Economic Evaluation of Adopting Occupational Sun Protection Policies

Economic Evaluation of Adopting Occupational Sun Protection Policies

In a recent publication in the Journal of Occupational and Environmental Medicine, Klein Buendel investigators and their colleagues discuss the economic evaluation of an intervention promoting adoption of occupational sun protection actions by Colorado public-sector employers.

The intervention, Sun Safe Workplaces (SSW), was a two-year randomized field trial promoting employer adoption of sun safety policy and providing training in personal sun protection for outdoor workers. The trial included 98 local Colorado government organizations such as municipalities, counties, and special districts (public organizations providing water, sanitation, parks and recreation, and fire protection). SSW intervention costs were organized into two components: “delivery” costs and “action” costs. Delivery costs were incurred to directly implement and maintain the SSW intervention and included costs of both project staff and the participating worksites. Action costs were incurred by the worksites themselves for implementing the sun protection actions.

The publication presents the results of the economic evaluation of SSW. A full description of the methods, measures, results, and conclusion of the research can also be found in the Journal of Occupational and Environmental Medicine publication.

This study demonstrated the interactions of cost and implementation that explain — and hopefully guide — the adoption of and investment in occupational sun safety. The SSW intervention was also successful in extending the adoption of sun protection actions among intervention worksites at a cost per employee that is comparable to other worksite health interventions.

This analysis was funded by a grant from the National Cancer Institute at the National Institutes of Health (CA134705; Dr. David Buller and Dr. Barbara Walkosz, Multiple Principal Investigators). The paper’s lead author is Dr. Richard Meenan from the Kaiser Permanente Center for Health Research in Oregon. Additional authors include Dr. David Buller, Dr. Barbara Walkosz, Ms. Mary Buller, Ms. Rachel Eye, and Ms. Savanna Olivas from Klein Buendel; and Dr. Allan Wallis from the University of Colorado Denver.

Collaborator Spotlight:
Dr. Michael Hecht

Collaborator Spotlight:
Dr. Michael Hecht

Michael L. Hecht, Ph.D., is the co-president of REAL Prevention LLC. He currently works with Klein Buendel Senior Scientist, Dr. David Buller, on a project entitled, “Feasibility of a Mobile Parent-Based Intervention to Reduce Alcohol Use by High School Seniors.” The Phase II SBIR research project is funded by the National Institute on Alcohol Abuse and Alcoholism (AA025293; Dr. Michael Hecht, Principal Investigator).

The program aims to provide an efficient, engaging and effective means to enhance parents’ ability to reduce prevalence of alcohol use and consequences, and other substance use. The program, called Parenting Now (PN), is adapted from the evidence-based Parent Handbook and includes a brief, interactive, self-paced, web-based curriculum for parents of non-college bound high-school-aged adolescents. KB will develop the PN program, which was previously tested in a Phase I trial, and it will include core and optional modules in order to target parents based on their communication style. Parents will be able to customize their experience by choosing or clicking through the optional content. Results will help prepare PN for dissemination through D.A.R.E. America’s new high school program as well as REAL Prevention’s other community-based partners, such as 4-H and Planned Parenthood.

In addition to substance abuse prevention research, Dr. Hecht specializes in developing and evaluating culturally grounded, narrative health messages to engage diverse communities. Through his work on an R01 in the 1990s, called “keepin’ it REAL” (kiR), Dr. Hecht co-founded REAL Prevention and has disseminated and implemented the program in all 50 states and 53 other countries. As co-president of REAL Prevention, Dr. Hecht provides training, consulting, support and evaluation services to organizations interested in adopting of kiR or developing new interventions.

Dr. Hecht earned his Ph.D. from the University of Illinois and is a Distinguished Professor Emeritus at Pennsylvania State University. He has won numerous awards, including the Gerald R. Philips Award for Distinguished Applied Communication Scholarship, two Distinguished Scholarship Awards for the International and Intercultural Division of the National Communication Association, and the Article of the Year Award for SIETAR. Additionally, Dr. Hecht has served on NIH’s Community-Level Health Promotion Review Group, including being selected as its chair, as well as on numerous editorial boards in communication and other fields.

Denver Mayor’s Diversity and Inclusion Awards

Denver Mayor’s Diversity and Inclusion Awards

On September 26, Klein Buendel helped sponsor the 2019 Denver Mayor’s Diversity and Inclusion Awards. The event was themed “Together for the Ages” and hosted by the Denver Commission on Aging for Denver Mayor Michael Hancock. Dr. Barbara Walkosz, KB Senior Scientist, is an appointed member of the Denver Commission on Aging.

By 2030, one in four residents of the city of Denver will be over 60 years of age. The Denver Commission on Aging helps to make Denver the best possible community for older adults through outreach, communication and advocacy, including:

  • Advocating for their rights and concerns
  • Empowering older adults through dissemination of information and sharing community resources
  • Monitoring and recommending legislation and proposed policy changes affecting older adults

The Mayor’s Diversity and Inclusion Awards is an annual program of the agency for Human Rights & Community Partnerships (HRCP). HRCP is the umbrella agency for nine offices and ten commissions that work to create a more just and equitable Denver. Through advocacy, capacity building, collaboration, community engagement, and direct services HRCP works to create lasting change for Denver’s residents. This includes ensuring that people from all corners of the Denver community community are empowered and supported with the innate knowledge that diverse perspectives, skills, and resources strengthen the foundation for lasting solutions.

Inclusivity is the cornerstone of HRCP’s work. They strive to give voices to the voiceless and to create a world class city where everyone matters. Mayor Michael B. Hancock and the community commissioners honored 10 individuals or organizations with the 2019 Mayor’s Diversity and Inclusion Awards.

Responsible Marijuana Vendor Training

Responsible Marijuana Vendor Training

Dr. David Buller, Klein Buendel Senior Scientist and Director of Research, presented recent work by his research team at the Tenth European Society for Prevention Research (EUSPR) Conference and Members’ Meeting in Ghent, Belgium in September. His presentation, “Effects of an Online Responsible Vendor Training for Recreational Cannabis Stores on Sales to Pseudo-intoxicated Customers: Need for Increased Deterrence,” was coauthored by Dr. Gill Woodall, Mr. Andrew Grayson, Ms. Sierra Svendsen, and Ms. Mary Buller from Klein Buendel; and Dr. Robert Saltz from the Pacific Institute for Research and Evaluation.

The advent of recreational cannabis in Canada, Uruguay, and several U.S. states raises the risk of polysubstance-impaired driving. In alcohol markets, training in responsible sales practices is an intervention to reduce sales to intoxicated patrons and thus prevent impaired driving and other harms. Similar training may benefit communities with recreational cannabis sales.

An online responsible marijuana vendor (RMV) training, Train To Tend, was developed with input from state regulators and store personnel. Among its five modules, learning elements taught store personnel to recognize signs of alcohol impairment and intoxication, refuse sales, and understand the risks of driving under the influence of cannabis. A sample of 150 recreational cannabis stores in Colorado, Oregon, and Washington State, USA were enrolled in a randomized controlled trial, half of which were randomly assigned to use the RMV training. Stores were posttested using a pseudo-intoxicated patron (PiP) protocol in which confederate buyers feigned obvious signs of intoxication.

Sales of cannabis to PiPs were refused at only 16 of 144 stores across the three states. There was no difference in refusal rates between intervention and control stores or between stores that used the RMV training or not. In 11 visits, store personnel commented on the buyers’ behavior or expressed concern/suspicion about buyers but sold to them anyway.

Training in responsible sales practices alone did not appear to reduce sales to intoxicated customers. Legal deterrence from making these sales may be insufficient or nonexistent for store management to support adherence to this responsible sales practice. Regulatory actions (such as swift, severe, and certain penalties) may be needed to increase perceived risk with such sales  to achieve training’s benefits.

This research was sponsored by a grant from the National Institute on Drug Abuse at the National Institutes of Health (DA038933; Dr. David Buller, Principal Investigator). Train To Tend was programmed by the Creative Team at Klein Buendel.

Dr. David Buller presenting the RMV training program
Smart Choices 4 Teens

Smart Choices 4 Teens

Three Klein Buendel researchers were part of a team that gave two presentations at the Tenth European Society for Prevention Research (EUSPR) Conference and Members’ Meeting in Ghent, Belgium in September. Dr. David Buller, Dr. W. Gill Woodall, and Ms. Julia Berteletti were part of the Smart Choices 4 Teens research team led by Dr. Brenda Miller from the Prevention Research Center at the Pacific Institute for Research and Evaluation (PIRE).

Smart Choices 4 Teens is an online, interactive, family-based program for parents and older teens designed to reduce teen alcohol use and risky sexual behaviors. The program features three sequential components (parent-teen communication, teen alcohol prevention, and teen romantic relationships) that parents and teens complete separately before working together through a discussion activity at the end of each component. A randomized controlled trial with 411 families found significantly better outcomes for teens in the experimental condition as compared to controls in terms of decreased alcohol use and decreased sexual risk behaviors.

Oral Presentation

Dr. Brenda Miller’s presentation focused on the design of the Smart Choices 4 Teens alcohol prevention component. This module targeted eleven topics: (1) the decision to drink or not drink, (2) social host laws, (3) physical effects of alcohol, (4) signs of alcohol poisoning, (5) social consequences of alcohol, (6) an interactive Blood Alcohol Calculator, (7) myths about alcohol, (8) creating a safety plan for parties, (9) parental influences, (10) refusal skills, and (11) defining a drinking problem. The module incorporated four different activity formats — video narratives, info-gadgets, interactive activities, and structured discussions. Parents and teens engaged in the same materials but did so separately, coming together to choose and discuss hypothetical scenarios that guided the discussion offline. A “nudge” feature was embedded to allow teens to prompt their parent to finish a module and move to the end-of-module offline discussion or vice versa. The nudge feature was used 561 times by 218 users.

Dr. Miller reported that 86% of experimental families began the intervention and 50% of families completed the teen alcohol prevention component. The average time needed to complete the alcohol component was 16 minutes. Parents and teens reported learning new lessons and becoming more comfortable discussing alcohol use together. Barriers to completion included limited understanding of some content and needing additional instructions.

Poster Presentation

Dr. David Buller presented a poster, with analysis led by Dr. W. Gill Woodall, on the effect of teen engagement with Smart Choices 4 Teens. Teens and parents (411 dyads) completed an online baseline survey prior to being assigned to either the intervention or control conditions. Follow-up online surveys were completed 6, 12, and 18 months later. The teen sample was 55% female and 72% non-Hispanic White. The parent sample was comprised predominately of mothers (84.7%).

The Smart Choices 4 Teens website tracked duration of time spent using each of the web-based components. In an analysis of teens who completed the program in the intervention group (n=142), linear regressions tested duration of teens’ time in each online component in the entire program as predictors of teens’ past 30-day alcohol use at the 6-month follow-up. More time spent by teens using interactive activities negatively predicted later alcohol use, as did teens’ time spent viewing videos. Also, teens’ time spent using info-gadget activities had a negative relationship with alcohol use.

The researchers report that activities with interactivity, animations, and video content may produce stronger preventive effects on alcohol use because teens prefer this format over written text in the info-gadgets, have more involvement with them, and/or find characters relatable. These reactions may stimulate deep processing of prevention content.

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 Dr. Miller’s research team included Dr. Hilary Byrnes, Ms. Veronica Rogers, and Dr. Joel Grube from PIRE; Dr. Beth Bourdeau from the University of California San Francisco; and Dr. David Buller, Dr. W. Gill Woodall, and Ms. Julia Berteletti from Klein Buendel. Smart Choices 4 Teens was programmed by the Creative Team at Klein Buendel.

Dr. Brenda Miller viewing Smart Choices 4 Teens
Project STRONG Expands into Spanish

Project STRONG Expands into Spanish

Ms. Julia Berteletti, Klein Buendel Research Program Manager, is a Co-Investigator on a new research project aimed at teaching adolescent boys, with their parents, skills on regulating their emotions and how to communicate their feelings.

Emotional regulation is the ability to successfully understand and express one’s emotions (1). The large empirical literature links violent behavior and adolescents who lack this ability. Furthermore, numerous studies show that parental involvement is crucial to offsetting dating violence risk (2).

Northeastern University, in collaboration with Klein Buendel, conducted a pilot study which was funded by the National Institute of Justice and titled “Partner Violence Prevention for Middle School Boys: A Dyadic Web-Based Intervention” (2014-MU-CX-4002). The aim of the study was to develop a web-based intervention to reduce the risk of dating violence among middle-school aged males. The engaging web program was used by parents and adolescents together, with both the parent and the child choosing an avatar, playing games together, and being prompted to discuss the content.

Results showed that families generally found the program helpful and useful (3). Adolescents randomized to the STRONG condition were less likely to report dating violence perpetration events and victimization events when compared to the control group (3). Additionally, adolescents in the STRONG condition reported an increase in a number of emotional regulation measures compared to control participants (3).

The new Project STRONG R01 study will be conducted in a larger randomized controlled trial titled “Project STRONG: A Web-Based Dating Violence Prevention Program for Parents and Middle School Boys”. The web-based program will be translated and developed in Spanish and will be tested for its ability to reduce the risk of dating violence among both English- and Spanish-speaking middle-school aged males. Again, parents and their sons will complete the program together.

The research is funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development at the National Institutes of Health (HD097126; Dr. Chris Houck and Dr. Christine Rizzo, Principal Investigators). Ms. Berteletti will be collaborating with Dr. Chris Houck of Rhode Island Hospital and Dr. Christine Rizzo of Brown University.

References

1. Houck CD, Hadley W, Barker D, Brown LK, Hancock E, Almy B. An emotion regulation intervention to reduce risk behaviors among at-risk early adolescents. Prev Sci. 2016;17(1):71-82. doi: 10.1007/s11121-015-0597-0
2. Lundgren R, Amin A. Addressing intimate partner violence and sexual violence among adolescents: emerging evidence of effectiveness. J Adolesc Health. 2015;56(1 Suppl):S42-S50. doi: 10.1016/j.jadohealth.2014.08.012
3. National Criminal Justice Reference Service; Rizzo CJ, Houck C. Summary Report: Partner Violence Prevention for Middle-School Boys: A Dyadic Web-Based Intervention Study (Project STRONG). Available at: https://www.ncjrs.gov/pdffiles1/nij/grants/252517.pdf. Published January 2019. Accessed August 21, 2019.

The Grow, Eat, Thrive School Gardening Curriculum is Now Free

The Grow, Eat, Thrive School Gardening Curriculum is Now Free

September is National Childhood Obesity Month because increasing awareness about how to prevent overweight and obesity children is a public health priority. To help with the effort, Klein Buendel is making its Grow, Eat, Thrive elementary school curriculum available to teachers for free online. Grow, Eat, Thrive pairs nutrition and physical activity education with container gardening for children in grades Kindergarten through 5. It teaches students about the benefits of eating fruits and vegetables and engaging in daily exercise for overall good health.

Grow, Eat, Thrive can stand alone or complement a teacher’s existing lesson plans. While completing lessons, students plant their own container or outdoor garden, care for it, and harvest what they have grown. This hands-on approach provides students with a sense of where fresh produce comes from, an appreciation for healthy foods and daily activity, and a connection to making healthy life choices. The lessons are age and grade level appropriate, and relate to a variety of content standards for easy implementation.

The evidence-based curriculum was created and tested by Klein Buendel with students at six Colorado elementary schools and was found to increase knowledge of a healthy diet in all grades. In younger grades, the curriculum improved attitudes toward a healthy diet and increased intake of healthier foods.

“As obesity rates continue to rise, education that addresses nutrition and physical activity in elementary schools is essential,” said Ms. Mary Buller, one of the curriculum collaborators from Klein Buendel. “Grow, Eat, Thrive helps makes that education easy and fun for everyone.”

Grow, Eat, Thrive was created with a grant from the U.S. Department of Agriculture (USDA 2005-33610-16469; Ms. Lee Stiffler-Myer, Principal Investigator). To access the free lesson plans, visit the Grow, Eat, Thrive website.

Using Panel Vendors to Recruit Research Participants

Using Panel Vendors to Recruit Research Participants

It has become more common to recruit research study participants through online panel vendors, such as GfK or Qualtrics. In a publication made available recently in PubMed Central from Evaluation and the Health Professions, Dr. Meme Wang-Schweig from the Prevention Research Center at the Pacific Institute for Research and Evaluation (PIRE) and her coauthors (including Dr. David Buller from Klein Buendel), report on the use of panel vendors for recruiting research participants into a randomized controlled trial. The research study was testing an online, family-based alcohol prevention program for parents and older teens, called Smart Choices 4 Teens.

Panel vendors are hired to recruit and match potential research participants to a target population for data collection.  Most panel vendors use non-probability sampling which does not involve random selection. People opt in to participate. The vendors advertise for panelists using website banner ads, emails, direct mail, etc. Panelists are paid but may also enjoy contributing their opinions to a research study. Panel vendors can recruit a potential research sample quickly.

Dr. Wang-Schweig’s paper endeavors to answer two methodological questions: (1) how well do panel vendors provide a sample of families to participate in a trial who meet specific inclusion criteria, and (2) how well do panel vendors provide a sample of families to participate in a trial who reflect the make-up of the general population? Using the Smart Choice 4 Teens project’s experience as a real-world example, the authors describe the process of working with panel vendors, the sample’s match to the intended target population, and the additional screening they employed to ensure the quality of the sample. Several recommendations are made for other research teams looking to use panel vendors to recruit study participants.

Smart Choice 4 Teens was supported by a grant from the National Institute on Alcohol Abuse and Alcoholism (AA020977; Dr. Brenda Miller, PIRE, Principal Investigator). Dr. Wang-Schweig’s coauthors for this publication included Dr. Brenda Miller, Dr. Hilary Byrnes, Dr. Beth Bourdeau, and Ms. Veronica Rogers from PIRE; and Dr. David Buller from Klein Buendel.

The Importance of Managers’ Awareness of Sun Protection Policy

The Importance of Managers’ Awareness of Sun Protection Policy

Improving occupational sun protection is a priority in the United States, as The Surgeon General’s Call to Action to Prevent Skin Cancer highlights. Klein Buendel and its collaborators responded to the call by launching a randomized trial to evaluate the effectiveness of a workplace sun protection program for outdoor workers. The program, Sun Safe Workplaces, was implemented with 98 public employers in Colorado, a state with high ultraviolet radiation due to its high elevation and sunny climate. The intervention promoted the adoption or strengthening of sun safety policy and the implementation of employee sun protection training. A two-year follow-up study also was completed with 68 of the 98 public sector employers.

In a recent publication in the American Journal of Industrial Medicine, Dr. Barbara Walkosz, Klein Buendel Senior Scientist, and her coauthors reported results related to the hypothesis that senior managers’ awareness of sun protection policy in the workplace would predict increased sun safety practices by employers and employees who work outdoors.

A full description of the methods (questionnaires and on-site observations), results, conclusions, and limitations of the research can be found in the American Journal of Industrial Medicine publication. In general, more sun safety messages, manager-employee communication, sun safety practices, and sun protection equipment (sunscreen, hats, etc. ) were evident when senior managers were more aware of their organization’s sun protection policy.

Overall, the authors found that occupational sun protection programs can be more effective on the “front line” (with people who work outdoors) when the “back office” (senior management) is aware of and can, therefore, support and encourage their organization’s sun safety policies and practices.

This analysis was funded by a grant from the National Cancer Institute at the National Institutes of Health (CA134705; Dr. David Buller and Dr. Barbara Walkosz, Principal Investigators). Dr. Walkosz’s coauthors on this paper included Dr. David Buller, Ms. Mary Buller, and Ms. Xia (Lucia) Liu from Klein Buendel, and Dr. Allan Wallis from the University of Colorado Denver.

Train To Tend Licensed to Avid Will LLC

Train To Tend Licensed to Avid Will LLC

Klein Buendel has licensed its online responsible vendor training program for recreational marijuana stores, Train To Tend®, to Avid Will LLC for sales and marketing. Senior Scientists, Dr. David Buller and Dr. W. Gill Woodall, and their collaborators created Train To Tend to provide retail staff with knowledge and skills to sell recreational marijuana responsibly in an effort to keep their communities safe. Avid Will LLC will make Train to Tend available immediately to retail recreational marijuana stores in Colorado. State-specific versions for Oregon, Washington State, Massachusetts, and California will be launched this year, as well.

In 2017 and 2018, Train To Tend was tested using a random sample of state-licensed recreational marijuana stores (n=225) in Colorado, Oregon, and Washington State. One hundred twenty-five stores were randomly selected to receive the Train To Tend training while the remaining stores received the usual and customary training in their state. Post-training surveys were administered to Train To Tend trainees to gauge their perceptions of self-efficacy toward responsible vending practices, as well as their ratings of usability for Train To Tend.

The training improved trainees’ ability to check IDs, and their confidence in using their state’s inventory tracking system and identifying intoxicated customers. Trainees rated the training as user-friendly and thought that the information and skills learned in the training would help keep their communities safe. In a recent review, Danielle, an Instructional Designer for Native Roots, a Colorado retail chain, said “Train To Tend has been effective and engaging for our employees, and we are thankful for the Train To Tend team and their online responsible vendor program.”

The development and evaluation of Train to Tend was funded by a grant from the National Institute on Drug Abuse at the National Institutes of Health (DA038933; Dr. David Buller, Principal Investigator). Additional scientific collaborators include Dr. W. Gill Woodall from Klein Buendel and Dr. Robert Saltz from the Pacific Institute for Research and Evaluation in California.