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Month: December 2019

Klein Buendel’s 2019 Research Highlights

Klein Buendel’s 2019 Research Highlights

In our 17th year, Klein Buendel scientists and staff continue to conduct rigorous behavioral science research with numerous collaborators from across the country. In 2019, our investigators published 15 new research manuscripts in peer-reviewed journals and presented their research findings via 18 posters and presentations at 10 local, national, and international conferences and expert meetings. One of our posters was nominated for Best Poster in the Prevention and Public Health division at the Science of Dissemination and Implementation in Health annual conference, and one of our papers was selected by its journal to be included in their December 2019 Continuing Medical Education (CME) exam.

In April 2019, KB opened a new satellite research office in Albuquerque, New Mexico. The office is led by Dr. Gill Woodall, KB Senior Scientist, and conducts research projects with southwestern populations. 

Dr. Valerie Myers, KB Senior Scientist, was appointed this year by the Board of Directors of the Society of Behavioral Medicine to serve as the Education, Training, and Career Development Committee Chair. Her three-year term will begin in April of 2020.

In March of 2019, Dr. Barbara Walkosz, KB Senior Scientist, lectured on Media Literacy and Health Communication at Beijing Normal University in China. Dr. Walkosz also serves as an appointed Commissioner for Denver Mayor Michael Hancock’s Commission on Aging, part of the Agency for Human Rights and Community Partnerships.

In April of 2019, Dr. David Buller, KB Director of Research, lectured on KB’s occupational sun protection research (Sun Safe Workplaces) in a class at the University of Colorado School of Medicine. And in December, he presented initial findings from an ongoing social media campaign for mothers to improve adolescent health and reduce indoor tanning (Health Chat) via webinar to the Health Communication and Informatics Research Branch of the National Cancer Institute.

In product news, we licensed our Train to Tend® responsible marijuana vendor training program to Avid Will LLC for marketing and sales have started to take off. Also, sales of the very successful Way To Serve® responsible alcoholic beverage server training program continue to accelerate. And in September, we made one of our long-time products – the Grow, Eat Thrive elementary school nutrition and gardening curriculum – available for free online.

Lastly, KB was recognized in 2019 as #47 on Colorado Biz Magazine’s Top 100 Woman-Owned Companies list, and was #130 on their Top 200 Private Companies list.

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


  • 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. Psychol Addict Behav. 2019 Feb;33(1):1-14. doi: 10.1037/adb0000442.
  • 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. 1 Apr 2019;34(2):145-158.
  • Kitt-Lewis E, Loeb SJ, Myers VH, Wion RK, Baney B, Strickfaden S. Developing educational modules to enhance care of aged and dying inmates: Set-up phase. Public Health Nurs. 2019;36(11): 401-410.
  • Buller DB, Walkosz BJ, Berteletti J, Pagoto SL, Bibeau J, Baker K, Hillhouse J, Henry KL. Insights on HPV vaccination in the United States from mothers’ comments on Facebook posts in a randomized trial. Hum Vaccin Immunother. 2019;15(7-8):1479-1487.
  • Buller DB, Walkosz BJ, Woodall WG. Use of media and social media in the prevention of substance abuse. In: Sloboda Z, Petras H, Robertson E, Hingson R, eds. Prevention of Substance Use. Cham, Switzerland: Springer Nature Switzerland AG; 2019 pp 319-334.
  • Newton RL Jr, Carter L, St. Romain J, Jerrod T, Griffith D, Myers V. Development of a mobile phone app to maintain physical activity in African American men: MobileMen. mHealth. 2019 Jun 13;5:16. doi: 10.21037/mhealth.2019.05.03. eCollection 2019.
  • Kitt-Lewis E, Loeb SJ, Wion RK, Myers VH, Jerrod T, Strickfaden S. Developing Computer-Based Learning on Care of Aged and Dying Incarcerated People. J Forensic Nurs. 2019 Jul 9. doi: 10.1097/JFN.0000000000000248. [Epub ahead of print]
  • Byrnes HF, Miller BA, Bourdeau B, Johnson MB, Buller DB, Berteletti J, Rogers VA. Prevention of alcohol and other drug overuse among nightclub patrons: a randomized trial of a group-based mobile intervention at nightclubs. J Stud Alcohol Drugs. 2019 Jul;80(4):423-430.
  • Walkosz B, Buller D, Buller M, Wallis A, Liu X. Senior managers’ awareness of sun protection policy predicts implementation of worksite sun safety in a randomized trial. Am J Ind Med. 2019 Oct;62(10):893-900.
  • Meenan RT, Walkosz BJ, Buller DB, Eye R, Buller MK, Wallis AD, Olivas S. Economic evaluation of an intervention promoting adoption of occupational sun protection policies. J Occup Environ Med. 2019 Dec 6;61(12):978-983.*

*The above paper was selected by JOEM as an article to be included in their December 2019 CME exam.

  • Gonzalez CD, Rundle CW, Pona A, Walkosz BJ, Dellavalle RP. Ultraviolet radiation may cause premature fading of colored tattoos. Photodermatol Photoimmunol Photomed. 2019 Aug 28. doi: 10.1111/phpp.12509. [Epub ahead of print]
  • Buller DB, Woodall WG, Saltz R, Buller MK. Compliance with ID regulations by recreational marijuana stores in two US states. J Stud Alcohol Drugs. J Stud Alcohol Drugs. 2019 Nov;80(6):679-686.
  • White KAM, Dailey YT, Guest DD, Zielaskowski K, Robers E, Sussman A, Hunley K, Hughes CR, Schwartz MR, Kaphingst KA, Buller DB, Hay JL, Berwick M. MC1R variation in a New Mexico opulation. Cancer Epidemiol Biomarkers Prev. 2019 Nov;28(11):1853-1856.
  • Gonzalez CD, Pona A, Walkosz BJ, Dellavalle RP. Hispanic Tattoo Artists Could Provide Skin Cancer Prevention via Aftercare and Social Media. J Drugs Dermatol. ; 2019 Dec 1;18(12):1237-1243.
  • Glynn NW, Gmelin T, Santanasto AJ, Lovato LC, Lange‐Maia BS, Nicklas BJ, Fielding RA, Manini TM, Myers VH, de Rekeneire N, Spring BJ, Pahor M, King AC, Rejeski WJ, Newman AB; for the Lifestyle Interventions and Independence for Elders Study Group. Impact of baseline fatigue on a physical activity intervention to prevent mobility disability. J Am Geriatr Soc. 2019 Dec 22. doi:10.1111/jgs.16274. [Epub ahead of print]

Conference Presentations

Society of Behavioral Medicine Annual Meeting: March 6-9 in Washington, DC

  • Berteletti J, Buller DB, Pagoto S, Walkosz B, Bibeau J, Baker K, Hillhouse J, Henry K. Mothers’ beliefs about adolescent marijuana use: insights from a Facebook-delivered intervention and randomized trial. Oral presentation.
  • Reynolds KD, Buller DB, Buller MK, Massie K, Berteletti J, Ashley J, Meenan RT. Randomized trial evaluating an intervention supporting implementation of sun safety policies in public elementary schools. Oral presentation.
  • Myers VH, Loeb SJ, Kitt-Lewis E, Wion R, Murphy J, Jerrod T, Carter M. E-training of Inmate Peer Caregivers for Enhancing Geriatric and End-of-Life Care in Prisons. Oral presentation.
  • Bibeau JL, Berteletti J, Goetz JM, Massie K. Using project management skills in behavioral research. Pre-conference workshop presentation.

American Society of Preventive Oncology Annual Meeting: March 10-12 in Tampa, Florida

  • Myers V. Technology and Health Behavior: Crossing the Digital Divide. Oral presentation.

Eastern Nursing Research Society Annual Meeting: April 3-5 in Providence, Rhode Island

  • Loeb SJ, Kitt-Lewis E, Myers VH, Wion R, and Murphy J, Jerrod T, Carter M. Inmate Caregiver Training in Geriatrics and End-Of-Life. Oral presentation.

DC Health Communication Conference: April 25-27 in Fairfax, Virginia

  • Buller D. Grant Writing 101: Boot Camp with NIH. Pre-conference workshop presentation.

Society for Prevention Research Annual Meeting: May 28-31 in San Francisco, California

  • Byrnes H, Miller B, Bourdeau B, Johnson MB, Buller DB, Berteletti J, and Rogers V. Group cohesion among social drinking groups at nightclubs and risk from alcohol and other drug use. Poster presentation.
  • Miller B, Byrnes H, Rogers V, Bourdeau B, Grube J, Johnson MB, Buller DB, Berteletti J. Group-based intervention for overuse of alcohol in a high-risk context: Examining the influence of group gender composition on outcomes. Poster presentation.
  • Saltz R, Buller D, Woodall WG, Grayson A. Refusal of pseudo-intoxicated customers by retail marijuana outlets in three U.S. states. Poster presentation.

Kettil Bruun Society Annual Meeting: June 3-7 in Utrecht, Netherlands

  • Woodall WG, Buller DB, Saltz R, Perez F, Chacon-Silva A, Sanchez V, Reither J, Starling R, Diaz L. WayToServe Español: A web-based responsible beverage service training for Spanish-speaking alcohol servers. Oral presentation.

National Research Society on Alcoholism Annual Scientific Meeting: June 22-26 in Minneapolis, Minnesota

  • Woodall WG, Saltz R, Buller D, Perez F, Chacon Silva A, Sanchez V, Starling R. Refusal of alcohol sales to pseudo-intoxicated patrons in primarily Spanish-speaking premises: A tale of two states. Oral presentation.

North American Association of Transportation Safety and Health Officials Annual Conference: September 8-12 in New Orleans, Louisiana

  • Grayson A. Go sun smart at work. Oral presentation.

European Society for Prevention Research Conference: September 16-18 in Ghent, Belgium

  • Buller D, Woodall WG, Saltz R, Grayson A, Svendsen S, Buller M. Effects of an online responsible vendor training for recreational cannabis stores on sales to pseudo-intoxicated customers: need for increased deterrence. Oral presentation. 
  • Miller B, Byrnes H, Rogers V, Bourdeau B, Grube J, Buller D, Woodall WG, Berteletti J. A family-based program to reduce teen alcohol use and risky sexual behavior. Oral presentation. 
  • Woodall WG, Miller B, Buller D, Byrnes H, Bourdeau B, Grube J, Rogers V, Berteletti J. Effect of teen engagement with a family-based online intervention on reduction in alcohol use by teens. Poster presentation.

The Science of Dissemination & Implementation in Health Conference: December 4-6 in Washington, DC

  • Buller DB, Reynolds KD, Buller MK, Meenan R, Ashley J, Berteletti J, Massie K. An implementation intervention for school sun safety policies increased parents’ reports of sun safety communication from schools and children’s sun protection. Oral presentation.
  • Buller DB, Walkosz B, Buller M, Meenan R, Eye R, Grayson A, Olivas S. An Implementation Model for the Cost-effective Scale-up of the Sun Safe Workplaces Program. Poster presentation.*

*The above poster was nominated for Best Poster in the division of Prevention and Public Health at the Science of Dissemination & Implementation in Health Conference.

ID Compliance by Recreational Marijuana Stores in Two States

ID Compliance by Recreational Marijuana Stores in Two States

The recreational sale of marijuana has begun in ten U.S. states and seems likely to expand to several others. Only state-licensed stores can sell recreational marijuana products and only persons over age 21 who provide a valid state-approved identification (ID) can enter the stores and purchase marijuana. The age and ID regulations are intended to prevent youth gaining access to recreational marijuana, and it is important to investigate whether these age and ID restrictions are actually working.

Research collaborators from Klein Buendel and the Pacific Institute for Research and Evaluation, measured compliance with age and ID regulations by state-licensed recreational marijuana stores in two states and reported their findings in the Journal of Studies on Alcohol and Drugs. The paper reports assessment of sale refusal rates in a large, diverse sample of stores selling recreational marijuana in the states of Colorado and Washington. The paper’s analyses describe ID checking behavior by store personnel, estimate refusal rates, and explore factors associated with refusal. 

One hundred seventy-five recreational marijuana stores in Colorado and Washington were visited twice by pseudo-buyer assessment teams in September 2016 to April 2017. A young-adult buyer attempted to enter the store and purchase marijuana without showing a state-approved identification. In the second Colorado visit, a buyer aged 18-20 showed an underage driver’s license and attempted to enter the store and purchase marijuana. No cannabis products were actually purchased.

All stores requested an ID. Stores refused buyers in 73.6% of visits at the entrance, 88.3% cumulative before the counter, and 92.6% cumulative by the time of a purchase attempt. Refusal was lower in Washington than in Colorado but it did not differ by buyer protocol. Overall, compliance with laws restricting marijuana sales to individuals 21 or older with a valid ID was high. The authors suggest that compliance in Washington might be improved by having store personnel check IDs at the store entry. Recreational stores may not be selling marijuana directly to youth, although no information was collected on straw purchases. The measures, methods, analyses, results, conclusions, and limitations are detailed in the publication.

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). Coauthors include Dr. Gill Woodall and Ms. Mary Buller from KB, and Dr. Robert Saltz from the Prevention Research Center at the Pacific Institute for Research and Evaluation.

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.

Parents’ Reports of School Communication on Sun Safety

Parents’ Reports of School Communication on Sun Safety

The U.S. Surgeon General and the Centers for Disease Control and Prevention have called on the nation’s schools to help prevent skin cancer by implementing sun safety practices and policies. The Sun Safe Schools program was designed by Klein Buendel researchers and collaborators in response to those calls to action. The program was implemented and evaluated with 118 public elementary schools in California.

Dr. David Buller, Klein Buendel Director of Research, presented data on the impact of the Sun Safe Schools intervention on parents’ reports of sun safety communication from schools and children’s sun protection behavior at the 12th Annual Conference on the Science of Dissemination and Implementation in Health in Washington, DC, December 4-6, 2019.

Schools randomized to the Sun Safe Schools intervention group (N=58) received support for implementing school sun safety practices by trained coaches over 20 months. Based on Diffusion of Innovations Theory, support and resources for implementation were tailored to school principals’ readiness to implement. Parents completed an online posttest survey through invitations sent by principals or while attending parent-oriented school events. Parents were surveyed to test the hypothesis that parents would report more communication about sun safety at schools receiving the intervention than at control schools.

The Sun Safe Schools program appeared to increase communication on sun safety and the use of student sun protection. Parents in intervention schools were more likely to report receiving information about sun safety from the school and that their children wore sun-protective clothing than in control schools. The improvement in sun safety appeared to result from policy implementation. In schools where principals reported implementing sun safety practices at posttest, parents reported that children spent less time outdoors and had fewer sunburns than at non-implementing schools. Further, parents who received information about sun safety from the school reported more sun protection for their child than parents not receiving the information.

In summary, a school district-level policy, combined with active technical support for schools within the district, appears to be effective at increasing implementation of school sun safety practices to help protect children from solar ultraviolet radiation, the primary risk factor for the development of skin cancer.

The Sun Safe Schools program is a joint research effort of Claremont Graduate University (CGU), the Kaiser Permanente Center for Health Research, and Klein Buendel. 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, CGU, and Dr. David Buller, Multiple Principal Investigators). Other collaborators included Dr. Richard Meenan from the Kaiser Permanente Center for Health Research in Portland, Oregon; Dr. Jeff Ashley from Sun Safety for Kids in Los Angeles, California; Kim Massie previously from Chapman University; and Julia Berteletti and Mary Buller from Klein Buendel.