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Manne S, Heckman CJ, Kashy D, Ritterband L, Thorndike F, Lozada C, Coups EJ. Moderators of the Effects of mySmartSkin, a Web-Based Intervention to Promote Skin Self-examination and Sun Protection Among Individuals Diagnosed With Melanoma. Ann Behav Med 2022; 56:804-815. [PMID: 35028656 PMCID: PMC9345181 DOI: 10.1093/abm/kaab104] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Identifying the characteristics of persons who benefit more from behavioral interventions can help health care providers decide which individuals should be offered particular interventions because this is the subgroup of persons who are more likely to derive greater benefit from the intervention and refine the underlying constructs of the model guiding the intervention. PURPOSE This study evaluated possible demographic, medical, knowledge and attitudinal, and psychosocial variables that may moderate the impact of an online intervention, called mySmartSkin (MSS), on engagement in skin self-examination (SSE) and sun protection behaviors among melanoma survivors. METHODS Participants completed a baseline survey and were then randomized to the MSS condition or usual care. Follow-up surveys were completed by participants at 8-, 24-, and 48-week postrandomization. RESULTS A greater impact of MSS on SSE was illustrated among participants with more phenotypic skin cancer risk factors and participants reporting lower baseline self-efficacy in conducting SSE. A more favorable response of MSS on sun protection behaviors was shown when initial knowledge about abnormal lesions and sun protection barriers were high. Greater use of MSS and more favorable evaluations of it were also associated with higher intervention response. CONCLUSIONS Future studies seeking to improve SSE and sun protection among melanoma survivors might benefit from focusing on survivors who report more skin cancer risk factors, lower self-efficacy in conducting SSE, less knowledge about what abnormal skin lesions look like, more perceived barriers to sun protection behaviors, and less worry about recurrence and cancer-related distress.
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Affiliation(s)
| | - Carolyn J Heckman
- Department of Medicine, Behavioral Sciences, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Deborah Kashy
- Michigan State University, Department of Psychology, East Lansing, MI, USA
| | - Lee Ritterband
- School of Medicine, Center for Behavioral Health and Technology, University of Virginia, Charlottesville, VA, USA
| | | | - Carolina Lozada
- Department of Medicine, Behavioral Sciences, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
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Heckman CJ, Riley M, Khavjou O, Ohman-Strickland P, Manne SL, Yaroch AL, Bhurosy T, Coups EJ, Glanz K. Cost, reach, and representativeness of recruitment efforts for an online skin cancer risk reduction intervention trial for young adults. Transl Behav Med 2021; 11:1875-1884. [PMID: 34160622 PMCID: PMC8541696 DOI: 10.1093/tbm/ibab047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Despite its increasing use, few studies have reported on demographic representativeness and costs of research recruitment via social media. It was hypothesized that cost, reach, enrollment, and demographic representativeness would differ by social media recruitment approach. Participants were 18-25 year-olds at moderate to high risk of skin cancer based on phenotypic and behavioral characteristics. Paid Instagram, Facebook, and Twitter ads, unpaid social media posts by study staff, and unpaid referrals were used to recruit participants. Demographic and other characteristics of the sample were compared with the 2015 National Health Interview Survey (NHIS) sample. Analyses demonstrated significant differences among recruitment approaches regarding cost efficiency, study participation, and representativeness. Costs were compared across 4,274 individuals who completed eligibility screeners over a 7-month period from: Instagram, 44.6% (of the sample) = 1,907, $9 (per individual screened); Facebook, 31.5% = 1,345, $8; Twitter, 1% = 42, $178; unpaid posts by study staff, 10.6% and referred, 6.5%, $1. The lowest rates of study enrollment among individuals screened was for Twitter. Most demographic and skin cancer risk factors of study participants differed from those of the 2015 NHIS sample and across social media recruitment approaches. Considering recruitment costs and number of participants enrolled, Facebook and Instagram appeared to be the most useful approaches for recruiting 18-25 year-olds. Findings suggest that project budget, target population and representativeness, and participation goals should inform selection and/or combination of existing and emerging online recruitment approaches.
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Affiliation(s)
| | - Mary Riley
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Olga Khavjou
- RTI International, Research Triangle Park, NC, USA
| | | | - Sharon L Manne
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Amy L Yaroch
- Gretchen Swanson Center for Nutrition, Omaha, NE, USA
| | | | | | - Karen Glanz
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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Manne SL, Marchetti MA, Kashy DA, Heckman CJ, Ritterband LM, Thorndike FP, Viola A, Lozada C, Coups EJ. mySmartCheck, a Digital Intervention to Promote Skin Self-examination Among Individuals Diagnosed With or at Risk for Melanoma: A Randomized Clinical Trial. Ann Behav Med 2021; 56:791-803. [PMID: 34637495 DOI: 10.1093/abm/kaab090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Regular skin self-examination (SSE) reduces melanoma mortality but is not often conducted. PURPOSE To promote SSE performance in individuals at increased risk for melanoma. METHODS One hundred sixteen individuals at heightened risk for development of melanoma (i.e., personal/family history of melanoma, high-risk mole phenotype) who did not conduct a thorough SSE during in the prior 3 months were randomly assigned to receive either an automated internet-based intervention (mySmartCheck) or usual care (UC). One hundred sixteen participants completed surveys before random assignment and 99 completed the follow-up survey 13-weeks afterward. The primary outcome was participant self-reported examination (SSE) of all 15 parts of the body in the last 3 months. Secondary outcomes were SSE of any part of the body in the last 3 months and number of body parts examined during the last SSE. RESULTS More mySmartCheck participants examined all 15 body parts (32.6% vs. 7.1%, p = .001). More individuals in mySmartCheck reported conducting SSE on any body part than those in UC (81.4% vs. 62.5%, p = .04). Effect sizes were large (d = 1.19 all 15 body parts) to moderate (d = 0.55 for any body part). mySmartCheck participants examined more body areas than UC participants (12.7 vs. 10.3, p = 0.003) during the last SSE. Participants in mySmartCheck reported higher levels of knowledge of suspicious lesions, SSE benefits, SSE self-efficacy, and planning for SSE, and lower SSE barriers, than those assigned to UC. CONCLUSIONS mySmartCheck had a significant positive impact on SSE performance and behaviors. Additional research with a larger sample size, a longer follow-up, and more varied clinical settings is needed. TRIAL REGISTRATION ClinicalTrials.gov registration # NCT03725449 (https://clinicaltrials.gov/ct2/show/NCT03725449).
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Affiliation(s)
- Sharon L Manne
- Rutgers Cancer Institute of New Jersey, 195 Little Albany Street, New Brunswick, NJ 08903, USA
| | - Michael A Marchetti
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Deborah A Kashy
- Department of Psychology, Michigan State University, East Lansing, MI, USA
| | - Carolyn J Heckman
- Rutgers Cancer Institute of New Jersey, 195 Little Albany Street, New Brunswick, NJ 08903, USA
| | - Lee M Ritterband
- Center for Behavioral Health & Technology, University of Virginia, Charlottesville, VA, USA
| | | | - Adrienne Viola
- Rutgers Cancer Institute of New Jersey, 195 Little Albany Street, New Brunswick, NJ 08903, USA
| | - Carolina Lozada
- Rutgers Cancer Institute of New Jersey, 195 Little Albany Street, New Brunswick, NJ 08903, USA
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Manne SL, Heckman CJ, Kashy DA, Ritterband LM, Thorndike FP, Lozada C, Coups EJ. Randomized controlled trial of the mySmartSkin web-based intervention to promote skin self-examination and sun protection among individuals diagnosed with melanoma. Transl Behav Med 2021; 11:1461-1472. [PMID: 33904921 DOI: 10.1093/tbm/ibaa103] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Adherence to regular, thorough skin self-examination (SSE) and consistent sun protection behaviors among melanoma survivors is relatively low. This study reports on the impact of an online intervention, called mySmartSkin (MSS), on engagement in SSE and sun protection behaviors among melanoma survivors, as well as the mediators of the intervention effects. The intervention was compared with usual care (UC), and primary outcomes were assessed at 24 and 48 weeks. Short-term outcomes were also evaluated at 8 weeks postbaseline. Results demonstrate a significant effect on SSE and sun protection. At all three follow-up assessments, the proportion of participants reporting conducting a thorough SSE in the time since the previous assessment was significantly greater in MSS than in UC. In addition, both multivariate and univariate analyses indicated that engagement in sun protection behaviors was significantly higher in MSS than UC at 24 weeks, but the effect on sun protection at 48 weeks was significant only in multivariate analyses. Beneficial effects of MSS were significantly mediated by knowledge about melanoma and characteristics of suspicious lesions, as well as self-efficacy. Participant engagement in MSS was satisfactory, with approximately two-thirds of participants completing at least two of the three core components. Content was rated as highly trusted, easy to understand, easy to navigate, and helpful. In conclusion, MSS illustrated significant and durable effects on SSE and mixed results on sun protection. Future studies should consider ways to further enhance treatment effects and engagement in MSS.
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Affiliation(s)
- Sharon L Manne
- Department of Medicine, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Carolyn J Heckman
- Department of Medicine, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Deborah A Kashy
- Michigan State University, Department of Psychology, East Lansing, MI, USA
| | - Lee M Ritterband
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Center for Behavioral Health & Technology, Charlottesville, VA, USA
| | - Frances P Thorndike
- Department of Psychiatry and Neurobehavioral Sciences, Pear Therapeutics, Boston, MA, USA
| | - Carolina Lozada
- Department of Medicine, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
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Viola AS, Drachtman R, Kaveney A, Sridharan A, Savage B, Delnevo CD, Coups EJ, Porter JS, Devine KA. Feasibility of Medical Student Mentors to Improve Transition in Sickle Cell Disease. J Pediatr Psychol 2021; 46:650-661. [PMID: 33779756 PMCID: PMC8291672 DOI: 10.1093/jpepsy/jsab031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 03/07/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Advances in medical care have resulted in nearly 95% of all children with sickle cell disease (SCD) living to adulthood. There is a lack of effective transition programming, contributing to high rates of mortality and morbidity among adolescents and young adults (AYAs) during the transition from pediatric to adult healthcare. This nonrandomized study evaluated the feasibility, acceptability, and preliminary outcomes of a novel medical student mentor intervention to improve transition outcomes for AYA with SCD. METHODS Eligible participants were ages 18-25 years, either preparing for transition or had transferred to adult care within the past year. Twenty-four AYA with SCD (Mage = 20.3, SD = 2.6) enrolled in the program and were matched with a medical student mentor. Feasibility and acceptability of the intervention was assessed through enrollment rates, reasons for refusal, retention rates, engagement with the intervention, satisfaction, and reasons for drop-out. Dependent t-tests were used to evaluate the preliminary effects of the intervention on patient transition readiness, health-related quality of life, self-efficacy, SCD knowledge, medication adherence, and health literacy. RESULTS Participants (N = 24) demonstrated adequate retention (75.0%), adherence to the intervention (M = 5.3 of 6 sessions), and satisfaction with the intervention components. Participants demonstrated significant improvements in transition readiness (p = .001), self-efficacy (p = .002), medication adherence (p = .02), and health literacy (p = .05). CONCLUSIONS A medical student mentor intervention to facilitate transition from pediatric to adult care for AYA with SCD is both feasible and acceptable to patients and medical students. Preliminary results suggest benefits for patients, warranting a larger efficacy study.
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Affiliation(s)
- Adrienne S Viola
- Rutgers Cancer Institute of New Jersey
- Rutgers Robert Wood Johnson Medical School
- Rutgers School of Public Health
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Heckman CJ, Riley M, Coups EJ, Niu Z, Stapleton JL. Society of Behavioral Medicine Position Statement: promote sun-safety policies and practices for youth in educational, childcare, and recreational settings. Transl Behav Med 2021; 10:498-501. [PMID: 31504986 DOI: 10.1093/tbm/ibz120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Youth should be allowed and encouraged to engage in sun-safe behaviors in educational, childcare, and recreational settings, including use of sunscreen, wide-brimmed hats, other sun-protective clothing, and shade.
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Affiliation(s)
- Carolyn J Heckman
- Population Science, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Mary Riley
- Population Science, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Elliot J Coups
- Population Science, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Zhaomeng Niu
- Population Science, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Jerod L Stapleton
- Population Science, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
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Coups EJ, Xu B, Heckman CJ, Manne SL, Stapleton JL. Physician skin cancer screening among U.S. military veterans: Results from the National Health Interview Survey. PLoS One 2021; 16:e0251785. [PMID: 34003851 PMCID: PMC8130944 DOI: 10.1371/journal.pone.0251785] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 05/04/2021] [Indexed: 11/18/2022] Open
Abstract
Introduction Although military veterans are at increased risk for skin cancer, little is known about the extent to which they have been screened for skin cancer. The study objective was to examine the prevalence and correlates of physician skin cancer screening among U.S. military veterans. Methods Data were drawn from the National Health Interview Survey. The study sample consisted of 2,826 individuals who reported being military veterans. Receipt of a physician skin examination was measured using a single question that asked participants whether they had ever had all of their skin from head to toe checked for cancer by a dermatologist or some other kind of doctor. Results Less than a third (30.88%) of participants reported ever having a physician skin examination. Factors positively associated with receipt of a physician skin examination in a multivariable logistic regression analysis included: older age, greater educational level, non-Hispanic white race/ethnicity, having TRICARE (military) health insurance, greater skin sensitivity to the sun, and engagement in more sun protection behaviors. Conclusions The majority of military veterans have never been screened for skin cancer by a physician. Screening rates were higher among individuals with one or more skin cancer risk factors. Future research is warranted to test targeted skin cancer screening interventions for this at risk and understudied population.
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Affiliation(s)
- Elliot J. Coups
- Medical Data Analytics, Parsippany, NJ, United States of America
| | - Baichen Xu
- Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States of America
| | - Carolyn J. Heckman
- Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States of America
- Department of Medicine, Rutgers Robert Wood Johnson Medical School, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States of America
- Department of Health Behavior, Society & Policy, Rutgers School of Public Health, Rutgers, The State University of New Jersey, Piscataway, NJ, United States of America
- * E-mail:
| | - Sharon L. Manne
- Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States of America
- Department of Medicine, Rutgers Robert Wood Johnson Medical School, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States of America
- Department of Health Behavior, Society & Policy, Rutgers School of Public Health, Rutgers, The State University of New Jersey, Piscataway, NJ, United States of America
| | - Jerod L. Stapleton
- Department of Health, Behavior & Society, University of Kentucky College of Public Health, Lexington, KY, United States of America
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Heckman CJ, Manne SL, Kashy DA, Bhurosy T, Ritterband L, Coups EJ. Correlates of sun protection behaviors among melanoma survivors. BMC Public Health 2021; 21:882. [PMID: 33962615 PMCID: PMC8105954 DOI: 10.1186/s12889-021-10951-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 04/29/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The study objective was to assess potential correlates of sun protection behaviors among melanoma survivors. METHODS Participants were 441 melanoma survivors recruited from three health centers and a state cancer registry in the United States. Sun protection behaviors (sunscreen, shade, protective shirts, and hats) were assessed through an online survey, as were potential correlates (demographic, melanoma risk, knowledge and beliefs, psychological and social influence factors). Hierarchical multiple regression analyses were conducted. RESULTS Correlates of sun protection behaviors included education, skin cancer risk factors, melanoma knowledge and beliefs, melanoma worry and distress, physician recommendation for sun protection, injunctive norms, and pro-protection beliefs (e.g., perceived barriers, self-efficacy). CONCLUSIONS Future efforts to improve sun safety among melanoma survivors may benefit from targeting individuals with lower education levels, and addressing sun protection social influence, barriers, and self-efficacy.
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Affiliation(s)
- Carolyn J Heckman
- Rutgers, The State University of New Jersey, 195 Little Albany St., New Brunswick, NJ, 08901, USA.
| | - Sharon L Manne
- Rutgers, The State University of New Jersey, 195 Little Albany St., New Brunswick, NJ, 08901, USA
| | | | - Trishnee Bhurosy
- Rutgers, The State University of New Jersey, 195 Little Albany St., New Brunswick, NJ, 08901, USA
| | | | - Elliot J Coups
- Rutgers, The State University of New Jersey, 195 Little Albany St., New Brunswick, NJ, 08901, USA
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Niu Z, Tortolero-Luna G, Lozada C, Heckman CJ, Coups EJ. Correlates of Sun Protection Behaviors Among Adults in Puerto Rico. Int J Behav Med 2021; 29:36-45. [PMID: 33928477 DOI: 10.1007/s12529-021-09991-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND The incidence of skin cancer has been increasing in Puerto Rico in recent years. Sun protection behaviors are suboptimal among Puerto Ricans. However, there are limited data regarding major factors associated with Puerto Rican adults' sun protection behaviors. To examine factors associated with Puerto Rican adults' sun protection behaviors, a survey study was conducted in Puerto Rico. METHOD A population-based sample of 667 Puerto Rican adults completed a telephone survey in 2016. Survey items addressed potential correlates of sun protection behaviors. Hierarchical multiple regression analyses examining correlates of the sun protection behaviors index were conducted. RESULTS Higher levels of sun protection behaviors were found among English language acculturated compared to Spanish language acculturated individuals (p < .05) and among individuals with private versus no health insurance (p < .05). Higher levels of sun protection behaviors were found among individuals with greater skin cancer knowledge (p < .001), fewer sun protection barriers (p < .01), and greater sun protection self-efficacy (p < .001). CONCLUSION By identifying correlates of Puerto Rican adults' sun protection behaviors, this timely study provides insight on factors to target in future skin cancer interventions in this understudied population.
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Affiliation(s)
- Zhaomeng Niu
- Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, 195 Little Albany Street, New Brunswick, NJ, 08901, USA.
| | - Guillermo Tortolero-Luna
- Division of Cancer Control and Population Sciences, University of Puerto Rico Comprehensive Cancer Centre, San Juan, PR, USA
| | - Carolina Lozada
- Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, 195 Little Albany Street, New Brunswick, NJ, 08901, USA
| | - Carolyn J Heckman
- Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, 195 Little Albany Street, New Brunswick, NJ, 08901, USA
- Department of Medicine, Rutgers Robert Johnson Medical School, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
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Viola AS, Levonyan-Radloff K, Drachtman R, Porter J, Savage B, Kaveney A, Sridharan A, Delnevo CD, Coups EJ, Devine KA. Understanding barriers to transition from pediatric to adult care among young adults with sickle cell disease to develop a transition mentor program. Clinical Practice in Pediatric Psychology 2021. [DOI: 10.1037/cpp0000372] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Shaffer KM, Coups EJ, Ritterband LM. e-Health Interventions for Cancer Prevention and Control. Psychooncology 2021. [DOI: 10.1093/med/9780190097653.003.0068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Many terms have been used to describe technology-delivered behavioral and psychological treatments, including web-based treatments, online treatments, e-therapy, digital health interventions, cybertherapy, computer-mediated interventions, and eHealth/mHealth, among others. Attempts have been made to standardize terminology and definitions, although terms are continuously gaining and losing favor across the literature. This chapter provides an overview of eHealth in cancer prevention and control. Types of eHealth intervention methodologies are reviewed along with examples within the context of cancer prevention and control, such as sun safety behaviors and cancer screening. Future research directions, including issues related to the development and implementation of eHealth interventions, are addressed.
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Niu Z, Willoughby JF, Coups EJ, Stapleton JL. Effects of Website Interactivity on Skin Cancer-Related Intentions and User Experience: Factorial Randomized Experiment. J Med Internet Res 2021; 23:e18299. [PMID: 33439131 PMCID: PMC7840277 DOI: 10.2196/18299] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 08/14/2020] [Accepted: 10/26/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Digital media technologies provide users with the ability to interact with content and to receive information based on their preferences and engagement. OBJECTIVE We used skin cancer and sun protection as a health topic to explore how modality interactivity, interface tools that afford users greater activity, resulting in greater depth and breadth of mentally representing and experiencing mediated content, and message interactivity, the extent to which the system allows users to exchange messages back and forth on health websites, influenced users' attitudes, knowledge, behavioral intentions, and experience. METHODS We employed a 2×2 (modality interactivity: high vs low; message interactivity: high vs low) between-subject online experiment for which 4 websites were created. Participants (n=293) were recruited using Amazon Mechanical Turk and randomly assigned into to 1 of 4 conditions. After browsing the website, participants completed an online survey regarding their experience and cognitive perceptions. General linear models and path analysis were used to analyze the data. RESULTS Both modality interactivity (P=.001) and message interactivity (P<.001) had an impact on intention to use sun protection. Attitudes toward health websites and perceived knowledge mediated the effects of modality interactivity and message interactivity on sun protection use intention, individually. Participants in the high modality interactivity and high message interactivity condition felt more satisfied (P=.02). Participants in the low message interactivity condition had more interest in the experience with health websites than participants in the high message interactivity condition (P=.044). CONCLUSIONS Findings suggested that modality interactivity influenced intention to use sun protection directly as well as via attitudes toward the websites. Message interactivity impacted intention to use sunscreen directly and also through perceived knowledge. Implications for designing health websites and health intervention content are discussed.
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Affiliation(s)
- Zhaomeng Niu
- Section of Behavioral Sciences, Division of Medical Oncology, Rutgers Institute of New Jersey, New Brunswick, NJ, United States
| | - Jessica Fitts Willoughby
- The Edward R Murrow College of Communication, Washington State University, Pullman, WA, United States
| | | | - Jerod L Stapleton
- Department of Health, Behavior & Society, College of Public Health, University of Kentucky, Lexington, KY, United States
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Stapleton JL, Hrywna M, Coups EJ, Delnevo C, Heckman CJ, Xu B. Prevalence and Location of Indoor Tanning Among High School Students in New Jersey 5 Years After the Enactment of Youth Access Restrictions. JAMA Dermatol 2020; 156:1223-1227. [PMID: 32876658 DOI: 10.1001/jamadermatol.2020.2935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Several state governments have enacted bans on the use of indoor tanning beds at tanning salons among minors, but studies of the association of such restrictions with tanning behavior have produced mixed results. Little is known about the prevalence of tanning in nonsalon locations that are typically not covered by restrictions. Evidence that age bans are associated with a reduction in tanning bed use is needed to support policy makers' efforts to expand tanning regulations. Objective To determine the prevalence and location of indoor tanning among New Jersey youths after a 2013 statewide indoor tanning ban for minors younger than 17 years. Design, Setting, and Participants This survey study comprised 4 biennial (2012-2018) and representative cross-sectional surveys conducted among 12 659 high school students (grades 9-12) in New Jersey. Main Outcomes and Measures The main outcome was the frequency of indoor tanning in the past year. Location of tanning bed use (ie, tanning salons or nonsalon locations, such as private residences or gyms) was also assessed. Results Survey responses from a total of 12 659 high school students (6499 female [51%]; mean [SD] age, 15.8 [1.3] years) were analyzed across the 4 survey waves. Tanning prevalence among students younger than 17 years (ie, younger than the legal tanning age) was 48% lower in 2018 compared with 2012 (adjusted odds ratio, 0.52; 95% CI, 0.33-0.81; P = .002). Tanning prevalence was 72% lower among female students 17 years or older (adjusted odds ratio, 0.28; 95% CI, 0.18-0.44; P < .001). Prevalence rates were not significantly different for male students 17 years or older and for racial/ethnic minority students. The prevalence of tanning in salons and private residences was similar among students younger than 17 years. Conclusions and Relevance This study suggests that the prevalence of tanning in New Jersey has begun to decrease among all youths younger than the legal tanning age and among female students of legal age in the 5 years after a statewide tanning ban. These findings provide valuable evidence to policy makers to support ongoing state-level efforts to enact age-specific bans on indoor tanning. The unique assessment of tanning location demonstrates the need for both greater enforcement of existing tanning salon regulations to ensure compliance and broadening restrictions to cover nonsalon tanning locations.
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Affiliation(s)
- Jerod L Stapleton
- Markey Cancer Center, University of Kentucky, Lexington.,Department of Health, Behavior & Society, University of Kentucky College of Public Health, Lexington
| | - Mary Hrywna
- Center for Tobacco Studies, Rutgers School of Public Health, New Brunswick, New Jersey.,Department of Health Behavior, Society, and Policy, Rutgers School of Public Health, Piscataway, New Jersey.,Division of Population Sciences, Rutgers Cancer Institute of New Jersey, New Brunswick
| | - Elliot J Coups
- Division of Population Sciences, Rutgers Cancer Institute of New Jersey, New Brunswick.,now at Medical Data Analytics, Parsippany, New Jersey
| | - Cris Delnevo
- Center for Tobacco Studies, Rutgers School of Public Health, New Brunswick, New Jersey.,Department of Health Behavior, Society, and Policy, Rutgers School of Public Health, Piscataway, New Jersey.,Division of Population Sciences, Rutgers Cancer Institute of New Jersey, New Brunswick
| | - Carolyn J Heckman
- Division of Population Sciences, Rutgers Cancer Institute of New Jersey, New Brunswick
| | - Baichen Xu
- Division of Population Sciences, Rutgers Cancer Institute of New Jersey, New Brunswick
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Niu Z, Bhurosy T, Jeong DC, Coups EJ, Heckman CJ, Stapleton JL. Associations of Social Media Use, Patient-centered Communication, and Knowledge with Perceived Human Papillomavirus Vaccine Effectiveness. Am J Health Behav 2020; 44:642-651. [PMID: 33121582 DOI: 10.5993/ajhb.44.5.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Objectives: Given the effectiveness of human papillomavirus (HPV) vaccination in preventing cervical cancer and other diseases, as well as the low rates of HPV vaccination in the United States, it is important to examine the determinants of perceived HPV vaccine effectiveness. In this study, we examined the associations between potential factors associated with perceived HPV vaccine effectiveness. Methods: We utilized data (N = 718) from the nationally representative 2017 Health Information National Trends Survey (HINTS). We examined the associations of health-related social media use, patient-centered communication, and HPV knowledge with perceived HPV vaccine effectiveness in preventing cervical cancer. We reported descriptive statistics, and conducted bivariable analyses, multivariable analysis, and mediation analyses. Results: Perceived HPV vaccine effectiveness was associated with sex, age, education, health-related social media use, and HPV knowledge. Additionally, HPV knowledge mediated the associations of health-related social media use and patient-centered communication with perceived HPV vaccine effectiveness. Conclusions: Improving health-related information from social media, patient-centered communication, and HPV knowledge may increase perceived HPV vaccine effectiveness and ultimately, vaccine adoption.
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Affiliation(s)
- Zhaomeng Niu
- Postdoctoral Associate, Population Science, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ;,
| | - Trishnee Bhurosy
- Research Associate, Population Science, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - David C. Jeong
- Postdoctoral Research Scholar, Annenberg School for Communication and Journalism, University of Southern California, Los Angeles, CA
| | | | - Carolyn J. Heckman
- Associate Professor, Population Science, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Jerod L. Stapleton
- Associate Professor, University of Kentucky College of Public Health, Lexington, KY
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15
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Manne SL, Heckman CJ, Kashy D, Lozada C, Gallo J, Ritterband L, Coups EJ. Prevalence and correlates of skin self-examination practices among cutaneous malignant melanoma survivors. Prev Med Rep 2020; 19:101110. [PMID: 32461880 PMCID: PMC7240727 DOI: 10.1016/j.pmedr.2020.101110] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 03/06/2020] [Accepted: 04/26/2020] [Indexed: 11/05/2022] Open
Abstract
Melanoma patients are at elevated risk for recurrence of the primary cancer as well as second primary melanomas. Regular skin self-examination (SSE) is recommended as part of follow-up surveillance. In this study, we examined SSE performance and comprehensiveness as well as knowledge and attitudinal correlates of SSE performance and comprehensiveness. Four hundred forty-one melanoma survivors completed measures of SSE performance as well as knowledge and attitudes about SSE and melanoma. Approximately two-thirds of the sample reported having conducted an SSE in the past two months; the average number of body parts examined was 10.64 (out of 15 maximum). Only 7.5% of the sample checked all 15 body parts. Greater worry about recurrence, fewer barriers to SSE, more planning for when to conduct SSE, and more confidence in the ability to conduct SSE and recognize a suspicious growth were associated with both SSE performance and greater SSE comprehensiveness. Physician influence was positively associated with SSE performance. Survivor education efforts may benefit from reminding survivors to check hard-to-see and sensitive areas, develop a plan for how to ask for assistance in conducting exams, as well as use mirrors to see hard-to-reach areas. Addressing perceived SSE barriers, fostering SSE planning, and improving SSE self-efficacy may be important foci for intervention efforts to enhance SSE performance and comprehensiveness.
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Affiliation(s)
| | | | | | | | - Joseph Gallo
- Rutgers Cancer Institute of New Jersey, United States
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16
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Affiliation(s)
- Tania Estapé
- Psychosocial Oncology Department, FEFOC Foundation, Barcelona, Spain
| | - Elliot J Coups
- Population Science Section, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
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Abstract
This narrative review describes the evidence regarding digital health interventions targeting adolescent and young adult (AYA) cancer survivors. We reviewed the published literature for studies involving Internet, mHealth, social media, telehealth, and other digital interventions for AYA survivors. We highlight selected studies to illustrate the state of the research in this unique patient population. Interventions have used various digital modalities to improve health behaviors (eg, physical activity, nutrition, tobacco cessation), enhance emotional well-being, track and intervene on cancer-related symptoms, and improve survivorship care delivery. The majority of studies have demonstrated feasibility and acceptability of digital health interventions for AYA survivors, but few efficacy studies have been conducted. Digital health interventions are promising to address unmet psychosocial and health information needs of AYA survivors. Researchers should use rigorous development and evaluation methods to demonstrate the efficacy of these approaches to improve health outcomes for AYA survivors.
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Affiliation(s)
- Katie A Devine
- Katie A. Devine, Adrienne S. Viola, and Elliot J. Coups, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ; Yelena P. Wu, Huntsman Cancer Institute, Salt Lake City, UT
| | - Adrienne S Viola
- Katie A. Devine, Adrienne S. Viola, and Elliot J. Coups, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ; Yelena P. Wu, Huntsman Cancer Institute, Salt Lake City, UT
| | - Elliot J Coups
- Katie A. Devine, Adrienne S. Viola, and Elliot J. Coups, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ; Yelena P. Wu, Huntsman Cancer Institute, Salt Lake City, UT
| | - Yelena P Wu
- Katie A. Devine, Adrienne S. Viola, and Elliot J. Coups, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ; Yelena P. Wu, Huntsman Cancer Institute, Salt Lake City, UT
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18
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Niu Z, Jeong DC, Coups EJ, Stapleton JL. An Experimental Investigation of Human Presence and Mobile Technologies on College Students' Sun Protection Intentions: Between-Subjects Study. JMIR Mhealth Uhealth 2019; 7:e13720. [PMID: 31452523 PMCID: PMC6732976 DOI: 10.2196/13720] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 05/15/2019] [Accepted: 05/16/2019] [Indexed: 11/13/2022] Open
Abstract
Background Health promotion and education programs are increasingly being adapted and developed for delivery through digital technologies. With this shift toward digital health approaches, it is important to identify design strategies in health education and promotion programs that enhance participant engagement and promote behavior change. Objective This study aimed to examine the impact of an experiment testing various mobile health (mHealth) skin cancer prevention messages on sun protection intentions and message perceptions among American college students. Methods A sample of 134 college students aged 18 years or older participated in a 2×2×2 between-subjects experimental study, designed to examine the individual and combinatory effects of multiple dimensions (human presence, screen size, and interactivity) of digital technologies. The primary study outcome was intention to use sun protection; secondary outcomes included attitudes toward the information, two dimensions of trust, and information processing. Results Generally, intention to use sun protection was positively associated with the presence of human characters in the health educational messages (P<.001), delivering educational health messages on a large screen (ie, iPad; P<.001), and higher interactivity (P<.001). Only human presence produced more favorable attitudes (P=.02). Affective trust was positively associated with human presence (P=.006) and large screen size (P<.001), whereas cognitive trust was positively associated with human presence (P<.001) and small screen size (P=.007). Moreover, large screen size led to more heuristic processing (P=.03), whereas small screen size led to more systematic processing (P=.04). Conclusions This experimental study demonstrates that the impact of mHealth skin cancer prevention messages differs based on platform and delivery design features. Effects on behavioral intentions, attitudes, and trust were found for conditions with human presence, highlighting the importance of including this feature in mHealth programs. Results from this experimental study can be used to optimize the design of mHealth educational interventions that promote sun protection.
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Affiliation(s)
- Zhaomeng Niu
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, United States
| | - David C Jeong
- University of Southern California, Los Angeles, CA, United States
| | - Elliot J Coups
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, United States.,Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, United States
| | - Jerod L Stapleton
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, United States.,Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, United States
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Viola A, Rashid H, Coups EJ, Devine KA. Wanting more: A look at preclinical students' desires for increased clinical experiences and interest in mentoring young adults with chronic illness. Med Sci Educ 2019; 29:909-913. [PMID: 33133759 PMCID: PMC7597659 DOI: 10.1007/s40670-019-00787-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
A growing population of children with chronic illness must transition from pediatric to adult healthcare. Medical students receive little formal training about the needs of these young patients. Strategies for educating students about how to address medical and psychosocial consequences of these conditions are needed. Interventions pairing medical students as mentors for young adults with chronic illness may provide dual benefit for both patient and student. To establish the feasibility of developing this type of program, we surveyed 165 medical students about their extra-curricular and clinical experiences as well their interest in and expectations for a patient mentoring experience.
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Affiliation(s)
- Adrienne Viola
- Rutgers Cancer Institute of New Jersey, 195 Little Albany Street, New Brunswick, NJ 08901 USA
- Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ USA
| | - Hanin Rashid
- Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ USA
| | - Elliot J. Coups
- Rutgers Cancer Institute of New Jersey, 195 Little Albany Street, New Brunswick, NJ 08901 USA
| | - Katie A. Devine
- Rutgers Cancer Institute of New Jersey, 195 Little Albany Street, New Brunswick, NJ 08901 USA
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20
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Coups EJ, Manne SL, Ohman Strickland P, Hilgart M, Goydos JS, Heckman CJ, Chamorro P, Rao BK, Davis M, Smith FO, Thorndike FP, Ritterband LM. Randomized controlled trial of the mySmartSkin web-based intervention to promote skin self-examination and sun protection behaviors among individuals diagnosed with melanoma: study design and baseline characteristics. Contemp Clin Trials 2019; 83:117-127. [PMID: 31255801 PMCID: PMC6690854 DOI: 10.1016/j.cct.2019.06.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 06/17/2019] [Accepted: 06/25/2019] [Indexed: 10/26/2022]
Abstract
>1.2 million people in the United States have a personal history of melanoma skin cancer and are at increased risk for disease recurrence and second primary melanomas. Many of these individuals do not follow recommendations to conduct regular, thorough skin self-examinations that facilitate early disease detection and do not sufficiently engage in sun protection behaviors. In this project, we are conducting a randomized controlled trial of an innovative, tailored, theory-driven Internet intervention-called mySmartSkin-to promote these behaviors among melanoma patients. This paper outlines the study design and characteristics of the study sample. A total of 441 patients were recruited (40.9% response rate) and randomized to the mySmartSkin or a Usual Care condition. Participants complete surveys at baseline and 8 weeks, 24 weeks, and 48 weeks later. The primary aim of the project is to examine the impact of mySmartSkin versus Usual Care on skin self-examination and sun protection behaviors. The secondary aim focuses on identifying mediators of the intervention's effects. In an exploratory aim, we will examine potential moderators of the impact of the intervention. At baseline, the recruited participants had a mean age of 61 years, 49% were female, 7.5% met criteria for having conducted a recent, thorough skin self-examination, and the mean score on the index of sun protection behaviors was 3.3 (on a scale from 1 to 5). The results of the project will determine whether the mySmartSkin intervention is efficacious in promoting skin self-examination and sun protection behaviors among individuals diagnosed with melanoma. Trial registration: ClinicalTrials.govNCT03028948.
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Affiliation(s)
- Elliot J Coups
- Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States; Department of Medicine, Rutgers Robert Johnson Medical School, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States; Department of Health Behavior, Systems & Policy, Rutgers School of Public Health, Rutgers, The State University of New Jersey, Piscataway, NJ, United States.
| | - Sharon L Manne
- Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States; Department of Medicine, Rutgers Robert Johnson Medical School, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States; Department of Health Behavior, Systems & Policy, Rutgers School of Public Health, Rutgers, The State University of New Jersey, Piscataway, NJ, United States
| | - Pamela Ohman Strickland
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States
| | - Michelle Hilgart
- Center for Behavioral Health and Technology, Department of Psychiatry and Neurobehavioral Sciences, University of Virginia School of Medicine, Charlottesville, VA, United States
| | | | - Carolyn J Heckman
- Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States; Department of Medicine, Rutgers Robert Johnson Medical School, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States; Department of Health Behavior, Systems & Policy, Rutgers School of Public Health, Rutgers, The State University of New Jersey, Piscataway, NJ, United States
| | - Paola Chamorro
- Department of Dermatology, Rutgers Robert Wood Johnson Medical School, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States
| | - Babar K Rao
- Department of Dermatology, Rutgers Robert Wood Johnson Medical School, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States
| | - Moira Davis
- Department of Surgery, Saint Barnabas Medical Center, Livingston, NJ, United States
| | - Franz O Smith
- Department of Surgery, Saint Barnabas Medical Center, Livingston, NJ, United States
| | | | - Lee M Ritterband
- Center for Behavioral Health and Technology, Department of Psychiatry and Neurobehavioral Sciences, University of Virginia School of Medicine, Charlottesville, VA, United States
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21
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Coups EJ. Significant limitations of a systematic review and meta-analysis of interventions to promote skin self-examination. Br J Dermatol 2019; 181:640-641. [PMID: 31093960 DOI: 10.1111/bjd.18130] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Affiliation(s)
- E J Coups
- Department of Medicine, Rutgers Robert Wood Johnson Medical School, Rutgers, The State University of New Jersey, New Brunswick, NJ, U.S.A.,Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, NJ, U.S.A.,Department of Health Behavior, Society & Policy, Rutgers School of Public Health, Rutgers, The State University of New Jersey, Piscataway, NJ, U.S.A
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22
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Coups EJ, Manne SL, Pagoto SL, Criswell KR, Goydos JS. Facebook Intervention for Young-Onset Melanoma Patients and Their Family Members: Pilot and Feasibility Study. JMIR Dermatol 2018. [DOI: 10.2196/derma.9734] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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23
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Niu Z, Parmar V, Xu B, Coups EJ, Stapleton JL. Prevalence and correlates of intentional outdoor and indoor tanning among adolescents in the United States: Findings from the FLASHE survey. Prev Med Rep 2018; 11:187-190. [PMID: 29992085 PMCID: PMC6034571 DOI: 10.1016/j.pmedr.2018.06.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 06/13/2018] [Accepted: 06/24/2018] [Indexed: 01/03/2023] Open
Abstract
A body of research has focused on adolescents' indoor tanning behaviors but relatively little is known about the prevalence of adolescents' intentional outdoor tanning (time spent outdoors to get a tan). The present study used data from the National Cancer Institute's 2014 Family Life, Activity, Sun, Health and Eating (FLASHE) cross-sectional survey to examine the prevalence and correlates of intentional outdoor and indoor tanning among adolescents in the United States. Both unadjusted (bivariate) and adjusted (multi-variate) logistic regressions were performed to test the associations between demographic variables, time spent on media (e.g., using computers), emotional status and outdoor or indoor tanning. The overall prevalence of frequent outdoor tanning among adolescents in the U.S. was 15.6% (95% CI 13.8-17.4%) and the rate of indoor tanning in the past 12 months was 3% (95% CI 2.2-3.9). The adjusted odds of intentional outdoor tanning were significantly higher among girls (AOR 2.39, 95% CI 1.75-3.27), Non-Hispanic Whites (AOR 2.85, 95% CI 1.99-4.07), and those who spent more time on cell phones (AOR 1.40, 95% CI 1.25-1.57). The adjusted odds of indoor tanning were significantly higher among those who spent more time on computers (AOR 1.38, 95% CI 1.09-1.74) and cell phones (AOR 1.49, 95% CI 1.19-1.87). This study provides evidence for the relationship between media use and tanning behaviors among adolescents.
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Affiliation(s)
- Zhaomeng Niu
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ 08903, United States of America
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24
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Affiliation(s)
- Elliot J Coups
- Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick
| | - Alan C Geller
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, Massachusetts
| | - Sherry L Pagoto
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester
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25
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Abstract
Indoor tanning (IT) is a known carcinogen, and regulation has increased across the USA. However, there is minimal point-of-sale regulation for adult users. The purpose of the present study is to explore whether IT users recall being provided with warnings or safety guidelines at tanning salons. A national sample of 273 young adult, female IT users (mean age = 22.26, SD = 2.38) was surveyed regarding the frequency that they recalled being provided with six different warnings and safety guidelines when at tanning salons. Between 65 and 90.1 % of participants reported recalling the various warnings and guidelines. Having very fair skin was reported by 16.8 % of participants, and these high-risk individuals were less likely to recall having read and signed a consent form than other IT users (p = .002). The current level of regulation is insufficient to provide IT users with consistent warnings and safety guidelines at tanning salons.
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Affiliation(s)
- Ashley K Day
- Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, 195 Little Albany Street, 5th floor, Room 5549.20, New Brunswick, NJ, 08903-2681, USA.
- School of Psychology, University of Adelaide, Adelaide, SA, Australia.
| | - Elliot J Coups
- Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, 195 Little Albany Street, 5th floor, Room 5549.20, New Brunswick, NJ, 08903-2681, USA
- Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
- Department of Health Education and Behavioral Science, Rutgers School of Public Health, Piscataway, NJ, USA
| | - Sharon L Manne
- Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, 195 Little Albany Street, 5th floor, Room 5549.20, New Brunswick, NJ, 08903-2681, USA
- Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
- Department of Health Education and Behavioral Science, Rutgers School of Public Health, Piscataway, NJ, USA
| | - Jerod L Stapleton
- Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, 195 Little Albany Street, 5th floor, Room 5549.20, New Brunswick, NJ, 08903-2681, USA
- Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
- Department of Health Education and Behavioral Science, Rutgers School of Public Health, Piscataway, NJ, USA
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Holman DM, Berkowitz Z, Guy GP, Lunsford NB, Coups EJ. The association between beliefs about vitamin D and skin cancer risk-related behaviors. Prev Med 2017; 99:326-331. [PMID: 28322879 PMCID: PMC5896002 DOI: 10.1016/j.ypmed.2017.03.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 03/08/2017] [Accepted: 03/12/2017] [Indexed: 10/19/2022]
Abstract
Major health organizations recommend obtaining most of one's vitamin D through dietary sources rather than from sun exposure, given the link between sun exposure and increased skin cancer risk. The purpose of this study is to examine the association between beliefs about vitamin D and skin cancer risk-related behaviors, a topic on which research is limited. We analyzed cross-sectional online survey data collected in the summer of 2015 from 4127U.S. adults aged 18years and older. Overall, 19.7% of adults believed that sun protection would put them at risk of not getting enough vitamin D. However, less than half (43.1%) thought they could get enough vitamin D from dietary sources. Individuals with this belief were more likely to protect their skin when spending time outdoors (71.3%) compared with those who were neutral or disagreed (56.5%; P<0.001). Only 5.1% of adults believed that indoor tanning is an effective way to get vitamin D. Compared to those who disagreed or were neutral, those who thought it was effective were more likely to be outdoor tanners (45.1% vs. 28.5%; P<0.001) and indoor tanners (13.8% vs 1.9%; P<0.001). Beliefs about vitamin D were associated with skin cancer risk-related behaviors. Including information about vitamin D in skin cancer prevention messages may be beneficial.
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Affiliation(s)
- Dawn M Holman
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway NE, MS F76, Atlanta, GA 30341, USA..
| | - Zahava Berkowitz
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway NE, MS F76, Atlanta, GA 30341, USA
| | - Gery P Guy
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway NE, MS F76, Atlanta, GA 30341, USA
| | - Natasha Buchanan Lunsford
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway NE, MS F76, Atlanta, GA 30341, USA
| | - Elliot J Coups
- Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA.; Department of Medicine, Rutgers Robert Wood Johnson Medical School, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA; Department of Health Education and Behavioral Science, Rutgers School of Public Health, Rutgers, The State University of New Jersey, 195 Little Albany Street, New Brunswick, NJ 08903, USA
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27
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Day AK, Stapleton JL, Natale-Pereira AM, Goydos JS, Coups EJ. Parent and Child Characteristics Associated with Child Sunburn and Sun Protection Among U.S. Hispanics. Pediatr Dermatol 2017; 34:315-321. [PMID: 28523887 DOI: 10.1111/pde.13136] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND/OBJECTIVES Skin cancer incidence has been increasing in U.S. Hispanics over several decades and the postdiagnosis outcomes are worse for Hispanics than for non-Hispanic whites. Parents are influential in children's health preventive behaviors, but little is known about parental factors associated with children's skin cancer-related behaviors in the U.S. Hispanic population. The present study examined parental and child correlates of skin cancer-related behaviors (sunburns, sunbathing, sun-protective clothing use, and sunscreen use) of children of Hispanic parents. METHODS This survey study included a population-based sample of 360 U.S. Hispanic parents (44.8% male) who had a child 14 years of age or younger. Measures included parental reports of parent and child demographic characteristics, parent skin cancer knowledge and linguistic acculturation, and parent and child skin cancer-related behaviors. RESULTS Approximately 28% of children and 31.9% of parents experienced at least one sunburn in the past year and approximately 29% of children and 36.7% of parents were reported to sunbathe. Moderate use of sun-protective clothing and sunscreen was reported for parents and their children. Child sun-protective clothing use and sunscreen use, sunburns, and sunbathing were associated with the corresponding behaviors of their parents. CONCLUSIONS Future research should consider the role of acculturation and perceived risk in the sun protection behaviors of U.S. Hispanic children, particularly in those who report a fair skin type. Hispanic parents should be included in interventions targeting their children's skin cancer-related behaviors, and it is suggested that such interventions could also encourage parents to improve their own behaviors.
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Affiliation(s)
- Ashley K Day
- Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, New Jersey.,School of Psychology, University of Adelaide, Adelaide, South Australia, Australia
| | - Jerod L Stapleton
- Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, New Jersey.,Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey.,Department of Health Education and Behavioral Science, Rutgers School of Public Health, Piscataway, New Jersey
| | | | - James S Goydos
- Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, New Jersey.,Department of Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey
| | - Elliot J Coups
- Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, New Jersey.,Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey.,Department of Health Education and Behavioral Science, Rutgers School of Public Health, Piscataway, New Jersey
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Coups EJ, Stapleton JL, Delnevo CD. Indoor tanning among New Jersey high school students before and after the enactment of youth access restrictions. J Am Acad Dermatol 2017; 75:440-2. [PMID: 27444078 DOI: 10.1016/j.jaad.2016.03.040] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Revised: 03/25/2016] [Accepted: 03/28/2016] [Indexed: 10/21/2022]
Affiliation(s)
- Elliot J Coups
- Rutgers Cancer Institute of New Jersey, Rutgers, State University of New Jersey, New Brunswick, New Jersey; Department of Medicine, Rutgers Robert Wood Johnson Medical School, Rutgers, State University of New Jersey, New Brunswick, New Jersey; Department of Health Education and Behavioral Science, Rutgers School of Public Health, Rutgers, State University of New Jersey, Piscataway, New Jersey.
| | - Jerod L Stapleton
- Rutgers Cancer Institute of New Jersey, Rutgers, State University of New Jersey, New Brunswick, New Jersey; Department of Medicine, Rutgers Robert Wood Johnson Medical School, Rutgers, State University of New Jersey, New Brunswick, New Jersey; Department of Health Education and Behavioral Science, Rutgers School of Public Health, Rutgers, State University of New Jersey, Piscataway, New Jersey
| | - Cristine D Delnevo
- Rutgers Cancer Institute of New Jersey, Rutgers, State University of New Jersey, New Brunswick, New Jersey; Department of Health Education and Behavioral Science, Rutgers School of Public Health, Rutgers, State University of New Jersey, Piscataway, New Jersey
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Stapleton JL, Hillhouse J, Coups EJ, Pagoto S. Social media use and indoor tanning among a national sample of young adult nonHispanic white women: A cross-sectional study. J Am Acad Dermatol 2017; 75:218-20. [PMID: 27317521 DOI: 10.1016/j.jaad.2016.01.043] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Revised: 01/28/2016] [Accepted: 01/28/2016] [Indexed: 11/25/2022]
Affiliation(s)
- Jerod L Stapleton
- Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick; Department of Medicine, Rutgers Robert Wood Johnson Medical School, Rutgers, The State University of New Jersey, New Brunswick; Department of Health Education and Behavioral Sciences, Rutgers School of Public Health, Rutgers, The State University of New Jersey, Piscataway.
| | - Joel Hillhouse
- Department of Community and Behavioral Health, East Tennessee State University, Johnson City
| | - Elliot J Coups
- Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick; Department of Medicine, Rutgers Robert Wood Johnson Medical School, Rutgers, The State University of New Jersey, New Brunswick; Department of Health Education and Behavioral Sciences, Rutgers School of Public Health, Rutgers, The State University of New Jersey, Piscataway
| | - Sherry Pagoto
- Department of Medicine, University of Massachusetts Medical School, North Worcester
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Coups EJ, Stapleton JL, Delnevo CD. Reply to: "Indoor tanning among New Jersey high school students before and after the enactment of youth access restrictions". J Am Acad Dermatol 2017; 76:e69. [PMID: 28089020 DOI: 10.1016/j.jaad.2016.10.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Accepted: 10/07/2016] [Indexed: 11/25/2022]
Affiliation(s)
- Elliot J Coups
- Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick; Department of Medicine, Rutgers Robert Wood Johnson Medical School, Rutgers, The State University of New Jersey, New Brunswick; Department of Health Education and Behavioral Science, Rutgers School of Public Health, Rutgers, The State University of New Jersey, Piscataway.
| | - Jerod L Stapleton
- Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick; Department of Medicine, Rutgers Robert Wood Johnson Medical School, Rutgers, The State University of New Jersey, New Brunswick; Department of Health Education and Behavioral Science, Rutgers School of Public Health, Rutgers, The State University of New Jersey, Piscataway
| | - Cristine D Delnevo
- Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick; Department of Health Education and Behavioral Science, Rutgers School of Public Health, Rutgers, The State University of New Jersey, Piscataway
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Giovenco DP, Casseus M, Duncan DT, Coups EJ, Lewis MJ, Delnevo CD. Association Between Electronic Cigarette Marketing Near Schools and E-cigarette Use Among Youth. J Adolesc Health 2016; 59:627-634. [PMID: 27720358 DOI: 10.1016/j.jadohealth.2016.08.007] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Revised: 08/02/2016] [Accepted: 08/02/2016] [Indexed: 11/18/2022]
Abstract
PURPOSE Electronic cigarettes (e-cigarettes) are now the most popular tobacco product among youth. Little is known about the relationship between exposure to e-cigarette marketing at the point-of-sale and youth e-cigarette use. METHODS Research staff collected data on e-cigarette availability and promotion in tobacco retailers within a half-mile of 41 schools participating in the 2014 New Jersey Youth Tobacco Survey. These data were linked with participant responses from the New Jersey Youth Tobacco Survey (n = 3,909) and log-Poisson regression models estimated adjusted prevalence ratios for ever and past-month e-cigarette use. RESULTS Nearly a quarter of high school students in New Jersey have tried e-cigarettes (24.1%) and 12.1% were past-month users. Prevalence was highest among males, non-Hispanic whites, and students who have used other tobacco products. After controlling for covariates and the clustered nature of the data, e-cigarette retailer density around schools was positively associated with ever and past-month use of e-cigarettes (p < .05). E-cigarette advertising volume significantly increased the probability of being a past-month e-cigarette user (adjusted prevalence ratio: 1.03, p = .031). CONCLUSIONS This study suggests that the point-of-sale environment around schools may contribute to e-cigarette use among youth. Policy efforts to restrict tobacco promotion at the point-of-sale may play a role in reducing the use of e-cigarettes.
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Affiliation(s)
- Daniel P Giovenco
- Center for Tobacco Studies, Department of Health Education and Behavioral Science, Rutgers School of Public Health, New Brunswick, New Jersey.
| | - Myriam Casseus
- Center for Tobacco Studies, Department of Health Education and Behavioral Science, Rutgers School of Public Health, New Brunswick, New Jersey
| | - Dustin T Duncan
- Department of Population Health, New York University School of Medicine, New York, New York
| | - Elliot J Coups
- Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
| | - M Jane Lewis
- Center for Tobacco Studies, Department of Health Education and Behavioral Science, Rutgers School of Public Health, New Brunswick, New Jersey
| | - Cristine D Delnevo
- Center for Tobacco Studies, Department of Health Education and Behavioral Science, Rutgers School of Public Health, New Brunswick, New Jersey
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Manne SL, Coups EJ, Kashy DA. Relationship factors and couples' engagement in sun protection. Health Educ Res 2016; 31:542-554. [PMID: 27247330 DOI: 10.1093/her/cyw027] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Accepted: 05/02/2016] [Indexed: 06/05/2023]
Abstract
Individuals may be more motivated to adopt health practices if they consider the benefits of these behaviors for their close relationships. The goal of this study was to examine couple concordance with sun protection and use the interdependence and communal coping theory to evaluate the role of relationship factors in sun protection. One hundred and eighty-four married couples aged 50 years and older completed measures of objective skin cancer risk, perceived risk, sun protection benefits, relationship-centered motivations for sun protection, discussions about sun protection, and sun protection. A mediational model was evaluated. Results indicated a high level of couple concordance. Partners who adopted a relationship-centered motivation for sun protection were more likely to discuss sun protection with one another, and partners who discussed sun protection together were more likely to engage in sun protection. One partner's attitude about personal risk and sun protection benefits was associated with the other partner's sun protection. Wives had higher relationship-centered motivation and discussed sun protection more with their husbands. Behavioral interventions may benefit from encouraging couples to discuss sun protection and encouraging married individuals to consider the benefits of sun protection for their relationship and for their spouse's health.
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Affiliation(s)
- S L Manne
- Section of Population Science, Department of Medicine, Robert Wood Johnson Medical School, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, 08903, USA
| | - E J Coups
- Section of Population Science, Department of Medicine, Robert Wood Johnson Medical School, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, 08903, USA
| | - D A Kashy
- Department of Psychology, Michigan State University, East Lansing, Michigan, 48824, USA
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Stapleton JL, Manne SL, Darabos K, Greene K, Ray AE, Turner AL, Coups EJ. Randomized controlled trial of a web-based indoor tanning intervention: Acceptability and preliminary outcomes. Health Psychol 2016; 34S:1278-85. [PMID: 26651469 DOI: 10.1037/hea0000254] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE This article describes the acceptability and preliminary behavioral outcomes of a pilot randomized control trial of a web-based indoor tanning intervention for young adult women. The intervention targets indoor tanning users' perceptions of the benefits and value of tanning and addresses the role of body image-related constructs in indoor tanning. METHOD Participants were 186 young adult women who reported indoor tanning at least once in the past 12 months. The study design was a 2-arm randomized controlled trial with pre- and postintervention assessments and random assignment to an intervention or control condition. Intervention acceptability was assessed by obtaining participants' evaluation of the intervention. Regression analyses were used to test for intervention condition differences in preliminary behavioral outcomes measured at 6 weeks postintervention. RESULTS Participants provided favorable evaluations of the intervention on several dimensions and a highly positive overall rating. Intervention participants were more likely to report abstaining from indoor tanning and indicated a lower likelihood of using indoor tanning in the future compared with control participants on the postintervention assessment. No differences were found for sunburns. CONCLUSIONS The results of this pilot randomized controlled trial provide evidence that the indoor tanning intervention is acceptable to participants and may encourage cessation of indoor tanning behavior. The findings provide preliminary support for an indoor tanning intervention that engages tanners to challenge their beliefs about the benefits of indoor tanning. The use of a web-based indoor tanning intervention is unique and provides strong potential for dissemination.
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Affiliation(s)
- Jerod L Stapleton
- Division of Population Sciences, Rutgers Cancer Institute of New Jersey
| | - Sharon L Manne
- Division of Population Sciences, Rutgers Cancer Institute of New Jersey
| | - Katie Darabos
- Division of Population Sciences, Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey
| | - Kathryn Greene
- Department of Communication, Rutgers, The State University of New Jersey
| | - Anne E Ray
- Center of Alcohol Studies, Rutgers, The State University of New Jersey
| | - Amber L Turner
- Division of Population Sciences, Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey
| | - Elliot J Coups
- Division of Population Sciences, Rutgers Cancer Institute of New Jersey
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Stapleton JL, Hillhouse JJ, Turrisi R, Baker K, Manne SL, Coups EJ. The Behavioral Addiction Indoor Tanning Screener (BAITS): An Evaluation of a Brief Measure of Behavioral Addictive Symptoms. Acta Derm Venereol 2016; 96:552-3. [PMID: 26568436 DOI: 10.2340/00015555-2290] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Jerod L Stapleton
- Division of Population Sciences, Rutgers Cancer Institute of New Jersey, 08903 New Brunswick, USA.
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Manne SL, Coups EJ, Kashy DA. Relationship factors in skin self-examination among couples. Br J Health Psychol 2016; 21:631-47. [PMID: 27009696 DOI: 10.1111/bjhp.12190] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Revised: 02/08/2016] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Individuals may be more motivated to adopt health-promoting practices if they consider the benefits of these behaviours for their close relationships. The goal of this study was to use the interdependence theory to evaluate the role of relationship factors in skin self-examination (SSE). DESIGN The study adopted a cross-sectional survey design. METHODS One hundred and eighty-four married couples aged 50 years and older completed measures of skin cancer worry, SSE benefits, SSE barriers, relationship-centred motivations for SSE, discussions about SSE, and SSE practices in the past year. RESULTS Couples who discussed SSE with one another were more likely to engage in it. Couples who adopted a relationship-centred motivation for SSE were more likely to discuss SSE, and, ultimately, engage in SSE. One partner's beliefs were associated with the other partner's SSE. Women who adopted a relationship-centred motivation for SSE had husbands who discussed SSE more and also had husbands who were more likely to conduct SSE. Men who adopted a relationship-centred motivation for SSE did not have wives who reported that they discussed SSE more with their husbands and/or wives who were more likely to conduct SSE. These findings suggest that wives' relationship beliefs and discussions with their husbands may have a stronger association with their husbands' SSE practices than the associations between husbands' relationship beliefs and discussions with their wives' SSE practices. CONCLUSIONS Behavioural interventions may benefit from encouraging couples to discuss SSE and consider the benefits of SSE for their relationship and for their spouse's health. Statement of contribution What is already known on this subject? Previous studies have shown that people are more motivated to adopt health-promoting behaviours if they consider the benefits of such behaviours for their close relationships. However, little is known about the role of the marital relationship in the engagement in skin self-examination (SSE) practices. What does this study add? This study builds on prior research evaluating the role of relationship factors in cancer screening and surveillance practices. Couples who discuss SSE with one another are more likely to engage in it. Couples who consider the benefits of engaging in SSE for their relationship are more likely to discuss skin examinations and engage in them.
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Affiliation(s)
- Sharon L Manne
- Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
| | - Elliot J Coups
- Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
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Stapleton JL, Tatum KL, Devine KA, Stephens S, Masterson M, Baig A, Hudson SV, Coups EJ. Skin Cancer Surveillance Behaviors Among Childhood Cancer Survivors. Pediatr Blood Cancer 2016; 63:554-7. [PMID: 26513138 PMCID: PMC4724328 DOI: 10.1002/pbc.25811] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Accepted: 09/28/2015] [Indexed: 01/07/2023]
Abstract
The risk of developing skin cancer is elevated among childhood cancer survivors (CCS), particularly among those treated with radiation. This survey study examined the skin cancer surveillance behaviors of 94 CCS. Approximately 48% of CCS had ever conducted skin self-examination (SSE) and 31% had ever received a physician skin examination. Rates of physician skin examination were 2.5 times higher among CCS treated with radiation compared to those without radiation. However, rates of SSEs did not differ based on treatment history. These findings highlight the need to promote skin cancer surveillance as an important aspect of CCS survivorship care.
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Affiliation(s)
- Jerod L Stapleton
- Rutgers Cancer Institute of New Jersey, The State University of New Jersey, New Brunswick, New Jersey
- Department of Medicine, Rutgers Robert Wood Johnson Medical School, The State University of New Jersey, New Brunswick, New Jersey
- Department of Health Education and Behavioral Science, Rutgers School of Public Health, The State University of New Jersey, Piscataway, New Jersey
| | - Kristina L Tatum
- Rutgers Cancer Institute of New Jersey, The State University of New Jersey, New Brunswick, New Jersey
| | - Katie A Devine
- Rutgers Cancer Institute of New Jersey, The State University of New Jersey, New Brunswick, New Jersey
- Department of Medicine, Rutgers Robert Wood Johnson Medical School, The State University of New Jersey, New Brunswick, New Jersey
- Department of Health Education and Behavioral Science, Rutgers School of Public Health, The State University of New Jersey, Piscataway, New Jersey
- Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, The State University of New Jersey, Somerset, New Jersey
| | - Sue Stephens
- Rutgers Cancer Institute of New Jersey, The State University of New Jersey, New Brunswick, New Jersey
| | - Margaret Masterson
- Rutgers Cancer Institute of New Jersey, The State University of New Jersey, New Brunswick, New Jersey
- Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, The State University of New Jersey, New Brunswick, New Jersey
| | - Amna Baig
- Department of Health Education and Behavioral Science, Rutgers School of Public Health, The State University of New Jersey, Piscataway, New Jersey
| | - Shawna V Hudson
- Rutgers Cancer Institute of New Jersey, The State University of New Jersey, New Brunswick, New Jersey
- Department of Health Education and Behavioral Science, Rutgers School of Public Health, The State University of New Jersey, Piscataway, New Jersey
- Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, The State University of New Jersey, Somerset, New Jersey
| | - Elliot J Coups
- Rutgers Cancer Institute of New Jersey, The State University of New Jersey, New Brunswick, New Jersey
- Department of Medicine, Rutgers Robert Wood Johnson Medical School, The State University of New Jersey, New Brunswick, New Jersey
- Department of Health Education and Behavioral Science, Rutgers School of Public Health, The State University of New Jersey, Piscataway, New Jersey
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Stapleton JL, Manne SL, Greene K, Darabos K, Carpenter A, Hudson SV, Coups EJ. Sociocultural experiences, body image, and indoor tanning among young adult women. J Health Psychol 2016; 22:1582-1590. [PMID: 26929174 DOI: 10.1177/1359105316631198] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
The purpose of this survey study was to evaluate a model of body image influences on indoor tanning behavior. Participants were 823 young adult women recruited from a probability-based web panel in the United States. Consistent with our hypothesized model, tanning-related sociocultural experiences were indirectly associated with lifetime indoor tanning use and intentions to tan as mediated through tan surveillance and tan dissatisfaction. Findings suggest the need for targeting body image constructs as mechanisms of behavior change in indoor tanning behavioral interventions.
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Day AK, Stapleton JL, Natale-Pereira AM, Goydos JS, Coups EJ. Occupational sunscreen use among US Hispanic outdoor workers. BMC Res Notes 2015; 8:578. [PMID: 26477041 PMCID: PMC4609133 DOI: 10.1186/s13104-015-1558-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Accepted: 10/05/2015] [Indexed: 12/02/2022] Open
Abstract
Background Occupational ultraviolet radiation (UVR) exposure is a risk factor for skin cancer, and Hispanic individuals are over-represented in a number of outdoor occupations (e.g., farming, landscaping). This study examined predictors of occupational sunscreen use in a group of US Hispanic adults who work outdoors. Results A population-based sample of outdoor workers (n = 149, 85 % male) completed survey measures regarding their demographics, melanoma risk, perceived skin cancer risk, skin cancer knowledge, and their occupational sunscreen use. Sixty-nine percent of the sample reported never or rarely wearing sunscreen while working outdoors. Being female (p = .02), having a higher level of education (p = .03), and residing at a higher latitude (p = .04) were associated with more frequent sunscreen use. Conclusions This study highlights the importance of interventions to promote sun protection behaviors among US Hispanic outdoor workers, and identifies potential intervention targets.
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Affiliation(s)
- Ashley K Day
- Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, 195 Little Albany Street, New Brunswick, NJ, 08901, USA. .,School of Psychology, University of Adelaide, North Tce Campus, Adelaide, SA, 5005, Australia.
| | - Jerod L Stapleton
- Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, 195 Little Albany Street, New Brunswick, NJ, 08901, USA. .,Department of Medicine, Rutgers Robert Wood Johnson Medical School, 125 Paterson Street, New Brunswick, NJ, 08901, USA. .,Department of Health Education and Behavioral Science, Rutgers School of Public Health, 683 Hoes Lane West, Piscataway, NJ, 08854, USA.
| | - Ana M Natale-Pereira
- Department of Medicine, Rutgers New Jersey Medical School, 185 South Orange Avenue, Newark, NJ, 07103, USA.
| | - James S Goydos
- Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, 195 Little Albany Street, New Brunswick, NJ, 08901, USA. .,Department of Surgery, Rutgers Robert Wood Johnson Medical School, 125 Paterson Street, New Brunswick, NJ, 08901, USA.
| | - Elliot J Coups
- Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, 195 Little Albany Street, New Brunswick, NJ, 08901, USA. .,Department of Medicine, Rutgers Robert Wood Johnson Medical School, 125 Paterson Street, New Brunswick, NJ, 08901, USA. .,Department of Health Education and Behavioral Science, Rutgers School of Public Health, 683 Hoes Lane West, Piscataway, NJ, 08854, USA.
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Day AK, Stapleton JL, Manne SL, Tatum KL, Goydos JS, Coups EJ. Receptivity to Internet-Delivered Interventions to Promote Skin Self-examination and Sun Protection Behaviors in Patients With Melanoma. JAMA Dermatol 2015; 152:213-5. [PMID: 26465805 DOI: 10.1001/jamadermatol.2015.2978] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Ashley K Day
- Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick
| | - Jerod L Stapleton
- Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick
| | - Sharon L Manne
- Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick
| | - Kristina L Tatum
- Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick
| | - James S Goydos
- Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick
| | - Elliot J Coups
- Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick
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Chapman GB, Colby H, Convery K, Coups EJ. Goals and Social Comparisons Promote Walking Behavior. Med Decis Making 2015; 36:472-8. [PMID: 26139447 DOI: 10.1177/0272989x15592156] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Accepted: 05/23/2015] [Indexed: 11/16/2022]
Abstract
The effectiveness of a pedometer intervention was affected by manipulating the goals given to participants and by providing social comparison feedback about how participants' performance compared with others. In study 1 (n= 148), university staff members received a low, medium, or high walking goal (10%, 50%, or 100% increase over baseline walking). Participants walked 1358 more steps per day (95% confidence interval [CI], 729, 1985), when receiving a high goal than when receiving a medium goal, but a medium goal did not increase walking relative to a low goal (554 more steps; 95% CI, -71,1179). In study 2 (n= 64), participants received individual feedback only or individual plus social comparison feedback. Participants walked 1120 more steps per day (95% CI, 538, 1703) when receiving social comparison feedback than when receiving only individual feedback. Goals and the performance of others act as reference points and influence the effect that pedometer feedback has on walking behavior, illustrating the applicability of the principles of behavioral economics and social psychology to the design of health behavior interventions.
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Affiliation(s)
- Gretchen B Chapman
- Institute for Health, Healthcare Policy, and Aging Research, Rutgers University, New Brunswick, NJ, USA (GBC, KC)
| | - Helen Colby
- Anderson School of Management, UCLA, Los Angeles, CA, USA (HC)
| | - Kimberly Convery
- Institute for Health, Healthcare Policy, and Aging Research, Rutgers University, New Brunswick, NJ, USA (GBC, KC)
| | - Elliot J Coups
- Rutgers Cancer Institute of New Jersey, Department of Medicine, Rutgers Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ, USA (EJC)
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Coups EJ, Stapleton JL, Davis CM, Delnevo CD. Frequent indoor tanning among New Jersey high school students. J Am Acad Dermatol 2015; 72:914-6. [PMID: 25890463 DOI: 10.1016/j.jaad.2015.01.035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Revised: 01/20/2015] [Accepted: 01/25/2015] [Indexed: 11/30/2022]
Affiliation(s)
- Elliot J Coups
- Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, New Jersey; Department of Medicine, Rutgers Robert Wood Johnson Medical School, Rutgers, The State University of New Jersey, New Brunswick, New Jersey; Department of Health Education and Behavioral Science, Rutgers School of Public Health, Rutgers, The State University of New Jersey, Piscataway, New Jersey.
| | - Jerod L Stapleton
- Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, New Jersey; Department of Medicine, Rutgers Robert Wood Johnson Medical School, Rutgers, The State University of New Jersey, New Brunswick, New Jersey; Department of Health Education and Behavioral Science, Rutgers School of Public Health, Rutgers, The State University of New Jersey, Piscataway, New Jersey
| | - Christine M Davis
- Department of Health Education and Behavioral Science, Rutgers School of Public Health, Rutgers, The State University of New Jersey, Piscataway, New Jersey
| | - Cristine D Delnevo
- Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, New Jersey; Department of Health Education and Behavioral Science, Rutgers School of Public Health, Rutgers, The State University of New Jersey, Piscataway, New Jersey
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Coups EJ, Ritterband LM. eHealth Interventions for Cancer Prevention and Control. Psychooncology 2015. [DOI: 10.1093/med/9780199363315.003.0080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Steinberg MB, Zimmermann MH, Delnevo CD, Lewis MJ, Shukla P, Coups EJ, Foulds J. E-cigarette versus nicotine inhaler: comparing the perceptions and experiences of inhaled nicotine devices. J Gen Intern Med 2014; 29:1444-50. [PMID: 24830741 PMCID: PMC4238186 DOI: 10.1007/s11606-014-2889-7] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Revised: 04/14/2014] [Accepted: 04/24/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND Novel nicotine delivery products, such as electronic cigarettes (e-cigarettes), have dramatically grown in popularity despite limited data on safety and benefit. In contrast, the similar U.S. Food and Drug Administration (FDA)-approved nicotine inhaler is rarely utilized by smokers. Understanding this paradox could be helpful to determine the potential for e-cigarettes as an alternative to tobacco smoking. OBJECTIVE To compare the e-cigarette with the nicotine inhaler in terms of perceived benefits, harms, appeal, and role in assisting with smoking cessation. DESIGN A cross-over trial was conducted from 2012 to 2013 PARTICIPANTS/INTERVENTIONS: Forty-one current smokers age 18 and older used the e-cigarette and nicotine inhaler each for 3 days, in random order, with a washout period in between. Thirty-eight participants provided data on product use, perceptions, and experiences. MAIN MEASURES The Modified Cigarette Evaluation Questionnaire (mCEQ) measured satisfaction, reward, and aversion. Subjects were also asked about each product's helpfulness, similarity to cigarettes, acceptability, image, and effectiveness in quitting smoking. Cigarette use was also recorded during the product-use periods. KEY RESULTS The e-cigarette had a higher total satisfaction score (13.9 vs. 6.8 [p < 0.001]; range for responses 3-21) and higher reward score (15.8 vs. 8.7 [p < 0.001]; range for responses 5-35) than the inhaler. The e-cigarette received higher ratings for helpfulness, acceptability, and "coolness." More subjects would use the e-cigarette to make a quit attempt (76 %) than the inhaler (24 %) (p < 0.001). Eighteen percent (7/38) of subjects abstained from smoking during the 3-day periods using the e-cigarette vs. 10 % (4/38) using the inhaler (p = 0.18). CONCLUSION The e-cigarette was more acceptable, provided more satisfaction, and had higher perceived benefit than the inhaler during this trial. E-cigarettes have the potential to be important nicotine delivery products owing to their high acceptance and perceived benefit, but more data are needed to evaluate their actual efficacy and safety. Providers should be aware of these issues, as patients will increasingly inquire about them.
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Affiliation(s)
- Michael B Steinberg
- Rutgers-Robert Wood Johnson Medical School, Division of General Internal Medicine, 125 Paterson Street, Suite 2300, New Brunswick, NJ, 08903, USA,
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Shen MJ, Coups EJ, Li Y, Holland JC, Hamann HA, Ostroff JS. The role of posttraumatic growth and timing of quitting smoking as moderators of the relationship between stigma and psychological distress among lung cancer survivors who are former smokers. Psychooncology 2014; 24:683-90. [PMID: 25345591 DOI: 10.1002/pon.3711] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2014] [Revised: 09/25/2014] [Accepted: 09/26/2014] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Patients diagnosed with lung cancer report high levels of stigma and psychological distress. This study examined posttraumatic growth among lung cancer survivors as a potential buffer against this relationship between stigma and psychological distress and examined how these relationships differed by the timing of quitting smoking (pre versus post-diagnosis). METHODS Stages IA and IB non-small-cell lung cancer survivors (N = 141) who were former smokers, 1-6 years post-treatment, and had no evidence of disease completed standardized questionnaires assessing stigma, posttraumatic growth, timing of quitting smoking history, and psychological distress. RESULTS Hierarchical linear regression and simple slope analyses indicated that among those who quit smoking prior to diagnosis (pre-diagnosis quitters), stigma had a positive association with psychological distress at high levels of posttraumatic growth (p = 0.003) and had a positive (but non-significant) association with psychological distress among those with low levels of posttraumatic growth (p = 0.167). Among those who quit smoking after diagnosis (post-diagnosis quitters), stigma had a positive association with psychological distress among those with low levels of posttraumatic growth (p = 0.004) but had no relationship among those with high levels of posttraumatic growth (p = 0.880). CONCLUSIONS Findings indicate that posttraumatic growth buffers against the negative effects of stigma on psychological distress but only among post-diagnosis quitters. Future interventions could focus on fostering posttraumatic growth as a way to decrease the negative effects of stigma.
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Affiliation(s)
- Megan Johnson Shen
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Elliot J Coups
- Department of Medicine, Rutgers Robert Wood Johnson Medical School, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Yuelin Li
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Jimmie C Holland
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Heidi A Hamann
- Harold C. Simmons Cancer Center, UT Southwestern Medical Center, Dallas, TX, USA
| | - Jamie S Ostroff
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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Affiliation(s)
- Elliot J Coups
- Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick
| | - Lee M Ritterband
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia Health System, Charlottesville
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Affiliation(s)
- Elliot J. Coups
- Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey University, New Brunswick2Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey3Department of Health Education and Behavioral Scien
| | - Jerod L. Stapleton
- Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey University, New Brunswick2Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey3Department of Health Education and Behavioral Scien
| | - Amanda Medina-Forrester
- Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey University, New Brunswick
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Philip EJ, Coups EJ, Feinstein MB, Park BJ, Wilson DJ, Ostroff JS. Patient-provider discussion of physical activity among early stage lung cancer survivors. Psychooncology 2014; 24:359-62. [PMID: 25044875 DOI: 10.1002/pon.3613] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Revised: 05/30/2014] [Accepted: 06/05/2014] [Indexed: 12/19/2022]
Affiliation(s)
- Errol J Philip
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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Pagoto S, Hillhouse J, Heckman CJ, Coups EJ, Stapleton J, Buller D, Turrisi R, Robinson J, Geller AC. Society of Behavioral Medicine (SBM) position statement: ban indoor tanning for minors. Transl Behav Med 2014; 4:124-6. [PMID: 24653783 DOI: 10.1007/s13142-013-0240-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The Society of Behavioral Medicine (SBM), an interdisciplinary professional organization focused on the science of health behavior joins the American Academy of Dermatology, the American Academy of Pediatrics, and a host of other national and international organizations in support of a total ban on indoor tanning for minors under the age of 18. According to the International Agency for Research on Cancer, artificial sources of ultraviolet radiation are in the highest category of carcinogens, joining tobacco and asbestos. Strong evidence links indoor tanning to increased risk for melanoma with repeated exposure during childhood being associated with the greatest increase in risk. Several countries and five US states have passed legislation banning indoor tanning in minors. We strongly encourage the remaining US states to do the same in an effort to protect children and prevent new cases of melanoma. SBM also strongly encourages research that explores the use of tanning beds in the home. Home-based indoor tanning has the potential to be especially dangerous given the complete absence of safety regulations. Children are currently protected from exposure to health-harming substances like tobacco and lead; thus, legislation protecting them from artificial sources of ultraviolet radiation is yet another important step forward in improving public health.
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Affiliation(s)
- Sherry Pagoto
- University of Massachusetts Medical School, Worcester, MA USA
| | | | | | - Elliot J Coups
- University of Medicine and Dentistry New Jersey, New Brunswick, NJ USA
| | - Jerod Stapleton
- University of Medicine and Dentistry New Jersey, New Brunswick, NJ USA
| | | | - Rob Turrisi
- Penn State University, University Park, PA USA
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Coups EJ, Stapleton JL, Manne SL, Hudson SV, Medina-Forrester A, Rosenberg SA, Gordon M, Tatum KS, Robinson JK, Natale-Pereira A, Goydos JS. Psychosocial correlates of sun protection behaviors among U.S. Hispanic adults. J Behav Med 2014; 37:1082-90. [PMID: 24532153 DOI: 10.1007/s10865-014-9558-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2013] [Accepted: 02/04/2014] [Indexed: 11/30/2022]
Abstract
The incidence of skin cancer among U.S. Hispanics increased 1.3% annually from 1992 to 2008. However, little research has focused on skin cancer prevention among the rapidly growing Hispanic population. In this study, we examined theory-driven, psychosocial correlates of sun protection behaviors in a population-based sample of 787 Hispanic adults (49.6% female, mean age = 41.0 years) residing in five southern or western U.S. states. Participants completed an English- or Spanish-language online survey in September 2011. The outcomes of focus were sunscreen use, shade seeking, and use of sun protective clothing. The correlates included suntan benefits, sun protection benefits and barriers, skin color preference, perceived natural skin protection, photo-aging concerns, perceived skin cancer risk, skin cancer worry, skin cancer fatalism, and sun protection descriptive norms. Results of multiple linear regression analyses revealed the following: sun protection barriers were negatively associated with each outcome; descriptive norms were positively associated with each outcome; perceived natural skin protection was inversely associated with sunscreen use; skin cancer worry was positively associated with shade seeking and use of sun protective clothing; skin cancer fatalism was negatively associated with shade seeking; and skin color preference was negatively associated with use of sun protective clothing. A number of additional statistically significant associations were identified in bivariate correlation analyses. This study informs the potential content of interventions to promote engagement in sun protection behaviors among U.S. Hispanics.
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Affiliation(s)
- Elliot J Coups
- Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, 195 Little Albany Street, New Brunswick, NJ, 08903, USA,
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Coups EJ. Reporting of a randomized controlled trial of Tibetan sound meditation and cognitive functioning among breast cancer patients. Psychooncology 2013; 22:2876. [PMID: 24311053 DOI: 10.1002/pon.3368] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2013] [Accepted: 07/08/2013] [Indexed: 11/09/2022]
Affiliation(s)
- Elliot J Coups
- Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA; Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA; Department of Health Education and Behavioral Science, Rutgers School of Public Health, Piscataway, NJ, USA
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