Latrice C. Pichon

The relation of acculturation to Latinas' perceived neighborhood safety and physical activity: a structural equation analysis.

Background: Physical activity rates are low for adult Latinas. In the United States, only 7.8% of adult Latinas met Centers for Disease Control and Prevention recommendations for weekly vigorous leisure-time physical activity.Purpose: The purpose of this study is to test a theoretical model examining the direct and indirect influence of individual factors (demographic factors and acculturation) and the direct influence of built environmental variables (perceived neighborhood safety/aesthetics) on Latinas’ physical activity in a U.S. border region.Methods: Acculturation, perceived neighborhood safety/aesthetics, sociodemographic variables, and minutes of physical activity a week were collected from 526 Latinas using standardized survey measures.Results: Only 30% of the Latinas reported meeting International Physical Activity Questionnaire’s vigorous physical activity criteria, 8.6% met moderate, and 46.4% met walking. Findings from the structural equation modeling indicated that acculturation was positively associated with Latinas’ vigorous and moderate physical activity, with no significant relation to walking. There were no direct associations of perceived neighborhood safety/aesthetics on any of the three measures of physical activity.Conclusions: Data suggest that acculturating to the U.S. mainstream culture may have positive effects on Latinas’ reported physical activity. Contrary to studies of other populations, the perceived neighborhood environment was not related to Latinas’ physical activity. Culturally appropriate interventions are needed for Latinas who are less acculturated into the United States.

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 Sun Safety Among US Postal Service Letter Carriers: Impact of a 2-Year Intervention

OBJECTIVES We examined whether US Postal Service letter carriers who received a sun safety intervention would wear wide-brim hats and sunscreen significantly more often than those who did not receive the intervention. METHODS We used a 2-group randomized design with 2662 evaluation cohort participants from 70 US postal stations. Evaluations were conducted at baseline, 3 months, 1 year, and 2 years. Questionnaire items assessed occupational use of sun-screen and wide-brim hats. The 2-year sun safety intervention included the provision of wide-brim hats, accessible sunscreen, reminders, and 6 educational sessions. RESULTS At the 3-month follow-up evaluations, the odds ratio (OR) for regular sun-screen use was 2.8 times higher among the intervention group than among the control group (95% confidence interval [CI]=2.2, 3.5); at the 2-year follow-up evaluations, the rate was still significantly higher (OR=2.0; 95% CI=1.6, 2.6). Intervention group participants also had significantly higher rates of hat use, with the differences remaining consistent across all follow-ups (OR=2.9; 95% CI=2.3, 3.6). CONCLUSIONS The intervention should be disseminated to postal stations nationwide and possibly to other occupational groups that work outdoors.

Long-term maintenance of a successful occupational sun safety intervention.

Skin cancer prevention specialists should attempt to reduce ultraviolet radiation exposure (UVR) among outdoor workers, as pointed out in a recent review.1 To address this need, Project SUNWISE, a randomized controlled sun safety intervention trial with Southern Californian United States Postal Service letter carriers, was conducted from 2001 through 2004. The intervention consisted of providing free sunscreen, free wide-brim hats, a series of 6 brief onsite educational sessions, and sun safety prompts. The primary outcome measures were validated questionnaire items that asked participants how often they had used specific sun protection strategies over the past 5 workdays while delivering mail.2, 3 They were administered at baseline and 3, 12, 24, and 36 months post-baseline. The 5 response options ranged from “never” to “always”; we considered “always” as “consistent use” in analyses. At the 2-year follow-up evaluation, participants at the intervention postal stations had significantly higher rates of consistent sunscreen use and wide-brim hat use than those at control stations.2 Details about the study procedures and sample characteristics have been published previously.2 Immediately following the 2-year evaluation, control station participants received the free items and 3 of the education sessions (i.e., introduction and protections strategies, sun safety for eyes, and recap/encouragement to maintain sun safety practices). At the intervention stations, we continued to provide free sunscreen during that year. This paper describes the behavioral outcomes at the 3-year follow-up evaluation. Evaluation cohort retention rates (of those completing questionnaires) from the 2- to 3- year follow-ups were 93.2% (927/994) for the intervention group and 94.4% (1130/1196) for the control group. The trends over 3 years in two key outcomes—consistent use of sunscreen and wide-brim hats--were analyzed using generalized linear mixed models treating 3 months, 1 year, 2 years, and 3 years as a set of repeated measures on each postal worker. In addition, we adjusted for postal workers nested within post offices within a multi-level model; the intraclass correlation coefficients for sunscreen and hats were .015 and .067, respectively. All analyses were adjusted for the baseline level of the corresponding outcome variable. For each analysis, we tested 1) the time by condition interaction, to determine if the intervention effect remained constant over time, and 2) the condition main effect. Consistent sunscreen use levels for intervention participants at the 2- and 3- year follow-ups were 39.2% and 38.3%, respectively, and for control participants, they were 26.3% and 34.3%, respectively. Wide-brim hat levels for intervention participants during these periods were 40.0% and 43.8%, respectively, and for control participants, they were 22.3% and 33.0%, respectively. Results of the analyses for each of these outcomes showed significant condition by time interaction effects (ps<0.0001), indicating that the differences between the conditions were changing over time. The table shows these patterns. For both behaviors, the change in the odds ratios from year 2 to year 3 is not due to a drop among intervention participants but rather to an increase among control group participants. We are encouraged that intervention effects were maintained at least one year after the program ended, and that once the control participants received the intervention, their consistent use of sun protection increased substantially. Table Results of generalized linear mixed-model analyses a: Patterns of odds ratios over three years of follow-up

Youth access to artificial UV radiation exposure

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.

Youth Access to Artificial Ultraviolet Radiation Exposure: Practices of 3,647 U.S. 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.