Klein Buendel investigators and their collaborators have published the results of the Go Sun Smart at Work project in the Journal of Occupational and Environmental Medicine. This research compared two methods for scaling up an evidence-based occupational sun protection program nationwide. 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 in 1:2 ratio. Managers completed pretest and posttest surveys and employees completed posttest surveys. Due to the COVID-19 pandemic, only posttest measures were analyzed (from 255 managers and 1387 employees).
After scale-up, more employees reported training and communication at workplaces in in-person rather than digital strategy. There were no differences in managers’ reports of sun protection training, communication, or actions by scalability method. Overall, occupational sun protection was implemented during program scale-up and employees recalled training/communication more in the in-person than digital strategy. A full description of methods, analyses, and results can be found in the Journal of Occupational and Environmental Medicine publication.
The research was supported by a Cancer Moonshot Initiative grant from the National Cancer Institute (CA210259; Dr. David Buller, Principal Investigator). Collaborators 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, and Ms. Mary Buller, Ms. Julia Berteletti, Ms. Alishia Kinsey, Ms. Irene Adjei, and Mr. 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 project.
Three occupational sun safety projects were presented by collaborating researchers from Klein Buendel and Emory University at the 16th Annual Conference on the Science of Dissemination and Implementation in Health held December 10-13, 2023, in Washington, DC. Each presentation complemented the conference theme of “Raising Expectations for Dissemination & Implementation Science: Challenges and Opportunities,” by approaching occupational skin cancer prevention in a unique and challenging way.
Poster 1
Title: Differences in Program Implementation and Sun Protection of an Occupational Sun Safety Intervention: Comparison of Two Dissemination Strategies
Presenter: Dr. David Buller, Klein Buendel
Dr. David Buller
Balancing effectiveness and cost is essential when scaling up evidence-based interventions. In this study, two methods for disseminating an evidence-based occupational sun protection intervention that differed in cost and personal contact were compared. Solar ultraviolet radiation is a carcinogen associated with skin cancer.
Sun Safe Workplaces (SSW), a policy and education intervention, was effective in a randomized trial in Colorado (1,2). Two methods for disseminating SSW were compared in a randomized pretest-posttest two-group trial design. State departments of transportation (DOTs; n=21) participated and the 136 districts within these DOTs were randomly assigned to receive SSW either by an in-person coaching method or a virtual coaching method. In each district, managers were pretested prior to randomization (n=1,484) and posttested (n=289) after 29-40 months (timing and attrition were affected by the COVID pandemic) on implementation of SSW training and communication and personal sun protection practices. Employees (n=1,388) also were posttested on training and communication implementation and personal sun protection practices.
There was no difference in managers’ reported implementation of sun protection actions at the workplace between dissemination methods. But more employees reported receiving sun protection training in in-person (60%) than virtual (46%) dissemination method and being more favorable toward this training (in-person M=3.70, virtual M=3.60.) Managers at workplaces receiving SSW via in-person dissemination experienced fewer sunburns in the past year while working outdoors than with virtual program delivery (M=0.69 v. M=1.58 sunburns; estimate=-0.875, p<0.011), especially at workplaces receiving it before the pandemic compared to later in the pandemic (in-person=0.43, virtual=0.79).
Effectiveness of evidence-based programs when scaled-up may be affected by the method of dissemination. Here, in-person coaching may have increased implementation of SSW training. It also may have aided coaches in convincing managers that there was a need for occupational sun safety and motivated them to avoid sunburn themselves and work to make employees see the value in training. The virtual delivery method may not have affected employees’ personal protection because they had limited contact with the coaches. Pandemic restrictions may have reduced intervention success.
This research was supported by a grant (CA210259; Dr. David Buller, PI) from the National Cancer Institute at the National Institutes of Health. Coauthors on this poster presentation included Ms. Julia Berteletti and Ms. Mary Buller from Klein Buendel; Dr. Kimberly Henry from Colorado State University; Dr. Richard Meenan from Kaiser Permanente, and Dr. Gary Cutter from the University of Alabama.
References
Buller, D. B., Walkosz, B. J., Buller, M. K., Wallis, A., Andersen, P. A., Scott, M. D., Eye, R., Liu, X., & Cutter, G. R. (2018). Results of a randomized trial on an intervention promoting adoption of occupational sun protection policies. American Journal of Health Promotion, 32, 1042-1053.
Walkosz, B. J., Buller, D. B., Buller, M. K., Wallis, A., Meenan, R., Cutter, G., Andersen, P. A., & Scott, M. D. (2018). Sun safe workplaces: Effect of an occupational skin cancer prevention program on employee sun safety practices. Journal of Occupational and Environmental Medicine, 60, 900-997.
Presentation 1
Title: Adaptation of an Evidence-based Occupational Sun Safety Program for Underserved Outdoor Workers in Southwest Georgia
Presenter: Dr. Alex Morshed, Emory University
Dr. David Buller, Ms. Mary Buller, Dr. Alex Morshed, Dr. Cam Escoffery
African American and Hispanic workers face unique skin cancer risks from UV exposure and are underrepresented in occupational sun safety research. This presentation reported on adaptation of an existing evidence-based sun safety program—Go Sun Smart at Work—to predominantly African American and Hispanic outdoor workers in local government employers in Southwest Georgia. The adaptation is renamed Go Sun Smart Georgia.
The systematic adaptation process was informed by Dr. Cam Escoffery’s Key Adaptation Steps (1), Implementation Research Logic Model (IRLM) (2), and the Framework for Reporting Adaptations and Modifications (3). The original intervention promotes workplace policy and education to improve sun protection and was effective in a randomized trial in Colorado (4,5). The team mapped the program and delivery using IRLM and developed an adaptation tracking tool based on Rabin et al. (6) to catalogue and make decisions about potential adaptations. The team integrated multiple sources of information to identify compatible and feasible adaptations: consultation with program experts and community partners, qualitative data collection with outdoor workers and managers at two local government employers (Jul-Sep 2023), and synthesis of literature.
The intervention includes training of peer coaches; written audit of employer sun safety policies, practices; employee training; and resource website (for example: training, sample policies, print materials, videos). In a pilot study with two local government employers, 11 employees identified by senior managers completed virtual 30-minute instruction to be peer coaches. Peer coaches delivered the sun safety training at staff meetings (21-39 employees per session). Several promising adaptations were identified, including modification of educational materials to better represent the worker population, addressing misconceptions, and use of external peer coaches at the workplace. Interviews with managers and focus groups with employees are in process.
Adaptation of existing, effective interventions to better address population characteristics and needs can increase feasibility and scalability with employers throughout Georgia, which furthers dissemination and reach of existing evidence base for improving occupational sun safety and preventing cancer.
This research was supported by a grant (U48DP006377) from the Centers for Disease Control and Prevention to the Emory University Prevention Research Center (Dr. Alex Morshed from Emory University and Dr. David Buller from Klein Buendel, MPIs). Coauthors on this oral presentation included Ms. Mary Buller, Dr. Barbara Walkosz, Ms. Irene Adjei, Mr. Brandon Herbeck, and Dr. David Buller from Klein Buendel; and Ms. Kayla Anderson, Dr. Cam Escoffery, and Radhika Agarwal from Emory University.
Title: “Technology for Workplace Implementation of Solar Radiation Safety in Response to Climate Change”
Presenter: Ms. Mary Buller, Klein Buendel
Ms. Mary Buller
The sun’s energy is both life-saving and life-threatening. Americans who work outdoors are exposed to rising temperatures and extreme levels of ultraviolet radiation from the sun. These exposures, without preventive measures, can cause heat illness, skin cancer, and death. It is estimated that solar radiation contributed to over 350,000 deaths from excessive heat in 2019 and over 120,000 deaths from skin cancer in 2020. The U.S. government recently launched an interagency effort to combat extreme heat, including for persons who work outdoors, and the Surgeon General has identified occupational sun safety as part of a national priority for skin cancer prevention.
Workplace interviews, a review of literature and existing programs, and expert consultants helped increase dissemination potential by expanding an intervention for occupational skin cancer prevention to include heat illness prevention. Content consultants included safety training professionals, behavioral scientists, and dermatologists. The program, Go Sun Smart at Work, also includes messaging for outdoor workers of all skin types and risk profiles for both heat illness and skin cancer to be delivered online through workplace learning management systems to improve its dissemination. It will be evaluated in 2024 in a randomized controlled trial enrolling 20 worksites, their managers, and outdoor employees.
A virtual learning environment (VLE) has been programmed to disseminate and guide the implementation of comprehensive sun exposure reduction to workplaces. The VLE is a web-based program with a content database, a media platform for trackable employee training (compliant with eLearning standards), and an innovative, automated decision support tool. The tool is a chat bot-like program that customizes advice on adopting workplace policy and implementing prevention procedures to management’s readiness to innovate on sun safety based on Diffusion of Innovations Theory.
Solar radiation prevention is urgently needed to help outdoor workers adapt to a warming world. Employers have been adopting virtual training rapidly to improve accessibility, resource and learning efficiency, engagement and information retention, and fidelity and trackability. Improvements in dissemination, training, and practice, as facilitated by this VLE, can save employers time and money, improve employee health behaviors, and reduce solar-related adverse events at work.
This research was supported by a grant (CA257778; Ms. Mary Buller, PI) from the National Cancer Institute. Coauthors on this poster presentation included Dr. Barbara Walkosz, Ms. Julia Berteletti, Mr. Brandon Herbeck, Ms. Irene Adjei, and Dr. David Buller from Klein Buendel.
Changes in patients’ family communication after offer of skin cancer genetic test
Melanoma is a serious preventable form of skin cancer. Genetic testing for skin cancer risk may help increase awareness. A team led by Dr. Jennifer Hay from the Memorial Sloan Kettering Cancer Center, and including Dr David Buller from Klein Buendel, examined how an offer for testing for the melanocortin-1 receptor gene (MC1R) may have enhanced communication surrounding skin cancer within families. The research team presented a poster of their findings at the 44th Annual Sessions and Meeting of the Society of Behavioral Medicine in Phoenix, Arizona on April 26-29, 2023.
The study examined frequency targets (which family member) and topics of family communication around skin cancer at a 3-month follow-up within a New Mexico study that randomized primary care patients (N=600; 48% Hispanic) to MC1R test invitation or usual care (Aim 1). Frequency and targets were assessed on 4-point scales (“not at all” to “a lot”) asking participants how often they talked with family and with each target. Topics were assessed by asking participants whether they discussed a series of topics with family. The impact of usual care genetic test refusal and test results (average or higher risk feedback) on frequency targets and topics of family communication was assessed using ANOVAs and Chi-Square tests (Aim 2).
Aim 1 analysis showed that at the 3-month follow-up the average frequency of overall family communication was between “a little” and “some”. The most common communication targets were spouses and children; the most common topic was sun protection. Aim 2 analysis showed no significant differences in communication frequency. However, communication targets who received high-risk feedback reported greater communication with their spouse compared to those in usual care. Lastly, the study found that certain topics of communication such as “who had skin cancer in the family” and “your own risk of getting skin cancer” were discussed more by those who had testing (both receiving average and high-risk feedback) than by those in usual care or by test refusers.
The findings provide important insight into family communication about skin cancer. The results indicate greater discussion with certain people and about certain topics when individuals had undergone genetic testing highlighting the potential role that genetic testing can play in fostering family communication. Future research could provide deeper insight into why individuals talk to certain people and about certain topics more than others as well as examine how family communication affects decision-making regarding offers for cascade genetic testing or interpretation of results.
This research was supported by a grant from the National Cancer Institute (CA181241; Dr. Jennifer Hay and Dr. Marianne Berwick, Multiple Principal Investigators). Authors in addition to Dr. Jennifer Hay include Ms. Caroline Salafia (poster presenter), Dr. Smita Banerjee, and Ms. Elizabeth Schofield from the Memorial Sloan Kettering Cancer Center; Dr. Andrew Sussman, Dr. Dolores Guest, and Dr. Keith Hunley from the University of New Mexico; Dr. Kimberly Kaphingst from the University of Utah; and Dr. David Buller from Klein Buendel.
Adapting a Sun Safety Program for Low-Risk Outdoor Workers
Ultraviolet radiation (UV) from the sun is an occupational hazard that causes skin cancer. Outdoor workers are disproportionately Hispanic and African American (AA). Though risk for skin cancer is greater for non-Hispanic Whites, Hispanics and AAs are more likely to die from skin cancer as a result of delays in detection. Interviews (n=32) and an online survey (n=81) were conducted with a predominantly male, Hispanic, and AA sample of outdoor workers to inform the systematic adaptation of an existing evidence-based workplace sun safety program. The goal was to learn how to target messaging to underrepresented outdoor workers with darker skin types.
The interview sample was largely male (87%), Hispanic (78%), and AA (25%). Interviews were qualitatively reviewed to identify common themes. Most employees reported not getting sunburned while at work. Some reported skin darkening as a negative consequence. Sun protection is not a topic usually discussed with others but skin cancer is a concern. They reported engaging in sun protection, but not frequently wearing sunscreen. They were positive about receiving sun safety training at work and suggested it be combined with heat stroke prevention, which is a common training topic. The survey sample also was largely male (74%), Hispanic (25%), and AA (58%). Respondents reported an average of 2.66 sunburns in the past year, 85% occurring at work. They learned about sun protection most often from parents (46%), followed by employers (37%) and healthcare providers (37%). Only half (49%) reported being very confident they can practice sun safety. Limiting time outside during high UV (46%) and wearing sunscreen (35%) were the least used forms of sun protection reported. Participants in the interviews and survey listed avoiding sunburn, preventing skin darkening, and preventing heat stroke as benefits of sun safety training.
Overall, employees with darker skin types knew about UV protection and often put the knowledge into practice on the job. Motivation based on perceived risk for skin cancer and self-efficacy could be improved, especially with regard to sunscreen. Other appearance and health concerns, such as preventing heat illnesses in this period of climate-driven extreme heat events, may be highlighted to motivate sun protection among outdoor workers with darker skin types. Employers are an important source of sun safety information for these employees, since many do not talk about it with other people in their lives.
This formative research is supported by the National Cancer Institute of the National Institutes of Health under award number CA257778 (Mary Buller, Klein Buendel President, Principal Investigator). Collaborators from Klein Buendel include Dr. Barbara Walkosz, Ms. Julia Berteletti, and Ms. Irene Adjei.
A Protocol for a Facebook Intervention for Young Melanoma Survivors and Their Families
Individuals diagnosed with melanoma before the age of 40 (young-onset melanoma survivors) and their first-degree relatives (FDRs) are a growing population at risk for developing recurrent melanoma or new melanomas. Regular surveillance using clinical skin examination (CSE) and skin self-examination (SSE), and engagement in preventive behaviors including sun protection are recommended. Given the growing population of young melanoma survivors and their families who are at increased risk, it is surprising that no behavioral interventions have been developed and evaluated to improve risk-reduction behaviors.
In response, 16 researchers from ten institutions and organizations have developed an intervention and published its protocol in JMIR Research Protocols. Ultimately, the intervention is designed to improve skin cancer prevention and screening for young-onset melanoma survivors and their families. The authors believe the intervention’s delivery via Facebook will increase its impact because of the dissemination potential.
The randomized controlled trial will evaluate the efficacy of a Facebook intervention providing information, goal setting, and peer support to increase CSE, SSE, and sun protection for young-onset melanoma survivors and their FDRs. A sample of over 500 melanoma survivors and their FDRs will be randomly assigned to either the Young Melanoma Family Facebook Group or another Facebook group control condition. Before and after the intervention, study participants will complete measures of CSE, SSE, sun protection, attitudes, and beliefs. An additional objective is to evaluate the efficacy of the Facebook interventions on perceived stress, physical activity, and healthy eating behaviors.
The authors plan to complete study enrollment by late 2023. Data analysis will employ multilevel modeling with family as the upper-level sampling unit and individual as the lower-level sampling unit. According to the authors, “Fixed effect predictors in these models will include condition, role, sex, all 2- and 3-way interactions, and covariates.” If effective, the Young Melanoma Family Facebook program could be disseminated by dermatology practices, public health and nonprofit melanoma organizations, and existing melanoma and skin cancer Facebook groups, expanding its reach.
Paper Authors and Affiliations
Dr. Sharon Manne, Dr. Carolyn Heckman, Sara Frederick, Mara Domider, and Marissa Grosso: Behavioral Sciences, Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, New Jersey
Dr. Sherry Pagoto: Department of Allied Health Sciences, College of Agriculture, Health and Natural Resources, University of Connecticut, Storrs, Connecticutt
Dr. Susan Peterson: Department of Behavioral Science, Division of Cancer Prevention and Population Sciences, MD Anderson Cancer Center, The University of Texas, San Antonio, Texas
Dr. Deborah Kashy: College of Social Science, Department of Psychology, Michigan State University, East Lansing, Michigan
Dr. Adam Berger: Division of Surgical Oncology, Department of Surgery, Robert Wood Johnson Medical School, Rutgers, The State University of New Jersey, New Brunswick, New Jersey
Dr. Christina Studts: Pediatrics – General Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
Dr. Rosalyn Negron: College of Liberal Arts, University of Massachusetts Boston, Boston, Massachusetts
Dr. David Buller: Klein Buendel, Inc, Golden, Colorado
Dr. Lisa Paddock and Alexandria Kulik: Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
Joseph Gallo: Hackensack Meridian Jersey Shore Medical Center, Hackensack Meridian Health, Neptune City, New Jersey
Morgan Pesanelli: School of Public Health, Rutgers, The State University of New Jersey, New Brunswick, New Jersey
This project was supported by a grant from the National Cancer Institute to Rutgers University (CA221854; Dr. Sharon Manne, Principal Investigator). Dr. David Buller, Klein Buendel Director of Research, is a Co-Investigator on the project.
The use of indoor tanning facilities by minors is a public health concern. In an effort to reduce risk for skin cancer, the Health Chat social media intervention was launched by Klein Buendel researchers and their colleagues to reduce mothers’ permissiveness toward their teenage daughters’ indoor tanning behavior.
For the Health Chat study, mothers with daughters aged 14-17 were recruited in 34 states that do not ban indoor tanning by minors. Participating mothers received an adolescent health social media campaign in Facebook private groups. Half of the mothers were in a group in which the health campaign included posts about preventing indoor tanning (intervention) and the other half, included posts on preventing prescription drug misuse (control). Follow-up surveys with mothers at 12 months and 18 months measured indoor tanning permissiveness, attitudes, intentions, communication, behavior, and support for state indoor tanning bans.
Analysis of the 18-month follow-up data from the Health Chat social media intervention was e-published recently inCancer Epidemiology, Biomarkers & Prevention. The research was led by Dr. David Buller from Klein Buendel and Dr. Sherry Pagoto from the University of Connecticut.
The methods and results of this randomized trial are detailed in the publication. Data analysis showed that at 18 months after the intervention, mothers in the intervention group were less permissive of indoor tanning by daughters and had greater self-efficacy to refuse daughter’s indoor tanning requests than mothers in the control group. Intervention-group mothers also had lower intentions to indoor tan themselves and were more supportive of bans on indoor tanning by minors than control-group mothers. In addition, daughters in the intervention group expressed less positive attitudes toward indoor tanning than daughters in the control group.
In summary, the Health Chat social media intervention may have influenced mothers’ decisions to withhold permission for their daughters to indoor tan for six months after the end of the program. Mothers’ support for bans on indoor tanning by minors also appears to have persisted.
This research was funded by a grant and supplement from the National Cancer Institute (CA192652; Dr. David Buller and Dr. Sherry Pagoto, Multiple Principal Investigators). Collaborating authors include Dr. Katie Baker and Dr. Joel Hillhouse from East Tennessee State University; Dr. Kimberly Henry from Colorado State University; Jessica Bibeau from the University of Connecticut; and Dr. Barbara Walkosz, Julia Berteletti and Alishia Kinsey from Klein Buendel.
Family Attitudes and Communication about Sun Protection
Young melanoma survivors and their families are at increased risk for developing melanoma, yet do not often practice sun protection for skin cancer prevention. Currently, little is known about the role of family interaction in sun protection.
Klein Buendel Senior Scientist, Dr. David Buller, was one of several authors on a recent paper on family attitudes and communication about sun protection among young melanoma skin cancer survivors and their family members e-published in the Journal of Health Communication. The research team was led by Dr. Sharon Manne from the Department of Medicine, Behavioral Sciences Section at the Rutgers Cancer Institute of New Jersey.
The research team set out to “examine correspondence between survivors and family sun protection, individual attitudes, and family attitudes and communication about risk-reducing behaviors, and evaluate the mediating role of family attitudes and communication in the association between individual sun protection attitudes and behavior.” Participants completed questionnaires about their individual attitudes, family attitudes and communication, and sun protection behaviors.
Analyses showed that families had varying levels of shared attitudes and behaviors. Family discussion was associated with higher sun protection for both men and women. Other findings differed for men vs. women and cancer survivors vs. family members. Full descriptions of the measures, methods, results, and conclusions can be found in the publication. Overall, the authors believe that family-focused interventions may prove effective because families’ attitudes and practices correspond with each other.
This research was supported by a grant from the National Institutes of Health (Dr. Sharon Manne, Principal Investigator). Other authors on the publication include Dr. Deborah Kashy from Michigan State University; Dr. Sherry Pagoto from the University of Connecticut; Dr. Susan Peterson from the University of Texas MD Anderson Cancer Center; Dr. Carolyn Heckman, Joseph Gallo, Dr. Adam Berger, Alexandria Kulik, Sara Frederick, and Morgan Pesanelli from the Rutgers Cancer Institute of New Jersey; and Dr. David Buller from Klein Buendel.
Klein Buendel Director of Research, Dr. David Buller, is a co-author on two recent publications reporting the results of studies on genetic testing and treatment decision-making for melanoma patients. Both papers report finding from a study directed by Dr. Jennifer Hay from the Memorial Sloan Kettering Cancer Center in New York and Dr. Marianne Berwick from the University of New Mexico.
Behavioral and Psychological Outcomes Associated with Skin Cancer Genetic Testing
The first paper has been published in the journal Cancer (Basel). The study investigated genomic testing of the common melanocortin-1 receptor (MC1R) gene for skin cancer risk in a randomized controlled trial in primary care settings in Albuquerque, New Mexico. Study participants were randomized 5:1 to a MC1R test invitation or usual care. Three-month sun protection, skin cancer screening, and skin cancer worry outcomes associated with testing, and key effect moderators (such as cancer risk perceptions, and skin cancer risk factors) were assessed.
Full research methods and results are reported in the publication and show that the primary outcomes were unchanged by the MC1R test offer, test acceptance, and level of risk feedback. Moderator analyses results are also presented in the publication. “Risk feedback did not prompt cancer worry, and average risk feedback did not erode existing sun protection,” according to the authors. More study is needed in the understanding and development of tailored strategies to address low skin cancer risk awareness and genetic testing.
This research was supported by the National Cancer Institute (CA181241; Jennifer Hay and Marianne Berwick, Multiple Principal Investigators). Collaborators include Kimberly Kaphingst from the University of Utah; David Buller from Klein Buendel; Elizabeth Schofield and Yuelin Li from the Memorial Sloan Kettering Cancer Center; Kirsten Meyer White from the New Mexico VA Health System; Andrew Sussman, Dolores Guest, Yvonne Dailey, Erika Robers, Matthew Schwartz, and Keith Hunley from the University of New Mexico.
Effect of Superstitious Beliefs and Risk Intuitions on Genetic Test Decisions
The second paper has been published in the journal Medical Decision Making. The study investigated cognitive causation, or superstitious thinking, and negative affect in risk as predictors of MC1R (moderate v. high risk) skin cancer genetic testing and responses to the testing.
Nearly 500 participants completed baseline assessments using validated measures of cognitive causation (beliefs that thinking about cancer risk increases cancer likelihood) and negative affect in risk (negative feelings generated during risk perception) and subsequently received a test offer. Participants could access a website to learn about and request genetic testing. Those who completed genetic testing for skin cancer completed assessments of cognitive and affective reactions two weeks after testing.
Methods, assessment measures, and full results are reported in the publication. In summary, negative affect in risk did not hamper test information seeking, but did inhibit the uptake of genetic testing. Those with higher cognitive causation showed more fear regarding their test result.
This research was supported by the National Cancer Institute (CA181241; Jennifer Hay and Marianne Berwick, Multiple Principal Investigators). Collaborators include Kristen Riley from Rutgers University; Andrew Sussman, Dolores Guest, Yvonne Dailey, Matthew Schwartz, and Keith Hunley from the University of New Mexico; Elizabeth Schofield from the Memorial Sloan Kettering Cancer Center; David Buller from Klein Buendel; and Kimberly Kaphingst from the University of Utah.
Dr. David Buller, Klein Buendel’s Director of Research, is a co-author on a paper published recently in Patient Education and Counseling that examines how health literacy skills impact primary care patients’ understanding of melanoma genetic testing results. The paper’s lead author is Dr. Kimberly Kaphingst from the Huntsman Cancer Institute and the Department of Communication at the University of Utah. Additional co-authors are from the Memorial Sloan Kettering Cancer Center in New York, and the Department of Internal Medicine at the University of New Mexico.
Making a significant health decision can be burdensome. It involves obtaining, processing, and weighing an abundance of new information. Personal health literacy skills may help lighten the load. According to the U.S. Department of Health and Human Services, “personal health literacy is the degree to which individuals have the ability to find, understand, and use information and services to inform health-related decisions and actions for themselves and others.”
The Patient Education and Counseling paper describes the methods and measures used to examine whether health literacy skills, educational attainment, or melanoma risk were related to patients’ short-term cognitive and affective responses to personal melanoma genetic test results. Cognitive responses that were measured included perceived clarity and believability of the test results, and how often respondents thought about the test results. Affective reactions that were assessed included things like confusion, fear, hopefulness, relief, and regret, among others. Study results, conclusions, limitations, and implications are reported in the publication. Overall, the authors report that some individuals may need assistance in understanding genetic information related to melanoma risk.
This research was supported by the National Cancer Institute (CA181241; Dr. Jennifer Hay and Dr. Marianne Berwick, Multiple Principal Investigators) and the Huntsman Cancer Foundation.
Melanoma Receptor Variation in a New Mexico Population
Dr. David Buller, KB Senior Scientist and Director of Research, is a co-author on a paper published recently in Cancer Epidemiology, Biomarkers & Prevention. The paper examines the Melanocortin 1 Receptor (MC1R) in a multicultural New Mexican population. MC1R is a risk factor for developing melanoma skin cancer because it contributes to skin pigmentation. The paper’s lead author is Dr. Kirsten White from the University of New Mexico. Other co-authors are from the Memorial Sloan Kettering Cancer Center in New York, the University of Utah, and the University of New Mexico.
Specifically, single-nucleotide polymorphisms (SNPs) in MC1R and their association with race and ethnicity, skin type, and perceived cancer risk were evaluated by genotyping MC1R in 191 primary care clinic patients in Albuquerque, New Mexico. A full description of the methods, results, conclusions, and limitations of the research can be found in the publication.
Overall, the authors concluded that a specific variant of interest in MC1R may not be a risk factor for melanoma among New Mexican Hispanics, and that genetic risk cannot be inferred from Northern European populations directly to non-European populations.
