KB Collaboratory

KB and Canada Host World’s Sun Safety Experts

April 16, 2018 Klein Buendel

How can sun safety messages convince travelers to seek shade and cover up in the sun on vacation? How can the built environment help increase sun safety by maximizing access to shady areas? How can the use of Big Data drive people to be more “sun smart”?

These and many other issues will be front and center at the 4^th International Conference on UV and Skin Cancer Prevention at Ryerson University in Toronto, May 1-4. Held in different countries around the world – the 2015 event was in Sydney, Australia – the International Conference on UV and Skin Cancer Prevention highlights the best in public health and community-based approaches to educating the public about the importance of UV protection.

“This fourth conference really aims to disrupt current ways of thinking in the field of skin cancer prevention by sparking new ideas, proposing new intersections between disciplines, and fostering new connections and collaborations,” said Ms. Mary Buller, conference organizer and Owner and President of Klein Buendel, a Golden, Colorado-based health communication research company whose investigators have been conducting skin cancer prevention research since the early 1990s.

While preventing skin cancer is the galvanizing theme of the conference, sessions cover topics ranging from urban planning, architectural design, public health and radiation science. The common goal is to increase public awareness – and public action – on the need for increasing shade and maximizing sun protection, not just during leisure pursuits, but also in the workplace.

“The sun is a workplace hazard that can cause skin cancer, heat stress and eye damage, yet these conditions are preventable with an increase in awareness,” said Dr. Thomas Tenkate, conference organizer and Director of the School of Occupational and Public Health at Ryerson University. …

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Sun Safety Policy at Work and School

April 13, 2018 Klein Buendel

KB scientists, research staff, and collaborators are presenting research findings at the 39^th Annual Meeting and Scientific Sessions of the Society of Behavioral Medicine, April 11-14, 2018 in New Orleans, Louisiana. One presentation and one poster address sun protection and skin cancer prevention policy in workplaces and schools:

Moderators of Implementation of Occupational Sun Protection Policy

Outdoor workers are at high risk for skin cancer. Dr. David Buller, KB Director of Research and SBM Fellow, is giving a presentation on the Sun Safe Workplaces Project. In this study, organizational and employee characteristics were examined as moderators of implementation of occupational sun protection policy. Public employers (n=98) in Colorado participated in a randomized controlled trial evaluating the Sun Safe Workplaces (SSW) intervention. Based on Diffusion of Innovations Theory, project staff promoted sun safety policy adoption and trained workers in sun protection. Line supervisors (n=3,650) and workers (n=1,555) completed a two-year follow-up survey at 68 employers. Among other findings, greater communication with employees occurred by employers with a policy than without one. The research was funded by a grant from the National Cancer Institute (R01CA134705; Dr. David Buller, PI). Dr. Barbara Walkosz, Mary Buller, and Lucia Liu from KB participated on the research team. Additional collaborators include Dr. Allan Wallis from the University of Colorado, Denver, and Dr. Richard Meenan from the Kaiser Permanente Center for Health Research in Portland, Oregon.

Correlates of Sun Safe Policy Implementation Among Elementary Schools

In 2014, the U.S. Surgeon General issued a Call to Action to Prevent Skin Cancer, citing its high and increasing prevalence and cost. The Centers for Disease Control and Prevention and the Surgeon General identified sun safety in schools as a priority to reduce UV exposure and sunburns of children, with school district policy a key aspect of school-based efforts to prevent skin cancer. Dr. Kim Reynolds, KB Collaborator from Claremont Graduate University (CGU), is presenting a poster on the Sun Safe Schools Project. This study explored correlates of the implementation of sun-safe practices, consistent with district board policy, among principals and teachers in public elementary schools. The sample included elementary school principals (N=118) and teachers (N=113) recruited from 40 California public school districts that had adopted Board Policy 5141.7 for sun safety and posted it online. Principals and teachers from the elementary schools reported on student sun protection policies and practices when surveyed. The study looked at the number of practices implemented consistent with California Senate Bill 1632 (Billy’s Bill), which protects the right of students to apply sunscreen at school without a physician note and to wear UV-protective clothing including hats on school grounds. Improved awareness of the existence and content of district board policy for sun safety may increase implementation of school skin cancer prevention.

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 (R01HD074416; Dr. Kim Reynolds, CGU, and Dr. David Buller, KB, PIs). Collaborators included Julia Berteletti and Mary Buller form KB, Kim Massie from CGU, Dr. Jeff Ashley from Sun Safety for Kids in Los Angeles, California and Dr. Richard Meenan from the Kaiser Permanente Center for Health Research in Portland, Oregon.

Designing a Web App to Promote Teen Vaccination Uptake

April 10, 2018 Klein Buendel

Ms. Julia Berteletti, KB Research Program Manager, is presenting a poster on formative research from the BeVaccinated Project at the 39^th Annual Meeting and Scientific Sessions of the Society of Behavioral Medicine, April 11-14, 2018 in New Orleans, Louisiana.

While vaccination rates for young children in the United States currently meet recommended standards, the Centers for Disease Control and Prevention reports adolescent vaccines uptake to be less than optimal, and in the case of the Human Papillomavirus (HPV) vaccine, seriously below desired uptake levels. To address this deficit, a web-browser application prototype, BeVaccinated, was developed to test reactions to and feasibility of delivering adolescent vaccine information via smartphone. The BeVaccinated app prototype was developed from formative research with 26 focus group participants and guided by an Expert Advisory Board comprised of vaccination experts and clinicians.

Usability testing on one module, about deciding to vaccinate, was conducted iteratively with nine parent and teen pairs in New Mexico and seven parent and teen pairs in Colorado. Pairs were comprised of one teen (ages 13-17) and their accompanying parent or guardian. Usability testing was conducted individually with the parent and teen by trained research staff. During the testing, participants used the app prototype, answering questions as prompted. At the conclusion of testing, participants completed the 10-item Bangor System Usability Scale (SUS). Parents and teens rated the app as very easy to use. SUS data also indicated that participants could quickly learn to use the app and that they would be confident using it.

A Specifications Document outlines the planned design of the full-scale app based on testing results. Findings included in the specifications document are: 1) provide tailored learning experiences to teens (i.e., game-based) and parents (i.e., didactic) within the same app; 2) integrate individualized information (e.g., clinic preferences); and 3) provide a vaccination record tracking feature. The planned app could improve dissemination of vaccine information, enhance parent/teen communication around health behavior choices, and ultimately, improve the uptake of vaccinations.

This research was funded by a grant from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (R41HD082901; Dr. Gill Woodall, KB Senior Scientist, PI) Research collaborators included Dr. Randall Starling and Dr. Lance Chilton from the University of New Mexico, Dr. Gregory Zimet from Indiana University, Dr. Nathan Stupiansky from the University of Arizona, and Sophia Strickfaden from KB.

Precision Pain Management App for Adolescents with Sickle Cell Disease

April 6, 2018 Klein Buendel

Dr. Valerie Myers, KB Senior Scientist, is presenting a poster on the Pinpoint Project at the 39^th Annual Meeting and Scientific Sessions of the Society of Behavioral Medicine, April 11-14, 2018 in New Orleans, Louisiana.

“Pinpoint: Gaming Technology to Engage Adolescent Sickle Cell Patients in Precision Pain Management” was a Phase I SBIR project that examined the feasibility and acceptability of a gamified tablet application intended to encourage teens (aged 13-17) to assess and talk about their sickle cell disease (SCD) pain. SCD is the most common inherited blood disorder in the U.S. and affects primarily African Americans and Hispanics. Approximately, 1,000 U.S. children are born with SCD annually. SCD complications can be serious and have a significant impact on well-being and quality of life.

Pain is the hallmark symptom associated with SCD and is the primary cause of SCD-related hospital admissions. Accurate assessment of pain specifiers (type, frequency, and intensity of pain) can help with ameliorating pain quickly and effectively. Reducing barriers to collection and promoting the value of accurate SCD pain assessment is a need in pediatric medicine. The interactive games for health literacy among youths have shown video games can improve self-efficacy; stimulate health discussions with friends, family, and clinical team; encourage seeking support and advice, and can emphasize behavior acquisition via experiential learning. Interactive games can provide information about causes, treatments, and self-care options, and can improve self-care and reduced emergency clinical utilization.

The Pinpoint app prototype for tablets and smartphones consisted of a Pain Assessment Tool, vocabulary game, body scanner reflection, educational self-disclosure activity, and excerpts from the Hope and Destiny Jr. book authored by Hsu, Rodrigues, and Brandalise. Four healthcare providers were interviewed on the app’s acceptability and potential function within the clinical practice. Sixteen teens participated in cognitive interviews, focus groups, and usability testing. The System Usability Scale (SUS), a validated tool for assessing the usability and acceptability of technological products, served as the primary outcome. The preliminary SUS score well above average, suggesting a high level of acceptability and usability among users. The conference poster will include final project outcomes and the plan for the future development of the full Pinpoint app.

This research was funded by a grant from the National Institute on Minority Health and Health Disparities (R43MD010746; Dr. Valerie Myers, PI). Research collaborators included Mary Buller from KB, and Dr. Hilton Hudson and Megan Lippert from the Hilton Publishing Company, publishers of the Hope & Destiny and Hope & Destiny Jr. sickle cell disease management books.

KB Scientist Shares Career Development Guidance in SBM Panel Discussions

April 2, 2018 Klein Buendel

Dr. Valerie Myers, KB Senior Scientist and SBM Fellow, is a co-presenter for three Panel Discussions related to training and career development at the 39^th Annual Meeting and Scientific Sessions of the Society of Behavioral Medicine, April 11-14, 2018 in New Orleans, Louisiana.

Perspectives on Effective Digital Health Training in Behavioral Medicine

To be a successful digital health researcher, most individuals find that they need to complete a set of training experiences not well encapsulated by a single degree program. Behavioral medicine scientists and practitioners that utilize digital health must take an entrepreneurial approach to advocating for receiving adequate training to be prepared for the challenges of this field. The call for cross-disciplinary digital health researchers necessitates that both trainees and mentors be flexible and creative with training opportunities. To discuss methods and philosophies for training the next generation of digital health researchers. The Society of Behavioral Medicine’s Digital Health Council has assembled a panel of digital health experts spanning academia and industry with varying educational backgrounds. The panel will include: (1) a senior-level academic with interests in mHealth and adolescent health; (2) a mid-career researcher from an academic medical center who receives NIH-funding and engages in formal recurrent consultation with numerous industry partners; (3) an early career electrical engineer with an interest in translational medicine and experience with research career development awards; and (4) a senior scientist at a small health communication and development firm who conducts research on behaviorally-based technological approaches to behavior change. Attendees will leave with practical advice for obtaining adequate digital health training in the post-graduate, postdoctoral, and established career phases. …

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Accuracy of Principal and Teacher Knowledge of School District Sun Protection Policies in California Schools

March 29, 2018 Klein Buendel

School policies that improve sun safety for children are essential to comprehensive school-based skin cancer prevention; however, a policy is only successful if school administration and teachers are aware of it and implement it. California was one of the first states that enacted legislation governing sun protection for students in public schools. In a recent publication in Preventing Chronic Disease, KB’s Dr. David Buller, Julia Berteletti and Mary Buller along with collaborators at Claremont Graduate University (CGU), Kaiser Permanente Center for Health Research (KPCHR) and the non-profit organization, Sun Safety for Kids (SSK), discuss how they explored the extent and accuracy of knowledge among principals and teachers in California public school districts about the content written in their district’s written sun safety policy.

Elementary schools in California school districts were recruited to a parent study via their principal and were eligible if 1) they subscribed to the California School Boards Association, 2) had adopted the recommended sun safety Sample Board Policy (designated BP 5141.7), and 3) posted their version of Board Policy 5141.7 online. A total of 118 principals provided consent for their school to participate and nominated one teacher or staff member who would be involved in implementing sun safety practices at the school and 109 of the 118 teachers completed the baseline survey.

The baseline survey for both principal and teacher asked whether or not the school district had a policy on sun protection for students. Those who answered yes were presented with a list of policy components and asked to indicate which components were included in the policy. Respondents were also asked about job characteristics, skin type, personal or family history of skin cancer, and demographic characteristics. Policy knowledge among principals and teachers was compared with the content of the written school district sun safety policy and principals’ and teachers’ knowledge of each component was classified as accurate or inaccurate. …

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Behavioral Counseling Recommendations for Skin Cancer Prevention

March 26, 2018 Klein Buendel

In the March 20, 2018 issue of the Journal of the American Medical Association, the U.S. Preventive Services Task Force (USPSTF) published a recommendation statement on behavioral counseling to prevent skin cancer.

The publication updated the 2012 USPSTF recommendation on behavioral counseling for the prevention of skin cancer.

The USPSTF determined that behavioral counseling interventions are of moderate benefit in increasing sun protection behaviors in children, adolescents, and young adults with fair skin types (aged 6 months to 24 years old). They found adequate evidence that behavioral counseling interventions result in a small increase in sun protection behaviors in adults older than 24 years with fair skin types.

The USPSTF, however, found inadequate evidence on the benefits and harms of counseling adults about skin self-examination to prevent skin cancer. This conclusion was based on the lack of evidence that skin self-examination is beneficial.

Two editorials – one led by Dr. June Robinson from the Department of Dermatology at the Northwestern University Feinberg School of Medicine in Chicago and the other led by Dr. David Buller, Director of Research at Klein Buendel – were also published along with the Task Force recommendations.

The editorial by Robinson and Jablonski points out that while physicians are trusted sources of health information, people at risk for skin cancer or with a family history of skin cancer may also find family members to be useful networks for information on prevention and self-examination.

The editorial by Buller, Heckman, and Manne expresses disappointment in the Task Force not recommending skin self-examination and points out that some ongoing studies to determine effectiveness of skin self-examination may find that it is effective.

Both editorials describe the Task Force’s definition of risk as “fair skin types” as narrow. They believe that many other people are at risk for skin cancer and could benefit from sun protection education and counseling. Some groups mentioned in the editorials include people who sunburn but are not considered fair-skinned, people who use indoor tanning equipment, children and adolescents, Hispanics, and people who are physically active outdoors. According to the authors, it is important not to disenfranchise these groups within the diverse U.S. population.

A Randomized Study of Shade Sails and Passive Recreation in Public Parks in Two Hemispheres

March 19, 2018 Klein Buendel

Skin cancer is the most common type of cancer¹ but the primary risk factor for skin cancer, UV exposure, is the most avoidable.² Purpose-built shade not only reduces UV exposure,³ it can also come with other benefits like provide protection without requiring planning⁴ and may even provide protection for individuals with negative attitudes towards sun safety who seek shade to keep cool.⁵

In a recent publication in American Journal of Public Health, KB’s Dr. David Buller, Mary Buller and collaborators in Australia, at the University of Melbourne (Dr. Dallas English) and Cancer Council Victoria, (Dr. Suzanne Dobbinson) conducted a stratified randomized study in Melbourne, Australia and Denver, Colorado where shade sails were built in 1 of 2 passive recreation areas (PRAs) in full sun in 144 parks (71 in Melbourne and 73 in Denver). The use of the PRAs with shade sails built as part of the study were compared with the nearby non-shaded PRAs for use by park visitors. The authors tested two hypotheses – the first being that the introduction of shade sails over PRAs would increase the use of these PRAs by visitors compared to unshaded PRAs – and the second being that the increase in use of shaded PRAs would be larger in Melbourne, Australia than Denver, Colorado due to stronger norms for sun safety in Australia than the United States.

Public parks enrolled in the study had to contain at least two unshaded PRAs that were in full sun at pretest, and one of the two PRAs had to contain a space where a shade sail could be constructed. Trained observers made observations at the PRAs for 30-minute periods on four weekend days during a 20-week period in the summer months for each city at pretest and posttest to determine the number of visitors during peak UV hours (11 am to 3 pm). Shade sails were designed to be attractive while also providing shade during peak UV times and the shade cloth selected reduced UV by at least 94%. …

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Collaborator Spotlight:
Areli Chacón Silva, PhD

March 12, 2018 Klein Buendel

Areli Chacón Silva, Ph.D., is the Interim Director of the Leadership Studies Program at the University of Texas at El Paso. She has a BA in International Business from Tecnológico de Monterrey (ITESM) (1996), an MBA from Angelo State University (1999), and a PhD in Economics from the University of La Havana (2011). Her research explores the Latino market in the United States, as well as business expansion opportunities for Mexican businesses. She has experience researching the cultural values of Latinos in America.

Currently, Dr. Chacón Silva is working with KB as a collaborating scientist with Dr. Gill Woodall and Dr. David Buller on WayToServe Español: A Culturally-Appropriate Online Responsible Beverage Service Training for Spanish-Speaking Servers (R44MD010405; Dr. Gill Woodall, Principal Investigator). This research project is funded by the National Institute on Minority Health and Health Disparities at the National Institutes of Health. On this project, she will assist with the creation of culturally-appropriate content and the translation of the English WayToServe® online responsible alcohol server training program to Spanish. She will ensure that the translation is compatible with the values and needs of workers in Spanish language-dominant bars and restaurants. The randomized control trial will take place at Spanish-dominant businesses in the Southwestern region of the United States.

In addition to her research collaboration with KB, Dr. Chacón Silva serves as Chair of the Curriculum Development Committee of the (L.E.A.D. Program) for Wise Latina International, a non-profit organization whose mission is to educate and empower Latinas and women of all walks of life to overcome barriers, to be self-reliant, to become leaders, and to act as agents of change in our communities.

Dr. Chacón Silva served on the Editorial Board Member Committee at the International Case Center of Tecnológico de Monterrey (ITESM) from 2008 to 2012. Her research has appeared in the International Journal of Case Method Research and Application and other scholarly outlets. She has worked as a consultant in international business, leadership, and business logistics since 2001.

Dr. Chacón Silva is also the co-author of the book ¡Reconquest! Advice for Business Owners in Chihuahua to do Business with Latinos in the US (2010). The book presents the results of research funded by CONACYT (National Science and Technology Fund of Mexico: CHIH-2006-CO2-59483) to developing capacity building strategies for Chihuahuan business people to increase commerce with Latinos in the United States, through the concept of the nostalgia marketing.

Real Health Photos – International Women’s Day

March 8, 2018 Klein Buendel

March 8 is International Women’s Day (IWD) around the globe. This year’s theme is Press for Progress — a call to motivate and unite friends, colleagues, and whole communities to think, act, and be, gender inclusive.

Started by the Suffragettes in the early 1900’s, the first International Women’s Day was celebrated in 1911. According to the IWD website, “International Women’s Day belongs to all communities everywhere – governments, companies, charities, educational institutions, networks, associations, the media and more. Whether through a global conference, community gathering, classroom lesson or dinner table conversation – everyone can play a purposeful part in pressing for gender parity.”

Women of all ages, races, ethnicities, sizes, shapes, disabilities, and capabilities are often the focus of targeted health promotion campaigns. Matching photographic images to a target population can improve the effectiveness of a health message, according to KB research. The message is more effective because the photographs increase the audience member’s identification with the message in a very real and visual way.

KB’s Real Health Photos stock photography enterprise includes thousands of images to help improve the effectiveness of health promotion messages for targeted audiences. Real Health Photos images show diversity of gender, race, ethnicity, age, income level, and health condition or physical ability.

Use Real Health Photos for improving the impact of health campaigns for all kinds people, including women.

For more images, visit Real Health Photos.

Real Health Photos is a stock photography service owned and operated by KB. It was created and evaluated with a research grant (R44MD003338, Mary Buller, Principal Investigator) from the National Institute of Minority Health and Health Disparities at the National Institutes of Health. Real Health Photos is designed to capture the diversity of health through photography and promote the inclusion of all populations in health promotion materials and media.

Real Health Photos® is a KB registered trademark.