myers, was an invited presenter at The Colorado Cancer Coalition Annual Symposium held November 8-9, 2018 in Lakewood, Colorado. The mission of the Coalition is to eliminate the burden of cancer in Colorado. This year’s symposium, Elevating Personalized Cancer Care in Colorado, shared updates on innovative cancer care in Colorado and provided education and networking opportunities for professionals who work in cancer prevention, control, treatment, and survivorship.

Dr. Myers spoke about Technology, Social Media and Behavior Change in a session on Using Technology and Social Media to Advance Your Mission. She addressed multiple types of mHealth and eHealth technologies and the research behind their use in implementing health behavior change programs. Using her active research project Caminemos Juntas as an example, she was able to showcase how a smartphone app like Caminemos Juntas can be used to help Latina women overcome barriers to physical activity.

Dr. Myers said, “The benefit of technologies and digital health tools is that they have the capacity to be used in the real world with real people. That is their appeal.” She also stressed the importance of the use of digital technologies saying, “People who normally wouldn’t have access to empirically based and theory driven interventions now have access to them, so it really promotes the ability for scale up. I think this is where individual clinical trial-based health and public health come together really well, because you can translate what’s been done in rigorous trials and get it to the people to see if you can move the needle on these health behaviors.”

In addition to its importance, Dr. Myers said that digital health technologies such as mHealth and eHealth are “the way to get interventions in the hands of people that may never have been exposed to this messaging. If it can reach those individuals who have been neglected traditionally by health intervention and also meet people in a place where they feel comfortable and safe and are ready for change, then that excites me.”

KB scientists and staff have been active members of the Colorado Cancer Coalition and its Skin Cancer Task Force for over a decade.

Nightlife Safety Research

Nightlife Safety Research

Dr. Brenda Miller from the Pacific Institute for Research and Evaluation (PIRE) gave a presentation at the 9th Conference and Members’ Meeting of the European Society for Prevention Research (EUSPR) in Lisbon, Portugal, October 24-26, 2018. EUSPR “promotes the development of prevention science, and its application to practice so as to promote human health and well-being through high quality research, evidence based interventions, policies, and practices.” The research presented by Dr. Miller was designed and conducted in collaboration with scientists and staff from Klein Buendel (KB).

The study of nightclub patrons and their social drinking groups, tests an intervention called Nightlife Safety Plans (NSP). NSP is designed to reduce escalation of overuse of alcohol and drugs, physical aggression, and sexual aggression during an evening at the club. NSP relies on social groups that arrive at the club together to identify early signs of problems and to take actions to intercede. The actions are: Outreach, Options, and Out.

Data analyzed in this presentation consisted of 352 groups (961 participants) gathered over 41 Friday and Saturday nights at seven different clubs in the Bay Area of California. Data from online surveys, alcohol breath tests, and biological drug tests (post-test only) were gathered at entrance and exit for pre- and post-test assessments of the intervention effects. Biological measures reveal at least one club patron per group was legally intoxicated (Breath Alcohol Concentration—BAC, >.08%) in 60% of groups and at least one patron was positive for drugs in 50% of the groups. Further, at least one club patron per group experienced physical and/or sexual aggression within 40% of the groups.

Results indicated that experimental groups were significantly more likely to intervene with group members, using a significantly higher number of intervention strategies (Outreach, Options, and Out), to assess situations for physical aggression and sexual harassment, and to respond to friends experiencing sexual harassment. Further, experimental groups used significantly more protective strategies to keep group members safe. Reduced levels of alcohol use and intoxication or impairment (BAC > .05), as assessed by breath tests, were found among the groups in the experimental as compared to the control condition.

In summary, groups provide an opportunity to deliver and implement peer-focused safety strategies to enhance safety during the time spent in the club. The research’s focus on clubs also reaches young adults who are working (two-thirds were not in college), whereas many of these types of interventions are targeted toward college students.

This research was funded by a grant from the National Institute on Alcohol Abuse and Alcoholism (AA022331; Dr. Brenda Miller, Principal Investigator). Collaborators included Veronica Rogers, Dr. Hilary Byrnes, Dr. Mark Johnson, and Dr. Joel Grube from PIRE; and Dr. David Buller and Julia Berteletti from KB.

 

Precision Pain Management App for Adolescents with Sickle Cell Disease

Precision Pain Management App for Adolescents with Sickle Cell Disease

Dr. Valerie Myers, KB Senior Scientist, is presenting a poster on the Pinpoint Project at the 39th Annual Meeting and Scientific Sessions of the Society of Behavioral Medicine, April 11-14, 2018 in New Orleans, Louisiana.

Pinpoint: Gaming Technology to Engage Adolescent Sickle Cell Patients in Precision Pain Management” was a Phase I SBIR project that examined the feasibility and acceptability of a gamified tablet application intended to encourage teens (aged 13-17) to assess and talk about their sickle cell disease (SCD) pain. SCD is the most common inherited blood disorder in the U.S. and affects primarily African Americans and Hispanics. Approximately, 1,000 U.S. children are born with SCD annually. SCD complications can be serious and have a significant impact on well-being and quality of life.

Pain is the hallmark symptom associated with SCD and is the primary cause of SCD-related hospital admissions. Accurate assessment of pain specifiers (type, frequency, and intensity of pain) can help with ameliorating pain quickly and effectively. Reducing barriers to collection and promoting the value of accurate SCD pain assessment is a need in pediatric medicine. The interactive games for health literacy among youths have shown video games can improve self-efficacy; stimulate health discussions with friends, family, and clinical team; encourage seeking support and advice, and can emphasize behavior acquisition via experiential learning. Interactive games can provide information about causes, treatments, and self-care options, and can improve self-care and reduced emergency clinical utilization.

The Pinpoint app prototype for tablets and smartphones consisted of a Pain Assessment Tool, vocabulary game, body scanner reflection, educational self-disclosure activity, and excerpts from the Hope and Destiny Jr. book authored by Hsu, Rodrigues, and Brandalise. Four healthcare providers were interviewed on the app’s acceptability and potential function within the clinical practice. Sixteen teens participated in cognitive interviews, focus groups, and usability testing. The System Usability Scale (SUS), a validated tool for assessing the usability and acceptability of technological products, served as the primary outcome. The preliminary SUS score well above average, suggesting a high level of acceptability and usability among users. The conference poster will include final project outcomes and the plan for the future development of the full Pinpoint app.

This research was funded by a grant from the National Institute on Minority Health and Health Disparities (R43MD010746; Dr. Valerie Myers, PI). Research collaborators included Mary Buller from KB, and Dr. Hilton Hudson and Megan Lippert from the Hilton Publishing Company, publishers of the Hope & Destiny and Hope & Destiny Jr. sickle cell disease management books.

KB Scientist Shares Career Development Guidance in SBM Panel Discussions

KB Scientist Shares Career Development Guidance in SBM Panel Discussions

Dr. Valerie Myers, KB Senior Scientist and SBM Fellow, is a co-presenter for three Panel Discussions related to training and career development at the 39th Annual Meeting and Scientific Sessions of the Society of Behavioral Medicine, April 11-14, 2018 in New Orleans, Louisiana.


Perspectives on Effective Digital Health Training in Behavioral Medicine

To be a successful digital health researcher, most individuals find that they need to complete a set of training experiences not well encapsulated by a single degree program. Behavioral medicine scientists and practitioners that utilize digital health must take an entrepreneurial approach to advocating for receiving adequate training to be prepared for the challenges of this field. The call for cross-disciplinary digital health researchers necessitates that both trainees and mentors be flexible and creative with training opportunities. To discuss methods and philosophies for training the next generation of digital health researchers. The Society of Behavioral Medicine’s Digital Health Council has assembled a panel of digital health experts spanning academia and industry with varying educational backgrounds. The panel will include: (1) a senior-level academic with interests in mHealth and adolescent health; (2) a mid-career researcher from an academic medical center who receives NIH-funding and engages in formal recurrent consultation with numerous industry partners; (3) an early career electrical engineer with an interest in translational medicine and experience with research career development awards; and (4) a senior scientist at a small health communication and development firm who conducts research on behaviorally-based technological approaches to behavior change. Attendees will leave with practical advice for obtaining adequate digital health training in the post-graduate, postdoctoral, and established career phases.

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Collaborator Spotlight:
Areli Chacón Silva, PhD

Collaborator Spotlight:
Areli Chacón Silva, PhD

Areli Chacón Silva, Ph.D., is the Interim Director of the Leadership Studies Program at the University of Texas at El Paso. She has a BA in International Business from Tecnológico de Monterrey (ITESM) (1996), an MBA from Angelo State University (1999), and a PhD in Economics from the University of La Havana (2011). Her research explores the Latino market in the United States, as well as business expansion opportunities for Mexican businesses. She has experience researching the cultural values of Latinos in America.

Currently, Dr. Chacón Silva is working with KB as a collaborating scientist with Dr. Gill Woodall and Dr. David Buller on WayToServe Español: A Culturally-Appropriate Online Responsible Beverage Service Training for Spanish-Speaking Servers (R44MD010405; Dr. Gill Woodall, Principal Investigator). This research project is funded by the National Institute on Minority Health and Health Disparities at the National Institutes of Health. On this project, she will assist with the creation of culturally-appropriate content and the translation of the English WayToServe® online responsible alcohol server training program to Spanish. She will ensure that the translation is compatible with the values and needs of workers in Spanish language-dominant bars and restaurants. The randomized control trial will take place at Spanish-dominant businesses in the Southwestern region of the United States.

In addition to her research collaboration with KB, Dr. Chacón Silva serves as Chair of the Curriculum Development Committee of the (L.E.A.D. Program) for Wise Latina International, a non-profit organization whose mission is to educate and empower Latinas and women of all walks of life to overcome barriers, to be self-reliant, to become leaders, and to act as agents of change in our communities.

Dr. Chacón Silva served on the Editorial Board Member Committee at the International Case Center of Tecnológico de Monterrey (ITESM) from 2008 to 2012. Her research has appeared in the International Journal of Case Method Research and Application and other scholarly outlets. She has worked as a consultant in international business, leadership, and business logistics since 2001.

Dr. Chacón Silva is also the co-author of the book ¡Reconquest! Advice for Business Owners in Chihuahua to do Business with Latinos in the US (2010). The book presents the results of research funded by CONACYT (National Science and Technology Fund of Mexico: CHIH-2006-CO2-59483) to developing capacity building strategies for Chihuahuan business people to increase commerce with Latinos in the United States, through the concept of the nostalgia marketing.

KB’S 2017 Research and Outreach Accomplishments and Other Highlights

KB’S 2017 Research and Outreach Accomplishments and Other Highlights

The year 2017 flew by, but we have taken time to reflect on what we have done at Klein Buendel (KB) to achieve our primary goal of creating and evaluating effective programs and products for health promotion and disease prevention. We are thankful for the research, education, and outreach opportunities that we have participated in, and we are looking forward to continuing our efforts in 2018. Details of some of our 2017 accomplishments and publications are listed below. The names of KB investigators and staff are bolded.

SUMMARY OF KLEIN BUENDEL’S 2017 RESEARCH AND OUTREACH ACCOMPLISHMENTS

  • In June, KB celebrated its 15th anniversary as a small woman-owned business.
  • In August, one of our Senior Scientists, Valerie Myers, was made a Fellow of the Society of Behavioral Medicine.
  • We were awarded 3 new prime grants and 1 subcontract.
  • We completed 7 prime and subcontract research projects.
  • KB scientists and staff presented research findings at 6 national and international conferences (19 posters or presentations).
  • KB scientists, collaborators, and staff published 12 papers of research findings in peer-reviewed journals.

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