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Biomedical subjects

J A Mayer

Publications and source records attributed to J A Mayer.

At least 19 recordsLinked to original sources
PubMed2001

Promoting sun safety among zoo visitors.

BACKGROUND: Each year, millions of children visit zoological parks, where they are exposed to long bouts of ultraviolet radiation (UVR). We conducted a study in the winter and replicated it in the summer to evaluate an intervention for reducing UVR exposure during the zoo visit. METHODS: Each study used a nonequivalent control group design: one zoological site received the intervention and a second received evaluation only. Key outcome measures consisted of observed prevalence of hat use by exiting children (N = 8,721 and 8,524, respectively, in winter and summer studies) and purchase rates of sunscreen and hats in zoo gift shops. Intervention consisted of tip sheets for parents, children's activities, prompts, and discounts off the price of sunscreen and sun-protective hats. RESULTS: In the summer study, sales of both sunscreen and target hats increased significantly at the intervention site relative to the control site, whereas in the winter study, only sunscreen sales at the intervention site had a significant (relative) increase. Children's hat use increased significantly at the intervention site, but only in the winter study. CONCLUSIONS: The multicomponent program was effective in promoting purchases of sun-safe items, but its impact on children's hat use was inconclusive.

California↗
PubMed2001

Compliance with federal and state legislation by indoor tanning facilities in San Diego.

BACKGROUND: The prevalence rates of both skin cancers and indoor tanning among the US population are high and have increased substantially in recent years. Low compliance by indoor tanning facilities with safety regulations may place consumers at greater risk of skin and ocular damage. OBJECTIVE: This study quantified the level of compliance by indoor tanning facilities with selected federal and state regulations and recommendations. METHODS: Tanning facilities (N = 54) in San Diego County, California, were visited by a confederate posing as a prospective customer. Compliance with 13 regulations/recommendations were assessed by either direct query or observation of the presence/absence of signs and warning labels. Operators' responses to 5 risk-based questions also were noted. RESULTS: No facility complied with all 13 regulations/recommendations. Compliance with 3 protective eyewear regulations was high (89%-100%). In contrast, compliance with maximum tanning frequency recommendations (approximately 6%) and parental consent regulations (approximately 43%) was disturbingly low. CONCLUSION: The investigators recommend instituting mandatory, comprehensive training for operators, as well as systematic compliance monitoring with enforcement of penalties for noncompliance.

Beauty Culture↗
PubMed2000

Confidence intervals for the risk ratio under cluster sampling based on the beta-binomial model.

In cohort studies, the risk ratio (RR) is one of the most commonly used epidemiologic indices to quantify the effect of a suspected risk factor on the probability of developing a disease. When we employ cluster sampling to collect data, an interval estimator that does not account for the intraclass correlation between subjects within clusters is likely inappropriate. In application of the beta-binomial model to account for the intraclass correlation, we develop four asymptotic interval estimators of the RR, which are direct extensions of some recently developed estimators for independent binomial sampling. We then use Monte Carlo simulation to evaluate the finite-sample performance of these four interval estimators in a variety of situations. We find that the estimator using the logarithmic transformation generally performs well and is preferable to the other three estimators in most of the situations considered here. Finally, we include an example from a study of an educational intervention with emphasis on behaviour change to illustrate the use of the estimators developed in this paper.

Child↗
PubMed2000

Patient reminder letters to promote annual mammograms: a randomized controlled trial.

BACKGROUND: This study assessed the effects of a reminder letter from a physician (relative to a mammography facility letter or no letter) on appointment compliance among women 50-74 years of age due for an annual screening mammogram. METHODS: A total of 1,562 women were randomly as signed to the groups. Each Group 1 subject received a reminder letter from her physician, each Group 2 subject received a reminder letter from her mammography facility, and Group 3 served as a control group. RESULTS: The return rates for Groups 1, 2, and 3 were 47.7, 46.6, and 28.3%, respectively; the overall difference was significant using a chi(2) analysis (P < 0.001). Bonferroni pairwise comparisons indicated no difference between Groups 1 and 2 but significant differences (P < 0.001) between Group 3 and the other two groups. Logistic regression indicated that relative to Group 3, the adjusted odds of returning for Groups 1 and 2 were 2.37 and 2.24, respectively. CONCLUSIONS: Mammography providers and their patients likely will benefit from in-reach reminder systems. Physicians who do not use reminder systems should refer their patients to facilities that use these systems.

Aged↗
PubMed2000

A national survey of sun safety activities at U.S. zoos.

Skin cancer incidence in the United States has increased. Exposure to ultraviolet radiation (UVR) is a major risk factor for skin cancer. Every year, millions of children with their families visit outdoor leisure facilities such as zoos where overexposure to UVR may occur. This study was conducted to assess the proportion of U.S. zoos that provided sun safety activities during the summer of 1998 and their willingness to incorporate skin cancer prevention strategies at their facility in the future. A 56 item self-administered questionnaire was mailed to 140 zoos accredited by the American Zoo and Aquarium Association. A follow-up telephone survey was also conducted with 33 mail non-respondents. The response rate was 97% (N = 136). Results revealed that in the summer of 1998, only 5% of zoos provided sun safety recommendations to visitors and 25% of zoos provided recommendations to their employees. The recommendations made most often to visitors and employees were to use sunscreen and wear protective clothing. Eighty-five percent of zoos indicated interest in providing sun safety activities at their facilities in the future. The next step will be to design environmentally appropriate sun safety programs for zoos and to encourage zoos to implement these programs.

Adult↗
PubMed2000

Rates and correlates of discomfort associated with mammography.

PURPOSE: To explore the rates and correlates of discomfort at mammography in asymptomatic women aged 50-74 years from six San Diego, Calif, mammography facilities. MATERIALS AND METHODS: Subjects (N = 1,800) completed a 43-item telephone interview approximately 3 weeks after screening mammography. Bivariate associations between variables were analyzed with chi(2) analysis. Logistic regression was used to assess the independent predictors of discomfort at mammography while controlling for all other factors. RESULTS: Nine hundred thirty-three (52%) women reported moderate to extreme discomfort at mammography. Discomfort was not related to the intention to undergo future mammography (P =.95). Factors that were significantly associated with discomfort in multivariate analyses were facility (P <.001), satisfaction with care (P <.04), and perception of the technologist's "roughness" (P <.001). CONCLUSION: Discomfort, although not related to the intention to undergo future mammography, had a relatively high incidence.

Aged↗
PubMed1998

Misleading nutrition claims on cracker packages prior to and following implementation of the Nutrition Labeling and Education Act of 1990.

OBJECTIVES: This study compared patterns in selected health claims on snack cracker packaging and fat content prior to and following enforcement of the Nutrition Labeling and Education Act of 1990 (NLEA). METHODS: Through observations at supermarkets in 1991 and 1995, the prevalence on packages of health claims that consumers associate with heart disease prevention was evaluated. The fat content of each product also was recorded. Criteria for potentially misleading claims were developed. RESULTS: Analysis of both cross-sectional data and products that were available in both years showed that fat content, as well as the number of products containing target claims, had significantly decreased by 1995. The prevalence of potentially misleading claims also declined significantly, from 77% in 1991 to 49% in 1995. CONCLUSIONS: Although the data regarding the changes from 1991 to 1995 are encouraging, the prevalence of potentially misleading health claims for this food category continues to be high.

Adult↗
PubMed1998

Skin cancer prevention counseling by pharmacists: specific outcomes of an intervention trial.

The purpose of this study was to evaluate the effects of an intervention on pharmacists' behaviors, knowledge, and attitudes related to skin cancer prevention counseling. Fifty-four pharmacy sites (N = 178 pharmacists) were randomly assigned to the intervention or control condition. Intervention consisted of video-based training, prompts installed in the pharmacy to promote pharmacist-patient discussions on the topic, and group-based feedback on previous week's counseling rates. Outcomes were measured using a mailed survey. The proportion of patients counseled at post-test was significantly higher among intervention subjects, adjusting for pretest values. Similar results were found for pharmacists' skin cancer knowledge and self-rated expertise, but not for counseling-related attitudes. The intervention was successful. If implemented on a wide scale, large segments of the U.S. population would be exposed to skin cancer prevention advice.

Adult↗
PubMed1998

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.

Adolescent↗
PubMed1998

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.

Counseling↗
PubMed1997

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.

Child↗
PubMed1997

Preventive services in a Medicare managed care environment.

The results of a four year demonstration project of preventive services for Medicare managed care enrollees suggest that health promotion programs can impact health behaviors and outcomes. The study provided selected preventive services to 1,800 Medicare enrollees in a managed care environment. Participants were randomly assigned to control and experimental groups with the experimental group receiving an intervention service package and the control group usual care. The results included enhanced health behavior practices, lower depression, and higher immunization rates among those individuals in the experimental group. This study suggests that selected preventive services can be provided in a managed care environment to Medicare enrollees with likely positive health status and utilization outcomes.

Aged↗
PubMed1997

Skin cancer prevention education: a national survey of YMCAs.

High skin cancer incidence and mortality rates have created a need for skin cancer prevention education. Children are an important target for this education, as overexposure to sun and sunburns at an early age have been linked to the development of skin cancer. This study identified the prevalence of skin cancer prevention education and the need for this education at YMCA swim classes. This study also assessed the feasibility of implementing Project SUNWISE, an existing skin cancer prevention curriculum, developed for YMCA swim classes. A 51-item survey was mailed to Aquatics Directors at all YMCAs with outdoor pools. Based on a 63% response rate (N = 208), only 28% of YMCAs thought the children in their swim classes were adequately protected from the sun, and only 28% offered skin protection or sun safety education in swim classes. Only 50% of YMCAs trained their swim instructors on skin cancer prevention. While 91% of YMCAs had one or more sun protection items near the pool (e.g., sunscreen, umbrella, covered area), 93% of YMCAs saw the need for additional protection. The majority of YMCAs (95%) were willing to incorporate a skin cancer prevention education curriculum, similar to Project SUNWISE, into their swim classes. This study emphasized the need for more skin cancer prevention education programs targeting children and examined the correlates of skin cancer prevention education at YMCAs. Geographic region, percent of possible sunshine, and ultraviolet radiation were significantly associated with the skin cancer prevention education program status at the YMCAs.

Administrative Personnel↗
PubMed1997

Assessing children's ultraviolet radiation exposure: the use of parental recall via telephone interviews.

OBJECTIVES: This study evaluated the validity of a parental report measure of children's solar protection behaviors. METHODS: Fifty-eight children had skin color assessed twice with a colorimeter. Between measurement sessions, parents were interviewed by telephone to assess children's indoor-outdoor status and solar protection across 40 hourly intervals. RESULTS: Parental report of child's indoor-outdoor status was significantly correlated with the colorimeter values, whereas the use of sunscreen and protective clothing was not. CONCLUSIONS: This measure was feasible for assessing ultraviolet exposure in young children. The component that assessed the number of intervals spent outdoors evidenced predictive validity.

Child↗
PubMed1996

Educating the public about skin cancer prevention: a role for pharmacists.

OBJECTIVES: The incidence of skin cancer is increasing at an alarming rate. This study aimed to assess pharmacists' willingness to counsel patients about skin cancer and factors which are predictive of this. METHODS: A 30 item survey assessing skin cancer prevention counselling attitudes and behaviours, personal skin cancer prevention behaviours, and willingness to counsel on skin cancer prevention, was mailed to 300 randomly selected San Diego County pharmacists. RESULTS: Data obtained from 128 pharmacists (43% response rate) indicated that the incidence of skin cancer prevention counselling was very low, with over one-third stating that they never counsel patients on this topic. Of those that did counsel, the percentage of patients counselled on skin cancer prevention was below 5%. Bivariate analyses indicated that pharmacists who counselled on this topic differed from those that did not on knowledge of skin cancer, attitudes and beliefs about counselling patients, pharmacy setting, services offered by their pharmacies, and their personal sun protective behaviours. Multivariate analysis indicated that two variables independently predicted skin cancer prevention counselling; whether the pharmacy where the respondent was employed offered this service, and attitude about counselling. Over 90% of respondents reported they were willing to counsel patients on skin cancer prevention and other health-related topics. CONCLUSIONS: Future studies should focus on skin cancer prevention counselling barriers and environmental prompts encouraging this type of interaction between pharmacists and patients.

Communication Barriers↗
PubMed1996

Assessing children's ultraviolet radiation exposure: the potential usefulness of a colorimeter.

OBJECTIVES: This study evaluated the colorimeter as an objective measure of children's ultraviolet (UV) radiation exposure. METHODS: Fifty-eight children, ages 6 to 9 years, attended two summer measurement sessions, with 46 attending a subsequent winter session. RESULTS: Comparisons between summer sessions for the L* scale showed that only the upper arm significantly changed in the tanner direction, while b* scale values indicated significant tanning for all body sites. All exposed body sites changed significantly in the less tan direction between summer and winter measurements. CONCLUSIONS: Using colorimeters to objectively measure children's UV exposure has potential applications for skin cancer prevention programs.

Child↗
PubMed1994

Changes in health behaviors of older adults: the San Diego Medicare Preventive Health Project.

BACKGROUND: This study presents behavioral outcomes at 1-year follow-up from a preventive services intervention trial with Medicare beneficiaries. METHODS: The health promotion package consisted of goal setting and counseling based on a health risk appraisal and a series of eight educational sessions. All subjects completed a health risk appraisal questionnaire immediately prior to the intervention and 1 year later; this served as the dependent measure. RESULTS: Results indicated that there were significant, positive changes in intervention subjects in activity level and selected nutrition behaviors relative to control subjects. The strengths and weaknesses of a broad-based approach to intervention are discussed.

Aged↗