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Curbing College Drinking and Risky Sexual Behavior Using Dynamic Feedback

Curbing College Drinking and Risky Sexual Behavior Using Dynamic Feedback

Two-thirds of college students are current drinkers of alcoholic beverages. One in three college students report past month binge drinking (five or more drinks in a row), and one in ten report high intensity drinking (ten or more drinks in a row). Greater student alcohol consumption and heavy drinking on a given day are linked to increased sexual activity and risky sexual behavior, such as unprotected sex and sex with casual partners. This puts students at risk for negative health outcomes, such as sexually-transmitted infections, and other harmful consequences, such as sexual victimization.

Klein Buendel is collaborating with Dr. Anne Ray at the University of Kentucky on 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. The intervention will leverage technology to incorporate daily assessments of student behavior and deliver weekly dynamic feedback. Participating students will be asked to complete four diary entries each week for three months.

A hybrid effectiveness-implementation design will allow the investigators to evaluate the effectiveness of the integrated personalized feedback intervention with 600 first-year college students at two college sites in a randomized controlled trial. In addition, formative evaluation with local and national stakeholders (students and student affairs staff) will help to better understand factors that influence implementation and ensure its success and sustained use.   

This research project is funded by the National Institute on Alcohol Abuse and Alcoholism at the National Institutes of Health (AA028246; Dr. Anne Ray, Principal Investigator). Collaborators include Dr. David Buller from Klein Buendel. KB’s Creative Team will develop the web-based program for college students.

New Study to Assess the Impact of California’s Mandatory Responsible Beverage Service Training Law

New Study to Assess the Impact of California’s Mandatory Responsible Beverage Service Training Law

Klein Buendel is collaborating with Dr. Robert Saltz and his team from the Pacific Institute for Research and Evaluation (PIRE) in California on a new research project to assess the impact of California’s new mandatory Responsible Beverage Service training law intended to prevent alcohol-involved motor vehicle crashes and other harms.  

Intoxicated driving continues to play a significant role in automobile accidents and fatalities. In response, California passed the Responsible Beverage Service Training Act of 2017. According to the California Department of Alcoholic Beverage Control, the law requires alcoholic beverage servers in California to attend responsible beverage service (RBS) training by July 1, 2022. Alcoholic beverage servers will be trained on the dangers of overserving alcohol to patrons in an effort to curb alcohol-related harm within local communities, particularly in regards to drunk driving and alcohol-related crimes. This change in law creates a new statewide mandate for licensees and a new training requirement for an estimated 1 million servers.

The new research study will examine whether there is a significant reduction in single nighttime motor vehicle injury crashes after implementation of the mandatory RBS training law, controlling for other factors in California that may influence this outcome, and the national trend in fatal alcohol-involved motor vehicle crashes. A second aim will address the question of whether the state mandate could have greater impact through wider use of high-quality evidence-based RBS training, or through RBS training supplemented by boosting management motivation to support the training objectives. The training program that will be implemented is the WayToServe® (WTS) online RBS training program developed and evaluated by PIRE, Klein Buendel, and the University of New Mexico. Currently, WTS is licensed to and sold by Wedge Communications LLC in multiple states.

A randomized controlled trial design will be used to examine the change in the refusal rate for alcohol service to pseudo-intoxicated patrons in a sample of 450 licensed on-premises bars and restaurants from 2020 (baseline) to 2024 (post-implementation of mandatory RBS training law). The evaluation will determine whether any change is more pronounced among bars that receive the original WTS RBS Training or the enhanced WTS Training Plus program. A significant feature of this design is that unlike previous evaluations of RBS training, this project will be able to document both short-term and long-term outcomes.  This is especially important for a statewide implementation where it cannot be known in advance how quickly or slowly servers will undertake the training, and how quickly, if at all, the training will have an effect on server behavior.

This research project will be funded by the National Institute on Drug Abuse (Dr. Robert Saltz, Principal Investigator). Collaborators include Dr. David Buller and Dr. W. Gill Woodall from Klein Buendel.

Inmates Care

Inmates Care

Whether one reaches the end of his or her life in a private home, a nursing home, or a correctional facility, the need for quality, compassionate palliative care is universal.

The demographics of the American prison population are shifting at a dramatic rate requiring new approaches to prison healthcare. Current estimates suggest that there are 2.3 million incarcerated persons in the United States (1). Similar to the free world, the aging of the Baby Boom generation is occurring in prisons. Notably, inmates 50 and older constitute over 20% of prisoners in state or federal facilities (2). Many sentenced offenders are living through middle and older adulthood within the confines of prisons (3,4). These trends profoundly impact prison systems that are legally responsible for providing needed care to prisoners along with ensuring their custody and control (5). The health status of aging inmates does not mirror the free world population. Prisoners typically present with health issues common to free citizens who are 10 to 15 years their senior. Collectively, these trends have had a profound impact on prison systems and prisons are facing sharply increased demands in caring for aged and dying inmates.

Dr. Susan Loeb of Penn State University and Dr. Valerie Myers of Klein Buendel (Multiple Principal Investigators) are leading a new research project being awarded to Klein Buendel entitled, E-training of Inmate Peer Caregivers for Enhancing Geriatric and End-of-Life Care in Prisons – the Inmates Care Project. Inmates Care is a computer-based interactive training system designed to provide inmate peer caregivers with training in geriatric and end-of-life (EOL) care. Broadly defined, EOL care is the care provided to persons in their final stages of life; also referred to as hospice care, comfort care, supportive care, palliative care or symptom management (6). The Inmates Care system will provide rigorous, evidence-based best practices through media-rich and highly interactive computer-based learning modules for providing EOL and geriatric care to prison peers. It will function within institutions’ technology and connectivity limitations and be much more engaging and interactive than the educational programs commonly available to those living in prison.

Prisons are facing sharply increased demands in caring for aged and dying inmates (7). Inmates offer an abundant human resource that is poised to contribute in important ways to augment corrections staff in meeting a growing care need in U.S. prisons. This new study will refine and expand the modules that were usability-tested in a previous study and evaluate the full program for its fit with inmate peer caregivers within the restrictive constraints of prison systems. Expanded testing of Inmates Care will establish its effectiveness as a program and will provide critical insights relevant to its dissemination and implementation with correctional facilities.

This Phase II research project is funded by a Small Business Innovation Research (SBIR) grant to Klein Buendel from the National Institute on Aging at the National Institutes of Health (AG057239). Dr. Erin Kitt-Lewis from the Penn State University College of Nursing is a Co-Investigator. The CBL modules will be programmed by the Creative Team at Klein Buendel.

References

1. Sawyer W, Wagner P. Mass incarceration: the whole pie 2019. Prison Policy Initiative. Available at: https://www.prisonpolicy.org/factsheets/pie2019_allimages.pdf. Published 2019 March 19. Accessed August 30, 2019.

2. Bronson J, Carson EA. Prisoners in 2017. Available at: https://www.bjs.gov/content/pub/pdf/p17.pdf. Published 2019 April 25. Accessed August 30, 2019.

3. Palazzolo J. U.S. Prisons Grapple With Aging Population. The Wall Street Journal.

4. Carson EA, Sabol WJ. Aging of the state prison population, 1993-2013. U.S. Department of Justice, Office of Justice Programs, Bureau of Justice Statistics. Special report NCJ 248766. Available at: https://www.bjs.gov/content/pub/pdf/aspp9313.pdf. Published May, 2016. Accessed August 30, 2019.

5. Rold WJ. Thirty years after Estelle v. Gamble: A legal retrospective. Journal of Correctional Health Care. 2008;14(1):11-20.

6. National Institutes of Health. National institutes of health state-of-the-science conference statement on improving end-of-life care. NIH Consensus Development Program. Available at: https://consensus.nih.gov/2004/2004EndOfLifeCareSOS024html.htm. Published 2004. Accessed August 30, 2019.

7. Williams BA, Goodwin JS, Baillargeon J, Ahalt C, Walter LC. Addressing the aging crisis in US criminal justice health care. Journal of the American Geriatrics Society. 2012;60(6):1150-1156

STAC-T: A Bystander Bullying Intervention for Middle Schools

STAC-T: A Bystander Bullying Intervention for Middle Schools

Nationally, 20.8% of students age 12-18 report being bullied at school and 11.5% report being cyberbullied (1). Bullying peaks in middle school with 26% of students reporting being a target of bullying (1). Among middle schoolers, bullying victimization is associated with a variety of mental health problems including anxiety, depression, and suicide attempts. In addition, negative consequences linked with bullying extend to students who observe bullying (2). Student bystanders are also at increased risk for mental health problems, such as helplessness, isolation, and guilt. With 8 out of 10 students witnessing bullying (2), students need to know how to appropriately intervene.

The goal of Klein Buendel’s new Phase I STTR project is to begin to develop and test the feasibility of a middle school intervention to reduce bullying and its negative consequences. The project is being led by Dr. Aida Midgett (Principal Investigator) and Dr. Diana Doumas (Co-Investigator) of Boise State University, and Dr. Valerie Myers (Co-Investigator) of Klein Buendel.  The project is entitled “Translation of an In-Person Brief, Bystander Bullying Intervention (STAC) into a Technology-Based Program”.

Research has shown that bystanders can stop bullying by intervening (3, 4). Yet, most students do not intervene to defend targets because they do not know what to do (5). Comprehensive, school-wide bullying programs can be effective (6), but time- and labor-intensive resources required for program implementation pose significant barriers for schools, particularly in low-income and rural communities, which can reduce program uptake. To reduce these barriers, Dr. Midgett developed a brief bullying bystander intervention, using four strategies: “Stealing the show,” “Turning it over,” “Accompanying others,” and “Coaching compassion” (STAC) (7). STAC has been shown to be effective in reducing bullying perpetration (8,9) and victimization (8) and negative mental health consequences for bystanders who witness bullying (10-15).

Although brief interventions reduce implementation barriers, in-person programs still require training and delivery by school personnel, placing significant demands on schools. The product developed in this Phase I project is a technology-based, brief bystander bullying intervention (STAC-T) that can impact current bullying prevention approaches by: (a) significantly reducing implementation barriers for middle schools, particularly those in low-income and rural communities that can face educational, social, and health disparities; (b) training bystanders to effectively intervene, reducing bullying while simultaneously improving the mental health of bystanders; and (c) improving the program sustainability potential at the middle school level when bullying behavior typically reaches its peak.

This research project is funded by a grant from the National Institute on Minority Health and Health Disparities at the National Institutes of Health (MD014943; Dr. Aida Midgett, Principal Investigator).

References

  1. National Center for Education Statistics. Student Reports of Bullying: Results from the 2015 School Crime Supplement to the National Crime Victimization Survey. U.S. Department of Education;2016. NCES 2017-015.
  2. Rivers I, Poteat VP, Noret N, Ashurst N. Observing bullying at school: the mental health implications of witness status. Sch Psychol Q. 2009;24(4):211-223.
  3. Salmivalli C, Voeten M, Poskiparta E. Bystanders matter: associations between reinforcing, defending, and the frequency of bullying behavior in classrooms. J Clin Child Adolesc Psychol. 2011;40(5):668-676.
  4. Padgett S, Notar CE. Bystanders are the key to stopping bullying. Universal Journal of Educational Research. 2013;1(2):33-41.
  5. Hutchinson M. Exploring the impact of bullying on young bystanders. Educational Psychology in Practice. 2012;28(4):425-442.
  6. Gaffney H, Ttofi MM, Farrington DP. Evaluating the effectiveness of school-bullying prevention programs: an updated meta-analytical review [published online ahead of print July 20]. Aggr Violent Behav. 2018 doi: https://doi.org/10.1016/j.avb.2018.07.001
  7. Midgett A, Doumas D, Sears D, Lundquist A, Hausheer R. A bystander bullying psychoeducation program with middle school students: a preliminary report. Professional Counselor. 2015;5(4):486-500.
  8. Midgett A, Doumas DM, Johnston AD. Establishing school counselors as leaders in bullying curriculum delivery:Evaluation of a brief, school-wide bystander intervention. Professional School Counseling. 2017;21(1):1-9.
  9. Midgett A, Doumas DM, Trull R, Johnson J. Training students who occasionally bully to be peer advocates: is a bystander intervention effective in reducing bullying behavior? Journal of Child and Adolescent Counseling. 2017;3(1):1-13.
  10. Moran M, Midgett A, Doumas DM, Porchia S, Moody S. A mixed method evaluation of a culturally adapted, brief, bullying bystander intervention for middle school students. Under review
  11. Doumas DM, Midgett A, Watts AD. The impact of a brief, bullying bystander intervention on internalizing symptoms: Is gender a moderator of intervention effects? [published online ahead of print February 14]. Sch Psychol Int. 2019 doi: 10.1177/0143034319830149
  12. Watts A, Doumas DM, Midgett A. The efficacy of a brief, bystander bullying intervention on alcohol use among high school students. Journal of Addictions and Offender Counseling. In press
  13. Midgett A, Doumas DM. The impact of a brief, bullying bystander intervention on depressive symptoms. Journal of Counseling and Development. In press
  14. Midgett A, Doumas DM, Trull R. Evaluation of a bystander bullying intervention program for elementary school students. Professional School Counselor. 2018;20(1):172-183.
  15. Midgett A, Doumas DM, Trull R, Johnston A. A randomized controlled study evaluating a brief, bystander bullying intervention with junior high school students. Journal of School Counseling. 2017;15
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.

Parenting Now Launch

Parenting Now Launch

Klein Buendel, Inc. is collaborating with Dr. Michael Hecht and his team at REAL Prevention LLC on a new research project to develop and evaluate Parenting Now, a digitized adaptation of Dr. Robert Turrisi’s parent-based teen alcohol prevention program, the Parent Handbook. The Parent Handbook is one of only two family-based interventions recommended in FACING ADDICTION IN AMERICA: The Surgeon General’s Report on Alcohol, Drugs, and Health.

In this new study, the hard copy/pdf-formatted Parent Handbook, which targets parents of college-bound youth, is being adapted for parents of high school-aged children and being programmed for interactive technology-based delivery. “Parenting Now will give parents in the digital age access to content on the go and at convenient intervals through their multiple and mobile devices,” explained Dr. Michael Hecht, the Parenting Now Project’s Principal Investigator.

The Phase II SBIR research team is (1) developing core Parenting Now modules to address essential topics such as improving communication and parent permissiveness toward adolescent drinking, (2) customizing additional topics to parents’ specific interests, and (3) personalizing the program to parents’ communication styles. “Having both core modules and optional content will allow parents to customize or click through the curriculum, a feature of digital information that makes it more engaging,” said Dr. Hecht. “Parenting Now will personalize the skills to match the parent’s existing communication style, a key feature of engaging technology.”

The research project will conduct a rigorous randomized controlled trial using a nationally-representative sample through GfK Global and an active control condition. The study is evaluating Parenting Now’s effects on youth alcohol use and other substance use (marijuana use, nicotine use, and their combined use with alcohol). Researchers are examining the process of how Parenting Now influences parents’ behaviors and how these in turn influence students’ behaviors.

The Parenting Now Project is funded by the National Institute on Alcohol Abuse and Alcoholism (AA025293; Dr. Michael Hecht, REAL Prevention, Principal Investigator). Research collaborators include Dr. Anne Ray from Rutgers University and Dr. David Buller from Klein Buendel. Klein Buendel’s Creative Team is building the latest version of Parenting Now, expanding on the prototype they developed for the companion Phase I SBIR project.