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Tag: Intervention

Results of a social media campaign to prevent indoor tanning by teens

Results of a social media campaign to prevent indoor tanning by teens

Results of the Health Chat social media intervention to reduce mothers’ permissiveness toward their teen daughters’ indoor tanning (IT) behavior have been published in Preventive Medicine Reports.

During the intervention, participating mothers received an adolescent health social media campaign in Facebook private groups. Half of the mothers were in a group in which the health campaign included posts about preventing IT (intervention) and the other half, included posts on preventing prescription drug misuse (control). Health Chat was designed by the research team based on an integrated conceptual framework of social cognitive theory, transportation theory, and diffusion of innovations theory.

Given mothers’ high use of social media, the research team, led by Klein Buendel Director of Research, Dr. David Buller, and Dr. Sherry Pagoto from the University of Connecticut, evaluated a social media campaign aimed at mothers to prevent IT by their daughters in a randomized trial that tested two hypotheses:

H1: The social media campaign on IT will significantly reduce (a) mother’s permissiveness regarding their daughter’s IT, (b) their daughter’s perception of maternal permissiveness toward IT, and (c) both mother’s and daughter’s IT relative to the control condition.

H2: A statistically significantly greater number of mothers will support a ban on IT for minors in the intervention group compared to the control condition.

Study methods, data, and results are detailed in the Preventive Medicine Reports’ publication and indicate that a social media campaign may be an effective strategy for convincing mothers to withhold permission for IT from their teen daughters, in an effort to reduce risk for skin cancer.

This research was funded by a grant and supplement from the National Cancer Institute (CA192652; Dr. David Buller and Dr. Sherry Pagoto, Multiple Principal Investigators). Collaborating authors include Dr. Katie Baker and Dr. Joel Hillhouse from East Tennessee State University; Dr. Kimberly Henry from Colorado State University; Jessica Bibeau from the University of Connecticut; and Dr. Barbara Walkosz and Julia Berteletti from Klein Buendel. 

Translation of an In-Person Bystander Bullying Intervention to a Technology-Based Platform

Translation of an In-Person Bystander Bullying Intervention to a Technology-Based Platform

Klein Buendel Senior Scientist, Dr. Valerie Myers, and collaborators from Boise State University will be presenting a poster showcasing the development of a technology-based bullying prevention program during the 42nd Annual Meeting & Scientific Sessions of the Society of Behavioral Medicine from April 12-16, 2021.

Bullying is a significant problem in the United States, with more than a quarter of middle school students reporting bullying victimization. Bullying is associated with multiple mental health, social, and academic consequences. Although comprehensive school-wide interventions are available, they require significant resources for implementation, reducing access to schools, particularly in rural or low-income communities. Thus, there is a need for bullying programs that effectively address bullying while removing implementation barriers.

The STAC intervention is a brief, bystander bullying intervention that includes psychoeducation and role-plays to increase knowledge and skills to intervene in bullying. STAC stands for four strategies students can use when they witness bullying: “Stealing the show,” “Turning it over,” “Accompanying others,” and “Coaching compassion.” A series of randomized controlled trials have demonstrated the efficacy of the STAC intervention in reducing bullying perpetration and victimization, as well as depression, anxiety, and alcohol use.

The goal of the project presented in the poster was to translate the STAC program into a technology-based platform (STAC-T) for middle schools. The aims of this study were to: (1) conduct a needs assessment with middle school personnel, (2) develop a web-based prototype based on the in-person STAC intervention through iterative focus groups, and (3) conduct usability testing with middle school students and school personnel. Qualitative data from the needs assessment indicated a strong interest in a technology-based bullying intervention and positive conditions for implementation including administrative support and school technology-readiness. Students who participated in iterative focus groups reported the app concept was easily understood and engaging and identified essential features for a successful prototype.

Results from usability testing indicated participants perceived the STAC-T program to be useful and appropriate for their school and community. Findings from this study showed that the STAC-T program is relevant and feasible for implementation in the middle school settings and is usable for the target audience.

The STAC-T project is funded by an STTR grant to Klein Buendel from the National Institute on Minority Health and Health Disparities at the National Institutes of Health (MD014943; Dr. Aida Midgett, Principal Investigator). A third collaborator, in addition to Dr. Midgett and Dr. Myers, is Dr. Diana Doumas from Boise State University.

Curbing College Drinking and Risky Sexual Behavior Using Dynamic Feedback

Curbing College Drinking and Risky Sexual Behavior Using Dynamic Feedback

Two-thirds of college students are current drinkers of alcoholic beverages. One in three college students report past month binge drinking (five or more drinks in a row), and one in ten report high intensity drinking (ten or more drinks in a row). Greater student alcohol consumption and heavy drinking on a given day are linked to increased sexual activity and risky sexual behavior, such as unprotected sex and sex with casual partners. This puts students at risk for negative health outcomes, such as sexually-transmitted infections, and other harmful consequences, such as sexual victimization.

Klein Buendel is collaborating with Dr. Anne Ray at the University of Kentucky on a new research project designed to curb drinking and risky sexual behavior by first-year college students. The new study will assess the impact of a brief, personalized intervention utilizing an innovative, cross-tailored, dynamic feedback component. The intervention will purposefully integrate content on the relationship between alcohol use and risky sexual behavior. The intervention will leverage technology to incorporate daily assessments of student behavior and deliver weekly dynamic feedback. Participating students will be asked to complete four diary entries each week for three months.

A hybrid effectiveness-implementation design will allow the investigators to evaluate the effectiveness of the integrated personalized feedback intervention with 600 first-year college students at two college sites in a randomized controlled trial. In addition, formative evaluation with local and national stakeholders (students and student affairs staff) will help to better understand factors that influence implementation and ensure its success and sustained use.   

This research project is funded by the National Institute on Alcohol Abuse and Alcoholism at the National Institutes of Health (AA028246; Dr. Anne Ray, Principal Investigator). Collaborators include Dr. David Buller from Klein Buendel. KB’s Creative Team will develop the web-based program for college students.

Collaborator Spotlight:
Barbara McCrady, PhD

Collaborator Spotlight:
Barbara McCrady, PhD

Barbara McCrady, PhD, is a Distinguished Professor of Psychology at the University of New Mexico, a licensed psychologist, a specialist in the treatment of alcohol abuse, and a long-time research collaborator with Dr. W. Gill Woodall, Senior Scientist at Klein Buendel.

The research project that Dr. McCrady and Dr. Woodall are currently working on together is entitled “Smartphone Help for DWI Offenders and their Families: A B-SMART App.” B-SMART is a smartphone app intervention designed to extend the drunken driving cessation initially provided by an interlock ignition device. It involves participation of a concerned family member of DWI (driving while intoxicated) offenders by providing coping skills, communication skills, and strategies to help avoid a subsequent DWI. This study is unique because it involves a family member in supporting the DWI offender to not drink and drive, and the use of smartphone technology to make family support immediate, accessible, and diffusible. Dr. McCrady developed the content for the intervention based on empirically validated couples therapy techniques for those with alcohol use disorders.

In her research, Dr. McCrady has focused on conjoint therapy, approaches that involve the social network, cognitive behavioral therapy, mutual help groups, and therapies for women. In her words: “As a clinical scientist, the overall goal of my work is to conduct research to test innovative treatments and treatment delivery systems for persons affected substance use disorders, and to better understand the mechanisms by which these treatments work. An ultimate goal is to improve clinical practice through the use of empirically supported assessment and treatment approaches.”

Dr. McCrady has published more than 250 refereed papers, books, book chapters, and commentaries. She has also published four treatment manuals and client workbooks with Elizabeth Epstein (a member of the B-SMART Project Expert Advisory Board) on empirically supported treatments for couple’s therapy and cognitive behavioral therapy for alcohol use disorders. She has a second edition of a textbook entitled, Addictions: A Comprehensive Guidebook, published by Oxford University Press.

She is the past Director of the Center on Alcoholism, Substance Abuse, and Addictions (CASAA) at the University of New Mexico, and is currently the Chair of the Diversity Committee for the Research Society on Alcoholism and the Vice President for the Research Advisory Committee of the Research Society on Alcoholism.

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.

Supporting Implementation of Sun Safety Policies in Schools

Supporting Implementation of Sun Safety Policies in Schools

Many schools in California are working to increase sun protection practices by students, parents, teachers, and staff in an effort to reduce over-exposure to ultraviolet radiation and prevent skin cancer in the long term. A paper published recently in Preventive Medicine presents the results of a large randomized trial assessing an intervention designed to close a sun safety policy-practice gap in California elementary schools. The trial tested the hypothesis that schools with sun safety policies randomly assigned to receive the Sun Safe Schools intervention would implement more sun safety practices than schools in a minimal information control group.

Research collaborators from Claremont Graduate University, Klein Buendel, the Kaiser Permanente Center for Health Research, and Sun Safety for Kids, Inc. implemented the Sun Safe Schools program in 118 elementary schools from 40 California public school districts. Each school district had a school board-approved policy for sun safety (Board Policy 5141.7). The 20-month intervention was delivered to principals and included a coaching session, telephone and email contacts, resources for implementing sun protection practices, and a small grant program (for example, to purchase sunscreen for students).

The Sun Safe Schools intervention was effective at narrowing the sun safety policy-practice gap in participating California elementary schools. The program increased the total number of sun safety practices implemented by intervention schools compared to control schools. Also, more intervention schools’ sun safety practices reflected elements of district policy and sometimes went beyond the elements included in district policy. Detailed descriptions of the sample, measures, methods, analyses, outcomes, strengths, and limitations of the randomized controlled trial can be found in the Preventive Medicine publication.

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, Claremont Graduate University, and Dr. David Buller, Multiple Principal Investigators). Coauthors, in addition to Dr. Reynolds and Dr. Buller, include Kim Massie formerly from CGU; Dr. Jeff Ashley from Sun Safety for Kids in Los Angeles, California; Dr. Richard Meenan from the Kaiser Permanente Center for Health Research in Portland, Oregon; and Julia Berteletti and Mary Buller 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.

Physical Activity Intervention for Older Adults

Physical Activity Intervention for Older Adults

In a publication in the Journal of the American Geriatrics Society, Dr. Nancy Glynn from the University of Pittsburgh, Klein Buendel’s Senior Scientist Dr. Valerie Myers, and several other contributors evaluate the effectiveness of the Lifestyle Interventions and Independence for Elders (LIFE) study.

The LIFE study was a randomized controlled trial designed to compare a moderate-intensity physical activity intervention with a health education program for sedentary older persons, 65 years or older, with low physical activity who are at risk for major mobility disability. LIFE’s primary goal was to investigate whether physical activity is an effective and practical way for preventing major mobility disability in older persons, which is defined as the inability to walk 400 meters.

For the study, participants at multiple centers were asked to perform a 400-meter walk at a normal pace every six months at which various measurements were assessed and calculated including baseline fatigue, self-reported fatigue, and energy levels. The physical activity intervention incorporated lower extremity resistance exercises, balance exercises, stretching and behavioral counseling. Health education seminars were also provided with information available about health-related matters and involved various upper extremity stretching exercises.

To learn more about the physical activity intervention and if it was effective at preserving the mobility of older adults, you can view a full description of the methods, results, and discussion in the publication.

This research was funded by a grant from the National Heart, Lung, and Blood Institute and the National Institute on Aging (AG022376; Marco Pahor, MD, University of Florida, Principal Investigator). Dr. Myers is one of the paper’s 16 authors, including the Interventions and Independence for Elders Study Group.

Project SHINE for Adolescent Tanning Prevention

Project SHINE for Adolescent Tanning Prevention

Dr. David Buller, Klein Buendel Director of Research, is a Co-Investigator on a new research project funded by the National Cancer Institute and being led by Dr. Yelena Wu, Principal Investigator, from the University of Utah. Project SHINE (Sun-safe Habits Intervention and Education) is a multi-modal intervention that targets adolescents’ views on the personal relevance of skin cancer and their ability to prevent the disease in order to increase their sun protection use and decrease their intentional tanning.

Project SHINE incorporates action plans, sun damage photographs, and education to teachers and parents in order to build on adolescents’ interest in novelty and need for highly personalized interventions. It also promotes environmental supports for adolescent skin cancer prevention. SHINE is novel in its application of the Extended Parallel Process Model, used in smoking and drug abuse interventions, to pediatric skin cancer prevention. The five-year study will be conducted with 30 high schools and over 10,000 students in 9th or 10th grade health classes. To support the rigor of this research, the project will objectively measure ultraviolet radiation (UVR) exposure among 10% of the sample who will wear a UVR monitoring device for 3-day periods after self-reported assessments.  

Dr. Buller is part of a well-established team that includes experts in skin cancer prevention, adolescent health behavior change, dermatology, school programs, and randomized trials. He will provide input on the design and implementation of the study, help develop parent/teacher education materials, and participate in results interpretation and manuscript preparation.

Skin cancer is a significant public health priority. It is the most commonly diagnosed form of cancer, afflicting more than 5 million people in the United States each year. Treatment costs total more than $8 billion each year. Skin cancer is highly preventable if individuals limit UVR exposure by using sun protection strategies, such as sunscreen, hats, protective clothing, and by avoiding tanning. Use of prevention strategies is critical during childhood and adolescence, when skin cells are particularly vulnerable to UVR damage leading to skin cancer. Due to their poor use of sun protection and likelihood to intentionally tan, adolescents, more than any other pediatric group, urgently need efficacious skin cancer preventive interventions. Schools offer the ideal setting to deliver skin cancer preventive interventions to large numbers of adolescents.

An Implementation Model for the Cost-effective Scale-up of the Sun Safe Workplaces Program

An Implementation Model for the Cost-effective Scale-up of the Sun Safe Workplaces Program

Dr. David Buller and Dr. Barbara Walkosz from Klein Buendel presented a poster on a new implementation model for the cost-effective scale-up of an occupational sun protection program at the 12th Annual Conference on the Science of Dissemination and Implementation in Health in Washington, DC, December 4-6, 2019. The poster was nominated for Best Poster from the Prevention and Public Health Division.

Scale-up is the effort to increase the impact of successful programs to benefit more people on a lasting basis. Scale-up efforts must increase reach, retain effectiveness, and lower costs to provide greater access to benefits and close the research-to-practice gap between effective programs and real-world application. This project is studying the nationwide scale-up of an occupational sun safety intervention, Sun Safe Workplaces, with state Departments of Transportation (DOTs), a public works sector with thousands of outdoor workers.

Costs of national distribution can be daunting and influence intervention intensity and program effectiveness. Identifying cost-effective scale-up strategies is essential for moving research into practice. The new framework draws upon existing implementation models, including those developed for occupational health and safety, and operationalizes implementation for scale-up within RE-AIM. The RE-AIM framework was adapted for this new framework by incorporating cost as a primary factor.

In a randomized trial, Sun Safe Workplaces (SSW) is assessing implementation rate and costs associated with two methods of scaling-up SSW. The original intervention depended on personal visits with managers, materials promoting sun protection policies and education, in-person sun safety training for employee groups, and on-going follow-up communication with managers supporting sun safety (SSW-IP), a resource-intensive form of intervention. Now SSW-IP is being contrasted to a scale-up strategy that uses web-based and telephone conferencing, responsive training platforms, and electronic resources for virtual contacts and training (SSW-T). Technology-based programs have the potential to deliver standardized, engaging content and increase portability while decreasing cost of delivery to enable reaching more employers when scaled-up to nationwide distribution. Districts within DOTs are randomized to one of the two scale-up methods. The SSW-IP and SSW-T interventions are being delivered in 21 state DOTs with 141 districts.

This research is funded by a grant from the National Cancer Institute (CA134705; Dr. David Buller and Dr. Barbara Walkosz, Multiple Principal Investigators). Additional poster coauthors include Dr. Richard Meenan from the Kaiser Permanente Center for Health Research; and Mary Buller, Rachel Eye, Andrew Grayson, and Savanna Olivas from Klein Buendel.