Browsed by
Tag: Skin Cancer Prevention

KB Investigators Present at EUSPR

KB Investigators Present at EUSPR

Three Klein Buendel Principal Investigators gave presentations on their recent or active research projects at the 14th European Society for Prevention Research Conference held October 4-6, 2023 in Sarajevo, Bosnia and Herzegovina. The presenters were Dr. David Buller, Director of Research, Dr. Barbara Walkosz, Senior Scientist, and Ms. Mary Buller, President. Each presentation complemented the conference theme of “Optimizing Prevention Infrastructures.” The prevention interventions were implemented in workplaces to reach their target populations directly and impactfully.   

Presentation 1

Dr. David Buller

“Formative Research on Professional Development Training to Maintain Responsible Beverage Service Practices”

Improved interventions are needed to reduce the negative consequences of alcohol intoxication. Responsible beverage service (RBS) training has been effective at reducing service to intoxicated customers in some cases. Its efficacy might be improved with an intervention that supports RBS techniques in the years between government-required RBS retraining. We conducted formative research to develop an ongoing professional development component for an online RBS training.

Formative research explored feasibility, acceptability, and content for an ongoing professional development intervention for alcohol servers. Semi-structured interviews were performed with owners/managers of licensed establishments (n=10) and focus groups (n=19) and survey (n=24) with alcohol servers in New Mexico and Washington. A prototype of a professional development component was produced, covering advanced RBS skills, support from experienced servers, professionalism, and basic management training, for delivery through social media. It was evaluated in a usability survey with alcohol servers (n=20) in California, New Mexico, and Washington.

While owners, managers, and alcohol servers were favorable toward RBS in their establishments, they endorsed the need for ongoing support for RBS for servers. Among topics of high interest were sharing tips, methods, and stories from experienced servers, balancing pressure to sell, navigating adult-use marijuana laws, dealing with children, recognizing intoxication, and managing difficult customers. The prototype was comprised of 50 social media posts, including text, infographics, videos, and interactive activity. Servers rated it as highly usable and appropriate for themselves and the establishment. Most servers (70%) were interested in receiving the ongoing information and activities.

Owners, managers, and servers believed that an ongoing professional development component on RBS would benefit servers and licensed establishments. Servers were interested in using such program. The professional development component has the potential to improve an existing RBS intervention.

Collaborators on this presentation included Dr. David Buller and Dr. W. Gill Woodall from Klein Buendel, and Dr. Robert Saltz from the Prevention Research Center at the Pacific Institute for Research and Evaluation in California. This research was supported by a grant from the National Institute on Alcohol Abuse and Alcoholism (AA029364; W. G. Woodall and D. Buller, MPIs).

Presentation 2

Dr. Barbara Walkosz

“Sun Safety Ink!: Sun Safety Practices of Tattoo Studio Clients”

Melanoma is the second most common cancer among young adults in the United States. Sunburn prevalence and low rates of sun protection are elevated in this group. Thus, efforts are needed to promote skin cancer prevention. An estimated 225 million people worldwide have tattoos with 40% of adults ages 18-29 with at least one tattoo, and at least 30% of American have tattooed skin. Sun Safety Ink! is a skin cancer prevention program targeted to clients of tattoo studios The goal of Sun Safety Ink! is to promote full-body comprehensive sun protection to clients of tattoo studios to compliment standard aftercare instructions that recommend sun protection for new tattoos.

Thirty-seven tattoo studios were enrolled in the Sun Safety Ink! program. At pretest, clients were recruited by tattoo artists to complete an online survey that assessed current self-reported sun protection (sunscreen, lip balm, hats, protective clothing, sunglasses, and shade), number of sunburns, and sunbed tanning frequency in the last year. Respondents were also asked to locate the position of tattoos on their body, using a drawing tool. 

A total of 861 clients completed the online survey. Respondent demographics: age, average 31 yrs.; 67% female, 30% male; 60% white, 27% more than one race, 2% African American, 1% Asian and Native American, 13% Hispanic/Latino. The most prominent tattoo locations included: front left arm, 66%, front right arm, 58%, front upper torso, 52%, and back upper torso, 48%. Sun safety practices, that is, full body sun protection, (on a 5-point scale of “always” to “never”) were reported as: apply sunscreen SPF 15+ on face (aftershave, face lotion, or make-up), 3.31; apply sunscreen SPF 30+ on all exposed skin areas, 3.22; reapply sunscreen, 3.08; apply a lip balm, 3.28; wear any hat, 2.91; wear wide-brimmed hat, 2.21; wear sunglasses, 3.89; stay mostly in the shade, 3.38; and wear protective clothing, 2.91. Respondents also reported the number of sunburns as 1.53 and number of times indoor tanning as 1.11 in the last 12 months.

The pretest results indicate that full-body sun safety practices of tattooed adult can benefit from improvement, particularly wearing of hats and sun protective clothing. Further, knowledge of tattoo locations can direct sun safety recommendations to include protecting not only tattoos on arms and torsos but also non-tattooed skin on those areas of the body. Tattoo studies may be a viable location to delivering effective sun safety interventions to hard-to-reach tattooed, young adults.

Collaborators on this presentation included Dr. Barbara Walkosz, Ms. Mary Buller, and Dr. David Buller from Klein Buendel, and Dr. Robert Dellavalle from the University of Colorado School of Medicine and the Department of Veteran Affairs. This research was supported by a grant (CA206569; B. Walkosz, PI) from the National Cancer Institute.

Presentation 3

Ms. Mary Buller

“Protection from Solar Radiation in the Era of Climate Change: Preventing Heat Illness and Skin Cancer for Outdoor Workers”

The sun’s energy is both a necessity and a threat to humans. Extreme heat linked to climate change and unprotected exposure to ultraviolet radiation (UV) make people who work outdoors vulnerable to life-threatening heat illness and skin cancer. It is estimated that infrared radiation (heat) and UV contributed to over 120,000 deaths from skin cancer in 2020 and over 350,000 deaths from excessive heat in 2019. Efforts to protect workers from heat or UV can work in tandem to help outdoor workers adapt to the warming world.

Workplace interviews, a review of literature, and expert consultants helped expand an existing intervention for U.S. occupational skin cancer prevention to include heat illness prevention, and to be delivered online. Content consultants include safety training professionals, behavioral scientists, and dermatologists. The program, Go Sun Smart at Work (GSSW), will be evaluated in 2024 in a randomized controlled trial enrolling 20 U.S. employers.

GSSW is an innovative virtual learning environment and resource hub promoting comprehensive solar radiation policy, training, and personal protection for outdoor workers. It includes (1) a manager resource hub that guides decision-makers through implementation strategies using a structured conversation agent; (2) an employee sun safety training video that is compliant with eLearning standards and compatible with learning management systems for monitoring; and (3) a trove of resources and downloadable materials addressing heat illness and skin cancer prevention. The structured conversational agent adjusts workplace implementation strategies for management’s readiness to innovate on sun safety based on Diffusion of Innovations Theory.

GSSW will help outdoor workers protect themselves from the serious threats of climate change by providing employers with a convenient, comprehensive solar radiation safety policy and training program. It will support the shift to online training to improve accessibility, fidelity, adherence, and tracking, while saving resources.

Collaborators on this presentation included Ms. Mary Buller, Dr. Barbara Walkosz, Ms. Julia Berteletti, Mr. Brandon Herbeck, Ms. Irene Adjei, and Dr. David Buller from Klein Buendel. This research was supported by a grant (CA257778; M. Buller, PI) from the National Cancer Institute.

Stringency of State Indoor Tanning Laws

Stringency of State Indoor Tanning Laws

Approximately five million cases of skin cancer are diagnosed among Americans at a cost nearing $9 billion annually. Indoor tanning (IT) is a risk factor for skin cancer. Restricting IT facilities, especially access by minors, has been the subject of state laws. More stringent restrictions on youth access (for example, bans by age vs. parental consent laws) appear to be associated with reduced IT by youth.

Julia Berteletti and David Buller at SBM

A team led by Dr. Carolyn Heckman from Rutgers University and Dr. David Buller from Klein presented a poster characterizing the IT policy landscape of U.S. states at the 44th Annual Sessions and Meeting of the Society of Behavioral Medicine in Phoenix, Arizona on April 26-29, 2023. The poster was entitled “Comparison of the stringency of indoor tanning bills regarding minors that passed and failed in state legislatures over the last 30 years.”

The research team coded 107 state IT law documents and compared passed laws to failed bills (proposed but not voted on or proposed but voted down), using a validated coding tool that assessed the presence of age bans, parental consent/accompaniment, warnings, operator requirements, and enforcement. Component codes were scaled on 10-point stringency measures (0=no regulation, 10=very strong regulation). Component and total summed scores were calculated, with higher scores indicating more stringent IT restrictions.

Between 1991 and 2022, 46 states and the District of Columbia passed a law on IT, with 23 banning access to IT facilities by minors under age 18. By contrast, 60 bills on IT failed to pass in 31 states since 2008. However, stringency of laws is weak, overall, which may explain why recent research found low compliance of IT facilities with regulations and continued IT among minors. Failed bills without minor bans were less stringent than similar passed laws, on nearly all components. Failure may have presented advocates opportunities to improve stringency of subsequent bills and time to garner more support for IT restrictions. In fact, less stringent bills may have failed because they had less support from outside constituencies (for example, medical societies and public health advocates) and among legislators. To gain insight into this public health legislation process, we are interviewing key informants from states with recent policy activity.

This research was supported by a grant to Rutgers University from the National Cancer Institute (CA244370; Dr. Carolyn Heckman and Dr. David Buller, Multiple Principal Investigators). Co-authors included Ms. Julia Berteletti from Klein Buendel and Ms. Anna Mitarotondo from Rutgers University.

Adapting a Sun Safety Program for Low-Risk Outdoor Workers

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

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.

Collaborator Spotlight:
Dr. Alexandra Morshed

Collaborator Spotlight:
Dr. Alexandra Morshed

Alexandra Morshed, Ph.D., is a Research Assistant Professor in the Department of Behavioral, Social and Health Education Services at Emory University. She is also a Co-Investigator with the Emory Prevention Research Center. Dr. Morshed received her Master of Science degree from Wageningen University in the Netherlands and her Ph.D. from Washington University in St. Louis.

Dr. Alexandra Morshed

Dr. Morshed is an implementation scientist with more than ten years of experience in public health research and practice. Her primary areas of interest include implementing interventions in vulnerable populations, chronic disease prevention, public health nutrition, and capacity building and knowledge expansion in dissemination and implementation science.

Dr. Morshed is currently collaborating with Dr. David Buller from Klein Buendel on a research study titled “Go Sun Smart at Work: A Sun Safety Program for Underserved Outdoor Workers” (Dr. Morshed and Dr. Buller, Multiple Principal Investigators). This CDC-funded study builds upon Klein Buendel’s evidence-based comprehensive occupational skin cancer prevention intervention, Go Sun Smart at Work, and aims to reduce UV exposure and prevent skin cancer among underserved outdoor workers in Georgia. Hispanic and African American adults have been overlooked in skin cancer prevention efforts, due to their lower incidence of skin cancer. However, among Hispanic and African Americans, skin cancer is diagnosed at more advanced stages, leading to higher mortality rates than non-Hispanic whites. The Emory University study aims to develop an intervention and implementation strategies to increase policies and practices to support sun safety among outdoor workers in Georgia.

UV Measured under Built Shade in Public Parks

UV Measured under Built Shade in Public Parks

Reducing exposure to ultraviolet radiation (UV) is crucial for preventing UV-induced diseases of the skin and eyes. Shade may offer significant protection from UV.

A research team from Klein Buendel and Cancer Council Victoria and LaTrobe University in Australia have published a paper on UV measurements under shade structure built in public parks in International Journal of Environmental Research and Public Health. The paper expands empirical research to quantify the UV protection offered from built shade to guide disease prevention practices and confidence in investment in shade.

Specifically, the research team quantified UV levels under built shade relative to unshaded passive recreation areas (PRAs) over summer months in parks in two cities (Denver, Colorado, USA and Melbourne, Victoria, Australia). In a randomized controlled trial, 1,144 UV measurements were recorded at the center and periphery of PRAs in a total sample of 144 public parks as part of pretest and posttest measures of use of the PRAs by park visitors. UV measurements were recorded for three recruitment waves per city during 2010 to 2014. Following pretest, 36 of the PRAs received built shade structures.

Regression analyses modelled pre-post change in UV (Standard Erythemal Dose (SED) per 30 min) at PRAs; and environmental predictors. Mean UV at the center of built shade PRAs decreased from pretest to posttest, adjusting for the covariates of ambient SED, solar elevation, and cloud cover. Clouds decreased and solar elevation increased UV levels under shade. No significant differences in UV by design of the shade structure occurred. A substantial reduction in UV exposure can be achieved using built shade with shade cloth designs, offering considerable protection for shade users. Supplementary sun protection  is recommended for extended periods of shade use during clear sky days. This could include things like brimmed hats, long sleeves, sunglasses, and sunscreen.

This research was supported by a grant from the National Cancer Institute (CA140367; Dr. David Buller, PI). Collaborators on this publication also include Dr. Suzanne Dobbinson and Dr. James Chamberlain from Cancer Council Victoria; Jody Simmons from LaTrobe University; and Mary Buller from Klein Buendel.

Indoor Tanning Policy and the Impact of COVID-19 on Tanning Facilities

Indoor Tanning Policy and the Impact of COVID-19 on Tanning Facilities

Julia Berteletti from Klein Buendel presented findings from a study on U.S. indoor tanning legislation efforts related to reduced indoor tanning by minors at the 43rd Annual Meeting & Scientific Sessions of the Society of Behavioral Medicine in Baltimore, MD, April 6-9 2022.

Skin cancer is a significant and expensive public health problem, with approximately 5 million Americans treated at a cost of over $8 billion annually. Indoor tanning (IT) is a well-established cause of melanoma and keratinocyte carcinomas.

Julia Berteletti Presenting at SBM

IT is regulated in two main ways: states restricting minor access and the U.S. Food and Drug Administration (FDA) regulations to minimize harm. Since 2012, 22 states and the District of Columbia adopted IT bans for all minors, ten banned some minors by age, and 12 required parental consent/accompaniment, but six have no law, primarily due to failed legislation. Seven states proposed new legislation in 2021. Additionally, FDA regulations (e.g., protective eyewear, session duration) exist to minimize harm from IT devices.

Recent evidence suggests that more stringent laws (for example, age bans vs. parental consent laws) are associated with less youth IT. Policy enforcement provisions and compliance with policies are also essential components of effective IT policy implementation, but enforcement and compliance are currently variable and inadequate. We are currently coding 102 state IT law documents that were proposed, passed, or failed, and 4 accompanying regulatory documents, using a validated coding tool. Documents are being assessed for regulation stringency, type of ban, warnings provided, operator requirements, and enforcement provisions.

Additionally, results show that beginning in March, 2020, in addition to state-level mandates, there have been additional guidelines and restrictions for IT salons due to the COVID-19 pandemic.  From March 2020 to April 2020, 49 states and the District of Columbia required salons to close to customers and reopened between April 2020 and December 2020 with varying restrictions, such as requiring appointments for services, requiring patrons to wear masks in public areas, and increasing ventilation in salons. Enforcement of these pandemic restrictions is unclear. Restrictions likely resulted in permanent salon closures and lower IT rates in 2020 but it is unknown how IT rates will be affected long-term, especially given the option for home tanning. Additional descriptive results of the policy coding and COVID-19 restrictions will be presented.

These data will help determine whether certain bill characteristics such as stringency or enforcement requirements are associated with law passage or not or bill stringency has increased over time, and the initial impact of the pandemic on IT policies. These findings will have implications for IT behavior and, ultimately, skin cancer incidence.

This research is funded by the National Cancer Institute (CA244370; Dr. Carolyn Heckman, Rutgers University, and Dr. David Buller, Klein Buendel, Multiple Principal Investigators). Authors collaborating on this conference poster include Julia Berteletti and Allyson Montalvo from Klein Buendel; and Anna Mitarotondo from Rutgers University.

Collaborator Spotlight:
Dr. Yelena Wu

Collaborator Spotlight:
Dr. Yelena Wu

Yelena Wu, PhD, is an Associate Professor in the Department of Dermatology at the University of Utah and a Research Investigator at the Huntsman Cancer Institute. She received a BA in Psychology from the University of California, Berkeley, and an MA and PhD in Clinical Child Psychology from the University of Kansas. She is also a licensed pediatric and clinical child psychologist.

Dr. Wu’s research and clinical practice center on promoting better health outcomes for children, adolescents, and young adults who have a history of cancer or who are at risk for developing cancer. A specific area of research interest is the prevention of skin cancer by improving adherence to preventive behavior recommendations among children and adolescents at increased risk for developing skin cancer.

Dr. Wu is currently the Principal Investigator on a 5-year project funded by National Cancer Institute (CA244674) to test a school-based program designed to increase adolescents’ use of sun protection and decrease participation in intentional tanning. Dr. David Buller, director of Research at Klein Buendel, collaborates as a Co-Investigator on the project.

In addition to her research, Dr. Wu provides consultations and therapeutic services to medical teams, patients, and caregivers to facilitate communication and aid in the management of cancer through the Family Cancer Assessment Clinic at the Huntsman Cancer Institute.

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.

This image has an empty alt attribute; its file name is spotlight_text.jpg
Persisting Effects of the Health Chat Program

Persisting Effects of the Health Chat Program

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 in Cancer 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.