Joni A. Mayer

Differences in cancer-risk-related behaviors in Latino and Anglo adults

METHODS. Latino (n = 358) and Anglo (n = 113) adults living in the San Diego area were surveyed on nutrition, smoking, and cancer screening behaviors. The Latino respondents were dichotomized into a low (L-Latino) or high (H-Latino) acculturation group according to a median split of an acculturation index. RESULTS. After controlling for age, years of education, gender, marital status, and income, significant cross-cultural differences were found in saturated fat/cholesterol avoidance, and fiber and high calorie food consumption. L-Latino respondents had the lowest degree of saturated fat/cholesterol avoidance, followed by H-Latinos and Anglos. A pattern of decreasing consumption with increasing acculturation was observed for fiber and high calorie foods. Significant differences were found among women in the prevalence of Pap smear exams, with L-Latinas having the lowest prevalence of ever and in the past year having had a Pap smear, followed by H-Latinas and Anglos. A similar significant pattern was observed among women 50 years of age or older with respect to the prevalence of ever having had a mammogram.

Density of Indoor Tanning Facilities in 116 Large U.S. Cities

BACKGROUND U.S. adolescents and young adults are using indoor tanning at high rates, even though it has been linked to both melanoma and squamous cell cancer. Because the availability of commercial indoor tanning facilities may influence use, data are needed on the number and density of such facilities. METHODS In March 2006, commercial indoor tanning facilities in 116 large U.S. cities were identified, and the number and density (per 100,000 population) were computed for each city. Bivariate and multivariate analyses conducted in 2008 tested the association between tanning-facility density and selected geographic, climatologic, demographic, and legislative variables. RESULTS Mean facility number and density across cities were 41.8 (SD=30.8) and 11.8 (SD=6.0), respectively. In multivariate analysis, cities with higher percentages of whites and lower ultraviolet (UV)index scores had significantly higher facility densities than those with lower percentages of whites and higher UV index scores. CONCLUSIONS These data indicate that commercial indoor tanning is widely available in the urban U.S., and this availability may help explain the high usage of indoor tanning.

Promoting Nutrition at the Point of Choice: A Review:

The modification of dietary behaviors on a community-wide basis requires broad- based, multilevel approaches. Dietary interventions at the point of choice have the potential, as one approach, of reaching a large number of individuals at minimal cost. This article presents the potential advantages and limitations of point-of-choice inter ventions, and describes the controlled evaluations of their efficacy in restaurants/ cafeterias and supermarkets. Discussion addresses the refinement and extension of successful restaurant-based strategies and the challenge of developing more powerful strategies for influencing supermarket purchases.

Solar protection behaviors among outdoor workers.

Due to the lack of information regarding how US workers protect themselves from ultraviolet radiation, this study explored solar protection behaviors among three groups of outdoor workers. This cross-sectional research involved two separate studies. Study 1 consisted of observations of 312 outdoor workers, and Study 2 was a paper and pencil survey (n = 240). For each data set, occupational groups were compared on ultraviolet radiation protection. Observational data indicated that 50.4% of the workers had adequate protection. Across occupational groups, the ranking from highest to lowest levels of protection was consistent for both data sets. Face and lower arms were consistently the least protected sites. The pattern of findings suggests the importance of assessing protection of individual body sites, as well as composite protection.

Sun-protective Behaviors of California Farmworkers

Objective: Farmworkers are exposed to long hours of solar ultraviolet radiation (UVR), placing them at higher risk for skin cancer. The goal of this study was to evaluate farmworkers’ sun exposure behaviors. Methods: Farmworkers (n = 326) in the San Joaquin Valley of California were interviewed about their sun protective behaviors; these behaviors also were observed directly and these data were used to assess whether participants adequately protected against UVR exposure. Results: All participants were Latino men with a mean age of 33 years. Although rates of wearing any hat and long-sleeved shirts were high, rates of wearing wide-brimmed hats and sunscreen were low. Conclusions: This study is important because there is limited research focused on farmworkers’ protective behaviors against UVR exposure. Interventions to improve sun protection behaviors of farmworkers are needed.

Ultraviolet radiation exposure in children: A review of measurement strategies

Rates of skin cancer in the U.S. are high and have been increasing rapidly. Recommendations for primary prevention focus on the reduction of ultraviolet radiation (UVR) exposure, especially in childhood. Valid, reliable strategies are needed to measure UVR exposure in children, to document baseline levels, and to assess intervention impact. This article reviews strategies reported in observational and intervention studies and considers their potential usefulness for application with children. The strategies include verbal report (by self or parent), direct observation, visual inspection, ultraviolet (UV) sensitive film, the Erythema Meter, the spectrophotometer, and the colorimeter. Each strategy is described along several dimensions, including ease of use, cost, and whether it is suitable for measuring acute and cumulative exposure. The review describes the existing validity and reliability data and points out a need for further research assessing the reliability and validity of most of these measures. Additionally, suggestions for matching strategies with measurement and intervention objectives are presented.

Dog walking: its association with physical activity guideline adherence and its correlates.

OBJECTIVE We examined the prevalence and correlates of dog walking among dog owners, and whether dog walking is associated with meeting the American College of Sports Medicine/American Heart Association physical activity guidelines. METHODS In March 2008, we mailed a survey to dog-owning clients from two San Diego County veterinary clinics. Useable data were obtained from 984 respondents, and 75 of these completed retest surveys. We assessed associations between potential correlates and dog walking (i.e., yes/no dog walking for at least 10 min in past week). RESULTS Test-retest reliability of measures was generally high. Approximately one-third of the sample (31.5%) were not dog walkers. Proportions of dog walkers versus non-dog walkers meeting United States guidelines were 64.3% and 55.0%, respectively. Dog walking was independently associated with meeting guidelines in a multivariate model (odds ratio=1.59, p=0.004). Three variables were independently associated with dog walking in a multivariate model: dog encouragement of dog walking, dog-walking obligation, and dog-walking self-efficacy. CONCLUSION Dog walking was associated with meeting physical activity guidelines, making it a viable method for promoting physical activity. Dog-walking obligation and self-efficacy may be important mediators of dog walking and may need to be targeted if interventions are to be successful.

Youth Access to Artificial UV Radiation Exposure Practices of 3647 US Indoor Tanning Facilities

OBJECTIVE To assess indoor tanning facility practices in a sample of facilities in 116 cities representing all 50 states. DESIGN Cross-sectional study. SETTING United States. PARTICIPANTS Employees of 3647 indoor tanning facilities were contacted by telephone. Data collectors (ie, confederates) posed as prospective, fair-skinned, 15-year-old female customers who had never tanned before. MAIN OUTCOME MEASURES Confederates asked respondents about their facilitys practices related to parental consent, parental accompaniment, and allowable tanning session frequency. RESULTS Approximately 87% of the facilities required parental consent, 14% required parental accompaniment, 5% said they would not allow the confederate to tan owing to her age, and 71% would allow tanning every day the first week of indoor tanning. In Wisconsin, which bans indoor tanning among those younger than 16 years, 70% of facilities would not allow the confederate to tan. Multivariate analyses indicated that facilities in states with a youth access law were significantly more likely to require parental consent (P <.001) and parental accompaniment (P <.001) than those in states without a youth access law. Law was not significantly related to allowable tanning frequency (P = .81). Conclusion We recommend that additional states pass youth access legislation, preferably in the form of bans.

Measuring Nonsolar Tanning Behavior : Indoor and Sunless Tanning

OBJECTIVE To develop items to measure indoor tanning and sunless tanning that can be used to monitor trends in population surveys or to assess changes in behavior in intervention studies. DESIGN A group of experts on indoor tanning convened in December 2005, as part of a national workshop to review the state of the evidence, define measurement issues, and develop items for ever tanned indoors, lifetime frequency, and past-year frequency for both indoor tanning and sunless tanning. Each item was subsequently assessed via in-person interviews for clarity, specificity, recall, and appropriateness of wording. SETTING Universities in Tennessee and Virginia, a medical center in Massachusetts, and a high school in New Hampshire. PARTICIPANTS The study population comprised 24 adults and 7 adolescents. RESULTS Participants understood indoor tanning to represent tanning from beds, booths, and lamps that emit artificial UV radiation, rather than sunless tanning, even though both can be obtained from a booth. Two items were required to distinguish manually applied from booth-applied sunless tanning products. Frequency of use was easier for participants to recall in the past year than for a lifetime. CONCLUSIONS While indoor tanning items may be recommended with confidence for clarity, sunless tanning items require additional testing. Memory aids may be necessary to facilitate recall of lifetime use of nonsolar tanning. In addition, studies that assess reliability and validity of these measures are needed. Since study participants were primarily young and female, testing in other populations should also be considered.

Promoting skin cancer prevention counseling by pharmacists.

OBJECTIVES This study evaluated the effects of an intervention on rates of skin cancer prevention counseling by pharmacists. METHODS Fifty-four pharmacies were randomly assigned to intervention or control conditions. Intervention consisted of training, feedback, and prompts. Counseling rates before and after the intervention were obtained from study confederates. RESULTS At pretest, the proportions of control and intervention sites providing counseling at least once were 7.4% and 0%, respectively (NS). At posttest, these proportions were 3.7% and 66.7%, respectively (P < .001). CONCLUSIONS The results indicated that the intervention was successful and that pharmacists can play an important role in educating the public about skin cancer prevention strategies.