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Klein Buendel Opens a Second Location

Klein Buendel Opens a Second Location

Klein Buendel is pleased to announce the opening of its first satellite location in New Mexico. The new Albuquerque office will house Klein Buendel Senior Scientist Dr. Gill Woodall and a small staff, to conduct multiple health communication and behavior research projects with people in New Mexico and Texas.

The Vacteens project aims to raise the public health profile of human papillomavirus (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 objectives of the project are 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. This research was funded by a grant from the National Cancer Institute (CA210125; Dr. W. Gill Woodall, Principal Investigator). Collaborators include Dr. Alberta Kong, Dr. Lance Chilton, and Dr. Tamar Ginossar from the University of New Mexico; Dr. Greg Zimet from Indiana University; and Dr. David Buller from Klein Buendel.

B-SMART is a project aimed at reducing intoxicated driving by people with court-ordered ignition interlock devices (IIDs) through improved communication and support from family members. Using smartphone web app technology, B-SMART teaches coping skills, communication skills, and strategies to help deter Driving While Impaired (DWI). Unique to this intervention are the involvement of family members in supporting the DWI offender to not drink and drive, English and Spanish language options, and the use of smartphone technology to make that support immediate, accessible, and diffusible. The research is funded by the National Institute on Alcohol Abuse and Alcoholism (AA022850; Dr. W. Gill Woodall, Principal Investigator) through the Small Business Innovation Research Program (SBIR). Collaborators include Dr. Barbara McCrady and Dr. Vern Westerberg from the University of New Mexico; Dr. Gary Cutter from Pythagorus, Inc. in Alabama; and Julia Berteletti from Klein Buendel.

WayToServe Espanol: A Culturally-Appropriate Online Responsible Beverage Service Training for Spanish-Speaking Servers is a redesign of WayToServe®, an evidence-based training to promote responsible alcohol beverage service (RBS). WayToServe Espanol was created after discovering current RBS training had not been tailored to address Spanish-speaking populations that represent disproportionately high rates of alcohol-related injury and death in the United States. This project promotes a culturally and linguistically adapted RBS training for Spanish-speaking servers, and changes to organizational and community norms because preventing alcohol-related injury and death is a national priority. This research is funded by the National Institute of Minority Health and Health Disparities at the National Institutes of Health (MD010405; Dr. Gill Woodall, Principal Investigator) through the SBIR. Collaborators include Dr. Victoria Sanchez from the University of New Mexico Health Sciences Center; and Dr. Areli Chacon Silva and Dr. Frank Perez from the University of Texas at El Paso.

Insights About HPV Vaccination in the United States from Mothers on Facebook

Insights About HPV Vaccination in the United States from Mothers on Facebook

According to the Centers for Disease Control and Prevention, the most common sexually transmitted infection is the human papillomavirus (HPV) but only about half of girls and less than 40% of boys in the United States have received all the recommended doses of the HPV vaccine (1). In a recent e-publication in Human Vaccines and Immunotherapeutics, Klein Buendel Senior Scientists, Dr. David Buller and Barbara Walkosz, and Project Manager, Julia Berteletti, and coauthors provide insights on HPV vaccination in the United States from mothers’ comments on Facebook posts in a randomized trial. The study evaluated responses from mothers of teenage girls living in various U.S. states in relation to HPV vaccine health and related information posted to private groups on Facebook.

A large number of mothers of 14-17-year-old girls joined private groups on Facebook where a variety of health information relevant to adolescent girls was posted daily. Topics included indoor tanning, mother-daughter communication, and HPV vaccinations. Posts discussing HPV vaccination were posted in each of the groups and ranged from didactic messages (e.g., the need for adolescent vaccines, how well HPV vaccines are working to decrease infection rate, number of parents choosing to vaccinate children against HPV, etc.) to narrative posts about women who have died from cervical cancer. Posts also included a link to an article, video, photograph, or an infographic.

Comments by participants were generally more favorable toward HPV vaccination than unfavorable. Mothers’ comments are further described in the journal article.

A strength of the analyses identifying participant pre-existing characteristics before posting the HPV messages on Facebook, therefore being able to show that HPV vaccination was a predictor of commenting behavior with mothers who had not vaccinated their daughters as the unfavorable commenters. It is noted that many of the mothers who did not comment had daughters that were vaccinated for HPV. A possible weakness of the study was that the sample of mothers may have limited generalizability. Authors conclude by stating that the fact that many mothers who had daughters vaccinated against HPV did not comment on the HPV posts could contribute to the idea that opposition to the HPV vaccine is larger than it is in actuality. Authors also suggest that U.S. public health agencies and practitioners need to find ways to dispel myths and provide information on vaccine safety and concerns, including that many mothers choose to vaccinate their daughters against HPV.

This research was funded by a grant to Klein Buendel from the National Cancer Institute (CA192652; Dr. David Buller, Principal Investigator). Additional authors include Dr. Sherry Pagoto and Jessica Bibeau from University of Connecticut, Dr. Katie Baker and Dr. Joel Hillhouse from East Tennessee State University, and Dr. Kimberly Henry from Colorado state University.

References

  1. Sexually transmitted disease surveillance 2017: other STDs. Centers for Disease Control and Prevention Web site. Available at: https://www.cdc.gov/std/stats17/other.htm#hpv. Accessed March 28, 2019.
COLLABORATOR SPOTLIGHT:
DR. GREGORY ZIMET

COLLABORATOR SPOTLIGHT:
DR. GREGORY ZIMET

Dr. Gregory Zimet is a Clinical Psychologist and Professor in the Department of Pediatrics at the Indiana University School of Medicine. Since he arrived there in 1993, he has guided an extensive, multi-faceted research program focused on attitudes about, and acceptance of, vaccines for the prevention of sexually-transmitted infections, including the human papillomavirus (HPV) vaccine.

Currently, Dr. Zimet serves as a KB collaborating scientist with Dr. Gill Woodall and Dr. David Buller on a research project entitled “Web App Technology for Boys and Parents: Improving HPV Vaccine Uptake.” Other collaborating investigators include Dr. Alberta Kong and Dr. Randall Starling from the University of New Mexico. The four-year HPV project, funded by a grant from the National Cancer Institute (CA210125; G. Woodall, PI), is designed to produce a mobile web app to accurately inform parents and adolescent boys about the HPV vaccination and address unique concerns about its safety and effectiveness for boys. The mobile web app is being developed for personal computers, smartphones, and tablet computers.

Dr. Zimet’s research also has involved randomized clinical trials designed to evaluate the effects of brief health communication messages on hepatitis B virus and HPV vaccine uptake, and on acceptance of HIV testing. Through his involvement over the past five years in the Adolescent Medicine Trials Network for HIV/AIDS Interventions, Dr. Zimet has expanded his research focus to examine factors related to recruitment of adolescents into biomedical HIV prevention clinical trials. Biomedical trials that may involve the recruitment of adolescents are related to pre-exposure prophylaxis, HIV vaccine, and microbicides. Some of his recent publications address HPV vaccination, microbicide acceptability among adolescents, and attitudes about HIV and herpes simplex virus type 2 testing.

Dr. Zimet has served as a research mentor to five physician fellows, over 20 pre- and post-doctoral fellows in psychology, social work, health behavior, and nursing, and several junior faculty in the Department of Pediatrics and the School of Nursing at Indiana University.

Use of AFIX-based Strategies for HPV Vaccination in Florida

Use of AFIX-based Strategies for HPV Vaccination in Florida

Dr. Barbara Walkosz, a Senior Scientist at Klein Buendel (KB), is one of several authors on a recent publication reporting on Florida pediatricians’ use of AFIX-based strategies for human papillomavirus (HPV) vaccination of adolescents and young adults. The report is published in the journal Preventive Medicine. Research collaborators (coauthors) are from the Moffitt Cancer Center and Research Institute, the University of South Florida College of Medicine, Pediatric Partners, the Indiana University School of Medicine, and the Johns Hopkins University School of Public Health.

HPV vaccination is recommended by the U.S. Centers for Disease Control and Prevention (CDC) to significantly reduce the incidence of cervical, vaginal, oral, and other cancers caused by the sexually transmitted virus. A series of vaccinations are recommended for adolescents and young adults, preferably before the onset of sexual activity (9-26 years of age).

However, rates of HPV vaccination in Florida and the U.S. are disappointingly low – less than 50% for girls and less than 40% for boys. In an effort to increase HPV vaccination of pediatric patients, the CDC created and implements the AFIX quality improvement program with healthcare providers. AFIX stands for Assessment, Feedback, Incentives, and the exchange of information – the four key strategies of the program which is delivered to clinics by local health departments.

The Preventive Medicine paper reports on the results of a cross-sectional survey of a representative sample of 770 pediatric and family medicine physicians in Florida to assess the use of the AFIX strategies. Less than half of the physicians surveyed reported implementing any AFIX strategies, leaving room for program engagement, uptake, and improvement.

BeVaccinated Web App Usability Testing

BeVaccinated Web App Usability Testing

Dr. W. Gill Woodall from Klein Buendel and the University of New Mexico presented findings from the BeVaccinated project at the 68th Annual Conference of the International Communication Association in Prague, Czech Republic, May 24-28, 2018. The project tested the usability of a prototype web app for improving adolescent vaccination uptake.

While vaccination rates for young children in the U.S. currently meet recommended standards, the CDC reports adolescent vaccines uptake (Gardasil 9 for HPV, MCV4 for meningococcal infection, Tdap for Tetanus, Diptheria and Pertussis protection, and Varicella vaccine for Chickenpox protection) to be less than optimal. In the case of the Human Papillomavirus (HPV) vaccine, rates are seriously below desired uptake levels. Despite established safety and effectiveness information about these vaccinations, and a wide variety of medical organizations recommending them, parents continue to have concerns about them, particularly the HPV vaccine.

For health communication researchers focused on Diffusion of Innovations, this is a classic difficulty of lack of effective messaging to prompt the uptake of an innovation by closing a knowledge gap among parents, in this case, on effective adolescent vaccines. The CDC and the Presidents Cancer Panel call for the development of effective and accessible messaging to improve vaccine decision-making as well as uptake. Because parents drive the decision to, and action for, vaccine uptake, messaging should be focused on them, but not exclusively, as there are benefits from parents and adolescents communicating about vaccines specifically and health issues generally. Approaching the vaccines as a recommended adolescent vaccine panel instead of each vaccine singularly may provide adoption benefit, as a vaccine panel approach builds the normative expectation for getting all adolescent vaccines as a group.

To address this vaccine uptake deficit, a web-browser application prototype, BeVaccinated, was developed to test reactions to and feasibility of delivering adolescent vaccine information via a smartphone. The majority of adults of parenting age own smartphones and use them to access online information, especially minority adults, and use mobile apps for information acquisition and decision support, making them a potentially efficacious channel for delivering vaccine information and tools. The prototype app was developed via formative research with focus group participants and guided by an Expert Advisory Board (EAB) comprised of vaccination experts and clinicians. Usability testing was conducted iteratively with nine parent and teen pairs in New Mexico and seven parent and teen pairs in Colorado. Pairs were comprised of one teen, ages 13-17, and their accompanying parent or guardian.

Usability testing was conducted individually with the parent and teen by trained research staff. Parents and teens reported that the prototype app was easy to use. Users reported that they could learn to use it quickly and that they were confident using it. With feasibility established, the full version of the app will be designed to improve dissemination of vaccine information, improve parent/teen communication around health behavior choices, and ultimately, improve the uptake of vaccinations.

This research was funded by a grant from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (R41HD082901; Dr. W. Gill Woodall, Principal Investigator). Collaborators included Julia Berteletti from KB; Dr. Randall Starling, Dr. Alberta Kong, and Dr. Lance Chilton from the University of New Mexico; Dr. Greg Zimet from Indiana University; and Dr. Nathan Stupiansky from the University of Arizona.