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The Importance of Managers’ Awareness of Sun Protection Policy

The Importance of Managers’ Awareness of Sun Protection Policy

Improving occupational sun protection is a priority in the United States, as The Surgeon General’s Call to Action to Prevent Skin Cancer highlights. Klein Buendel and its collaborators responded to the call by launching a randomized trial to evaluate the effectiveness of a workplace sun protection program for outdoor workers. The program, Sun Safe Workplaces, was implemented with 98 public employers in Colorado, a state with high ultraviolet radiation due to its high elevation and sunny climate. The intervention promoted the adoption or strengthening of sun safety policy and the implementation of employee sun protection training. A two-year follow-up study also was completed with 68 of the 98 public sector employers.

In a recent publication in the American Journal of Industrial Medicine, Dr. Barbara Walkosz, Klein Buendel Senior Scientist, and her coauthors reported results related to the hypothesis that senior managers’ awareness of sun protection policy in the workplace would predict increased sun safety practices by employers and employees who work outdoors.

A full description of the methods (questionnaires and on-site observations), results, conclusions, and limitations of the research can be found in the American Journal of Industrial Medicine publication. In general, more sun safety messages, manager-employee communication, sun safety practices, and sun protection equipment (sunscreen, hats, etc. ) were evident when senior managers were more aware of their organization’s sun protection policy.

Overall, the authors found that occupational sun protection programs can be more effective on the “front line” (with people who work outdoors) when the “back office” (senior management) is aware of and can, therefore, support and encourage their organization’s sun safety policies and practices.

This analysis was funded by a grant from the National Cancer Institute at the National Institutes of Health (CA134705; Dr. David Buller and Dr. Barbara Walkosz, Principal Investigators). Dr. Walkosz’s coauthors on this paper included Dr. David Buller, Ms. Mary Buller, and Ms. Xia (Lucia) Liu from Klein Buendel, and Dr. Allan Wallis from the University of Colorado Denver.

Implementation of Sun Safety Policies in Public Elementary Schools

Implementation of Sun Safety Policies in Public Elementary Schools

Klein Buendel Research Program Manager, Julia Berteletti, presented insights from a randomized controlled trial that tested a technical assistance program designed to help principals implement district sun safety policies in elementary schools at the 40th Annual Meeting and Scientific Sessions of the Society of Behavioral Medicine, March 6-9, 2019 in Washington, DC.

The Centers for Disease Control and Prevention (CDC) and U.S. Surgeon General have advised the nation’s schools to adopt and implement sun protection policy to reduce children’s exposure to solar ultraviolet radiation to prevent skin cancer. A total of 118 elementary schools from 40 California public school districts that had adopted a school board-approved policy for sun safety were recruited and the principal and a teacher at each school reported on school sun protection practices at baseline and posttest.

Half of the schools were randomly assigned to receive the 20-month Sun Safe Schools intervention, delivered by trained Sun Safety Coaches who met with principals, described the district policy, helped them select and plan implementation of sun safety practices, and provided support and resources matched to the principal’s readiness to implement practices based on Diffusion of Innovation Theory. Control schools received a minimal information treatment containing basic school sun safety information from the CDC, the National Association of State Boards of Education, and U.S. Surgeon General.

Compared to controls, principals at intervention schools reported implementing more sun safety practices in general, whether present in the district’s written policy or not. Similarly, teachers at intervention schools reported implementing a larger number of sun safety practices in general, including practices in their district’s written policy or not, compared with control schools. Overall, the intervention was effective at increasing sun safety practices in public elementary schools. However, convincing school districts to adopt policies may be only the first step in improving sun safety practices becasue districts need to actively disseminate the new policy to schools and provide assistance and materials to facilitate implementation.

This research was supported by a grant from the Eunice Kennedy Shriver National Institute for Child Health and Human Development (HD074416; Dr. Kim Reynolds, Principal Investigator). Collaborators in addition to Julia Berteletti, include Dr. Kim Reynolds and Kim Massie from Claremont Graduate University in California; Dr. David Buller and Mary Buller from Klein Buendel; Dr. Jeff Ashley from Sun Safety for Kids in, California; and Dr. Richard Meenan from Kaiser Permanente Center for Health Research in Oregon.

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.