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Month: April 2021

Long-term Effects of a Social Media Campaign for Mothers to Prevent Indoor Tanning by Teens in a Randomized Trial

Long-term Effects of a Social Media Campaign for Mothers to Prevent Indoor Tanning by Teens in a Randomized Trial

Indoor tanning (IT) increases risk of developing melanoma, yet IT remains popular with some teen girls. Mothers can influence IT initiation. Dr. David Buller, Director of Research at Klein Buendel, presented long-term effects of a social media intervention for indoor tanning at the 42nd Annual (Virtual) Meeting & Scientific Sessions of the Society of Behavioral Medicine, April 12-16, 2021.

Several states require parents to consent or accompany minor children using IT facilities. Health Chat, a social media campaign was tested that aimed to reduce mothers’ permissiveness for their teen daughters to indoor tan, decrease mothers’ and daughters’ IT behavior, and increase mothers’ support for bans on IT by minors. A sample of mothers (n=869) with daughters aged 14-17 in 34 states without bans on IT by minors were enrolled in a 12-month randomized trial.

All mothers received a campaign on adolescent health in Facebook private groups containing posts on a variety of health topics (for example, substance abuse or mental health) and mother-daughter communication. In the intervention group, the campaign included posts about preventing IT, whereas in the control group, it included posts about preventing prescription drug misuse. Long-term effects were assessed by comparing mothers’ responses at baseline to responses at 18-months post-randomization. Measures assessed permissiveness for daughters to indoor tan, self-efficacy for refusing permission for IT, communication with daughters about avoiding IT, attitudes and intentions toward IT, IT behavior, and support for state bans on IT by minors. The daughters (n=469) only completed baseline and follow-up assessments.

At the 18-month follow-up, intervention-group mothers were less permissive of IT by daughters, reported more communication with daughters about avoiding IT, had greater self-efficacy to refuse daughter’s request for IT, expressed less positive attitudes toward IT, had lower intentions to indoor tan, and were more supportive of bans on IT by minors under age 18 than control-group mothers. At 18-months, daughters in the intervention group had less positive attitudes toward IT than in the control group.

Social media may be an effective channel to convince mothers to withhold permission for IT by daughters and thus reduce IT by minors in states requiring parental permission provided IT facility operators request this permission. Increased support among mothers for bans on IT might facilitate efforts to place more restrictions on IT.

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

Experiences from the Health Chat Intervention

Experiences from the Health Chat Intervention

Dr. David Buller, Director of Research at Klein Buendel, presented experiences from the Health Chat Intervention during a symposium at the 42nd Annual (Virtual) Meeting & Scientific Sessions of the Society of Behavioral Medicine, April 12-16, 2021. Health Chat is a social media intervention for mothers and their teenage daughters designed to influence their decisions related to indoor tanning.

Despite declines in recent years, indoor tanning (IT) remains popular with some adolescent females. IT initiation can be influenced by mothers’ permissiveness toward IT and IT behavior. Social media is a popular channel with mothers for adolescent health information. Our research team developed a series of social media posts to prevent IT and evaluated their impact on mothers’ permissiveness, mothers’ and daughters’ IT attitudes, intentions, and behavior, and mothers’ support for bans on IT by minors. Investigators used an iterative method to develop theory-based social media posts, based on diffusion of innovations theory, social cognitive theory, and transportation theory of narratives.

Two innovative research techniques were employed. First, to stimulate engagement with the IT messaging, posts were embedded in a larger social media campaign on adolescent health (for example, substance abuse, diet and physical activity, and mental wellness), with 2-3 posts on IT (about 113 posts total) among the 14 health posts per week (about 710 posts total). Frequency and currency of IT posts were adjusted to avoid message fatigue and disengagement. Second, the campaign was delivered to in two Facebook private groups to create experimental separation, with control-group mother receiving posts on preventing prescription drug misuse. Recruitment was challenging with initial community-based techniques (such as schools, community groups/events, and out-calls) being largely unsuccessful.

The sample of mothers (n=869) was ultimately obtained from the Qualtrics Internet Panel from 34 states without bans IT by minors. They completed assessments at baseline and 12- and 18-months post randomization. Daughters were invited to complete baseline and follow-up assessments but just over half did so at baseline. Most mothers (87%) stayed in the private groups for the entire 12-month campaign and 277 mothers engaged with the IT posts. The effects of the IT posts in 12- and 18-months follow-ups were most evident in mothers’ reduced permissiveness and increased communication with daughters about the harms of IT. It also reduced mothers’ intentions to indoor tan. At the long-term follow-up, the campaign increased mothers’ support for bans on IT by minors and self-efficacy to refuse IT request from daughters. While there was no direct effect on mothers’ or daughters’ IT behavior, these changes may serve to prevent daughters from engaging in IT in the future. They also could help to support public policy efforts to curb further IT by minors.

This research project is funded by a grant and supplement from the National Cancer Institute (CA192652; Dr. David Buller and Dr. Sherry Pagoto, Multiple Principal Investigators).

Listen to the Health Chat presentation:

Baseline Survey of Managers on Occupational Sun Protection in a Randomized Trial of Scale-up

Baseline Survey of Managers on Occupational Sun Protection in a Randomized Trial of Scale-up

Scale-up is the effort to increase the impact of successful prevention interventions to benefit more people on a lasting basis. Successful and affordable methods for scaling-up evidence-based programs are needed to prevent skin cancer among adults, particularly those who work outdoors in the sun.

Dr. David Buller, Director of Research at Klein Buendel, presented baseline findings from the scale-up of an occupational skin cancer prevention program at the 42nd Annual (Virtual) Meeting & Scientific Sessions of the Society of Behavioral Medicine, April 12-16, 2021.

A randomized trial is being conducted to compare two methods of scaling up, nationwide, an effective occupational sun protection intervention, Sun Safe Workplaces, that promotes policy and education for outdoor workers. Departments of Transportation (DOTs) from 21 U.S. states are participating and their 138 regional districts were randomized following baseline assessment. The state DOTs range in size from 997 to 18,415 employees. At baseline, 1,113 managers (49.0%) completed the pretest. Managers were generally supportive of occupational sun safety policy, but also felt employees should take action on their own on sun protection. A minority reported that their DOT had a written policy or standard operating procedure on occupational sun protection. Just over half reported that the DOT provided training on sun safety to employees and/or managers and supervisors. About two-thirds reported that the DOT provided messaging on sun protection and sun protection resources, such as sunscreen, clothing, hats, or eyewear. Other sun safety actions were less commonly reported (for example, provision of shade, UV Index monitored and outdoor work activities adjusted, or employees encouraged to regularly check skin for signs of skin cancer.

Occupational sun exposure receives some attention at DOTs, mainly in the form of training and provision of sun safety resources. However, it appears that several employees may not be practicing sun protection because of lack of policy and/or sun safety prevention efforts. Policy on occupational sun safety is less common, despite the link of solar UV to skin cancer. Health promotion approaches that incorporate policy with education might help to improve implementation of sun safety at the workplace.

This research project (CA210259; Dr. David Buller, Principal Investigator) is funded as part of the National Cancer Institute’s Cancer Moonshot Initiative, which aims to accelerate cancer research in order to make more therapies available to patients, while also improving the ability to prevent cancer and detect it at an early stage. Collaborators on the conference presentation include Dr. Richard Meenan from Kaiser Permanente’s Center for Health Research, Dr. Gary Cutter from Pythagoras, Inc., Dr. Sherry Pagoto from the University of Connecticut, and Ms. Mary Buller, Ms. Julia Berteletti, Ms. Rachel Eye, and Dr. Barbara Walkosz from Klein Buendel. This baseline data is published in Contemporary Clinical Trails.

Listen to the Research Spotlight presentation.

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.

Using Project Management Skills in Behavioral Research

Using Project Management Skills in Behavioral Research

Research projects have various moving parts throughout their lifespan needing to be completed within a certain timeframe and budget as outlined in the grant awarded. Project management skills are crucial in ensuring all phases, tasks, and logistics of a research project are organized and completed within deadline and scope.

The workload of a project is driven by how each aim breaks down into a phase, each with its own specific deliverables to be fulfilled and unique timeline to be met. As each phase of a project moves forward, the responsibilities are often compounded due to overlapping timelines, creating an increased need to think ahead and utilize efficient multi-tasking and organizational skills.

Research Project Management Phases

  • Determining and communicating the scope derived from the grant aims and methods;
  • Developing timelines;
  • Protocol development (such as recruitment, screening, data entry, intervention, data management, and adverse event processing);
  • Obtaining necessary institutional approvals;
  • Staff identification/hiring, training, and evaluation;
  • Goal setting including incremental goals as well as larger overarching goals;
  • Project implementation;
  • Delivering objectives including communication of progress toward objectives;
  • Tracking budgeted and expended costs;
  • Required reporting to aid in communicating progress; and
  • Problem-solving as issues inevitably arise.

Communication is a key component to ensuring a smooth flow of the deliverables throughout the project. All personnel on a project need to maintain the same vision and goals. This can often be accomplished using regular meetings, phone calls, emails, and reports. Beyond the regular means of communication, a more comprehensive system such as project management software can be used to keep track of deliverables and deadlines.

Klein Buendel Research Program Manager, Julia Berteletti, organized and participated in a research project management Pre-Conference Workshop at the virtual 42nd Annual Meeting and Scientific Sessions of the Society of Behavioral Medicine (SBM), April 12-16, 2021. Her co-presenter was Jessica Bibeau from the University of Connecticut. The presenters have been coordinating multi-site research projects from coast-to-coast with each other for several years. Ms. Berteletti explained, “Our projects run on effective partnerships. Facilitating teamwork is one of my favorite parts of my job. It meant a lot to me for us to share our methods for effective collaboration and project management with other research teams.” The SBM seminar provided a guide for managing a research project using a project management approach which included: (a) understanding the scope, (b) setting goals, (c) considering the costs, (d) implementation (intervention/data collection), and (e) close-out. A hypothetical project was used to present each part of the approach. Team organization, communication, important considerations, timelines, charts, and reports were reviewed to aid in organization, and project management software ideas were provided along with a tutorial of the Basecamp software.

Advisory Boards and Usability Testing of an E-Training Program for End-of-Life Care in Prisons

Advisory Boards and Usability Testing of an E-Training Program for End-of-Life Care in Prisons

The 14th Annual Academic and Health Policy Conference on Criminal Justice Health, hosted by the Academic Consortium on Criminal Justice Health, was held virtually on April 8-10, 2021. Susan J. Loeb, PhD, RN, FGSA, FAAN, from the Penn State College of Nursing gave two presentations on research conducted in collaboration with Klein Buendel Senior Scientist, Valerie Myers, PhD. The presentations were titled, “Planning, Maximizing, and Sustaining Advisory Boards to Inform and Facilitate Research in Prisons” and “Usability Testing of an E-Training Package to Enhance Geriatric and End-of-Life Care in Prisons.” 

Planning, Maximizing, and Sustaining Advisory Boards to Inform and Facilitate Research in Prisons 

Dr. Susan J. Loeb discussed working with Advisory Boards for research in prisons. Advisory Boards are comprised of targeted stakeholders who collaborate with researchers to promote cultural awareness, consideration of environmental facilitators and constraints, and the upholding of ethical responsibilities to keep the best interests of research participants at the forefront. 

Effective partnering with Advisory Boards can promote entrée and execution of corrections research and enhance the credibility, relevance, and translation of study findings. The team systematically considered stakeholders who were engaged on Advisory Boards across four previous NIH-funded studies to assess how to promote stability, infuse fresh perspectives, refine the focus of consultation, and extend the array of research settings during an era when in-person meetings were not feasible due to a pandemic. 

Adopting multiple advisory boards with unique foci and constituted by people possessing expertise in a focused area, allows for laser-focused videoconference meetings. While virtual meetings may not afford the same intensive opportunities for relationship building that on-site meetings do, the former does lessen travel-related budgetary, logistical, and time burdens. 

The research team concluded that teaming with and sustaining a diverse array of community stakeholders is a key strategy for generating science that is tailored to address the health needs and promote health equity for people living in prisons. 

Usability Testing of an E-Training Package to Enhance Geriatric and End-of-Life Care in Prisons 

Dr. Susan J. Loeb presented on usability testing and best practices of a full-scale media-rich interactive computer-based learning system for corrections staff in response to the growing population needing geriatric and end-of-life (EOL) care in prisons, which are not consistently adopted. The training is called, Enhancing Care of the Aged and Dying in Prisons (ECAD-P). 
The research team conducted face- to- face usability testing of the 6-module ECAD-P training with corrections staff in two rounds at two correctional facilities in different states. The System Usability Scale (SUS) was administered to assess usability and acceptability of ECAD-P. Full scale testing included 173 participants at seven state prisons who completed cognitive and posttest measures and the SUS. 
The mean SUS score was 75.10 in the face-to-face usability testing, which indicated a high level of acceptability and usability since a score of 68 is above average. For the large-scale testing, cognitive posttest scores were significantly higher than cognitive pretest scores. At posttest, affective measures were significantly higher than at pretest. The mean SUS score for the full-scale testing was 69.34. 

The corrections environment is not technology-rich; however, prison administration and staff are accustomed to and receptive of computer-based learning (a frequently used delivery platform for mandatory training sessions). Therefore, the research team concluded the ECAD-P product is acceptable, feasible, and usable in corrections.  

The research presented at ACCJH was funded by multiple SBIR/STTR grants to Klein Buendel from the National Institute on Aging (AG049570; AG057239; Dr. Susan J. Loeb and Dr. Valerie Myers, Multiple Principal Investigators). Collaborators on the two presentations also included Dr. Erin Kitt-Lewis, Sherif Olanrewaju, and Katherine Fiochetta from Penn State University; and Jeannyfer Reither and Savanna Olivas from Klein Buendel.