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Month: January 2019

Implementation of Occupational Sun Safety at a 2-Year Follow-Up in a Randomized Trial

Implementation of Occupational Sun Safety at a 2-Year Follow-Up in a Randomized Trial

The American Academy of Dermatology acknowledges that outdoor workers receive more UV radiation exposure and are at a higher risk for skin cancer than other workers.1 In a recent article e-published in the American Journal of Health Promotion, KB’s Dr. David Buller, Dr. Barbara Walkosz, and Mary Buller, along with multiple collaborators, evaluated the implementation of sun protection policies two years after the initial intervention, called Sun Safe Workplaces (SSW), in cities, counties, and special districts in Colorado with workers in public works, public safety, and parks and recreation. Authors were also interested in whether or not the organizational characteristics had an effect on the implementation of the sun safety policies.

In the original 24-month long study, 98 government organizations in Colorado were enrolled in 2010 and 2011 and half were randomly selected to receive the SSW intervention, where the primary outcome was adoption of a sun protection policy. Each of the organizations’ written workplace policies were assessed and senior managers completed surveys before and after the intervention. In 2015 and 2016, two years after the intervention was completed, the organizations were contacted for a second follow-up and 63 of the original 98 agreed to participate. Self-administered surveys were given to frontline supervisors and employees who worked outdoors by key contact managers. Project staff visited each organization to conduct semi structured interviews with key managers and complete an audit of the workplace for sun protection messages and items.

Implementation of sun protection policies was measured in three ways: 1) inspection of the workplace for sun protection messages and personal sun protection items, such as shade structures or sunscreen; 2) reports from frontline supervisors on whether the organization communicated with employees about sun safety, had unwritten standard operating procedures on sun safety, or provided personal sun protection equipment for employees, such as wide-brimmed hats, sunscreen, long-sleeved shirts, long pants, etc.; and 3) reports from employees on whether they had received any training on sun safety at the workplace or sun safety communication from the organization or a coworker.

Results showed that two years after the initial intervention, sun protection messages and sun protection items were used more often in organizations that were originally part of the intervention group compared to the control group. Survey responses from frontline supervisors at intervention organizations also showed more communication about sun protection to employees, more standard operating procedures on sun safety and more free/reduced cost sunscreen than those from control organizations. Sun protection training and sun safety communication from coworkers and the employer was higher in intervention organizations when compared to control organizations. Additionally, organizations with a sun protection policy implemented more sun safety actions (communication about sun safety and provided personal sun protection equipment) than organizations without a policy.

The authors conclude that the SSW intervention appeared to increase local government organizations’ sun safety actions over time. Authors state that formal policies on sun protection and training together appear to be an important part of occupational sun protection efforts. A full description of the methods, results, conclusions, and limitations of this study can be found in the publication in the American Journal of Health Promotion.

This research was funded by the National Cancer Institute (CA187191; Dr. David Buller and Dr. Barbara Walkosz, Principal Investigators). Collaborators/coauthors include Mary Buller from Klein Buendel, Dr. Allan Wallis from the University of Colorado Denver, Dr. Peter Andersen from San Diego State University, Dr. Michael Scott from Mikonics, Inc., Dr. Richard Meenan from Kaiser Permanente’s Center for Health Research, and Dr. Gary Cutter from the University of Alabama at Birmingham.

Reference

  1. Outdoor workers and skin cancer. Safety+Health. September 23, 2018. Available at: https://www.safetyandhealthmagazine.com/articles/17480-outdoor-workers-and-skin-cancer. Accessed January 14, 2019.

Developing Geriatric and End-of-Life E-training For Inmate Peer Caregivers

Developing Geriatric and End-of-Life E-training For Inmate Peer Caregivers

Dr. Susan Loeb from Penn State University presented on the development of computer-based learning modules for caregivers of the aged and dying in prisons at the 11th Annual Conference on the Science of Dissemination and Implementation in Health in Washington DC, December 3-5, 2018. This research is being conducted with Dr. Valerie Myers at Klein Buendel (KB), a co-author on the presentation.

The increasing numbers and complex needs of aged and dying inmates intensifies the burden of care and costs incurred by prisons. In an initial study (NR011874), best practices in the community were adapted in the Toolkit for Enhancing End-of-Life Care (EOL) in Prisons to train prison staff in EOL care. The print-based Toolkit was well received; however, not well suited for dissemination and lacked geriatric content. The Toolkit was transformed and expanded into Enhancing Care of the Aged and Dying in Prisons (ECAD-P) computer-based learning (CBL) modules in a second study (AG049570). ECAD-P development revealed the need to develop e-training for inmates to assist staff as caregivers for aged and dying inmates.

The purpose of the third study, which was presented at the D&I Conference, is to transform best practices in inmate peer caregiving into a comprehensive training program  that consists of media-rich and interactive computer-based learning modules for providing geriatric and EOL care to peers (i.e., prisoner to prisoner). Focus groups with inmate caregivers, prison staff, and training staff were conducted to determine a menu of CBL modules. An Advisory Board of experts in EOL care, geriatrics, ethics, and corrections health informed the selection of modules for development. Usability testing will soon be conducted in one men’s and one women’s prison with inmates who are experienced in providing mental health peer support, but have not been caregivers for their aged and dying peers. Focus group data will be analyzed using thematic analysis. Usability data will be analyzed using descriptive statistics and content analysis. Data are currently being collected. Analysis will be complete in October and the presentation completed by November.

The Prisoner to Prisoner (P2P) project allows the creation of innovative technology while being mindful of security and safety concerns regarding prisoners. Expanded testing of the P2P product will optimize the scalable unit for broader dissemination, establish the effectiveness of the training, provide critical insights relevant to dissemination of the commercial product, and position the research team to study broad dissemination and implementation outcomes.

This research was funded by a Small Business Technology Transfer (STTR) grant to KB from the National Institute on Aging at the National Institutes of Health (AG057239; Dr. Susan Loeb, Principal Investigator) and Dr. Valerie Myers, Co-Investigator. Additional collaborators on the work presented at the conference include Dr. Erin Kitt-Lewis and Dr. Rachel Wion from the Penn State University College of Nursing, and Tiffany Jerrod and Morgan Carter from KB. The technology is being developed by the KB Creative Team.