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Month: July 2020

Bilingual Web App to Improve HPV Vaccine Uptake

Bilingual Web App to Improve HPV Vaccine Uptake

Dr. W. Gill Woodall, Klein Buendel Senior Scientist, presented findings from the Vacteens/Vacuna Adolescente Project at the virtual 33rd International Papillomavirus Conference & Basic Science, Clinical and Public Health Workshops (IPVC), July 20-24, 2020.

The uptake of HPV vaccine in the United States remains substantially below the Healthy People 2020 goal of 80% series completion, particularly for young adolescents, when immunogenic response to the vaccine is strongest. Physician and clinic-based interventions have shown some limited positive effect on vaccine uptake. However, parental barriers to HPV vaccination may be addressed by digital interventions, such as smartphone applications, that are tailored to their concerns. Potential parental barriers include confusion, uncertainty, and misinformation about HPV vaccine schedule, safety, and effectiveness.

A research project was conducted to test whether digital information delivered to parents in a community setting may be an effective way to help reach HPV vaccine uptake goals in the United States. Diffusion of Innovations Theory principles were used to guide the development of the Vacteens/Vacuna Adolescente mobile app in English and Spanish. The app was designed  to encourage HPV vaccination in New Mexico, an ethnically-diverse state with insufficient vaccine uptake. Parents and adolescents were recruited from pediatric clinics in New Mexico to a randomized trial evaluating the mobile web app, which focused on daughters (ages 11-14). Parents were randomized to receive either the Vacteens/VacunaAdolescente mobile web app or the usual and customary online HPV vaccination pamphlet from the U.S. Centers for Disease Control and Prevention. Adolescent vaccine records were collected for daughters at a 9-month assessment point. Vaccine uptake results from the trial found that parents who received the Vacteens/VacunaAdolescente web app were significantly more likely to have their daughters vaccinated.

This research was funded by grants from PCORI and the National Cancer Institute (CA210125; Dr. W. Gill Woodall, Principal Investigator). Dr. Woodall’s collaborators include Dr. Alberta Kong and Dr. Lance Chilton from the University of New Mexico, Dr. Greg Zimet from Indiana University, and Jeannyfer Reither, Dr. David Buller, and Dr. Valerie Myers from Klein Buendel.



Dr. David Buller, Director of Research from Klein Buendel, presented findings from the Health Chat Project at the virtual 33rd International Papillomavirus Conference & Basic Science, Clinical and Public Health Workshops (IPVC), July 20-24, 2020.

Parental decisions on HPV vaccine uptake in the United States are influenced by information and misinformation about the vaccine in social media. Mothers’ reports on vaccination of their adolescent daughters were examined in an evaluation of a social media adolescent health campaign.

For this intervention, 881 mothers from 34 states were recruited into a randomized controlled trial evaluating a social media adolescent health campaign. Eligibility criteria included having a daughter aged 14-17, in state without a complete ban on indoor tanning by minors, using a Facebook account one or more times a week, completing the baseline survey, and joining the Facebook group. The campaign included didactic and narrative posts some of which promoted HPV vaccination, such as the need for vaccine, percent of adolescents vaccinated, and how HPV vaccines are decreasing infection rates. It was delivered through two Facebook private groups differing on inclusion of indoor tanning or prescription drug mis-use posts .

At baseline, nearly two-thirds of mothers reported that their daughters had been vaccinated for HPV. HPV vaccine uptake increased during the 12-month social media campaign. At the 12-month posttest, nearly 8% more mothers reported that daughters had been vaccinated for HPV. The increase appeared to be largest in completion of the multi-dose series. Uptake increased among older and more educated mothers and those with a family history of skin cancer. Mothers’ reports of HPV vaccine uptake were corroborated by daughters. Effective strategies are needed in social media to promote HPV vaccines and counter misinformation about and resistance to them.

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 include Jessica Oleski from the University of Connecticut, Dr. Katie Baker and Dr. Joel Hillhouse from East Tennessee State University, Dr. Kim Henry from Colorado State University, and Dr. Barbara Walkosz and Julia Berteletti from Klein Buendel.

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.

Investigation of Indoor Tanning Policy Enactment

Investigation of Indoor Tanning Policy Enactment

Klein Buendel is collaborating with Dr. Carolyn Heckman and her team from Rutgers University on a new research project to study the process of translating indoor tanning policy efforts into stringent legislation and compliance, and the effects of the legislation on reduced indoor tanning by minors in the United States.

Indoor tanning is a well-established cause of skin cancer (1-8,10). Most tanners begin indoor tanning as teens or young adults (22). In order to reduce indoor tanning and protect this at-risk population, indoor tanning is currently being regulated in two ways. First, some states restrict access by minors or require parental consent or accompaniment (11). Second, the Food and Drug Administration (FDA) attempts to minimize harm from indoor tanning devices with precautions like protective eyewear and session duration limits (12).  Recent evidence suggests that more stringent indoor tanning laws such as age bans (vs. parent consent laws or no law) are associated with less youth indoor tanning (15,16). Unfortunately, enforcement and compliance with laws are variable and inadequate (9,17-21). Although underutilized (13), legislation such as age restrictions and taxation has been quite successful in decreasing engagement in other risky behaviors such as smoking (14).

The goals of this five-year research project are to (1) clarify the indoor tanning legislation adoption process, (2) employ a pseudo-patron assessment, national survey, and archival data to investigate legislation implementation, and (3) integrate data from the first two aims and external data to assess economic effects relevant to policy sustainability of indoor tanning stringency, enforcement, and compliance.

Health-related policy adoption and promotion is an effective, yet underutilized, strategy for health promotion. To protect the public from melanoma and non-melanoma skin cancer, government bodies have begun to enact legislation to restrict minor access to indoor tanning and minimize harm from indoor tanning devices. In order to contribute to the currently limited evidence base for future policy decision making and sustainability and to accelerate reductions in indoor tanning and sunburn, this project will address policy characteristics associated with regulation compliance, cost-benefits of these policies, and barriers and facilitators of policy adoption.

This research project is funded by the National Cancer Institute (CA244370; Dr. Carolyn Heckman, Rutgers University, and Dr. David Buller, Klein Buendel, Multiple Principal Investigators). Collaborators include Dr. Rich Meenan from the Kaiser Permanente Center for Health Research; Dr. Jared Stapleton from the University of Kentucky; Dr. Shawna Hudson, Dr. Cristine Delnevo, and Dr. Kevin Schroth from Rutgers University; and Julia Berteletti from Klein Buendel.


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