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Custody & Caring Conference

Custody & Caring Conference

A research team from Penn State University and Klein Buendel gave three presentations on their recent work related to the care of persons aging and dying in prison at the 18th Biennial International Conference on the Nurse’s Role in the Criminal Justice System. The Custody & Caring Conference was held in Saskatoon, SK, Canada on September 20-23, 2023.

Podium Presentation and Poster 1

“Small-Scale Usability Testing: E-learning Modules for Peer Caregivers”

Growing numbers of people globally will grow old and die while incarcerated. Research evidence supports using peer caregivers to assist staff with geriatric and end-of-life care. Currently, peer caregiver training varies widely in content and duration. Evidenced-based, accessible, and contextually relevant materials are needed to effectively prepare the caregivers. This study’s purpose was to conduct research and development of Just Care, a six-module e-learning program for peer caregivers and a single module to guide corrections staff in implementing the program. University IRB, U.S. Department of Health & Human Services, and Department of Corrections permissions were obtained, and participants signed informed consent. Deputy Wardens assisted in identifying people meeting our inclusion criteria. Nineteen people living in prison and 11 staff took part in the usability testing of the progam. Researchers directed participants to share their thoughts aloud. Field notes were taken. Participants completed six open-ended questions and the System Usability Scale (SUS).

Findings focused on functionality, design, and content of Just Care. All users easily navigated through the program with minimal guidance. Many noted Just Care’s utility for future peer caregivers. Challenges faced were clustered by level of severity from 1-3 (1=most; 3=least severe). There were no severity-level 1 issues in either round. In Round 1, Just Care received a SUS score of 87.5 by incarcerated users and 74.5 by staff. A SUS score of 68 is an above average score. Following rapid refinement, Round 2 incarcerated participants scored Just Care at 85.28 while staff scored it at 83.75. Some incarcerated users had difficulty navigating the post-test assessments in Round 2. A few staff users noted liking the additional resources available via links to PDFs. One staff user voiced concern about the safety of having incarcerated people help with care. Overall, participants found Just Care easy to navigate with interactive content that is very useful, engaging, and relevant to providing geriatric and end-of-life care in prisons. Staff also noted that Just Care raised awareness about the growing need for programming on geriatric care in prisons and that a peer caregiver program like Just Care is a viable solution that is implementable by prison staff.  

Poster 2

“Determining Priority Dementia Care Training Needs for Correctional Staff and Peer Caregivers”

People aged 50 and older in prisons are at particular risk for developing Alzheimer’s Disease and Related Dementias (ADRD) due to several social determinants of health. The number of patients in prison with ADRD is not known. This situation can likely be attributed to many corrections health, social, and security staff lacking the requisite skills for identifying ADRD. Dementia care inequities between prisons and community settings need to be addressed. A standardized, feasible, and acceptable ADRD education program developed for those caring for and/or managing people who are incarcerated and living with ADRD is a pressing need.

The key purpose of the research was to identify three priority learning needs of multidisciplinary prison staff to provide enhanced management and care for people living with ADRD in prisons which also represented the critical learning needs of peer caregivers so that they may assist staff with ADRD care. The study also sought to identify a logo to brand the new Just Care for Dementia training. The third outcome was to translate best practices from community-based ADRD care into accessible and relevant content for training staff and peer caregivers that is evidence-based and can be programmed into highly interactive prototype e-learning modules that fit within the restrictive context of corrections. Focus group methodology facilitated potential future users input to aid us in ensuring the content, design, and technology plans match the needs and constraints of prison. Approvals were secured from the: Institutional Review Board; federal government; and Department of Corrections. Participants provided signed informed consent. The settings were one men’s and one women’s state prison in the United States. Twelve interdisciplinary staff and 11 peer caregivers participated.

Thematic analyses revealed three priority content areas: fostering a safe and calm environment; addressing behavioral and psychological symptoms of dementia; and enhancing awareness of need. Insights on nine showcased logos revealed two clear preferences. Consultation with the study’s advisory board informed final logo selection for branding the Just Care for Dementia e-learning product. In conclusion, participants confirmed the need for a such a training program and indicated this is a viable approach to addressing a pressing training and related care need in prisons.

This research was funded by an STTR grant to Klein Buendel from the National Institute on Aging [AG057239; Dr. Susan Loeb (Penn State) and Dr. Barbara Walkosz (Klein Buendel), Multiple Principal Investigators]. Collaborators on the presentation and posters also included Dr. Erin Kitt-Lewis, Mr. Sherif Olanrewaju, and Ms. Katherine Aiken from The Penn State University; and Mr. Brandon Herbeck, Ms. Amanda Brice, and Mr. Steve Fullmer from Klein Buendel.  

Social Media IN-SERVICE TRAINING for Responsible Alcohol Serving

Social Media IN-SERVICE TRAINING for Responsible Alcohol Serving

Among prevention strategies for driving while intoxicated (DWI), responsible beverage service (RBS) training has been effective in some cases. A research team from Klein Buendel and the Pacific Institute for Research and Evaluation (PIRE) reported on the results of a pilot project to create an in-service professional development social media component for the online evidence-based RBS training, WayToServe®, at the 46th Annual Research Society on Alcohol Scientific Meeting held in Bellevue, Washington on June 24-28, 2023.

In-service support beyond initial RBS training may counter management disinterest or resistance to RBS. A prototype of the WayToServe Plus in-service professional development social media component was produced by the authors. It contained 51 social media posts on advanced RBS skills training (such as home delivery), experienced servers supporting new servers (such as tips and tricks), professionalism (such as handling disruptive customer), and basic management procedures (such as house policies). Messages were intended to (a) increase confidence and motivation to implement RBS methods, (b) create a professional community of servers supporting RBS actions, and (c) prevent degradation of RBS skills and motivation. Thirty-six (36) posts contained text, graphics, and/or links, 14 had TikTok-style videos, and one presented an interactive learning activity from the WayToServe training.

One hundred eleven (111) alcohol servers who completed WayToServe training in New Mexico or Washington State participated in a 4-week pilot test. Participants were enrolled in either a Facebook private group with the WayToServe Plus feed and online posttest survey (n=60 servers) or in a control group with the posttest survey only (n=51 servers). WayToServe Plus posts were posted once a day, Monday to Friday. All servers in the WayToServe Plus group (100%) followed the feed for all 4 weeks; 83.3% viewed a post; and 46.7% reacted/commented on a post. WayToServe Plus servers expressed increased self-efficacy for RBS practices and response efficacy for RBS reducing DWI compared to control servers. Servers felt WayToServe Plus was appropriate and usable, and 77.9% were likely to use it in the future.

In-service professional development delivered over social media is feasible with alcohol servers and has the potential to maintain and support RBS techniques during intervals between state-approved RBS training.

This research was supported by a grant to Klein Buendel from the National Institute on Alcohol Abuse and Alcoholism (AA029364; W. Gill Woodall and David Buller, Multiple Principal Investigators). Additional authors on the conference poster include Dr. Robert Saltz from the PIRE Prevention Research Center in Berkley, California, and Ms. Lila Martinez from Klein Buendel.



Driving while intoxicated (DWI) remains a preventable source of morbidity and mortality in the United States. The Ignition Interlock Device (IID) requires a driver to blow into a breathalyzer installed in a vehicle to establish sobriety and reduces drunk driving while installed. The use of IIDs has become widespread. Most states now require DWI offenders to install IIDs in their cars. 

However, once IIDs are removed, DWI recidivism levels return to those similar to offenders who had no IID installed. The B-SMART app has been systematically developed for DWI offenders and their Concerned Family Members (CFMs) to extend non-intoxicated driving beyond the IID installation period. 

B-SMART Module Topics

  • Life with the Interlock – orientation to Ignition Interlock Devices
  • Family processes to support changes in drinking
  • Effective communication skills for families
  • Finding family activities that do not involve alcohol 

Results of a randomized trial of the B-SMART app on a variety of alcohol consumption, IID, and family communication variables were reported by Dr. W. Gill Woodall, Klein Buendel Senior Scientist, at the 46th Annual Research Society on Alcohol Scientific Meeting held in Bellevue, Washington on June 24-28, 2023.

Study participants, who were pairs of DWI Offenders and CFMs, were randomly assigned to receive the B-SMART web app or an available IID information page from the New Mexico Department of Transportation (Usual and Customary/UC condition). Participants were assessed at baseline, 3 months, and 9 months. 

Analyses of alcohol consumption variables yielded two results on alcohol quantity frequency with available data. For average drinks per day during the last 30 days at the 3-month assessment, a near significant between groups difference was detected such that client participants in the UC group reported significantly higher drinks per day when drinking than B-SMART intervention client participants. A second alcohol consumption effect was found for reported average drinks per week, where UC participants reported increasing average weekly drinking from baseline to 3-month follow-up, while intervention participants reported no significant change in average drinks per week from baseline to 3-month follow-up. Results suggest that the B-SMART app may improve outcomes for DWI offender families.

This research was funded by the National Institute on Alcohol Abuse and Alcoholism (AA022850; Dr. W. Gill Woodall, Principal Investigator). Dr. Woodall’s scientific collaborators include Dr. Barbara McCrady and Dr. Vern Westerberg from the University of New Mexico, and Ms. Julia Berteletti, Ms. Marita Brooks, and Ms. Lila Martinez from Klein Buendel.

Changes in patients’ family communication after offer of skin cancer genetic test

Changes in patients’ family communication after offer of skin cancer genetic test

Melanoma is a serious preventable form of skin cancer. Genetic testing for skin cancer risk may help increase awareness. A team led by Dr. Jennifer Hay from the Memorial Sloan Kettering Cancer Center, and including Dr David Buller from Klein Buendel, examined how an offer for testing for the melanocortin-1 receptor gene (MC1R) may have enhanced communication surrounding skin cancer within families. The research team presented a poster of their findings at the 44th Annual Sessions and Meeting of the Society of Behavioral Medicine in Phoenix, Arizona on April 26-29, 2023.

The study examined frequency targets (which family member) and topics of family communication around skin cancer at a 3-month follow-up within a New Mexico study that randomized primary care patients (N=600; 48% Hispanic) to MC1R test invitation or usual care (Aim 1). Frequency and targets were assessed on 4-point scales (“not at all” to “a lot”) asking participants how often they talked with family and with each target. Topics were assessed by asking participants whether they discussed a series of topics with family. The impact of usual care genetic test refusal and test results (average or higher risk feedback) on frequency targets and topics of family communication was assessed using ANOVAs and Chi-Square tests (Aim 2).

Aim 1 analysis showed that at the 3-month follow-up the average frequency of overall family communication was between “a little” and “some”. The most common communication targets were spouses and children; the most common topic was sun protection. Aim 2 analysis showed no significant differences in communication frequency. However, communication targets who received high-risk feedback reported greater communication with their spouse compared to those in usual care. Lastly, the study found that certain topics of communication such as “who had skin cancer in the family” and “your own risk of getting skin cancer” were discussed more by those who had testing (both receiving average and high-risk feedback) than by those in usual care or by test refusers.

The findings provide important insight into family communication about skin cancer. The results indicate greater discussion with certain people and about certain topics when individuals had undergone genetic testing highlighting the potential role that genetic testing can play in fostering family communication. Future research could provide deeper insight into why individuals talk to certain people and about certain topics more than others as well as examine how family communication affects decision-making regarding offers for cascade genetic testing or interpretation of results.

This research was supported by a grant from the National Cancer Institute (CA181241; Dr. Jennifer Hay and Dr. Marianne Berwick, Multiple Principal Investigators). Authors in addition to Dr. Jennifer Hay include Ms. Caroline Salafia (poster presenter), Dr. Smita Banerjee, and Ms. Elizabeth Schofield from the Memorial Sloan Kettering Cancer Center; Dr. Andrew Sussman, Dr. Dolores Guest, and Dr. Keith Hunley from the University of New Mexico; Dr. Kimberly Kaphingst from the University of Utah; and Dr. David Buller from Klein Buendel.

Physical Activity Research with Apps and Wearable Trackers

Physical Activity Research with Apps and Wearable Trackers

Klein Buendel Scientist, Dr. Kayla Nuss, was a presenter or co-author on four panels, posters, and presentations at the 44th Annual Sessions and Meeting of the Society of Behavioral Medicine in Phoenix, Arizona on April 26-29, 2023. The presentations highlighted research Dr. Nuss conducted as a Post-doctoral Fellow at the University of Victoria in Canada before joining Klein Buendel as a Scientist in 2022.

Dr. Kayla Nuss at SBM

Presentation 1: Poster Session

“Examining the Effect of Daily Social Media Use of Physical Activity Behaviors: A Daily Diary Study”

Presenters: Ms. Rebecca Coulter, Dr. Sam Liu, and Dr. Kayla Nuss

Previous studies have assessed the effects of health-related social media use on physical activity; however the evidence remains mixed. Currently, little is known about how daily social media use influences daily physical activity behavior. Understanding the influence of social media use on physical activity behavior may help design future interventions. The objective of this study was to examine whether the daily consumption of health-related social media content is associated with daily physical activity behaviors. Results provided evidence that viewing health-related social media content can influence daily physical activity behavior – specifically , exercise intensity. The authors suggested that future studies should focus on within-person variations in behavior based on social media use.

Presentation 2: Symposium 1

“Contextual and Situational Motivation for Physical Activity in Wearable Activity Tracker Users: A Daily Diary Study”

Presenters: Ms. Rebecca Coulter, Dr. Sam Liu, and Dr. Kayla Nuss

Wearable activity trackers (WAT) were developed to support physical activity engagement but little is known about how WAT users are motivated for physical activity. The presenters have identified distinct motivational profiles among WAT users; but no study has assessed the relationship between contextual and situational motivation for physical activity. To evaluate this relationship, intensive daily survey methodology is needed. Understanding the relationship between contextual and situational motivation for physical activity is critical to improve the effectiveness of WAT. The objectives of the study were to: (1) evaluate the feasibility of collecting day-level situational motivation for physical activity using a customized mobile app made by a no-code app development platform; and 2) describe two levels of motivation (contextual and situational) in WAT users using the hierarchical model of motivation. The presenters hypothesized that they would identify distinct motivational profiles and that those profiles would predict differing levels of situational motivation. Collecting situational motivation for physical activity was feasible using a no-code mobile platform. WAT users vary in their contextual motivational profile for physical activity and these predict some types of situational motivation. They suggested that future research should further investigate physical activity motivation in WAT users to identify intervention opportunities. 

Presentation 3: Symposium 2

“Implementing Mobile Health Interventions and Observational Studies Using a No-code App Development Platform”

Presenters: Dr. Denver Brown, Dr. Sam Liu, Dr. Kayla Nuss, and Ms. Amanda Willms

Mobile health (mHealth) technology holds tremendous potential to deliver behavior health interventions and understand human behavior. However, a challenge facing researchers when conducting mHealth research is the resources required to develop and maintain mHealth apps. Specifically, a no-code mHealth research app development platform may enable researchers with no previous software programming skills to create apps through a graphical user interface. In this symposium, presenters discussed how a no-code app development platform, was created and used to co-design and implement physical activity mHealth interventions and conduct longitudinal observational studies to understand physical activity behavior. The first presenter provided an overview of the no-code mHealth research platform and discussed its development and usability testing. The second presenter discussed how the platform was used to co-design adaptive mHealth physical activity interventions. Dr. Nuss discussed how the platform was used to implement a daily diary study to examine changes in situational motivation for physical activity based on contextual motivational profile in current wearable activity tracker users over a 14-day period. The final presenter discussed how the platform was used conduct a longitudinal feasibility study examining the influence that first-year roommates have on one another’s device-measured physical activity behavior during the transition to university which included weekly surveys to capture dyadic relations.

Presentation 4: Paper Session

“Reflecting on Physical Activity across Two Years of the COVID-19 Pandemic: Predictors if Intention-Behavior Profiles”

Presenter: Dr. Ryan Rhodes

Co-authors: Dr. Sam Liu, Dr. Kayla Nuss, and Dr. Wuyou Sui

The COVD-19 Pandemic has affected how many people engage in regular moderate-to-vigorous intensity physical activity (MVPA). Understanding the correlates of various motivational and behavioral profiles is important to producing effective interventions. The purpose of this study was to predict current and dynamic (across two years of the COVID-19 Pandemic) intention and MVPA profiles using the multi-process action control (M-PAC) framework. Few participants increased MVPA across the pandemic and dynamic patterns of intention-MVPA profiles by pre-pandemic MVPA showed the presence of two at risk groups (relapsed non-intenders relapsed unsuccessful intenders) who have relapsed in MVPA. Collectively, the findings support the joint promotion of reflective regulatory and reflexive processes in the choice of behavior change techniques to promote post-pandemic MVPA intention and behavior. 

Stringency of State Indoor Tanning Laws

Stringency of State Indoor Tanning Laws

Approximately five million cases of skin cancer are diagnosed among Americans at a cost nearing $9 billion annually. Indoor tanning (IT) is a risk factor for skin cancer. Restricting IT facilities, especially access by minors, has been the subject of state laws. More stringent restrictions on youth access (for example, bans by age vs. parental consent laws) appear to be associated with reduced IT by youth.

Julia Berteletti and David Buller at SBM

A team led by Dr. Carolyn Heckman from Rutgers University and Dr. David Buller from Klein presented a poster characterizing the IT policy landscape of U.S. states at the 44th Annual Sessions and Meeting of the Society of Behavioral Medicine in Phoenix, Arizona on April 26-29, 2023. The poster was entitled “Comparison of the stringency of indoor tanning bills regarding minors that passed and failed in state legislatures over the last 30 years.”

The research team coded 107 state IT law documents and compared passed laws to failed bills (proposed but not voted on or proposed but voted down), using a validated coding tool that assessed the presence of age bans, parental consent/accompaniment, warnings, operator requirements, and enforcement. Component codes were scaled on 10-point stringency measures (0=no regulation, 10=very strong regulation). Component and total summed scores were calculated, with higher scores indicating more stringent IT restrictions.

Between 1991 and 2022, 46 states and the District of Columbia passed a law on IT, with 23 banning access to IT facilities by minors under age 18. By contrast, 60 bills on IT failed to pass in 31 states since 2008. However, stringency of laws is weak, overall, which may explain why recent research found low compliance of IT facilities with regulations and continued IT among minors. Failed bills without minor bans were less stringent than similar passed laws, on nearly all components. Failure may have presented advocates opportunities to improve stringency of subsequent bills and time to garner more support for IT restrictions. In fact, less stringent bills may have failed because they had less support from outside constituencies (for example, medical societies and public health advocates) and among legislators. To gain insight into this public health legislation process, we are interviewing key informants from states with recent policy activity.

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). Co-authors included Ms. Julia Berteletti from Klein Buendel and Ms. Anna Mitarotondo from Rutgers University.

Usability Testing of Just Care Modules in Prisons

Usability Testing of Just Care Modules in Prisons

Prison population demographics are shifting such that many people will grow old and spend their final days in prison. Research evidence supports using peer caregivers to assist prison staff with providing supportive care. However, the training received by peer caregivers varies widely. Evidenced-based, accessible, and contextually relevant learning materials are needed to effectively prepare peer caregivers for their role.

A research team from The Penn State University Ross and Carol Nese College of Nursing and Klein Buendel have developed Just Care, a six-module e-learning program designed to augment the face-to-face training that is typically provided to peer caregivers. Small-scale usability testing of the Just Care program was conducted with twenty men and women, who are incarcerated, and ten staff members at one men’s and one women’s state prison in a southeastern state. Two rounds of usability tests were conducted via a video-conferencing platform. The results of the usability tests were recently presented at the annual conference of Academic Consortium on Criminal Justice Health (ACCJH) in Raleigh, North Carolina on April 13-14, 2023.

Most users, who were incarcerated, did activities without aid and no tasks or programming issues were identified that made it impossible to use the application as intended. However, a few usability and content issues were noted including: (a) some users did find the x-ray scanner activity challenging when trying to drag the scanner across the body image to reveal symptoms as death approaches; and (b) a few staff users noted that the returning citizens’ video testimonials in the Staff Module lacked racial diversity.​

The System Usability (SUS) scores for each round respectively were 87.5 (incarcerated), 74.5 (staff); and 85.28 (incarcerated), 83.75 (staff). A SUS score of 68 is considered above average. Overall, both participant groups found Just Care easy to navigate with content that is interactive, useful, engaging, and relevant. Prison staff noted that Just Care raised awareness about peer caregivers’ need for training to help care for older people in prisons.

Next steps for the research team is to address the issues raised in the usability tests and prepare for large-scale usability testing to be conducted in state prisons in the summer and fall of 2023. This research was funded by an STTR grant to Klein Buendel from the National Institute on Aging [AG057239; Dr. Susan Loeb (Penn State) and Dr. Barbara Walkosz (Klein Buendel), Multiple Principal Investigators]. Collaborators on the ACCJH poster presentation also included Dr. Erin Kitt-Lewis, Mr. Sherif Olanrewaju, and Ms. Katherine Aiken from The Penn State University; and Ms. Amanda Brice and Mr. Steve Fullmer from Klein Buendel. 

Scaling Media Literacy in a School District Environment

Scaling Media Literacy in a School District Environment

Implementation science, the study of methods and strategies that facilitate the uptake of evidence-based practices, is emerging as a framework to study the application of media literacy. Implementation science emerged in the public health field, and is just becoming known and applied in media literacy programs.

A research team led by Dr. Tessa Jolls from the Center for Media Literacy in California, and including Dr. Barbara Walkosz from Klein Buendel, conducted a panel discussion at the Global Media Education Summit held March 2-4, 2023 at Simon Fraser University in Vancouver, Canada. The panel was entitled, “Implementation Science: The Road to Scaling in a District Environment.” Two additional panelists included Dr. Marilyn Cohen from the University of Washington and Ms. Heather Van Benthuysen from the Chicago Public Schools.

The research team discussed the rising field of implementation science and presented an example underway in a U.S. school district. Relying on theories of change and rigorous evaluations of programming that exemplify these theories of change, the panelists described how implementation science provides a solid foundation for dissemination, scaling, and helping media literacy take its rightful place as a central educational offering. The panelists illustrated how implementation science works to strengthen and sustain media literacy in schools.

The Global Media Education Summit is convened by the UK’s Centre for Excellence in Media Practice, in collaboration with a leading media education space, in a different country each year. In 2023, the School of Communication and the Community Engaged Research Initiative at Simon Fraser University hosted the event, in partnership with the McLuhan Foundation. The Global Media Education Summit brings together an international network of researchers, educators, and practitioners across all aspects of media education, media and digital literacies, youth media production and media and technology in education. As the leading global showcase for research, pedagogy, and innovation, the Summit explores the changing currents across media education and media literacy communities around the world.

EUROGIN HPV Panel Presentation

EUROGIN HPV Panel Presentation

Klein Buendel Senior Scientists, Dr. W. Gill Woodall and Dr. David Buller, presented two research projects in a panel discussion at the EUROGIN International Multidisciplinary HPV Congress on Feb 8-11, 2023 in Bilbao, Spain. The “Digital Interventions to Increase HPV Vaccination” panel featured four presentations and was moderated by Dr. Greg Zimet from the University of Indiana. Other Klein Buendel scientists and staff (at the time of abstract submission) contributing as co-authors included Dr. Barbara Walkosz, Ms. Marita Brooks, Ms. Lila Martinez, and Ms. Jeanny Reither. Klein Buendel employees’ names are bolded.

Presentation 1

Title: “Randomized Trials of HPV Vaccine Uptake Improvement: Web Apps for Parents and Young Adolescent Girls and Boys”

Presenter: W. Gill Woodall, PhD, Senior Scientist, Klein Buendel, Inc. Albuquerque, NM, USA

Co-authors: A. Kong, G. Zimet, D. Buller, L. Chilton, J. Reither, L. Martinez, M. Brooks

This presentation discussed the results of two randomized trials of parent-focused web apps to improve HPV vaccine uptake for young adolescents (ages 11-14).  For the first trial, the web app was tailored to parents and young adolescent girls, and in the second trial, the web app was tailored to parents and young adolescent boys. Results of both trials indicated significant web app impact on HPV vaccine uptake for adolescent girls and boys, as well as other vaccine uptake related variables.  The discussion included a consideration of web app content and tailoring to determine HPV vaccine uptake improvement.

Presentation 2

Title: “Successful technology-based rural patient HPV vaccination reminder intervention and social media assessment of strategies to reduce HPV vaccine misinformation”

Presenter: Deanna Kepka, PhD, MPH, University of Utah, Salt Lake City, UT, USA

Co-authors: K. Christini, E. McGough, B. Gibson, E. Warner, H. Brandt

This presentation described a multi-level and multi-component intervention that included healthcare team training activities and technology-based HPV vaccination reminders. Missed opportunities for HPV vaccination declined significantly from the pre-intervention to the post-intervention period. Participants who recalled receipt of an electronically delivered vaccination reminder had higher unadjusted odds of scheduling a visit compared with those who did not recall receiving a reminder. Social media-delivered misinformation related to HPV vaccination is pervasive. The presenters also discussed new strategies to evaluate and reduce the impact of HPV vaccine misinformation in rural settings.

Presentation 3

Title: “Promoting HPV vaccination to emerging adults in rural communities in a multi-risk factor cancer prevention social media intervention”

Presenter: David Buller, PhD, Senior Scientist, Klein Buendel, Inc., Denver, CO, USA

Co-authors: A. Sussman, D. Kepka, W. G. Woodall, E. Warner, B. Walkosz

This presentation described an innovative social media campaign targeting six cancer risk factors, including HPV vaccination. It is being developed for the diverse population of adults aged 18-26 in rural counties in the Mountain West region of the U.S. Emerging adults obtain health information online far more than information from health care providers and other media. A framework for social media message development was presented based on social cognitive, self-determination, and diffusion of innovation theory. Misinformation, especially on vaccination, will be combatted by instructing emerging adults in digital and media and by using an epidemiological model of monitoring and quickly responding to correct misinformation. The campaign will be tested with a sample of 1000 emerging adults in a stepped-wedge quasi-experimental design.

Presentation 4

Title: “U.S. National Digital Point of Care Communication to Improve Uptake of HPV and Other Adolescent Vaccines in Clinic Settings”

Presenter: Judy Klein, BA, BS, President, UNITY Consortium, Philadelphia, PA, USA

Co-authors: G. Zimet, V. Agadi, C. Hu, A. Jaramillo

This presentation reported on a study that involved digital targeted adolescent vaccination infographics and videos widely disseminated to clinical practices throughout the U.S. Over 11,000 clinicians whose practices received these digital interventions (exposed condition) were matched to an equal number of non-exposed comparison practices matched on multiple practice characteristics. The outcomes of interest were the number of vaccine doses (Tetanus-diphtheria-pertussis booster or Tdap, HPV, MenACWY, and MenB) administered to patients 11-18 years of age. The exposed clinics showed significant increases in administration of adolescent vaccines, including HPV vaccine, compared to the non-exposed clinics.

STAC Parent Module Pilot Study

STAC Parent Module Pilot Study

Klein Buendel collaborator, Dr. Aida Midgett from Boise State University, presented formative research findings from her CTR-IN Pilot Grant at the Mountain West CTR-IN Annual Meeting in Las Vegas, Nevada, November 17-18, 2022. Mountain West CTR-IN connects research investigators to mentors, collaborators, and funding opportunities to improve the health and lives of people in mountain west communities, including through research projects funded by the National Institutes of Health. Ms. Mary Buller, President of Klein Buendel, is Dr. Aida’s mentor for the CTR-IN Pilot Grant.

Dr. Midgett presented on the “Development, Acceptability, and Short-Term Outcomes of a Parent Module for Brief, Bullying Bystander Intervention for Middle School Students in Rural, Low-Income Communities.” Her co-author was Dr. Diana Doumas from Boise State University. The project statistician was Ms. Laura Bond from Boise State University. The pilot study used a mixed-methods design to develop a 30-minute pre-recorded Parent Module as a companion training to a brief bullying prevention program for middle schools, called STAC. The study assessed the need, feasibility, acceptability, delivery format preference and immediate outcomes (e.g., knowledge, attitudes, self-efficacy, and behavioral intentions) of the Parent Module.

As background, the STAC bystander intervention is a 75-minute training that includes didactic and experiential components. It teaches middle school students to act as “defenders” on behalf of targets of bullying through utilizing four intervention strategies: (1) “Stealing the Show” – using humor or distraction to interrupt a bullying situation and remove the attention away from the target; (2) “Turning it Over” – identifying a trusted adult at school, reporting, and asking for help during a bullying incident; (3) “Accompanying Others” – befriending and/or providing support to a peer who was a target of bullying; and (4) “Coaching Compassion” – gently confronting the perpetrator and increasing empathy for the target.

Dr. Midgett reported that preliminary data with 23 parents in the pilot study demonstrated acceptability, relevance, and need and increases in immediate post-training outcomes including knowledge, confidence, self-efficacy, responsibility, and anti-bullying attitudes, as well as parents’ behavioral intentions to support their adolescents to utilize the STAC strategies.

Another aim of Dr. Midgett’s CTR-IN pilot grant is to provide data to support a STTR Fast Track proposal to develop and evaluate a web-based version of the Parent Module as a STAC companion training. The proposal will be submitted through Klein Buendel and the research plan will include a multi-site randomized trial in rural schools. Klein Buendel’s Creative Team will program the web-based Parent Module.