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Month: January 2025

Design of a high-resistance inspiratory muscle strength training app

Design of a high-resistance inspiratory muscle strength training app

Dr. Kayla Nuss, Klein Buendel Scientist, and a collaborative research team from Klein Buendel and the University of Colorado Boulder have published a paper on the feasibility and design of a novel smartphone app to deliver blood pressure-lowering high-resistance inspiratory muscle strength training in the journal mHealth.

High-resistance inspiratory muscle strength training (IMST) is a time-efficient form of respiratory exercise shown to lower blood pressure in midlife and older adults (aged ≥50 years) in randomized controlled trials delivered in clinical research settings. The purpose of this study was to design a feasible and acceptable smartphone application (app) for independently delivering IMST for lowering blood pressure.

Two rounds of iterative focus groups comprised of midlife and older women and men with above-normal systolic blood pressure (self-reported ≥120 mmHg) were performed to gain feedback on interest in an IMST smartphone app and design features. Focus group results were analyzed using a Consensual Qualitative Research (CQR) coding and data analysis protocol. Clickable wireframes were developed based on focus group findings. The wireframes were then beta tested for usability and additional feedback from target users was obtained.

Among midlife and older adults, there was considerable interest in app-delivered IMST as a
lifestyle intervention for lowering blood pressure. Potential facilitators and barriers of use for a potential app also were uncovered. Furthermore, the app wireframes were found to be highly usable, indicating that the app is ready for full-scale programming. Detailed research methods, analyses, and results of this research are reported in the mHealth paper. In conclusion, the authors report that they have designed a feasible and acceptable smartphone app for independently delivering blood pressure-lowering IMST in midlife and older adults.

The research is supported by an STTR grant to Klein Buendel from the National Heart, Lung, and Blood Institute (HL167375; Dr. Douglas Seals, Principal Investigator, from the University of Colorado Boulder). The authors are Dr. Kayla Nuss, Amanda Brice, and Steven Fullmer from Klein Buendel; and Elizabeth Jones, CeAnn Udovich, Dr. Kaitlin Freeberg, Narissa McCarty, Dr. Douglas Seals, and Dr. Daniel Craighead from the Department of Integrative Physiology at University of Colorado Boulder.

Analysis of Indoor Tanning Legislation in the United States

Analysis of Indoor Tanning Legislation in the United States

Dr. David Buller, Klein Buendel Director of Research, and a national team of scientists, physicians, and attorneys, have published an article in the American Journal of Public Health that describes the progression, content, and stringency of state legislation regulating indoor tanning in the United States.

Skin cancer is a highly prevalent, potentially deadly, and expensive disease. Indoor tanning is a well-established cause of melanoma and keratinocyte (non-melanoma) carcinomas. In the most recent estimates, nearly 6% of adolescents and 5% of adults indoor tan. Most individuals begin indoor tanning as adolescents or young adults. Stringent state indoor tanning laws that include age bans for minors instead of just parental consent are associated with less indoor tanning.

For this study, trained research assistants used legal mapping methods to collect and code legislative bills on indoor tanning introduced in U.S. states, the District of Columbia, and Puerto Rico. The research aimed to (1) describe the progression of state indoor tanning legislation (enacted or failed); (2) detail the content and stringency of bills with special attention to whether bills banned indoor tanning by minors (individuals aged younger than 18 years (under-18 ban); and (3) explore the potential impact of political party affiliation of state government leadership when bills were proposed.

Between 1992 and 2023, 184 bills were introduced in 49 of 50 states and the District of Columbia (56 laws were enacted, and 126 bills failed). An under-18 ban was enacted in 22 states and the District of Columbia. Analyses calculated composite scores on the stringency of age restrictions and of warnings, operator requirements, and enforcement. The research team evaluated associations of the political party of the legislative sponsor and legislature majority. Specific methods, coding protocols, statistical analyses, results, conclusions, limitations, and public health implications are detailed in the American Journal of Public Health paper.

In many states, it took several years and proposed bills before a law on indoor tanning was enacted. Enacted bills were more stringent than failed bills. Party affiliation of the bill sponsor and legislature majority combined to affect bill passage and age restrictions. Increasing support for stringent regulations on indoor tanning is evident and may motivate other states or the federal government to prohibit minors from using indoor tanning facilities in an effort to improve health and prevent death.

This research was supported by a grant to Rutgers University from the National Cancer Institute (CA244370; Dr. Carolyn Heckman and Dr. David Buller, Multiple Principal Investigators). Paper authors include Dr. Carolyn Heckman, Ms. Anna Mitarotondo, and Mr. Kevin Schroth from Rutgers University; Mr. Alan Geller from Harvard University; Dr. Jerod Stapleton from the University of Kentucky; Ms. Samantha Guild from the AIM at Melanoma Foundation in Texas; Dr. Jeffrey Gershenwald from the MD Andersen Cancer Center at the University of Texas; Dr. Robert Dellavalle from the University of Minnesota; Dr. Sherry Pagoto from the University of Connecticut; and Dr. David Buller, Ms. Julia Berteletti and Ms. Irene Adjei from Klein Buendel.

Recruitment Challenges for Project SHINE

Recruitment Challenges for Project SHINE

Dr. David Buller, Klein Buendel Director of Research, is part of a multiple institution research team that published a paper on recruitment challenges for Project SHINE. The research team is led by Dr. Yelena Wu from the University of Utah and the Huntsman Cancer Institute. The paper entitled, “Challenges and lessons learned in recruiting participants for school-based disease prevention programs during COVID-19,” was published in Contemporary Clinical Trials.

Schools provide an ideal setting for delivery of disease prevention programs due to the ability to deliver health education and counseling, including health behavior interventions, to large numbers of students. However, the remote and hybrid learning models that arose during the COVID-19 pandemic created obstacles to these efforts. The Contemporary Clinical Trials paper provides insights on collaborating with schools to deliver disease prevention programming during the height of the COVID-19 pandemic, and in subsequent years. The authors illustrate recruitment and engagement strategies by drawing upon their research experiences engaging high schools in a school-based cancer prevention trial focused on sun safety.

Delivery of a cluster-randomized trial of a school-based skin cancer prevention program was initiated in the spring of 2020 at the onset of the COVID-19 pandemic in the United States. The authors present multilevel evaluation data on strategies used to reach schools remotely and share lessons learned that may inform similar approaches moving forward during times of crises.

Although the COVID-19 pandemic interrupted school-based recruitment for this trial, enrollment improved one year later and did not appear to differ between rural and urban schools. Recruitment strategies and trial-related procedures were modified to address new challenges brought about by the pandemic. Despite the COVID-19 crisis altering classrooms, disease prevention programming can continue to be offered within schools, given close community partnerships and new adaptations to the ways in which such programming and research are conducted.

This research is sponsored by the National Cancer Institute (Dr. Yelena Wu from the University of Utah and the Huntsman Cancer Institute, Principal Investigator). Dr. David Buller from Klein Buendel is a Co-Investigator.