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Sun Safe Schools Program Implementation

Sun Safe Schools Program Implementation

Ms. Kim Massie is presenting a poster on the implementation of the Sun Safe Schools project at the 4th International Conference on UV and Skin Cancer Prevention in Toronto, Canada, May 1-4, 2018. The poster focuses on the delivery of a sun protection policy intervention to public elementary schools in California.

The U.S. Surgeon General’s Call to Action to Prevent Skin Cancer in 2014 emphasized the importance of sun safety for schools; however, there is limited information on how to effectively assist schools in implementing sun safety. The Sun Safe Schools project was developed to provide technical assistance to 118 public elementary schools in California with the implementation of sun safety practices consistent with district board policy for sun protection (BP 5141.7). A trained coach worked with principals to select sun safety practices within policy categories, such as education of students and parent outreach, and develop their implementation plan. The coach recorded all reported intervention activities within a tracking database including practice selection date, policy category, practice description, and implementation date.

A variety of practices, such as posting the UV Index and providing sunscreen, were implemented at 58 intervention schools. Practices were predominately implemented in the first 12 months of the 20-month program. Most practices were implemented in the spring. Low periods of implementation coincided with summer and winter breaks in the school calendar. The most frequently implemented practices included distributing sun safety information to parents, arranging sun safety presentations for students, and providing a sun safety webinar to staff. Policy categories most frequently implemented included education of students, parent outreach, and education of teachers.

Overall, working with schools presents unique challenges for implementation of sun safety. To be effective, implementation assistance should be designed around the school calendar and allow the principal to determine the pace and priorities.

This research was supported by a grant from the Eunice Kennedy Shriver National Institute for Child Health and Human Development (R01HD074416; Dr. Kim Reynolds, Claremont Graduate University, Principal Investigator). Collaborators include Kim Massie and Brianne Freeth from Claremont Graduate University in California; Dr. David Buller, Julia Berteletti, and Mary Buller from Klein Buendel; and Dr. Jeff Ashley from Sun Safety for Kids, Inc. in Los Angeles, California.

Klein Buendel is one of the North American hosts of the UV 2018 conference. The conference was organized by a joint planning committee of skin cancer prevention experts in Canada and the United States from Ryerson University in Toronto, the Canadian Dermatology Association in Ottawa, and Klein Buendel in Denver.

 

Methodological Challenges of Social Media-Delivered Health Promotion Interventions

Methodological Challenges of Social Media-Delivered Health Promotion Interventions

Dr. Sherry Pagoto, SBM President-elect and KB Collaborator, was a co-presenter for a Behavioral Informatics and Technology Panel Discussion on social media health promotion at the 39th Annual Meeting and Scientific Sessions of the Society of Behavioral Medicine, April 11-14, 2018 in New Orleans, Louisiana. Dr. Pagoto shared methodological challenges related to participant recruitment, intervention content development, and intervention delivery for a Facebook intervention targeting mothers of teen daughters in order to reduce the incidence of indoor tanning. This project is currently being conducted by KB and several collaborators from the University of Connecticut, East Tennesee State University, and Colorado State University.

Social media platforms can be used to deliver health promotion interventions to wide audiences without the barriers that plague traditionally-delivered programs, such as geography, transportation, scheduling, and childcare. Because most people access their social media feeds daily, health programming can be delivered to populations who are not necessarily seeking help or are motivated to change. Despite these promising and unique features, designing studies to evaluate social media-delivered interventions involves methodological challenges for recruitment and participation. During the panel discussion, Dr. Pagoto shared some of our research project’s challenges, implications of alternative recruitment and engagement methods, and valuable lessons learned.

This research project is called “Likes Pins and Views: Engaging Moms on Teen Indoor Tanning Thru Social Media.” It is funded by a grant from the National Cancer Institute (RO1CA192652; Dr. David Buller, KB, Principal Investigator). Collaborators include Dr. Barbara Walkosz and Julia Berteletti from KB, Dr. Sherry Pagoto, Jessica Oleski, and Ashley Panzarino from the University of Connecticut, Dr. Katie Baker and Dr. Joel Hillhouse from East Tennessee State University, and Dr. Kim Henry from Colorado State University.

KB and Canada Host World’s Sun Safety Experts

KB and Canada Host World’s Sun Safety Experts

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 4th 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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Behavioral Counseling Recommendations for Skin Cancer Prevention

Behavioral Counseling Recommendations for Skin Cancer Prevention

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

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

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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Sun Safe Policies in Elementary Schools

Sun Safe Policies in Elementary Schools

School policies that improve sun safety for children are essential to comprehensive school-based skin cancer prevention. California was one of the first states that enacted legislation governing sun protection for students in public schools. In a research letter recently published in JAMA Dermatology, KB’s Julia Berteletti, Dr. David Buller and Lucia Liu along with collaborators at Claremont Graduate University and the non-profit organization, Sun Safety for Kids, looked at how elementary schools in California adopted a policy for sun safety as recommended by the California School Boards Association (CSBA), a nonprofit membership-based education association representing elected officials who govern public school districts.

The Sample Policy, created through a collaboration with CSBA during a previous study, was based on sun safety recommendations put forth by California law and the Centers for Disease Control and Prevention recommendations and was disseminated to member school districts. The authors examined the content of sun safety policies for any deviation from the Sample Policy for 190 member districts that included elementary schools, subscribed to CSBA policy services, and posted their Board Policy online. The sun safety content of the Sample Policy and each districts’ sun safety policy was coded in 11 categories, such as sunscreen use, UV protective clothing, student education, and shade provision. Each policy was scored on content per category, strength of action specified, and intent for sun protection.

The majority of policies addressed sunscreen, protective clothing and hats. Most included shade, scheduling of outdoor activities to avoid peak UV hours, staff modeling and parent outreach. 75% of policies included student education. Educating teachers, resource allocation, and accountability were addressed in almost no policies. Also, 40% of districts altered their own policy to remove some content from the CSBA Sample Policy. The most frequently removed items were student education, outdoor shade or parent outreach. Authors also found that districts that removed content had significantly more students and administrators than those that adopted the Sample Policy verbatim.

Authors concluded that the CSBA played an influential role in the school districts’ adoption of sun safety policy and suggest that establishing a partnership with a similar association could be an important part of achieving school-based skin cancer prevention.

This research was funded by a grant from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD074416; Dr. Kim Reynolds, Claremont Graduate University and Dr. David Buller, KB, Principal Investigators).

KB to Co-Host International UV Conference May 1-4, 2018

KB to Co-Host International UV Conference May 1-4, 2018

Klein Buendel is a proud North American organizer and host of the 4th International Conference on UV and Skin Cancer Prevention being held May 1-4, 2018 in Toronto, Canada. The 2018 conference is being organized by a joint planning committee of skin cancer prevention experts in Canada and the United States from Ryerson University in Toronto, the Canadian Dermatology Association, and Klein Buendel.

The UV and Skin Cancer Prevention conferences provide an innovative scientific program that showcases the work of the international skin cancer prevention community. The previous conferences have been held in Copenhagen, Denmark (2011), Berlin, Germany (2013), and Melbourne, Australia (2015) and have attracted international experts in skin cancer prevention, UV radiation science, dermatology, allied behavioral and clinical disciplines and members of the environmental planning and design communities who are working in the field of UV and skin cancer prevention. The conferences have been organized by local planning committees dedicated to advancing skin cancer prevention.

The Toronto conference will feature multiple concurrent sessions and poster sessions addressing primary and secondary prevention, school settings, worksites, shade design, sun safety campaigns, indoor tanning trends, sunscreen, and more.

Special plenary sessions will address:

  • New Research Methods for Skin Cancer Prevention
  • Issues in Dissemination of Skin Cancer Prevention Interventions
  • Second Generation Audiences for Skin Cancer Prevention
  • Environmental Issues in Skin Cancer Prevention
  • Screening for Skin Cancer Prevention

Four additional workshops will be held on May 1st:

  • Sun Safety and Skin Health in Youth
  • Young Adulthood Physical Activity
  • Skin Smart Campus
  • Online, Mobile, and Social Media Interventions

To see the program-at-a-glance, speakers, and registration information, visit…

4th International Conference on UV and Skin Cancer Prevention

 

Expressing Empathy: Part 3

Expressing Empathy: Part 3

Tips for Showing Empathy: Strategies for Becoming More Empathic

Nonverbal Communication

  • Listen to what is not being said. Pay attention to the nonverbal cues being sent by you and the other person.
  • Face the person. Keep your body posture relaxed and open. Lean toward the person.
  • Maintain eye contact. Mimic their facial expressions –be careful that your expression is not blank or frowning.
  • Physical contact, such as a hug or touching the person’s arm, may be helpful.
  • Recognize what you are feeling, especially negative feelings.

Verbal Communication

What to Say:

  • If possible, talk in a place that is comfortable and will have minimal interruptions.
  • Allow the person to talk uninterrupted.
  • Ask open-ended questions. This lets the person know that you’re willing to listen. Example – How are you doing with this? Would it help to talk about this? Is there something troubling you? What are you feeling?
  • Use a pleasant tone of voice.
  • Statements you might say:
    • “You seem worried.”
    • “I see why you are concerned about this.”
    • “Tell me more about what is worrying you.”
    • “I will be here for you.”
    • “It sounds like you are feeling…(fill in the blank).”

What Not to Say:

  • Do not try to fix the problem, interpret or analyze what is happening, or argue.
  • Do not preach, lecture, judge, blame or criticize. Avoid saying “should” or “ought to.”
  • Do not minimize their fears by saying, “It will be fine” or “you’ll be OK” or “at least it isn’t…”

Communicating About Cancer Series Info

This research project was funded by a grant from the National Cancer Institute (CA144235; Dr. Wayne Beach, San Diego State University, Principal Investigator). Co-investigators included Dr. David Dozier from San Diego State University, and Mary Buller, Dr. Valerie Myers, and Dr. David Buller from Klein Buendel, Inc.

Expressing Empathy: Part 2

Expressing Empathy: Part 2

Empathy in Patient/Doctor Relationships

*Names have been changed to protect privacy.*

Carl Patterson was with his elderly stepfather when he died from acute lymphatic leukemia. Tom had been a laid-back, easy going man who made friends easily and preferred to have a glass of wine than worry about small details. Carl, on the other hand, was detail-oriented and had been looking after his stepfather’s affairs for years.

Tom wanted to donate his body to a local university for medical research. In most cases, if a body is not received promptly after death, research organizations will refuse the donation. Carl knew this. So he grew impatient when hours passed after his stepfather died and the doctor, who needed to process the paperwork to release Tom’s body, didn’t appear. Carl repeatedly questioned the nurses. The nurses repeatedly paged the doctor. When she arrived, the doctor told Carl, “I have more important things to do with the living than with the dead.” Carl was stunned. “He had just died,” he said. “Her bedside manner didn’t exist.”

Numerous studies have found that empathy is often missing in doctor-patient communication. Expressing empathy can be even more difficult in situations involving conflict, anger, sadness or fear. These feelings are common on a cancer journey.  When medical professionals show empathy, patients feel more satisfied with the relationship. They also have more trust in their doctor, are less anxious about their condition, and are more likely to follow the doctor’s recommendations. Doctors feel better about their work too. Empathy is a learnable skill being taught more frequently in medical schools to help improve patient-doctor communication. …

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Expressing Empathy: Part 1

Expressing Empathy: Part 1

“Empathy is really the opposite of spiritual meanness. It’s the capacity to understand that every war is both won and lost. And that someone else’s pain is as meaningful as your own.” – Barbara Kingsolver, author.

Katrine Bellamy thinks this story is funny. It’s the story of how people sometimes react when they hear about cancer. Katrine and her neighbor took turns walking the kids to and from school. But, on the day she learned her 9-year-old son had a brain tumor, she asked her neighbor to pick up the children. When Katrine arrived home, she saw her neighbor standing in the driveway, waiting for her. “She literally collapsed in my arms,” said Katrine. The distraught women cried as Katrine reassured her that everything would be alright. Katrine needed a friend who would listen. She ended up helping her friends cope with the news instead.

This is an article about empathy. It is easy to misunderstand the difference between sympathy and empathy. When you have sympathy you have compassion for another person and acknowledge their hardship. Empathy is when you understand and feel another person’s feelings for yourself; it is a mutual experience of feeling. With empathy you “put yourself in their shoes.” …

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