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Month: April 2025

Cost Analysis of an Occupational Sun Safety Intervention

Cost Analysis of an Occupational Sun Safety Intervention

Klein Buendel investigators and their collaborators have e-published the results of the cost analysis of distributing the Go Sun Smart at Work program via two different methods in the Journal of Occupational and Environmental Medicine (JOEM).

This randomized trial compared two methods (digital and in-person) for scaling up an evidence-based occupational sun protection program nationwide. The program was designed to help workplaces implement skin cancer prevention policy and training for employees who work outdoors. One hundred thirty-eight (138) regional districts in 21 state Departments of Transportation throughout the United States were randomized to receive the Go Sun Smart at Work program via in-person or digital scalability methods in 2019-2022. Results of the effectiveness of the trial were published in JOEM in January 2025.

For the economic analysis reported in this companion publication, the cost of delivering the Go Sun Smart at Work program was obtained from project accounting records and manager reports. The study followed the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) reporting guideline for economic evaluation (1). The primary outcome of the economic analysis was an incremental cost-effectiveness ratio (ICER) from the perspective of the disseminating organization, although induced costs to the employer were also recorded and reported. The ICER numerator is the incremental difference between digital and in-person strategies in average program cost (C) per regional district. The denominator is the incremental difference between digital and in-person strategies in the mean number of implemented workplace sun protection actions (per regional district) (E [for effect]):

                                    ICER = (Cdigital – Cin-person) / (Edigital – Ein-person)

Program delivery costs were estimated to be $15,658 for the digital strategy and $74,275 for the in-person strategy. Across all districts, the ICER was $3,305, representing average cost savings from a sun safety action not implemented under the digital strategy but implemented under the in-person strategy. In summary, the digital scalability strategy was cost-effective relative to an in-person strategy, generating substantial cost savings and offsetting a lower mean number of implemented program actions. Full descriptions of the research methods, results, and limitations are included in the JOEM publication.

The research was supported by a Cancer Moonshot Initiative grant from the National Cancer Institute (CA210259; Dr. David Buller, Principal Investigator). Co-authors include Dr. Richard Meenan from Kaiser Permanente Center for Health Research; Dr. Gary Cutter from the University of Alabama in Birmingham; Dr. Kimberly Henry from Colorado State University; Dr. Sherry Pagoto from the University of Connecticut; and Mary Buller, Julia Berteletti, Irene Adjei, and Noah Chirico from Klein Buendel. The authors thank the American Association of State Highway and Transportation Officials (AASHTO) and the senior managers of the participating state Departments of Transportation for supporting this research project.

References

  1. Husereau D, Drummond M, Augustovski F, et al. Consolidated health economic evaluation reporting standards 2022 (CHEERS 2022) statement: updated reporting guidance for health economic evaluations. Value Health. 202;25:3-9.

KB Research Presented at SBM – Part 2

KB Research Presented at SBM – Part 2

Ms. Amanda Brice from Klein Buendel presented a Live Research Spotlight at the 46th Annual Sessions and Meeting of the Society of Behavioral Medicine in San Francisco, California, March 26-29, 2025.

*Klein Buendel authors are bolded.

Ms. Amanda Brice

Research Spotlight

Title: Rural Emerging Adults’ Physical Activity Motivation, Intentions, Planning, and Engagement Patterns: A Cross-Sectional Analysis

Presenter: Amanda Brice

Authors:  Kayla Nuss, Julia Berteletti, Amanda Brice, Alishia Kinsey, Noah Chirico, and Sierra Held

Emerging adulthood, the period between 18 and 26 years old, is critical for the development of long-term health behaviors, like physical activity engagement. Only 25% of emerging adults meet the recommended 150 minutes per week of moderate to vigorous physical activity (MVPA). In rural communities, where residents have less access to behavioral health resources, healthcare, and community services, fewer than 20% of adults meet physical activity recommendations, but data on rural emerging adults is limited. Further, data are lacking in this population on potent drivers of physical activity, such as motivation, intention, and planning. Therefore, the purpose of this study is to describe physical activity engagement, motivation, intention, and planning in a sample of emerging adults from the rural western United States.

Participants were recruited via a nationwide survey panel. Inclusion criteria were: 18 to 26 years old, able to read and understand English, and live in a rural country as defined by the Rural Urban Commuting Area Codes 4-9 in one of the Western states of Colorado, Utah, New Mexico, or Arizona. We assessed physical activity with the Global Physical Activity Questionnaire (GPAQ), Self-Determination Theory motivation with the Behavioral Regulations in Exercise Questionnaire v.3 (BREQ-3), intention and planning with the Behavioral Intentions Scale, and collected demographic variables.

Means, standard deviations, and percentages were calculated for descriptive and outcome variables. Participants reported minutes of MVPA accumulated through work and recreation, and we calculated total MVPA minutes. Using the Shapiro-Wilk test for normality, we found neither total nor recreational weekly minutes of MVPA were normally distributed. The non-normality was due to a high number of participants reporting zero MVPA minutes. We created binary variables of “Meets Recommendations” (≥ 150 minutes of MVPA per week) vs. “Does Not Meet Recommendations” (≤ 149 minutes of MVPA per week) for both total and recreational MVPA.

The sample included 141 respondents: 115 (81.56%) female and 25 (17.73%) male, aged 22.00±2.63 years. Seventy-five (53.19%) met MVPA recommendations when work was included whereas without, only 32 (22.70%) met recommendations. Participants reported low levels of amotivation, external, introjected, identified, and integrated regulation, and intrinsic motivation. They also reported low levels of intention and planning for physical activity.

More emerging adults met MVPA recommendations when minutes accumulated at work were included. Rural emerging adults have low quality of motivation and low intention and planning for physical activity. Researchers should investigate barriers to physical activity participation in this group as they have high instances of health disparities and low access to health resources.

This research was sponsored by Klein Buendel and led by Dr. Kayla Nuss.