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Workplace Sun Safety Training Goes All-Virtual

Workplace Sun Safety Training Goes All-Virtual

People who work outdoors are exposed to high levels of solar ultraviolet radiation (UV) over a lifetime that can substantially increase their risk for developing skin cancer. Workplaces can be an effective channel for UV safety policy and training for employees in order to reduce their UV over-exposure and risk for skin cancer.

Klein Buendel researchers and their collaborators have been developing, evaluating, and refining comprehensive approaches to occupational sun protection for two decades. Now, the experienced research team is launching a new project funded by the National Cancer Institute to develop and evaluate a mechanism for distributing an established sun protection program virtually to diverse workplaces in the United States. The virtual environment will be comprised of a database, content management (interactive toolbox), and media platform (trackable training) to tailor the sun safety program to management’s readiness to innovate on sun safety based on Diffusion of Innovations Theory. In addition, the virtual platform will better integrate sun safety training by improving appropriateness for Hispanic and African American workers and conforming with the latest learning management systems technologies.

The Fast-Track SBIR project (CA257778) will complete a 9-month Phase I feasibility study and a 2-year Phase II effectiveness trial through employers across the country. The primary hypothesis of the study is that compared to employers in a minimal information control group, employers assigned to receive SSW Works will have employees that practice more sun protection at posttest. The research will be led by Mary Klein Buller, Principal Investigator. Co-Investigators include Dr. Barbara Walkosz, Julia Berteletti, and Dr. David Buller from Klein Buendel. The virtual platform will be engineered by Klein Buendel’s Creative Team.

The outdoor workforce in the United States is large and, in many places, at very high risk for skin cancer. Improving sun safety will help reduce health care costs and save lives. Thus, the research will have high impact and potential for commercial adoption, two objectives of SBIR projects.

Association of Occupational Sun Safety Policy with Employee Practices

Association of Occupational Sun Safety Policy with Employee Practices

Occupational sun protection policies are fundamental for the increased implementation of employee sun safety practices. Investigators and staff from Klein Buendel, led by Dr. David Buller, Director of Research, recently published baseline results from a large-scale workplace sun safety policy project in the American Journal of Industrial Medicine.

In the publication, the authors report on the coding and evaluation of written safety policies from 21 state Departments of Transportation (DOTs) enrolled in a randomized trial testing methods for scaling-up an occupational sun safety intervention. A total of 1,113 managers who supervised people who work outdoors reported on workplace and employee sun safety practices in a baseline survey.

Analysis showed that 20 of the state DOTs had a policy with at least one sun protection component (e.g., sunscreen, eye protection, use of shade). Sun safety training was increased at workplaces with written sun safety policy and unwritten standard operating procedures on sun protection. Sun safety actions were highest where there was a written sun safety policy and unwritten standard operating procedures on workplace sun protection. The measures, methods, analyses, results, conclusions, and limitations of the baseline manager survey are detailed in the publication.

This research was funded by a grant from the National Cancer Institute at the National Institutes of Health (CA210259; Dr. David Buller, Principal Investigator). Coauthors include Dr. Barbara Walkosz, Savanna Olivas, Rachel Eye, Xia Liu, Alishia Kinsey, Mary Buller, and Andrew Grayson from Klein Buendel.

Scaling-up an Evidence-based Workplace Sun Safety Program

Scaling-up an Evidence-based Workplace Sun Safety Program

Authors of a recent online publication in Contemporary Clinical Trails recommend that “successful methods for scaling-up evidence-based programs are needed to prevent skin cancer among adults who work outdoors in the sun.” The paper describes the design and baseline descriptive data from a workplace intervention being conducted by Klein Buendel and several research collaborators. The on-going randomized trial compares two methods of scaling-up the Sun Safe Workplaces intervention with 21 state Departments of Transportation and their employees who work outdoors. 

A total of 138 regional districts from the Departments of Transportation were randomly assigned to either an in-person program where project staff meet personally with managers, conduct trainings for employees, and provide printed materials, or a digital program where project staff conduct these same activities virtually, using conferencing technology, online training, and electronic materials.

Delivery of Sun Safe Workplaces in both groups is tailored to managers’ readiness to adopt occupational sun safety. Posttesting will assess manager’s support for and use of Sun Safe Workplaces and employees’ sun safety. An economic evaluation will explore whether the method that uses digital technology that may result in lower implementation of Sun Safe Workplaces, is more cost-effective relative to the in-person method.

The 21 state Departments of Transportation vary in size from 997 to 18,415 employees. At baseline, managers reported being generally supportive of occupational sun safety. A minority reported that the Departments had a written sun safety policy, half reported sun safety training for employees, and two-thirds reported messaging and communication about sun protection for employees. The research will help determine whether digital methods can facilitate a cost-effective scale-up of Sun Safe Workplaces for outdoor workers in industries across the country.  

This research project (CA210259) is funded as part of the National Cancer Institute’s Cancer Moonshot Initiative, which aims to accelerate cancer research in order to make more therapies available to patients, while also improving the ability to prevent cancer and detect it at an early stage. This project, Sun Safe Workplaces-Technology, is being led by KB’s Director of Research, Dr. David Buller, as Principal Investigator. Co-authors on the Contemporary Clinical Trails publication include Dr. Richard Meenan from Kaiser Permanente’s Center for Health Research, Dr. Gary Cutter from Pythagoras, Inc., Dr. Sherry Pagoto from the University of Connecticut, and Ms. Mary Buller, Ms. Julia Berteletti, Ms. Rachel Eye, and Dr. Barbara Walkosz from Klein Buendel.

Economic Evaluation of Adopting Occupational Sun Protection Policies

Economic Evaluation of Adopting Occupational Sun Protection Policies

In a recent publication in the Journal of Occupational and Environmental Medicine, Klein Buendel investigators and their colleagues discuss the economic evaluation of an intervention promoting adoption of occupational sun protection actions by Colorado public-sector employers.

The intervention, Sun Safe Workplaces (SSW), was a two-year randomized field trial promoting employer adoption of sun safety policy and providing training in personal sun protection for outdoor workers. The trial included 98 local Colorado government organizations such as municipalities, counties, and special districts (public organizations providing water, sanitation, parks and recreation, and fire protection). SSW intervention costs were organized into two components: “delivery” costs and “action” costs. Delivery costs were incurred to directly implement and maintain the SSW intervention and included costs of both project staff and the participating worksites. Action costs were incurred by the worksites themselves for implementing the sun protection actions.

The publication presents the results of the economic evaluation of SSW. A full description of the methods, measures, results, and conclusion of the research can also be found in the Journal of Occupational and Environmental Medicine publication.

This study demonstrated the interactions of cost and implementation that explain — and hopefully guide — the adoption of and investment in occupational sun safety. The SSW intervention was also successful in extending the adoption of sun protection actions among intervention worksites at a cost per employee that is comparable to other worksite health interventions.

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, Multiple Principal Investigators). The paper’s lead author is Dr. Richard Meenan from the Kaiser Permanente Center for Health Research in Oregon. Additional authors include Dr. David Buller, Dr. Barbara Walkosz, Ms. Mary Buller, Ms. Rachel Eye, and Ms. Savanna Olivas from Klein Buendel; and Dr. Allan Wallis from the University of Colorado Denver.

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 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.