Smart Choices 4 Teens

Smart Choices 4 Teens

Healthy decision-making by older adolescents and young adults can be fostered by active parental relationships and mutual engagement.

Two Klein Buendel Scientists are co-authors on a paper in the journal JMIR Pediatrics and Parenting looking at healthy decision-making. Dr. Gill Woodall and Dr. David Buller are members of a research team led by Dr. Brenda Miller from the Pacific Institute for Research and Evaluation (PIRE). The paper, whose lead author is Dr. Beth Bourdeau from the University of California, San Francisco, reports findings from a study designed to test the efficacy of the Healthy Relationships and Sexual Decision-making component of a web-based intervention for older adolescents and their parents, called Smart Choices 4 Teens.

The paper describes the details of the final segment of a randomized controlled trial conducted with 411 families with adolescents aged 16-17 years. Adolescents and parents worked through the web-based, self-paced program together. “Participation in the relationships component increased the frequency of parental sexual communication and increased the number of dating rules after accounting for other significant adolescent characteristics.” The paper reports that “Smart Choices 4 Teens demonstrated efficacy in increasing the frequency of sexual communication between parents and adolescents in the long term.”

The Smart Choices 4 Teens research was supported by a grant from the National Institute on Alcohol Abuse and Alcoholism (AA020977; Dr. Brenda Miller, PIRE, Principal Investigator). Other authors on this publication include Dr. Hilary Byrnes and Dr. Joel Grube from PIRE; Dr. Beth Bourdeau from the University of California San Francisco; and Dr. Gill Woodall and Dr. David Buller from Klein Buendel. Smart Choices 4 Teens was programmed by the Creative Team at Klein Buendel.

WayToServe Plus

WayToServe Plus

Among effective interventions to reduce driving while intoxicated (DWI) by alcohol, Responsible Beverage Service (RBS) training of alcohol servers has shown promise. RBS training is currently required or incentivized by 36 states and California will require it starting in 2022.

Klein Buendel and its research collaborators from the University of New Mexico and the Pacific  Institute for Research and Evaluation (PIRE) have shown that an online RBS training, named WayToServe®, was effective in two randomized research trials. WayToServe is currently commercially available in multiple states in English and Spanish.

Now, researchers from Klein Buendel and PIRE are launching a new research project funded by the National Institute on Alcohol Abuse and Alcoholism (AA029364) to develop and test an in-service professional development component for alcohol servers trained by WayToServe to enhance its effectiveness. It is intended to motivate servers to implement the RBS skills in the face of common barriers, provide support for RBS actions from a “community” of alcohol servers, and prevent natural degradation of skills over time. The in-service component – WayToServe Plus – will be delivered through the WayToServe Facebook page that currently is followed by over 20,000 alcohol servers trained by WayToServe.

The Fast-Track SBIR project will complete a 12-month Phase I feasibility study and a 2-year Phase II effectiveness trial in New Mexico and Washington State. The primary outcome will be the effect of WayToServe Plus on refusal of sales to pseudo-intoxicated patrons. The research will be led by Dr. David Buller and Dr. Gill Woodall (Multiple Principal Investigators) from Klein Buendel, and Dr. Robert Saltz from PIRE.

This research is innovative as WayToServe Plus will be the first continuous in-service professional development for RBS training and will increase the WayToServe training’s effectiveness and commercial advantage with alcohol servers and corporate clients.

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.

Collaborator Spotlight:
Dr. Anne Ray

Collaborator Spotlight:
Dr. Anne Ray

Anne Ray, Ph.D., is an Assistant Professor at the University of Kentucky College of Public Health in the Department of Health, Behavior & Society. She earned a B.S. in Psychology from Penn State University in 2004, an M.Ed. in Counselor Education from Penn State in 2010, and a Ph.D. in Biobehavioral Health from Penn State in 2011.

Dr. Ray’s areas of research interest include etiology and prevention of substance use in adolescence and emerging adulthood; self-regulated drinking behaviors and their associations with alcohol use and consequences; gender differences in alcohol use behaviors; mechanisms of change and moderators of program efficacy; and event-specific measurement of health behaviors.

Klein Buendel and Dr. Ray are currently collaborating on two intervention-based research projects. The first intervention is called Parenting Now. It aims to provide an efficient, engaging, and effective means to enhance parents’ ability to reduce prevalence of substance use and its consequences through a digital curriculum for parents of high-school-aged adolescents. Parenting Now is a brief, interactive, self-paced, and digital curriculum for parents of high-school-aged adolescents created from the evidence-based Parent Handbook, available in hard copy and DVD for college-bound youth only. The curriculum is needed because most parent-based prevention interventions target children or young adolescents, neglecting older adolescents, despite that fact that alcohol use increases in frequency and risk through mid-adolescence. This research project is led by Dr. Michael Hecht from Real Prevention and is funded by the National Institute on Alcohol Abuse and Alcoholism at the National Institutes of Health (AA025293).

The second intervention is a new research project designed to curb drinking and risky sexual behavior by first-year college students. The new study will assess the impact of a brief, personalized intervention utilizing an innovative, cross-tailored, dynamic feedback component. The intervention will purposefully integrate content on the relationship between alcohol use and risky sexual behavior. It will leverage technology to incorporate daily assessments of student behavior and deliver weekly dynamic feedback to help reduce risky behavior. This research project is led by Dr. Ray and is funded by the National Institute on Alcohol Abuse and Alcoholism at the National Institutes of Health (AA028246)

Results of a Social Media Campaign to Prevent Indoor Tanning by Teens: A Randomized Controlled Trial

Results of a Social Media Campaign to Prevent Indoor Tanning by Teens: A Randomized Controlled Trial

Indoor tanning (IT) increases the risk of developing melanoma. A social media campaign to reduce mother’s permissiveness toward their teenage daughters’ IT was designed and evaluated by Dr. David Buller, Director of Research at Klein Buendel, and his research team. He gave a presentation on the Health Chat campaign at the virtual 71st Annual International Communication Association Conference, May 27-31, 2021.  

A total of 869 mothers of teenage daughters aged 14-17 in 34 states without bans on IT by minors were enrolled in a randomized controlled trial with two assessments, baseline and 12-month follow-up in 2017-19. A year-long adolescent health campaign was delivered to all participants. The intervention group received posts on preventing IT while the control group received posts about preventing prescription drug misuse. Mothers completed assessments of permissiveness for daughters to indoor tan, self-efficacy for refusing permission, communication with daughters about avoiding IT, attitudes and intentions toward IT, IT behavior, and support for state IT bans. Daughters (n=469; 54%) completed the assessments at baseline and at 12 months.  

At the 12-month follow-up, intervention-group mothers were less permissive of IT by daughters, reported more communication with daughters about avoiding IT, and had lower intentions to indoor tan than control-group mothers. Daughters confirmed intervention-group mothers communicated about IT and shared IT posts more than control-group mothers.  

Overall, a social media campaign may be an effective strategy to convince mothers to withhold permission for IT, which may help increase the effectiveness of state laws designed to reduce IT by minors by requiring parental permission.  

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. Sherry Pagoto and Jessica Bibeau from the University of Connecticut; Dr. Kimberly Henry from Colorado State University; Dr. Katie Baker and Dr. Joel Hillhouse from East Tennessee State University; and Dr. Barbara Walkosz and Julia Berteletti from Klein Buendel. 

Responding to COVID-19 Misinformation in a Social Media Feed

Responding to COVID-19 Misinformation in a Social Media Feed

Social media play a large role in disseminating news on COVID-19 but they also have spread misinformation. Strategies have been suggested for correcting misinformation from fact-checking to digital and media literacy. Dr. David Buller, Director of Research at Klein Buendel, is studying an approach to responding to misinformation in a social media feed on COVID-19 and the reactions of participants to responses. He gave a presentation on the research at the University of Connecticut’s virtual mHealth Conference, May 13-14, 2021.

A total of 303 mothers with adolescent daughters who had previously participated in a social media campaign on indoor tanning were recruited in January 2021 and enrolled in a single-factor design comparing information sources in a 9-week Facebook feed (government agencies v. near-peer parents v. news media) with four assessments (baseline, 3 weeks, 6 weeks, and 9 weeks). The social media feed addressed non-pharmaceutical interventions such as social distancing, COVID-19 vaccination, digital and media literacy skills, and family communication about COVID-19. A community manager scheduled posts (5 per week), monitored reactions and comments, and responded to mothers’ comments that conveyed misinformation within 24 hours following a pre-established protocol. Misinformed comments were defined as being in opposition to recommendations of scientific authorities.

Of the 135 posts total (45 per group), 13% received comments containing misinformation (54 comments) and the community manager responded to 48 of the misinformed comments. Mothers posted the most misinformation in the near-peer parent group (27 comments); those in government agency group (17 comments) and news media groups (10 comments) posted less misinformation. Most comments with misinformation were in response to vaccination posts. The community manager’s responses to misinformation acknowledged mothers’ comments and then stated facts (such as efficacy and safety of vaccines) and cited evidence-based sources (such as the CDC) to refute the misinformation. The community manager also validated mothers’ concerns and confusion, if expressed in these posts, and occasionally stated personal experience or asked a follow-up question to promote dialogue. After responses were posted, ten original posters commented again and three reacted to the reply with “like/love”. Also, at times, other moms commented, reacted, or sent a private direct message related to response to misinformation.

Feeds on COVID-19 vaccines and non-pharmaceutical interventions can attract misinformation from individuals following them. Response strategies did not appear to generate a debate with mothers who posted misinformation, possibly because it conveyed an understanding of their positions or acknowledged their uncertainty or confusion rather than confronted them. Responses seemed to garner some supportive reactions from other mothers for the community manager, perhaps because the response made them feel supported to express their disagreement with the misinformation. These reactions could serve to reinforce the correction of misinformation for other followers of the social media feed.

This research is 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. Sherry Pagoto and Joseph Divito from the University of Connecticut; and Dr. Barbara Walkosz, Dr. Gill Woodall, Julia Berteletti, and Alishia Kinsey from Klein Buendel.

Engagement with a Social Media Campaign for Mothers to Reduce Permissiveness for Daughters’ Indoor Tanning

Engagement with a Social Media Campaign for Mothers to Reduce Permissiveness for Daughters’ Indoor Tanning

Indoor tanning (IT) by adolescents increases lifetime risk of developing melanoma. Dr. David Buller, Director of Research at Klein Buendel, is leading an examination of a social media campaign for mothers to reduce their permissiveness toward indoor tanning by their teenage daughters. Dr. Buller presented findings on mothers’ engagement with the social media campaign – Health Chat – at the D.C. Health Communication (Virtual) Conference, April 23-24, 2021.

Several states require parents to consent or accompany minor children using IT facilities. Engagement of mothers with the social media campaign was examined to see if it modified campaign effects on mothers’ permissiveness for their teen daughters to indoor tan. Mothers (N=869) with daughters aged 14-17 were recruited in 34 states that do not ban IT by minors under 18 for a randomized trial with follow-ups at 12-month and 18-month post-randomization.

Mothers received an adolescent health social media campaign in Facebook private groups. Half of mothers were in a group in which the campaign included posts about preventing IT (intervention) and the other half, included posts on preventing prescription drug misuse (control). Engagement was measured by extracting reactions (e.g., like, sad, etc.) and comments posted by mothers to the campaign posts addressing IT or prescription drug misuse. Follow-up surveys assessed mothers’ permissiveness for daughters to indoor tan, i.e., whether mothers would permit daughters to indoor tan or facilitate them doing so (e.g., take them to a tanning facility). Daughters (n=469; 54.0%) were invited to complete baseline and follow-up assessments.

Mothers were mostly non-Hispanic white, college educated, and had household incomes exceeding $80,000. Nearly one-third had a family history of skin cancer and just over one quarter had high-risk skin types. At 12-month and 18-month follow-up, engagement with the social media campaign moderated the impact of treatment group on mothers’ permitting and facilitating IT by daughters. Specifically, among mothers who engaged with the campaign, mothers in the intervention group had lower permissiveness for IT and less facilitation of IT by their daughters than in the control group. These differences did not occur between treatment groups among mothers with no engagement in either permissiveness or facilitation at either follow-up.

Social media campaigns may be used to improve IT public policies by decreasing mothers’ permissiveness and increasing communication with daughters about avoiding IT. However, social media messages need to reach and engage mothers to be effective, in this case on convincing mothers to not permit or facilitate daughters’ request to indoor tan. Prevention messages, when interspersed in a social media feed on adolescent health, may reduce IT by female adolescents by improving compliance with public policies restricting minor access to IT facilities.

This research is 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. Sherry Pagoto and Jessica Bibeau from the University of Connecticut, Dr. Kimberly Henry from Colorado State University, Dr. Katie Baker and Dr. Joel Hillhouse from East Tennessee State University, and Dr. Barbara Walkosz, Julia Berteletti, and Lucia Liu from Klein Buendel.

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.