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STAC-T Phase II Project

STAC-T Phase II Project

A collaborative research team from Boise State University, Plymouth State University, the University of Mississippi, and Klein Buendel is launching a Phase II STTR research project to develop and evaluate the impact of a middle school intervention to reduce bullying and its negative consequences. The project is entitled “Translation of an In-Person Brief, Bystander Bullying Intervention (STAC) into a Technology-Based Program.” STAC uses four strategies in its bullying bystander intervention: “Stealing the show,” “Turning it over,” “Accompanying others,” and “Coaching compassion.”  

The project will use state-of-the-art technology to adapt a novel, evidence-based bullying bystander intervention to a user-centered, technology-based format for an underserved population with significant mental health disparities. STAC-T will extend the scope of the original STAC intervention by providing a delivery mechanism that increases access and reduces implementation barriers for schools in rural, low-income communities, as well as providing interactive, user-centered content. STAC-T will address both bullying and negative mental health outcomes for targets and bystanders through an evidence-based approach adapted for a broader audience and utilize  technology to effectively implement bullying prevention.

Phase II Specific Aims

  • Develop a fully-programmed, media-rich, interactive STAC-T intervention in English and Spanish consisting of (1) core modules providing interactive training on essential topics (such as bullying, bystander roles, STAC strategies), (2) interactive skills practice with avatars moving through bullying scenarios with feedback, and (3) booster sessions in which students report strategy use and feedback and badges for intervening.
  • Conduct usability testing of the fully-programmed STAC-T in three middle schools in two states with students and school personnel to evaluate the user interface, ease of use, and perceived barriers in order to optimize the program prior to a large-scale investigation.
  • Test the fully-programmed, dual language (English and Spanish) STAC-T in six middle schools in four states through a randomized controlled trial to evaluate changes in (1) knowledge, confidence, and use of STAC strategies, (2) bullying and cyberbullying perpetration and victimization, and (3) mental health outcomes.

The investigators hypothesize that STAC-T will (1) improve access by reducing implementation barriers for middle schools, particularly those in rural and low-income communities, (2) train bystanders to effectively intervene, reducing bullying while simultaneously improving the mental health of bystanders, and (3) improve program sustainability at the middle school level when bullying behavior peaks.

The STAC-T project is funded by an STTR Phase II grant to Klein Buendel from the National Institute on Minority Health and Health Disparities at the National Institutes of Health (MD014943; Dr. Aida Midgett, Principal Investigator). Dr. Midgett is a Professor and Chair of the Department of Counselor Education at Boise State University. Her collaborators on this research project include Dr. Diana Doumas and Dr. Laura Bond from Boise State University; Dr. Robin Hausheer from Plymouth State University; Dr. Amanda Winburn from the University of Mississippi; and Ms. Mary Buller from Klein Buendel. The STAC-T modules will be programmed by Klein Buendel’s Creative Team.

Promoting Health Equity for Diverse Populations During a Pandemic

Promoting Health Equity for Diverse Populations During a Pandemic

Dr. Susan Loeb, PhD, RN, FGSA, FAAN, from the Pennsylvania State University College of Nursing and College of Medicine – and an active Klein Buendel research collaborator – presented on promoting health equity during the COVID-19 pandemic at 34th Annual Scientific Session of the Eastern Nursing Research Society on March 31 through April 1, 2022 in Providence, Rhode Island. The theme of the conference was “Charting the Path of Diversity, Equity, and Inclusion Through Nursing Science.”

The interruption of face-to-face human subjects’ research by universities and correctional institutions due to the COVID-19 pandemic has necessitated researchers to adopt alternative approaches for proceeding with their work. Adaptations and strategies that the research team employed to keep their study progressing forward in meaningful ways despite a protracted public health emergency were presented. A study focusing on the research and development of highly interactive e-learning modules to prepare incarcerated people to assist corrections staff in caring for people are older and/or approaching the end of life in prison served as an exemplar for the presentation. The study – the Inmates Care Project – is an STTR grant awarded to Klein Buendel by the National Institute on Aging (AG057239; Dr. Susan Loeb and Dr. Barbara Walkosz, Multiple Principal Investigators).

The theoretical framework for the study is the Institute for Healthcare Improvement’s Framework for Going to Full Scale. Identification of barriers and facilitators, re-envisioning how the team would restructure their day-to-day work, and preparing for the future are just a few of the essential steps that were taken. Examples of daily restructuring included a) approach to weekly team meetings; b) data collection protocols; c) advisory board meetings; and d) opportunities for networking and community building.

Key lessons learned through this experience included the a) importance of taking stock and seizing the opportunity to make investments in team member development; b) writing protocols that detail both in-person and virtual options for data collection to allow the team to pivot quickly when the next challenge arises; and c) reaching out to brainstorm with funding agency program officers, Institutional Review Board analysts, advisory board members, and other researchers from beyond your team.

Well-thought-out adaptations that are approved by funding agencies, offices of research protections, and other stakeholders in the research can result in scientifically sound, public health safe, and pragmatic approaches for moving ahead to remain research-productive, despite public health challenges. Taken together, these approaches can maintain study progress, and scientific integrity, as well as identify alternate ways to achieve study aims in a timeline necessarily relaxed, but as close as possible to the original plan.

Co-authors on the presentation and top poster included Dr. Erin Kitt-Lewis, Sherif Olanrewaju, and Leigh Casey from Penn State University; Dr. Valerie Myers and Savanna Olivas formerly from Klein Buendel; Jeannyfer Reither from Klein Buendel; and Katherine Aiken from the Penn State College of Health and Human Development.

ezPreemie Project

ezPreemie Project

Today, 80-90% of very preterm infants survive. However, preterm birth alters the development of the prefrontal cortex, the brain region heavily involved in behavior regulation and inhibition. This places children born very preterm at high risk for developmental delays and behavioral problems.

Early prevention and intervention can interrupt the development of problem behaviors, reduce active problem behaviors and improve functioning for children and families. Behavioral parent training (BPT) is a gold standard for prevention and treatment of child behavior problems. BPT teaches child management skills and positive parenting strategies. Little is known about the use and effects of BPT programs for former very preterm infants with their unique medical, developmental, and psychological risk profiles.

A research team from Ohio State University, Rush University, Nationwide Children’s Hospital, and Klein Buendel is launching a 5-year research project to develop and evaluate a technology-based, widely accessible, and effective form of BPT delivery to address the unmet and unique needs of parents of very preterm children. The app will be tested alone and in combination with specialized coaching. The project is called “Parent Training for Parents of Toddlers Born Very Premature.” It is being led by Dr. Susie Breitenstein from Ohio State University (OSU) and Dr. Michele Greene from Rush University (Multiple Principal Investigators). The project is funded by The Eunice Kennedy Shriver National Institute of Child Health and Human Development at the National Institutes of Health (HD104072).

The research project will design and develop a web-based app, similar to one developed previously by Dr. Breitenstein and her team, called ezParent. ezParent was designed for parents of children ages 2-6 years. It provides behavioral training through brief videos, interactivity, reflection questions, and assessments to parents of young children. The new iteration of ezParent, ezPreemie, will assess the independent and combined effects of ezParent and coaching calls on parent and child outcomes in families with very preterm infants.

Dr. Breitenstein, PhD, RN, FNAP, FAAN, is an Associate Professor, Assistant Dean for Research and Innovation, and Senior Director, Community Outreach and Engagement & CHW Training Program in the OSU College of Nursing. Dr. Michelle Greene is an Associate Professor and Director of the Psychology Section in the Department of Pediatrics at Rush Medical College. Research Co-investigators include Dr. Michael Schoeny and Dr. Kousiki Patra from Rush University, Dr. Sarah Keim and Dr. Mary Lauren Neel from Nationwide Children’s Hospital, and Ms. Julia Berteletti from Klein Buendel. The ezPreemie app will be engineered by Klein Buendel’s Creative Team.

STAC-T: Formative Research Results

STAC-T: Formative Research Results

Formative research, such as target population focus groups and usability testing, is essential for the design and development of interactive technology-based programs. Usability testing results of a brief web-based middle school bystander bullying prevention program, STAC-T, were published recently in JMIR Formative Research. The research team was led by Dr. Aida Midgett from Boise State University. Key collaborators included Dr. Diana Doumas from Boise State University and Dr. Valerie Myers, formerly from Klein Buendel.

STAC-T translates four strategies to train bystanders to effectively intervene to reduce bullying into a time- and cost-effective web-based program for middle school students and staff. The four strategies are: “Stealing the show,” “Turning it over,” “Accompanying others,” and “Coaching compassion.”

The main purpose of the formative research was to assess the usability and acceptability of a STAC-T prototype in advance of full-scale development. Other aims included understanding school needs and barriers to program implementation, and assessing differences in usability between middle school staff and students. 

Sixteen participants from three middle schools in rural, low-income communities completed STAC-T usability testing and a qualitative interview. The publication describes the usability testing methods and outcomes of data analyses, including ratings of prototype program satisfaction, acceptability, feasibility, needs, barriers, and recommendations for program adjustments. Overall, school staff and students reported satisfaction with the web-based program. They found it easy to use, acceptable, and feasible. The findings have encouraged the authors to pursue the full-scale development of the STAC-T web-based bullying prevention app for middle schools.

The STAC-T feasibility project was funded by a small business STTR grant to Klein Buendel from the National Institute on Minority Health and Health Disparities at the National Institutes of Health (MD014943; Dr. Aida Midgett, Principal Investigator). The STAC-T prototype was programmed by Klein Buendel’s Creative Team.

Translation of an In-Person Bystander Bullying Intervention to a Technology-Based Platform

Translation of an In-Person Bystander Bullying Intervention to a Technology-Based Platform

Klein Buendel Senior Scientist, Dr. Valerie Myers, and collaborators from Boise State University will be presenting a poster showcasing the development of a technology-based bullying prevention program during the 42nd Annual Meeting & Scientific Sessions of the Society of Behavioral Medicine from April 12-16, 2021.

Bullying is a significant problem in the United States, with more than a quarter of middle school students reporting bullying victimization. Bullying is associated with multiple mental health, social, and academic consequences. Although comprehensive school-wide interventions are available, they require significant resources for implementation, reducing access to schools, particularly in rural or low-income communities. Thus, there is a need for bullying programs that effectively address bullying while removing implementation barriers.

The STAC intervention is a brief, bystander bullying intervention that includes psychoeducation and role-plays to increase knowledge and skills to intervene in bullying. STAC stands for four strategies students can use when they witness bullying: “Stealing the show,” “Turning it over,” “Accompanying others,” and “Coaching compassion.” A series of randomized controlled trials have demonstrated the efficacy of the STAC intervention in reducing bullying perpetration and victimization, as well as depression, anxiety, and alcohol use.

The goal of the project presented in the poster was to translate the STAC program into a technology-based platform (STAC-T) for middle schools. The aims of this study were to: (1) conduct a needs assessment with middle school personnel, (2) develop a web-based prototype based on the in-person STAC intervention through iterative focus groups, and (3) conduct usability testing with middle school students and school personnel. Qualitative data from the needs assessment indicated a strong interest in a technology-based bullying intervention and positive conditions for implementation including administrative support and school technology-readiness. Students who participated in iterative focus groups reported the app concept was easily understood and engaging and identified essential features for a successful prototype.

Results from usability testing indicated participants perceived the STAC-T program to be useful and appropriate for their school and community. Findings from this study showed that the STAC-T program is relevant and feasible for implementation in the middle school settings and is usable for the target audience.

The STAC-T project is funded by an STTR grant to Klein Buendel from the National Institute on Minority Health and Health Disparities at the National Institutes of Health (MD014943; Dr. Aida Midgett, Principal Investigator). A third collaborator, in addition to Dr. Midgett and Dr. Myers, is Dr. Diana Doumas from Boise State University.

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
Precision Pain Management App for Adolescents with Sickle Cell Disease

Precision Pain Management App for Adolescents with Sickle Cell Disease

Dr. Valerie Myers, KB Senior Scientist, is presenting a poster on the Pinpoint Project at the 39th Annual Meeting and Scientific Sessions of the Society of Behavioral Medicine, April 11-14, 2018 in New Orleans, Louisiana.

“Pinpoint: Gaming Technology to Engage Adolescent Sickle Cell Patients in Precision Pain Management” was a Phase I SBIR project that examined the feasibility and acceptability of a gamified tablet application intended to encourage teens (aged 13-17) to assess and talk about their sickle cell disease (SCD) pain. SCD is the most common inherited blood disorder in the U.S. and affects primarily African Americans and Hispanics. Approximately, 1,000 U.S. children are born with SCD annually. SCD complications can be serious and have a significant impact on well-being and quality of life.

Pain is the hallmark symptom associated with SCD and is the primary cause of SCD-related hospital admissions. Accurate assessment of pain specifiers (type, frequency, and intensity of pain) can help with ameliorating pain quickly and effectively. Reducing barriers to collection and promoting the value of accurate SCD pain assessment is a need in pediatric medicine. The interactive games for health literacy among youths have shown video games can improve self-efficacy; stimulate health discussions with friends, family, and clinical team; encourage seeking support and advice, and can emphasize behavior acquisition via experiential learning. Interactive games can provide information about causes, treatments, and self-care options, and can improve self-care and reduced emergency clinical utilization.

The Pinpoint app prototype for tablets and smartphones consisted of a Pain Assessment Tool, vocabulary game, body scanner reflection, educational self-disclosure activity, and excerpts from the Hope and Destiny Jr. book authored by Hsu, Rodrigues, and Brandalise. Four healthcare providers were interviewed on the app’s acceptability and potential function within the clinical practice. Sixteen teens participated in cognitive interviews, focus groups, and usability testing. The System Usability Scale (SUS), a validated tool for assessing the usability and acceptability of technological products, served as the primary outcome. The preliminary SUS score well above average, suggesting a high level of acceptability and usability among users. The conference poster will include final project outcomes and the plan for the future development of the full Pinpoint app.

This research was funded by a grant from the National Institute on Minority Health and Health Disparities (R43MD010746; Dr. Valerie Myers, PI). Research collaborators included Mary Buller from KB, and Dr. Hilton Hudson and Megan Lippert from the Hilton Publishing Company, publishers of the Hope & Destiny and Hope & Destiny Jr. sickle cell disease management books.

KB’S 2017 Research and Outreach Accomplishments and Other Highlights

KB’S 2017 Research and Outreach Accomplishments and Other Highlights

The year 2017 flew by, but we have taken time to reflect on what we have done at Klein Buendel (KB) to achieve our primary goal of creating and evaluating effective programs and products for health promotion and disease prevention. We are thankful for the research, education, and outreach opportunities that we have participated in, and we are looking forward to continuing our efforts in 2018. Details of some of our 2017 accomplishments and publications are listed below. The names of KB investigators and staff are bolded.

SUMMARY OF KLEIN BUENDEL’S 2017 RESEARCH AND OUTREACH ACCOMPLISHMENTS

  • In June, KB celebrated its 15th anniversary as a small woman-owned business.
  • In August, one of our Senior Scientists, Valerie Myers, was made a Fellow of the Society of Behavioral Medicine.
  • We were awarded 3 new prime grants and 1 subcontract.
  • We completed 7 prime and subcontract research projects.
  • KB scientists and staff presented research findings at 6 national and international conferences (19 posters or presentations).
  • KB scientists, collaborators, and staff published 12 papers of research findings in peer-reviewed journals.

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