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THE B-SMART APP: FINDINGS FROM AN IGNITION INTERLOCK STUDY

THE B-SMART APP: FINDINGS FROM AN IGNITION INTERLOCK STUDY

Driving while intoxicated (DWI) is a preventable source of morbidity and mortality in the United States. The Ignition Interlock Device (IID) requires a driver to blow into a breathalyzer installed in a vehicle to establish sobriety and reduces drunk driving while installed. IIDs have become widespread. Most U.S. states require DWI offenders to install IIDs in their cars. However, once IIDs are removed, DWI recidivism levels return to those similar to offenders who had no IID installed.

Klein Buendel Senior Scientist, Dr. W. Gill Woodall, presented DWI intervention study results at the 47th Annual Research Society on Alcoholism Scientific Meeting on June 22-26 in Minneapolis, Minnesota. The purpose of this study was to develop and test an app (“B-SMART”) for DWI offenders and their Concerned Family Members (CFMs) to extend non-intoxicated driving beyond the IID installation period.

The B-SMART app has four modules: 1) Life with the Interlock – orientation to IIDs, 2) processes to support changes in drinking, 3) effective communication skills, and 4) family activities that don’t involve alcohol. Participants (pairs of DWI Offenders and CFMs N=76) were randomly assigned to receive the B-SMART web app (n=30) or access to an IID New Mexico Department of Transportation information page [Usual and Customary (UC) condition, n=46]. Data on failed IID tests and IID lockout events were obtained from Ignition Interlock providers and were the primary outcome variables.

IID data were collected at the end of the project period on 58% (n=71) of 123 participants, with one IID provider not providing IID data due to corporate policy restrictions. Two summary outcome variables were created: 1) the frequency of any failed test during IID installation period, and 2) IID lockout events, which occur when a driver repeatedly fails the breathalyzer test in a set time period. The mean number of failed IID tests was not significantly different for UC participants (n=45) than versus B-SMART participants (n=26). For lockout events, UC participants had significantly more Lockout events than B-SMART participants.

Results indicate the B-SMART app reduced IID Lockout events, which is an important outcome as lower IID events predict reduced DWI recidivism. 

This research was supported by a grant from the National Institute on Alcohol Abuse and Alcoholism (AA022850; Dr. W. Gill Woodall, Principal Investigator). Collaborators on this conference presentation included Dr. Barbara McCrady and Dr. Vern Westerberg from the Univeristy of New Mexico; and Ms. Julia Berteletti, Ms. Marita Brooks, and Ms. Lila Martinez from Klein Buendel. The B-SMART app was developed by the Creative Team at Klein Buendel.

B-SMART: RESULTS OF A WEB APP FOR DWI OFFENDER FAMILIES

B-SMART: RESULTS OF A WEB APP FOR DWI OFFENDER FAMILIES

Driving while intoxicated (DWI) remains a preventable source of morbidity and mortality in the United States. The Ignition Interlock Device (IID) requires a driver to blow into a breathalyzer installed in a vehicle to establish sobriety and reduces drunk driving while installed. The use of IIDs has become widespread. Most states now require DWI offenders to install IIDs in their cars. 

However, once IIDs are removed, DWI recidivism levels return to those similar to offenders who had no IID installed. The B-SMART app has been systematically developed for DWI offenders and their Concerned Family Members (CFMs) to extend non-intoxicated driving beyond the IID installation period. 

B-SMART Module Topics

  • Life with the Interlock – orientation to Ignition Interlock Devices
  • Family processes to support changes in drinking
  • Effective communication skills for families
  • Finding family activities that do not involve alcohol 

Results of a randomized trial of the B-SMART app on a variety of alcohol consumption, IID, and family communication variables were reported by Dr. W. Gill Woodall, Klein Buendel Senior Scientist, at the 46th Annual Research Society on Alcohol Scientific Meeting held in Bellevue, Washington on June 24-28, 2023.

Study participants, who were pairs of DWI Offenders and CFMs, were randomly assigned to receive the B-SMART web app or an available IID information page from the New Mexico Department of Transportation (Usual and Customary/UC condition). Participants were assessed at baseline, 3 months, and 9 months. 

Analyses of alcohol consumption variables yielded two results on alcohol quantity frequency with available data. For average drinks per day during the last 30 days at the 3-month assessment, a near significant between groups difference was detected such that client participants in the UC group reported significantly higher drinks per day when drinking than B-SMART intervention client participants. A second alcohol consumption effect was found for reported average drinks per week, where UC participants reported increasing average weekly drinking from baseline to 3-month follow-up, while intervention participants reported no significant change in average drinks per week from baseline to 3-month follow-up. Results suggest that the B-SMART app may improve outcomes for DWI offender families.

This research was funded by the National Institute on Alcohol Abuse and Alcoholism (AA022850; Dr. W. Gill Woodall, Principal Investigator). Dr. Woodall’s scientific collaborators include Dr. Barbara McCrady and Dr. Vern Westerberg from the University of New Mexico, and Ms. Julia Berteletti, Ms. Marita Brooks, and Ms. Lila Martinez from Klein Buendel.

EUROGIN HPV Panel Presentation

EUROGIN HPV Panel Presentation

Klein Buendel Senior Scientists, Dr. W. Gill Woodall and Dr. David Buller, presented two research projects in a panel discussion at the EUROGIN International Multidisciplinary HPV Congress on Feb 8-11, 2023 in Bilbao, Spain. The “Digital Interventions to Increase HPV Vaccination” panel featured four presentations and was moderated by Dr. Greg Zimet from the University of Indiana. Other Klein Buendel scientists and staff (at the time of abstract submission) contributing as co-authors included Dr. Barbara Walkosz, Ms. Marita Brooks, Ms. Lila Martinez, and Ms. Jeanny Reither. Klein Buendel employees’ names are bolded.

Presentation 1

Title: “Randomized Trials of HPV Vaccine Uptake Improvement: Web Apps for Parents and Young Adolescent Girls and Boys”

Presenter: W. Gill Woodall, PhD, Senior Scientist, Klein Buendel, Inc. Albuquerque, NM, USA

Co-authors: A. Kong, G. Zimet, D. Buller, L. Chilton, J. Reither, L. Martinez, M. Brooks

This presentation discussed the results of two randomized trials of parent-focused web apps to improve HPV vaccine uptake for young adolescents (ages 11-14).  For the first trial, the web app was tailored to parents and young adolescent girls, and in the second trial, the web app was tailored to parents and young adolescent boys. Results of both trials indicated significant web app impact on HPV vaccine uptake for adolescent girls and boys, as well as other vaccine uptake related variables.  The discussion included a consideration of web app content and tailoring to determine HPV vaccine uptake improvement.

Presentation 2

Title: “Successful technology-based rural patient HPV vaccination reminder intervention and social media assessment of strategies to reduce HPV vaccine misinformation”

Presenter: Deanna Kepka, PhD, MPH, University of Utah, Salt Lake City, UT, USA

Co-authors: K. Christini, E. McGough, B. Gibson, E. Warner, H. Brandt

This presentation described a multi-level and multi-component intervention that included healthcare team training activities and technology-based HPV vaccination reminders. Missed opportunities for HPV vaccination declined significantly from the pre-intervention to the post-intervention period. Participants who recalled receipt of an electronically delivered vaccination reminder had higher unadjusted odds of scheduling a visit compared with those who did not recall receiving a reminder. Social media-delivered misinformation related to HPV vaccination is pervasive. The presenters also discussed new strategies to evaluate and reduce the impact of HPV vaccine misinformation in rural settings.

Presentation 3

Title: “Promoting HPV vaccination to emerging adults in rural communities in a multi-risk factor cancer prevention social media intervention”

Presenter: David Buller, PhD, Senior Scientist, Klein Buendel, Inc., Denver, CO, USA

Co-authors: A. Sussman, D. Kepka, W. G. Woodall, E. Warner, B. Walkosz

This presentation described an innovative social media campaign targeting six cancer risk factors, including HPV vaccination. It is being developed for the diverse population of adults aged 18-26 in rural counties in the Mountain West region of the U.S. Emerging adults obtain health information online far more than information from health care providers and other media. A framework for social media message development was presented based on social cognitive, self-determination, and diffusion of innovation theory. Misinformation, especially on vaccination, will be combatted by instructing emerging adults in digital and media and by using an epidemiological model of monitoring and quickly responding to correct misinformation. The campaign will be tested with a sample of 1000 emerging adults in a stepped-wedge quasi-experimental design.

Presentation 4

Title: “U.S. National Digital Point of Care Communication to Improve Uptake of HPV and Other Adolescent Vaccines in Clinic Settings”

Presenter: Judy Klein, BA, BS, President, UNITY Consortium, Philadelphia, PA, USA

Co-authors: G. Zimet, V. Agadi, C. Hu, A. Jaramillo

This presentation reported on a study that involved digital targeted adolescent vaccination infographics and videos widely disseminated to clinical practices throughout the U.S. Over 11,000 clinicians whose practices received these digital interventions (exposed condition) were matched to an equal number of non-exposed comparison practices matched on multiple practice characteristics. The outcomes of interest were the number of vaccine doses (Tetanus-diphtheria-pertussis booster or Tdap, HPV, MenACWY, and MenB) administered to patients 11-18 years of age. The exposed clinics showed significant increases in administration of adolescent vaccines, including HPV vaccine, compared to the non-exposed clinics.

Vacteens: A Web App to Boost HPV Vaccine Uptake

Vacteens: A Web App to Boost HPV Vaccine Uptake

Dr. W. Gill Woodall, Klein Buendel Senior Scientist, and his coauthors published the results of the Vacteens Project in the online journal, Frontiers in Digital Health.

The uptake of HPV vaccine in the United States remains lower than preferred by health authorities, particularly for young adolescents, when immunogenic response to the vaccine is strongest. Potential parental barriers to low vaccine uptake include confusion, uncertainty, and misinformation about HPV vaccine schedule, safety, and effectiveness. Dr. Woodall and his collaborators believe that parental barriers to HPV vaccination may be addressed by digital interventions, such as web apps, that are tailored to their concerns.

The Vacteens Project project tested a web app for educating parents. The study was conducted with 82 parent-adolescent (daughter) pairs recruited from in nine pediatric clinics in New Mexico. It tested whether digital information delivered to parents in a community setting may be an effective way to help reach HPV vaccine uptake goals in the United States. Diffusion of Innovations Theory principles were used to guide the development of the Vacteens/Vacunadolescente mobile app in English and Spanish.

Parents were randomized to receive either the Vacteens/VacunaAdolescente mobile web app or the usual and customary online HPV vaccination pamphlet from the U.S. Centers for Disease Control and Prevention (CDC). Parents completed surveys at baseline and month 3, and child vaccine records were collected at month 12. Vaccine uptake results from the study found that parents who received the Vacteens/VacunaAdolescente web app were more likely to have their daughters vaccinated than parents in the control condition. Study methods, results, and limitations are detailed in the online publication.

This research was funded by a grant from the Patient-Centered Outcomes Research Institute (PCORI) to the University of New Mexico (#1511-33018; Dr. W. Gill Woodall, Principal Investigator). Dr. Woodall’s collaborators include Dr. Greg Zimet from Indiana University, Dr. Alberta Kong, Dr. Lance Chilton, and Dr. Randall Starling from the University of New Mexico, and Dr. David Buller, Jeannyfer Reither, and Dr. Valerie Myers from Klein Buendel.