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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.

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.

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.

¡Caminemos Juntas!: A Smartphone App for Latinas to Connect with Walking Partners

¡Caminemos Juntas!: A Smartphone App for Latinas to Connect with Walking Partners

Dr. Valerie Myers, Klein Buendel (KB) Senior Scientist, is the Principal Investigator leading a new research project aimed at helping Latinas combat barriers to physical activity using smartphone technology and social networks.

Hispanic women are a growing and influential segment of the population, yet health disparities for Latinas remain high. Latinas are more likely than their non-Hispanic White counterparts to be overweight, diagnosed with diabetes, and physically inactive. Regular physical activity promotes physical and emotional well-being, such as lower risk of heart disease and diabetes, weight management, and improved quality of life, yet physical activity interventions for Latinas remain limited.

Community-focused walking interventions produce improvements in physical activity and are well-received by Latinas when they are socioculturally sensitive. New technology has the ability to provide Latinas with innovative ways to connect socially and increase PA. Location-based services (LBS) are a popular technology that uses geographical positioning to allow individuals to use their smartphones to connect to their surrounding environment.

¡Caminemos Juntas! is a physical activity walking app that uses location-based services to connect Latinas within nearby neighborhoods as a way to provide social support for increased walking behavior. A prototype of the ¡Caminemos Juntas! app was programmed for both iOS and Android smartphones in a previous Phase I project. Multi-method formative research was conducted to guide app design and content prior to conducting field usability testing. To guide prototype development, a national sample of Latinas (n=98; mean age 32.7 +/- 7.8 years; 45% primary Spanish speaking; 28.6% with annual income < $15,000) were surveyed to better understand their preferences, usage, needs, and obstacles of current apps in relation to health and physical activity. Latinas’ current physical activity behaviors and smartphone use, opinions on health-related apps using LBS, how often they access social networking sites on their mobile phone, and their likelihood of using a social networking app to connect to others with intentions to be physically active were also examined.

Phase I results revealed that 22.5% never or rarely exercised, 73.5% accessed social networking sites daily with an average of 8 times a day, and 43.9% used LBS every day. Ease of use (82%), informationally accurate (79.2%), and reliability (84.7%) were app features rated as highly important. Over 63% reported high likelihood of using a social networking app to connect to others with the intentions of being physically active, and 67.4% reported that this type of app would be very helpful. Focus groups showed that the app was appealing, also.

In the new Phase II project, the ¡Caminemos Juntas! app will be fully developed and evaluated in a randomized control trial with Latinas aged 18-45 in San Jose, CA and Denver, CO. Changes in physical activity, social support for exercise, and quality of life will be evaluated. New features to be explored include Fitbit® device integration, mapping of walks, and social media integration. The LBS features of the app will allow Latinas to determine a safe place to meet for a walk, connect with other users nearby, and be notified if there was an available walk in the user’s vicinity.

The research is funded by the National Institute on Minority Health and Health Disparities (MD009652) at the National Institutes of Health through the Small Business Innovation Research Program. Dr. Myers’ collaborators include Dr. Abby King from Stanford University, and Dr. Gary Cutter from Pythagorus, Inc. in Alabama.

Methodological Challenges of Social Media-Delivered Health Promotion Interventions

Methodological Challenges of Social Media-Delivered Health Promotion Interventions

Dr. Sherry Pagoto, SBM President-elect and KB Collaborator, was a co-presenter for a Behavioral Informatics and Technology Panel Discussion on social media health promotion at the 39th Annual Meeting and Scientific Sessions of the Society of Behavioral Medicine, April 11-14, 2018 in New Orleans, Louisiana. Dr. Pagoto shared methodological challenges related to participant recruitment, intervention content development, and intervention delivery for a Facebook intervention targeting mothers of teen daughters in order to reduce the incidence of indoor tanning. This project is currently being conducted by KB and several collaborators from the University of Connecticut, East Tennesee State University, and Colorado State University.

Social media platforms can be used to deliver health promotion interventions to wide audiences without the barriers that plague traditionally-delivered programs, such as geography, transportation, scheduling, and childcare. Because most people access their social media feeds daily, health programming can be delivered to populations who are not necessarily seeking help or are motivated to change. Despite these promising and unique features, designing studies to evaluate social media-delivered interventions involves methodological challenges for recruitment and participation. During the panel discussion, Dr. Pagoto shared some of our research project’s challenges, implications of alternative recruitment and engagement methods, and valuable lessons learned.

This research project is called “Likes Pins and Views: Engaging Moms on Teen Indoor Tanning Thru Social Media.” It is funded by a grant from the National Cancer Institute (RO1CA192652; Dr. David Buller, KB, Principal Investigator). Collaborators include Dr. Barbara Walkosz and Julia Berteletti from KB, Dr. Sherry Pagoto, Jessica Oleski, and Ashley Panzarino 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.

Welcome to the new KB Collaboratory!

Welcome to the new KB Collaboratory!

Welcome to the new KB Collaboratory – a fresh new edition of Klein Buendel’s blog. The KB Collaboratory complements our newly-designed website and disseminates timely information about our behavioral health research and collaborations.

Because we’re a “small bunch,” KB’s behavioral scientists, research staff, and developers collaborate with researchers, clinicians, and creatives from companies, universities, research institutes, and cancer centers around the world to design programs and products to prevent chronic disease. Along with our research publications, conference presentations, website, and social media, this blog is a dynamic outlet for sharing the health communication, education, and technology research that we do in collaboration with our distinguished research, business, and creative partners.

Watch for articles and features in the KB Collaboratory on our:

  • Research collaborators
  • Abstracts and conference presentations
  • Publications
  • New research projects
  • Technology and products
  • Outreach and education
  • News and announcements

If you’d like to get in touch, please email Mary Buller at mbuller@kleinbuendel.com.