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Computer-Based Training for Geriatric and End-of-Life Care in Prisons

Computer-Based Training for Geriatric and End-of-Life Care in Prisons

In a recent publication in the Journal of Correctional Health Care, authors from Penn State University, Indiana University, King’s College, and Klein Buendel share insights into the testing of a computer-based training for peer caregivers (PCs) in prisons to care for aged and dying prisoners. 

As the aged and dying incarcerated population increases, so does the demand on corrections health care. In the publication, the research team describes their process of conducting focus groups and performing usability testing with PCs and corrections staff members who ultimately helped identify the priority training topics.  

The focus groups, in consultation with an Expert Advisory Board, led to the creation of three prototype modules: Standard Precautions; Loss and Grief; and Role of the Inmate Caregiver in the Final Hours. Following the focus groups, face-to-face usability testing was conducted with PCs and staff who confirmed the contextual training relevance and feasibility of the computer-based training program. 

The team concluded that the computer-based training, Inmates Care, provides evidence to complement nurse-led training within the corrections setting with a standardized e-training package. A full description of the methods, results, discussion, strength and limitations, and conclusions can be found in the publication.  

This research was funded by a Phase I grant from the National Institute on Aging (AG057239). The project was led by Principal Investigator Dr. Susan Loeb from Penn State University and Co-Investigator Dr. Valerie Myers from Klein Buendel. Additional authors include Dr. Erin Kitt-Lewis from Penn State University, Tiffany Jerrod from Klein Buendel, Dr. Rachel Wion from Indiana University, and Dr. Julie Murphy from King’s College. 

Results of a social media campaign to prevent indoor tanning by teens

Results of a social media campaign to prevent indoor tanning by teens

Results of the Health Chat social media intervention to reduce mothers’ permissiveness toward their teen daughters’ indoor tanning (IT) behavior have been published in Preventive Medicine Reports.

During the intervention, participating mothers received an adolescent health social media campaign in Facebook private groups. Half of the mothers were in a group in which the health campaign included posts about preventing IT (intervention) and the other half, included posts on preventing prescription drug misuse (control). Health Chat was designed by the research team based on an integrated conceptual framework of social cognitive theory, transportation theory, and diffusion of innovations theory.

Given mothers’ high use of social media, the research team, led by Klein Buendel Director of Research, Dr. David Buller, and Dr. Sherry Pagoto from the University of Connecticut, evaluated a social media campaign aimed at mothers to prevent IT by their daughters in a randomized trial that tested two hypotheses:

H1: The social media campaign on IT will significantly reduce (a) mother’s permissiveness regarding their daughter’s IT, (b) their daughter’s perception of maternal permissiveness toward IT, and (c) both mother’s and daughter’s IT relative to the control condition.

H2: A statistically significantly greater number of mothers will support a ban on IT for minors in the intervention group compared to the control condition.

Study methods, data, and results are detailed in the Preventive Medicine Reports’ publication and indicate that a social media campaign may be an effective strategy for convincing mothers to withhold permission for IT from their teen daughters, in an effort to reduce risk for skin cancer.

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

Adopting Policy to Eliminate Indoor Tanning

Adopting Policy to Eliminate Indoor Tanning

Dr. David Buller from Klein Buendel joined two other behavioral scientists to publish a Viewpoint in JAMA Dermatology in April calling on dermatologists and others to support legislative efforts and other policies in their local areas to help dramatically curtail indoor tanning in the United States. The other two authors were Dr. Carolyn Heckman from the Rutgers Cancer Institute of New Jersey and Dr. Jerod Stapleton from the University of Kentucky.

The Viewpoint describes policy and regulation as “among the most effective strategies for influencing health behaviors and public health.” Indoor tanning restrictions in multiple states are helping to reduce skin cancer incidence and death.  Achieving continued and additional restrictions will require concerted research, advocacy, and policy efforts to overcome remaining barriers to new laws and to close lingering gaps in existing laws.

In their editorial, the authors put out a Call to Action to dermatologists to increase their awareness of local indoor tanning laws, or lack thereof, and to educate their patients, legislators, school boards, local business groups, and others about the dangers of indoor tanning and the need for more restricted use, especially by minors.

The Viewpoint was published online in JAMA Dermatology on April 28, 2021.

Online Responsible Vendor Training in Recreational Marijuana Stores

Online Responsible Vendor Training in Recreational Marijuana Stores

A collaborative research team with scientists and staff from Klein Buendel, the Prevention Research Center in Berkeley, California, and the University of Alabama, Birmingham recently published the results from a randomized trial testing an online responsible vendor training program in recreational marijuana stores in the United States. The team was led by Dr. David Buller, Director of Research, and the results were published in the Journal of Studies on Alcohol and Drugs (JSAD).

The responsible marijuana vendor (RMV) training program implemented in the study was Train To Tend®. Train To Tend is an interactive, media-rich, online, comprehensive RMV program created by Klein Buendel. It’s five modules address state laws and regulations, preventing sales to minors, health effects of marijuana, customer service, and rules of the trade. Train To Tend provides state-approved instruction and certification of cannabis sellers. 

In the JSAD publication, the authors detail the measures, methods, analyses, and results of the randomized trial to evaluate the impact of the RMV training program on refusing sales to buyers without proper identification. The trial was conducted with 175 recreational marijuana stores in Colorado and Washington State using a pseudo-underage patron procedure. The results showed that online RMV training could increase sellers’ refusal of potential buyers at entrance to the store who looked youthful and did not provide state-approved identification.

As more states legalize recreational marijuana sales, responsible vendor training in the safe sale of cannabis products can become more essential to helping to ensure youth and community safety.

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). Co-authors on the publication include Dr. Robert Saltz from the Prevention Research Center in California; Dr. Gary Cutter from the University of Alabama, Birmingham; and Dr. W. Gill Woodall, Andrew Grayson, Mary Klein Buller, Sierra Svendsen, and Xia (Lucia) Liu from Klein Buendel.

Association of Occupational Sun Safety Policy with Employee Practices

Association of Occupational Sun Safety Policy with Employee Practices

Occupational sun protection policies are fundamental for the increased implementation of employee sun safety practices. Investigators and staff from Klein Buendel, led by Dr. David Buller, Director of Research, recently published baseline results from a large-scale workplace sun safety policy project in the American Journal of Industrial Medicine.

In the publication, the authors report on the coding and evaluation of written safety policies from 21 state Departments of Transportation (DOTs) enrolled in a randomized trial testing methods for scaling-up an occupational sun safety intervention. A total of 1,113 managers who supervised people who work outdoors reported on workplace and employee sun safety practices in a baseline survey.

Analysis showed that 20 of the state DOTs had a policy with at least one sun protection component (e.g., sunscreen, eye protection, use of shade). Sun safety training was increased at workplaces with written sun safety policy and unwritten standard operating procedures on sun protection. Sun safety actions were highest where there was a written sun safety policy and unwritten standard operating procedures on workplace sun protection. The measures, methods, analyses, results, conclusions, and limitations of the baseline manager survey are detailed in the publication.

This research was funded by a grant from the National Cancer Institute at the National Institutes of Health (CA210259; Dr. David Buller, Principal Investigator). Coauthors include Dr. Barbara Walkosz, Savanna Olivas, Rachel Eye, Xia Liu, Alishia Kinsey, Mary Buller, and Andrew Grayson from Klein Buendel.

Scented Lotions and Adverse Tattoo Reactions

Scented Lotions and Adverse Tattoo Reactions

Klein Buendel Senior Scientist, Dr. Barbara Walkosz, is a co-author on a recent publication in the Dermatology Online Journal. In the manuscript, Dr. Walkosz and her co-authors discuss how scented lotions may cause scaring, premature aging, and fading of tattoos.

Tattoo aftercare instructions are often provided to clients after receiving a tattoo. However, aftercare instructions can vary by studio and are often not universal or supported by research. The authors examine a case study of a man with no pre-existing skin conditions, family history, allergies, or other factors, who developed a rash on his new tattoo. Upon questioning, it was discovered that the client had applied a scented lotion to the new tattoo, at which point he began to experience problems with scabbing and fading tattoo ink.

The authors provide a case discussion about how the use of a scented lotion may have caused a negative, adverse reaction to the new tattoo and discuss the importance of treating a new tattoo as flesh wound. The full discussion and conclusion can be found in the publication.

This research team was funded by a grant and supplement from the National Cancer Institute (CA206569; Dr. Barbara Walkosz and Dr. Robert Dellavalle, Multiple Principal Investigators). Authors also include, Dr. Adrian Pona from the Department of Dermatology at University of Colorado School of Medicine and the Department of Internal Medicine at the Vidant Medical Center of East Carolina University; Dr. Cristian Gonzalez from the Department of Dermatology at University of Colorado School of Medicine; and Dr. Robert Dellavalle from the University of Colorado School of Medicine and the U.S. Department of Veterans Affairs Rocky Mountain Regional VA Medical Center Dermatology Service. 

Health Literacy and Genomic Testing for Melanoma

Health Literacy and Genomic Testing for Melanoma

Dr. David Buller, Klein Buendel’s Director of Research, is a co-author on a paper published recently in Patient Education and Counseling that examines how health literacy skills impact primary care patients’ understanding of melanoma genetic testing results. The paper’s lead author is Dr. Kimberly Kaphingst from the Huntsman Cancer Institute and the Department of Communication at the University of Utah. Additional co-authors are from the Memorial Sloan Kettering Cancer Center in New York, and the Department of Internal Medicine at the University of New Mexico.

Making a significant health decision can be burdensome. It involves obtaining, processing, and weighing an abundance of new information. Personal health literacy skills may help lighten the load. According to the U.S. Department of Health and Human Services, “personal health literacy is the degree to which individuals have the ability to find, understand, and use information and services to inform health-related decisions and actions for themselves and others.”

The Patient Education and Counseling paper describes the methods and measures used to examine whether health literacy skills, educational attainment, or melanoma risk were related to patients’ short-term cognitive and affective responses to personal melanoma genetic test results. Cognitive responses that were measured included perceived clarity and believability of the test results, and how often respondents thought about the test results. Affective reactions that were assessed included things like confusion, fear, hopefulness, relief, and regret, among others. Study results, conclusions, limitations, and implications are reported in the publication. Overall, the authors report that some individuals may need assistance in understanding genetic information related to melanoma risk.

This research was supported by the National Cancer Institute (CA181241; Dr. Jennifer Hay and Dr. Marianne Berwick, Multiple Principal Investigators) and the Huntsman Cancer Foundation.

Tattoo Aftercare Instructions and Sun Protection

Tattoo Aftercare Instructions and Sun Protection

Skin cancer rates continue to rise in the United States, so health researchers continue to explore novel ways to reach people with potentially life-saving information. In a recent commentary published in the Journal of Clinical and Aesthetic Dermatology, Klein Buendel Senior Scientist, Dr. Barbara Walkosz, and co-authors discuss how tattoo studios and their aftercare instructions provide a unique opportunity to reach younger adults with skin cancer prevention recommendations.

Sun protection for new tattoos, to some degree, is provided to most clients as part of the tattoo aftercare process. However, most aftercare instructions focus on the protection of the client’s tattooed skin, not comprehensive full-body sun protection. Most artists are not prepared to impart thorough sun safety recommendations, “such as applying sunscreen prior to sun exposure with a sun protection factor (SPF) of 30 or higher, reapplying sunscreen when outdoors for more than two hours, using clothing that physically blocks ultraviolet rays, wearing wide-brimmed hats that shade the head, or seeking shade when available.”

However, research suggests that tattoo artists are interested in learning about sun safety measures and open to sharing the information with their clients. In the commentary, the authors pinpoint the unique opportunity tattoo studios provide to reach younger adults with public health information, including through studio websites and social media pages. The commentary also shares results from in-depth interviews with tattoo artists and describes how tattoo aftercare instructions vary from state to state.

This research team was funded by a grant and supplement from the National Cancer Institute (CA206569; Dr. Barbara Walkosz and Dr. Robert Dellavalle, Multiple Principal Investigators). Authors include Dr. Cristian Gonzalez from the Department of Dermatology at University of Colorado School of Medicine, Dr. Barbara Walkosz from Klein Buendel, and Dr. Robert Dellavalle from the University of Colorado School of Medicine and the U.S. Department of Veterans Affairs Rocky Mountain Regional VA Medical Center Dermatology Service.  

Scaling-up an Evidence-based Workplace Sun Safety Program

Scaling-up an Evidence-based Workplace Sun Safety Program

Authors of a recent online publication in Contemporary Clinical Trails recommend that “successful methods for scaling-up evidence-based programs are needed to prevent skin cancer among adults who work outdoors in the sun.” The paper describes the design and baseline descriptive data from a workplace intervention being conducted by Klein Buendel and several research collaborators. The on-going randomized trial compares two methods of scaling-up the Sun Safe Workplaces intervention with 21 state Departments of Transportation and their employees who work outdoors. 

A total of 138 regional districts from the Departments of Transportation were randomly assigned to either an in-person program where project staff meet personally with managers, conduct trainings for employees, and provide printed materials, or a digital program where project staff conduct these same activities virtually, using conferencing technology, online training, and electronic materials.

Delivery of Sun Safe Workplaces in both groups is tailored to managers’ readiness to adopt occupational sun safety. Posttesting will assess manager’s support for and use of Sun Safe Workplaces and employees’ sun safety. An economic evaluation will explore whether the method that uses digital technology that may result in lower implementation of Sun Safe Workplaces, is more cost-effective relative to the in-person method.

The 21 state Departments of Transportation vary in size from 997 to 18,415 employees. At baseline, managers reported being generally supportive of occupational sun safety. A minority reported that the Departments had a written sun safety policy, half reported sun safety training for employees, and two-thirds reported messaging and communication about sun protection for employees. The research will help determine whether digital methods can facilitate a cost-effective scale-up of Sun Safe Workplaces for outdoor workers in industries across the country.  

This research project (CA210259) 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. This project, Sun Safe Workplaces-Technology, is being led by KB’s Director of Research, Dr. David Buller, as Principal Investigator. Co-authors on the Contemporary Clinical Trails publication 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.

Sun Safe Partners Online

Sun Safe Partners Online

Findings from a pilot randomized controlled trial evaluating the feasibility and preliminary impact of an online couple-focused intervention to improve sun protection behavior were published recently in the Journal of Medical Internet Research. The research team was led by Dr. Sharon Manne from the Rutgers Cancer Institute of New Jersey. Collaborators from Michigan State University, the University of Connecticut, Memorial Sloan Kettering Cancer Center, and Klein Buendel rounded out the research team.

At the time of the study, Sun Safe Partners Online was a web-based intervention with four individual-focused modules and four couple-focused modules. A total of 75 couples who reported suboptimal levels of sun protection were randomly assigned to receive either Sun Safe Partners Online or a generic sun safety education intervention. Participants were recruited through Facebook advertising, resulting in rapid enrollment and higher acceptance than was evident in a previous trial testing telephone and print intervention. Feasibility was assessed by enrollment, engagement, survey completion, module completion, and module satisfaction. Participants also completed pre/post surveys assessing sun protection, sun exposure on weekends, sunburn incidence, and attitudes toward sun protection. A full description of the methods, analyses, and effects of the study can be found in the publication.

Sun Safe Partners Online was found to be an innovative strategy for engaging adults in sun safety. The authors conclude that “a couple-focused intervention may hold promise as a way to improve sun protection behaviors beyond interventions focused solely on individuals by leveraging the concern, collaboration, and support among intimate partners and addressing relationship-based barriers to sun protection.”

This pilot research was supported by Rutgers Cancer Institute of New Jersey Institutional funds.