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Collaborator Spotlight:
Dr. Alexandra Morshed

Collaborator Spotlight:
Dr. Alexandra Morshed

Alexandra Morshed, Ph.D., is a Research Assistant Professor in the Department of Behavioral, Social and Health Education Services at Emory University. She is also a Co-Investigator with the Emory Prevention Research Center. Dr. Morshed received her Master of Science degree from Wageningen University in the Netherlands and her Ph.D. from Washington University in St. Louis.

Dr. Alexandra Morshed

Dr. Morshed is an implementation scientist with more than ten years of experience in public health research and practice. Her primary areas of interest include implementing interventions in vulnerable populations, chronic disease prevention, public health nutrition, and capacity building and knowledge expansion in dissemination and implementation science.

Dr. Morshed is currently collaborating with Dr. David Buller from Klein Buendel on a research study titled “Go Sun Smart at Work: A Sun Safety Program for Underserved Outdoor Workers” (Dr. Morshed and Dr. Buller, Multiple Principal Investigators). This CDC-funded study builds upon Klein Buendel’s evidence-based comprehensive occupational skin cancer prevention intervention, Go Sun Smart at Work, and aims to reduce UV exposure and prevent skin cancer among underserved outdoor workers in Georgia. Hispanic and African American adults have been overlooked in skin cancer prevention efforts, due to their lower incidence of skin cancer. However, among Hispanic and African Americans, skin cancer is diagnosed at more advanced stages, leading to higher mortality rates than non-Hispanic whites. The Emory University study aims to develop an intervention and implementation strategies to increase policies and practices to support sun safety among outdoor workers in Georgia.

An Implementation Model for the Cost-effective Scale-up of the Sun Safe Workplaces Program

An Implementation Model for the Cost-effective Scale-up of the Sun Safe Workplaces Program

Dr. David Buller and Dr. Barbara Walkosz from Klein Buendel presented a poster on a new implementation model for the cost-effective scale-up of an occupational sun protection program at the 12th Annual Conference on the Science of Dissemination and Implementation in Health in Washington, DC, December 4-6, 2019. The poster was nominated for Best Poster from the Prevention and Public Health Division.

Scale-up is the effort to increase the impact of successful programs to benefit more people on a lasting basis. Scale-up efforts must increase reach, retain effectiveness, and lower costs to provide greater access to benefits and close the research-to-practice gap between effective programs and real-world application. This project is studying the nationwide scale-up of an occupational sun safety intervention, Sun Safe Workplaces, with state Departments of Transportation (DOTs), a public works sector with thousands of outdoor workers.

Costs of national distribution can be daunting and influence intervention intensity and program effectiveness. Identifying cost-effective scale-up strategies is essential for moving research into practice. The new framework draws upon existing implementation models, including those developed for occupational health and safety, and operationalizes implementation for scale-up within RE-AIM. The RE-AIM framework was adapted for this new framework by incorporating cost as a primary factor.

In a randomized trial, Sun Safe Workplaces (SSW) is assessing implementation rate and costs associated with two methods of scaling-up SSW. The original intervention depended on personal visits with managers, materials promoting sun protection policies and education, in-person sun safety training for employee groups, and on-going follow-up communication with managers supporting sun safety (SSW-IP), a resource-intensive form of intervention. Now SSW-IP is being contrasted to a scale-up strategy that uses web-based and telephone conferencing, responsive training platforms, and electronic resources for virtual contacts and training (SSW-T). Technology-based programs have the potential to deliver standardized, engaging content and increase portability while decreasing cost of delivery to enable reaching more employers when scaled-up to nationwide distribution. Districts within DOTs are randomized to one of the two scale-up methods. The SSW-IP and SSW-T interventions are being delivered in 21 state DOTs with 141 districts.

This research is funded by a grant from the National Cancer Institute (CA134705; Dr. David Buller and Dr. Barbara Walkosz, Multiple Principal Investigators). Additional poster coauthors include Dr. Richard Meenan from the Kaiser Permanente Center for Health Research; and Mary Buller, Rachel Eye, Andrew Grayson, and Savanna Olivas from Klein Buendel.