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Family Determinants of Sun-Safe Behaviors in Hispanic Children

Family Determinants of Sun-Safe Behaviors in Hispanic Children

Melanoma is common, particularly among Non-Hispanic Whites (NHW). However, Hispanics are diagnosed at more advanced stages compared to NHW prompting the need for more research into Hispanic sun protection practices.  

Sarah Davila, Klein Buendel collaborator and student from Claremont Graduate University, recently presented findings on family determinants of child sun protection from the Sun Safe Schools project at the virtual 2020 American Public Health Association conference. Family determinants of child sun protection have seldom been tested among Hispanics. The team hypothesized that parent sun protection behavior, perceived risk for skin cancer, skin-phenotype, and purchase of sun protection products, along with child skin-phenotype and interaction of child skin-phenotype with child ethnicity would associate with child sun protection behavior and child sunburn. To test this, parents of elementary school-aged children completed self-report surveys and a multilevel analysis was conducted with Hispanic and NHW parents nested within schools and nested within districts.  

Parent sun protection behavior, number of sun-safe items purchased, and child skin-phenotype were all positively associated with child sun protection behavior, while parent perceived risk was negatively associated. The interaction of child skin-phenotype with child ethnicity was significant, indicating no difference at Type 1 skin-phenotype, but greater protective behavior for Hispanics relative to NHW for subsequent skin-phenotypes. Parent perceived risk and child skin-phenotype were also positively associated with child sunburn. Overall, the results suggest a need for parent modeling and environmental controls to increase sun protection behavior in Hispanic children.  

This research was funded by a grant from the Eunice Kennedy Shriver National Institute of Child Health and Human Development at the National Institutes of Health (HD074416; Dr. Kim Reynolds and Dr. David Buller, Multiple Principal Investigators). Other authors included Dr. Richard Meenan from the Kaiser Permanente Center for Health Research in Portland, Oregon; Dr. Jeff Ashley from Sun Safety for Kids in Los Angeles, California; Kim Massie previously from Claremont Graduate University; and Julia Berteletti, Mary Buller, and Lucia Liu from Klein Buendel. 

Implementing E-Training for Geriatric and End-of-Life Care in Corrections

Implementing E-Training for Geriatric and End-of-Life Care in Corrections

Dr. Susan Loeb from The Pennsylvania State University College of Nursing is presenting on the creation of a computer-based learning (CBL) program for corrections staff at the 32nd Annual Scientific Sessions virtual conference of the Eastern Nursing Research Society on March 26-27, 2020. Klein Buendel Senior Scientist, Dr. Valerie Myers, is a co-author on the presentation.

Experts in corrections have identified the care of older individuals who are incarcerated as a high priority area for research and policy. Therefore, there is a need to provide evidence-based training tailored to frontline corrections personnel who are charged with the care and oversight of aged and dying incarcerated individuals. In response, the research team developed, implemented, and tested a CBL program that aligned with contextual environment constraints and the infrastructure-specific needs of corrections.

The virtual presentation will describe how the adoption mechanisms and support systems were integrated from set up to full-scale usability testing of the CBL program, Enhancing Care for the Aged and Dying in Prison (ECAD-P) for corrections staff. Specifically, factors that affect adoption and support systems were identified, examined and implemented at each phase of the development and implementation process of ECAD-P. In the Set-Up phase, the format of a paper-pencil toolkit was not sustainable for long-term, broad dissemination of the program, so support systems were evaluated to determine the capabilities of CBL. Throughout the development, Expert and Community Advisory Boards critically examined the content and programming measures of the product to ensure the product complied with usual practices and institutional constraints.

During testing, small scale usability-testing was conducted to determine human capacity, infrastructure capabilities, reporting systems, and program design and function. In going to full-scale, large-scale usability testing provided valuable insights on implementation considerations, such as leadership, communication, policy, and culture of institution. Consideration of adoption mechanisms and support systems ultimately allowed for researchers to refine ECAD-P for future, effective, large-scale dissemination.

This research was funded by a Small Business Technology Transfer grant to Klein Buendel from the National Institute on Aging at the National Institutes of Health (AG049570; Dr. Susan Loeb and Dr. Valerie Myers, Multiple Principal Investigators). Collaborators on the work presented include Dr. Erin Kitt-Lewis and Kaléi Kowalchik from The Pennsylvania State University College of Nursing; Dr. Rachel Wion from Indiana University School of Nursing; Julie Murphy from King College Nursing Program; and Dr. Valerie Myers and Tiffany Jerrod from Klein Buendel.

Health Chat Presentation for NCI

Health Chat Presentation for NCI

Dr. David Buller from Klein Buendel presented initial findings from an ongoing social media campaign for mothers to improve adolescent health and reduce indoor tanning, called Health Chat, via webinar to the Health Communication and Informatics Research Branch of the National Cancer Institute on December 10, 2019.

Despite the substantial risk of skin cancer from indoor tanning, it remains popular among older adolescent females aged 14-17 and mothers aged 27-45. The CDC1 and the Surgeon General2 have set a national goal of reducing indoor tanning by teens and public policies restricting indoor tanning are increasing. However, many states still allow minors to indoor tanning, with varying forms of restriction.3 

Because mothers’ permissiveness of indoor tanning and her own indoor tanning are strong predictors of adolescent daughters indoor tanning, and many daughters initiate indoor tanning with their mother, the research team developed a program aimed at moms in an effort to reduce indoor tanning by minors. A multi-faceted adolescent health and wellness campaign was created to be delivered through Facebook private groups that included messages on indoor tanning prevention, prescription drug misuse, vaccinations, healthy lifestyles, substance use, mother-daughter communication, and more. Mothers (n=869) were in the groups for one year and received messages daily. Mothers and their daughters completed surveys at baseline and 12-month follow-up, and 18-month follow-up surveys are currently underway.

Dr. Buller reported on how the Health Chat program was created, the potential of using social media for research, campaign engagement measures, and initial findings from the 12-month follow-up survey of mothers and daughters. He shared methodological challenges that arose from using Facebook private groups such as Facebook algorithms changing, the inability for participants to share content outside of the groups, and logistical barriers of adding participants to groups. He also shared plans for coding user-generated content,4 including hundreds of comments left by mothers on the Facebook posts. Full results should be published in 2020.

This research was funded by a grant to Klein Buendel from the National Cancer Institute [CA192652; Dr. David Buller and Dr. Sherry Pagoto (from the University of Connecticut), Multiple Principal Investigators]. Co-Investigators include Dr. Katie Baker and Dr. Joel Hillhouse from East Tennessee State University, and Dr. Kimberly Henry from Colorado State University.

References

1. Healthy People 2020 – topics & objectives. Office of Disease Prevention and Health Promotion Web site. Available at: https://www.healthypeople.gov/2020/topics-objectives. Published 2012. Accessed December 17, 2019.

2. U.S. Department of Health and Human Services. The Surgeon General’s Call to Action to Prevent Skin Cancer. Washington, D.C.: U.S. Department of Health and Human Services, Office of the Surgeon General; 2014.

3. National Conference of State Legislatures. Indoor tanning restrictions for minors: A state-by-state comparison. National Conference of State Legislatures Web site. Available at: http://www.ncsl.org/research/health/indoor-tanning-restrictions.aspx. Published May 20, 2019. Accessed December 17, 2019.

4. Buller D, Walkosz B, Berteletti J, et al. Insights on HPV vaccination in the United States from mothers’ comments on Facebook posts in a randomized trial. Hum Vaccin Immunother. 2019;15(7-8):1479-1487. doi: 10.1080/21645515.2019.1581555