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#4Corners4Health

#4Corners4Health

A collaborative team of highly-experienced cancer prevention and control investigators from the Four Corners Cancer Centers Collaborative (University of Arizona, University of Colorado, University of New Mexico, and University of Utah), Colorado State University, and Klein Buendel is launching a research study that focuses on decreasing cancer risk factors among emerging adults (ages 18-26) living in rural counties in the “Four Corners” states (Arizona, Colorado, New Mexico, and Utah) using a social media campaign. Cancer risks related to infrequent physical activity, unhealthy diet, nicotine product use, alcohol intake, ultraviolet radiation exposure and lack of HPV vaccination are prevalent among emerging adults and contribute to cancer later in life.

The project will test a theory-based, multi-risk factor social media approach to cancer prevention through the use of Facebook and its private group function. Social media can improve information dissemination, credibility, and relevance, be used to detect and respond to emerging trends, and engage users with user-generated content that personalizes information. It offers a superior intervention for emerging adults compared to health care, schools, and workplaces which can be challenging to implement in low-resourced rural communities and will not reach many emerging adults who have low preventive health care utilization, school enrollment, and/or employment.

#4Corners4Health Specific Aims

  • Develop a social media intervention for diverse emerging adults in rural communities via a community-engaged process that combines expert advice, user-generated content, and online instruction about behavioral cancer risks, cancer misinformation, counter marketing, digital and media literacy, and family communication.
  • Evaluate the effect of a theory-based social media intervention on moderate to vigorous physical activity (MVPA), health eating patterns, nicotine product use, alcohol intake, sunburn prevalence, and HPV vaccination with the diverse (ethnically/ socioeconomically) population of emerging adults aged 18-26 in rural counties in the Four Corner states recruited from Qualtrics’ survey panel and enrolled in a pragmatic randomized trial using a stepped-wedge design in which individual emerging adults will be randomized to one of four cohorts and receive social media feed for varying durations in separate Facebook private groups.
  • Test if improvements in merging adults cancer risk knowledge and beliefs, digital and media literacy skills, accurate cancer prevention information, and family communication mediate impact of the social media campaign.
  • Explore whether the impact of the social media campaign differs according to a) level of emerging adults engagement with campaign, b) cancer risk factors, and c) biological sex of the participants.

The investigators hypothesize that (1) emerging adults will increase MVPA and healthy eating pattern, reduce nicotine product and alcohol use, and sunburns, and increase HPV vaccine uptake from pre to post when receiving social media campaign, and (2) positive impact of the social media campaign on cancer risk factors among emerging adults will be mediated by improved cancer risk knowledge and beliefs (self-response efficacy; norms; social support; vaccine antecedents), digital and media literacy skills, misinformation, and family communication.

This research will be led by Dr. David Buller from Klein Buendel and Dr. Andrew Sussman from the University of New Mexico (Multiple Principal Investigators). It is being funded by a 5-year R01 grant from the National Cancer Institute (CA268037). Key collaborators include Dr. Kimberly Henry from Colorado State University; Dr. Cindy Blair from the University of New Mexico; Dr. Judith Gordon, Dr. Cynthia Thomson, and Dr. Jennifer Hatcher from the University of Arizona; Dr. Evelinn Borrayo and Dr. Douglas Taren from the University of Colorado; Dr. Deanna Kepka, Dr. Echo Warner, and Dr. David Wetter from the University of Utah; and Dr. Gill Woodall, Dr. Barbara Walkosz, Dr. Kayla Nuss, and Ms. Julia Berteletti from Klein Buendel.

Collaborator Spotlight:
Dr. Carolyn Heckman

Collaborator Spotlight:
Dr. Carolyn Heckman

Dr. Carolyn J. Heckman is an Associate Professor of Medicine and Co-Leader of the Cancer Prevention and Control Program at the Rutgers Cancer Institute of New Jersey. She received a BA in Psychology from Brown University and PhD in Counseling Psychology from the University of Iowa. She completed a postdoctoral fellowship in health psychology and addictions at Virginia Commonwealth University. She is also a licensed psychologist.

Dr. Heckman has published more than 100 research papers and presented at many national and international conferences. Much of her work focuses on skin cancer prevention and detection. Her other interests include online interventions and tobacco use and cessation. She has been funded numerous times by the National Cancer Institute and has also received funding from the American Cancer Society and Pfizer, Inc.

In addition to her research, Dr. Heckman is a member of the NIH Community Level Health Promotion study section and she is on the Editorial Board of the journal Translational Behavioral Medicine. She is the Founder/Leader of the Cancer Institute of New Jersey’s Dissemination and Implementation Science Working Group. Dr. Heckman has served on several steering and advisory, grant review, search committee, training, and other committees and community groups. For example, she served as the National Chair of the Don’t Fry Day skin cancer prevention awareness campaign sponsored by the National Council on Skin Cancer Prevention.

Currently, Dr. Heckman is a Co-Investigator on a five-year R01 study called “A Multi-Level Investigation of U.S. Indoor Tanning Policy Enactment, Implementation, Compliance, Impact, and Economics” with Klein Buendel’s Dr. David Buller. The goals of this research project are to complete three specific aims: 1) conduct a comparative case study to elucidate the indoor tanning legislation adoption process; 2) use a pseudo-patron (confederate) assessment, national survey, and archival data to investigate indoor tanning legislation implementation, as well as indoor tanning and sunburn outcomes among adolescents and young adults; and 3) integrate data from the first two aims and external data to assess economic effects relevant to policy sustainability of indoor tanning stringency, enforcement, and compliance.

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