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Uptake of MC1R Testing for Melanoma Risk

Uptake of MC1R Testing for Melanoma Risk

The use of personalized medicine or tailoring medicine based on sequencing and analyzing an individual’s DNA, is drastically changing cancer research and treatment, risk assessment and clinical practices1, and skin cancer is one area being affected by this research.2 Currently, melanoma in U.S. Hispanic populations is on the rise and despite melanoma being more common in Caucasians than Hispanics, a melanoma diagnosis is more likely to be fatal for Hispanics.3

In a study recently published in JAMA Dermatology, several researchers (lead author Dr. Jennifer Hay) including Dr. David Buller from Klein Buendel, examined interest and uptake, as well as demographic and skin cancer risk factor covariates of interest and uptake, of the melanocortin-1 receptor gene (MC1R) saliva test among 499 adult participants recruited from diverse clinics in Albuquerque, New Mexico. Forty-four percent (44%) of participants were non-Hispanic white, 48% were Hispanic, and all were registered clinic patients for longer than six months, were 18-years of age or older, and spoke English or Spanish fluently. A study website log-in was given to participants to give them the option to log on and read three educational modules presenting the rationale and pros and cons of MC1R testing.

Results showed that almost 50% (n=232) of participants logged on to the website and that non-Hispanic whites and those with higher education were more likely to do so. Furthermore, participants with a history of sunburn and with at least one first-degree relative were also more likely to log on to the website. Of those who logged on, almost 90% (n=204) decided to request testing and a little over 80% (n=167) of those who requested testing returned the kit. Non-Hispanic whites and older participants had a higher rate of returning the kit.

Authors cite the large, diverse sample and the behavioral outcomes versus self-reported outcomes as strengths of the study while citing the single location and use of one primary care health system for recruitment as a limitation on generalizability. Lastly, authors conclude by calling for future research in socioeconomic and demographic discrepancies in interest and uptake of genetic testing in order to ensure ease of availability of genetic information seeking in the general population.

References

  1. Orchard C. Genomic medicine in the real world: “hope” and “hype”. Harvard T.H. Chan School of Public Health Web site. Available at: https://www.hsph.harvard.edu/ecpe/genomic-medicine-in-the-real-world-hope-and-hype/. Published June 1, 2015. Accessed June 20, 2018.
  2. Genetics of skin cancer (PDQ) – health professional version: genetic testing. National Cancer Institute Web site. Available at: https://www.cancer.gov/types/skin/hp/skin-genetics-pdq#link/_393_toc. Updated June 14, 2018. Accessed June 20, 2018.
  3. Perez MI. Hispanics get skin cancer, too. Skin Cancer Foundation Web site. Available at: https://www.skincancer.org/prevention/are-you-at-risk/hispanic. Published May 25, 2016. Accessed June 20, 2018.
Online Responsible Alcohol Beverage Server Training for Spanish Language Populations

Online Responsible Alcohol Beverage Server Training for Spanish Language Populations

Data from a Klein Buendel (KB) research project on the formative development of an online responsible alcohol beverage server training program for Spanish language populations the U.S. Southwest was presented in June at the 41st Annual Scientific Meeting of the Research Society on Alcoholism in San Diego, California.

Preventing alcohol-related injury and death is a national priority. Evidence-based interventions to change organizational and community norms, including training to promote responsible alcohol beverage service (RBS), are important public health approaches. However, current RBS training has not been tailored to address Spanish-speaking populations that represent disproportionately high rates of alcohol-related injury and death in the U.S. WayToServe®, an evidence-based RBS intervention, is being redesigned to promote a culturally and linguistically adapted RBS training for Spanish-speaking servers, titled WayToServe Español.

Four focus groups were conducted with Spanish-speaking alcohol servers to identify linguistic and culturally relevant additions to create WayToServe Español. Focus groups were held in El Paso, Texas, on weekdays in spring 2017, between 1:30-3:00 pm. Of the 37 participants, all were either monolingual or bilingual Spanish-speakers and active or recent alcohol sellers/servers. Research team members conducted the groups. The discussions were audiotaped and transcribed verbatim from Spanish to English. Two team members reviewed all transcripts for recurring ideas and comments and then categorized them into main themes.

Preliminary analysis identified four overarching themes: (1) challenges faced by servers, such as setting clear limits for alcohol service for their patrons; (2) support for RBS training; (3) participants’ evaluations of previous training (for example, the low quality of existing Spanish-language RBS training; and (4) their recommendations for Spanish-language RBS training, such as the importance of culturally-respectful training. Participants noted easy access to the web-based RBS training. Overall, the data suggest that WayToServe Español for Spanish-speaking servers is an important step in the creation of culturally- and linguistically-relevant approaches to enhance RBS.

This research project is titled “WayToServe Español: A Culturally-Appropriate Online Responsible Beverage Service Training for Spanish-Speaking Servers” and is funded by the National Institute of Minority Health and Health Disparities at the National Institutes of Health (R44MD010405. Dr. W. Gill Woodall, a KB Senior Scientist, is the project’s Principal Investigator. Collaborating co-authors on this presentation included Dr. Victoria Sanchez from the University of New Mexico Health Sciences Center, Dr. Areli Chacon Silva and Dr. Frank Perez from the University of Texas at El Paso, and Ms. Jeanny Camacho Reither, KB Senior Project Coordinator.

Methodological Challenges of Social Media-Delivered Health Promotion Interventions

Methodological Challenges of Social Media-Delivered Health Promotion Interventions

Dr. Sherry Pagoto, SBM President-elect and KB Collaborator, was a co-presenter for a Behavioral Informatics and Technology Panel Discussion on social media health promotion at the 39th Annual Meeting and Scientific Sessions of the Society of Behavioral Medicine, April 11-14, 2018 in New Orleans, Louisiana. Dr. Pagoto shared methodological challenges related to participant recruitment, intervention content development, and intervention delivery for a Facebook intervention targeting mothers of teen daughters in order to reduce the incidence of indoor tanning. This project is currently being conducted by KB and several collaborators from the University of Connecticut, East Tennesee State University, and Colorado State University.

Social media platforms can be used to deliver health promotion interventions to wide audiences without the barriers that plague traditionally-delivered programs, such as geography, transportation, scheduling, and childcare. Because most people access their social media feeds daily, health programming can be delivered to populations who are not necessarily seeking help or are motivated to change. Despite these promising and unique features, designing studies to evaluate social media-delivered interventions involves methodological challenges for recruitment and participation. During the panel discussion, Dr. Pagoto shared some of our research project’s challenges, implications of alternative recruitment and engagement methods, and valuable lessons learned.

This research project is called “Likes Pins and Views: Engaging Moms on Teen Indoor Tanning Thru Social Media.” It is funded by a grant from the National Cancer Institute (RO1CA192652; Dr. David Buller, KB, Principal Investigator). Collaborators include Dr. Barbara Walkosz and Julia Berteletti from KB, Dr. Sherry Pagoto, Jessica Oleski, and Ashley Panzarino from the University of Connecticut, Dr. Katie Baker and Dr. Joel Hillhouse from East Tennessee State University, and Dr. Kim Henry from Colorado State University.

Behavioral Counseling Recommendations for Skin Cancer Prevention

Behavioral Counseling Recommendations for Skin Cancer Prevention

In the March 20, 2018 issue of the Journal of the American Medical Association, the U.S. Preventive Services Task Force (USPSTF) published a recommendation statement on behavioral counseling to prevent skin cancer.

The publication updated the 2012 USPSTF recommendation on behavioral counseling for the prevention of skin cancer.

The USPSTF determined that behavioral counseling interventions are of moderate benefit in increasing sun protection behaviors in children, adolescents, and young adults with fair skin types (aged 6 months to 24 years old). They found adequate evidence that behavioral counseling interventions result in a small increase in sun protection behaviors in adults older than 24 years with fair skin types.

The USPSTF, however, found inadequate evidence on the benefits and harms of counseling adults about skin self-examination to prevent skin cancer. This conclusion was based on the lack of evidence that skin self-examination is beneficial.

Two editorials  – one led by Dr. June Robinson from the Department of Dermatology at the Northwestern University Feinberg School of Medicine in Chicago and the other led by Dr. David Buller, Director of Research at Klein Buendel –  were also published along with the Task Force recommendations.

The editorial by Robinson and Jablonski points out that while physicians are trusted sources of health information, people at risk for skin cancer or with a family history of skin cancer may also find family members to be useful networks for information on prevention and self-examination.

The editorial by Buller, Heckman, and Manne expresses disappointment in the Task Force not recommending skin self-examination and points out that some ongoing studies to determine effectiveness of skin self-examination may find that it is effective.

Both editorials describe the Task Force’s definition of risk as “fair skin types” as narrow. They believe that many other people are at risk for skin cancer and could benefit from sun protection education and counseling. Some groups mentioned in the editorials include people who sunburn but are not considered fair-skinned, people who use indoor tanning equipment, children and adolescents, Hispanics, and people who are physically active outdoors. According to the authors, it is important not to disenfranchise these groups within the diverse U.S. population.

A Randomized Study of Shade Sails and Passive Recreation in Public Parks in Two Hemispheres

A Randomized Study of Shade Sails and Passive Recreation in Public Parks in Two Hemispheres

Skin cancer is the most common type of cancer1 but the primary risk factor for skin cancer, UV exposure, is the most avoidable.2 Purpose-built shade not only reduces UV exposure,3 it can also come with other benefits like provide protection without requiring planning4 and may even provide protection for individuals with negative attitudes towards sun safety who seek shade to keep cool.5

In a recent publication in American Journal of Public Health, KB’s Dr. David Buller, Mary Buller and collaborators in Australia, at the University of Melbourne (Dr. Dallas English) and Cancer Council Victoria, (Dr. Suzanne Dobbinson) conducted a stratified randomized study in Melbourne, Australia and Denver, Colorado where shade sails were built in 1 of 2 passive recreation areas (PRAs) in full sun in 144 parks (71 in Melbourne and 73 in Denver). The use of the PRAs with shade sails built as part of the study were compared with the nearby non-shaded PRAs for use by park visitors. The authors tested two hypotheses – the first being that the introduction of shade sails over PRAs would increase the use of these PRAs by visitors compared to unshaded PRAs – and the second being that the increase in use of shaded PRAs would be larger in Melbourne, Australia than Denver, Colorado due to stronger norms for sun safety in Australia than the United States.

Public parks enrolled in the study had to contain at least two unshaded PRAs that were in full sun at pretest, and one of the two PRAs had to contain a space where a shade sail could be constructed. Trained observers made observations at the PRAs for 30-minute periods on four weekend days during a 20-week period in the summer months for each city at pretest and posttest to determine the number of visitors during peak UV hours (11 am to 3 pm). Shade sails were designed to be attractive while also providing shade during peak UV times and the shade cloth selected reduced UV by at least 94%.

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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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