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Sustained use of an occupational sun safety program in a recreation industry: follow-up to a randomized trial on dissemination strategies

  • Original research
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Translational Behavioral Medicine

Abstract

The sustainability of evidence-based programs is needed to obtain long-term benefits. To assess sustainability of Go Sun Smart (GSS), an occupational skin cancer prevention program disseminated to the North American ski industry. Fifty-three of the 68 ski areas from the original dissemination trial participated in 2012 and 2013, 5 to 7 years after program distribution by enhanced or basic dissemination strategies. Sustained use was measured by: (1) on-site observation of sun protection communication and (2) an online survey with senior managers. In the sustainability assessment, sun safety communication had declined, and dissemination strategy did not affect continued use. Managers held weaker attitudes about skin cancer importance and program fit, but more managers provided free/reduced-cost sunscreen than in the dissemination trial. Manager turnover was a key factor in program discontinuance. Sustainability remains a challenge. Additional research is needed to determine the best strategies for sustainability.

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Acknowledgments

This project was supported by a grant from the National Cancer Institute (CA159840).

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the appropriate institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Disclosure of Potential Conflicts of Interest

David Buller was supported by grants from the National Institutes of Health and received a salary from Klein Buendel, Inc., his employer. David Buller’s spouse owns stock in Klein Buendel, Inc. Barbara Walkosz was supported by grants from the National Institutes of Health and received a salary from Klein Buendel, Inc., her employer. Barbara Walkosz has no financial disclosures. Peter Andersen was supported by grants from the National Institutes of Health and received a salary from San Diego State University, his employer. Peter Andersen has no financial disclosures. Michael Scott was supported by grants from the National Institutes of Health and received compensation from Mikonics, Inc. Michael Scott has no financial disclosures. Gary Cutter was supported by grants from the National Institutes of Health and Department of Defense, received a salary from the University of Alabama, Birmingham, his employer, participated on Data and Safety Monitoring Committees focus on medical research for Apotek, Ascendis, Biogen-Idec, Cleveland Clinic, Glaxo Smith Klein Pharmaceuticals, Gilead Pharmaceuticals, Modigenetech/Prolor, Merck/Ono Pharmaceuticals, Merck, Neuren, PCT Bio, Teva, Vivus, NHLBI (Protocol Review Committee), NINDS, NMSS, and NICHD (OPRU oversight committee), and consulted, received speaking fees, and served on advisory Boards for Alexion, Allozyne, Bayer, Consortium of MS Centers (grant), Klein Buendel, Inc., Genzyme, Medimmune, Munck Wilson Mandala LLP, Novartis, Nuron Biotech, Receptos, Revalesio, Sanofi-Aventis, Spiniflex Pharmaceuticals, Somahlution, Teva Pharmaceuticals, and Xenoport. Gary Cutter owns Pythagoras, Inc., a private consulting company.

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Authors and Affiliations

  1. Klein Buendel Inc, 1667 Cole Blvd. Ste. 225, Golden, CO, 80113, USA

    David B. Buller PhD & Barbara J. Walkosz PhD

  2. San Diego State University, San Diego, CA, USA

    Peter A. Andersen PhD

  3. Mikonics Inc, Auburn, CA, USA

    Michael D. Scott PhD

  4. University of Alabama, Birmingham, AL, USA

    Gary R. Cutter PhD

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  1. David B. Buller PhD
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  2. Barbara J. Walkosz PhD
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  3. Peter A. Andersen PhD
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  4. Michael D. Scott PhD
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Corresponding author

Correspondence to David B. Buller PhD.

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Implications

Implication for researchers: Assessment of program effects over several years is needed to determine whether dissemination strategies have lasting effects on health behavior that can potentially reverse disease trends.

Implications for practitioners: Competing priorities and turnover in management pose challenges to sustained use of evidence-based workplace prevention programs. Long-term efforts are needed early in program dissemination to avoid initially steep declines in program use once external support for program implementation is withdrawn.

Implication for policy makers: Creating a culture of sun safety at the workplace might be a side benefit of disseminating an evidence-based occupational sun protection program that could support sustainability of workplace disease prevention.

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Buller, D.B., Walkosz, B.J., Andersen, P.A. et al. Sustained use of an occupational sun safety program in a recreation industry: follow-up to a randomized trial on dissemination strategies. Behav. Med. Pract. Policy Res. 5, 361–371 (2015). https://doi.org/10.1007/s13142-015-0321-4

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