Workers in the U.S. spend large amounts of time on the job, making the workplace a key venue for preventive health programs. A workplace risk that has received limited attention is sun protection, despite the fact 8% of the U.S. workforce (over 9 million workers) work outdoors. Our research team has demonstrated that sun safety education can promote sun protection at work. In this second amended application, we propose to systematically study a comprehensive approach to workplace sun safety that goes beyond employee education to promote institutional change. We will implement and evaluate a proactive campaign to change workplace sun protection policies and promote sun safety to managers rather than individual employees. We will assess whether policy adoption alters organizational operations in public employers rather than the private employers examined in our previous research.
The specific aims are to: a) create a campaign comprised of personal contacts, printed materials, and Internet tools and resources to promote workplace sun protection policies to managers at public employers and b) evaluate the effectiveness of the campaign at promoting adoption and implementation of workplace sun protection policies. The plans outlined in this application are guided by principles of diffusion of innovations theory and pilot interviews with public administrators about policy processes. An advisory board of public administrators and health experts has been constituted to advise our team on campaign and evaluation procedures. Analysis of public employers'existing policies and practices, additional in-depth interviews with public administrators, information design analysis, and usability testing will be conducted to develop an effective campaign. The campaign will be evaluated in a group-randomized, pretest-posttest controlled design. City and county governments in Colorado (n=140) will serve as the unit of randomization and analysis;interviews will be conducted with a sample of administrators, adjusted for clustering at these public employers at baseline (n=7 per employer;980 administrators total), interim posttest (n=6 per employer), and final posttest (n=5 per employer). Public employers will be studied because they employ a sizable number of outdoor workers (but results should generalize to for-profit companies and organizations outside Colorado) and we were able to measure government policies and survey public administrators on health issues previously. Outcomes will be evaluated at the employer and administrator levels. At the employer level (n=140 employers), adoption of workplace sun protection policies at pretest and each posttest will be assessed with a protocol for coding written workplace policies (primary outcome measure) that demonstrated high reliability in a pilot study. At the administrator level (n=980 administrators), policy implementation (secondary outcome), theoretical mediators of adoption and implementation, and individual, organizational, political decision making and program variables that might moderate change will be measured in baseline, interim posttest (halfway through the intervention) and final posttest (end of intervention) surveys.

Public Health Relevance

The policies to be promoted in this application will reduce a major hazard by improving sun safety for employees who spend a large amount of their work time outdoors in high UV environments. A successful campaign could reduce ill health and possibly drive down health care costs for workers, employers, and the nation. This proposal advances our efforts by promoting a comprehensive approach to workplace sun protection that promotes institutional change at the workplace (i.e., policies on sun protection), not simply sun safety education for employees.

National Institute of Health (NIH)
National Cancer Institute (NCI)
Research Project (R01)
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Community-Level Health Promotion Study Section (CLHP)
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Patrick, Heather A
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Klein Buendel, Inc.
United States
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Buller, David B; Walkosz, Barbara J; Buller, Mary Klein et al. (2018) Results of a Randomized Trial on an Intervention Promoting Adoption of Occupational Sun Protection Policies. Am J Health Promot 32:1042-1053
Walkosz, Barbara J; Buller, David B; Andersen, Peter A et al. (2015) Factors Associated With Occupational Sun-Protection Policies in Local Government Organizations in Colorado. JAMA Dermatol 151:991-7
Wallis, Allan; Andersen, Peter A; Buller, David B et al. (2014) Adoption of sun safe workplace practices by local governments. J Public Health Manag Pract 20:608-16
Buller, David B; Walkosz, Barbara J; Andersen, Peter A et al. (2012) Sustainability of the dissemination of an occupational sun protection program in a randomized trial. Health Educ Behav 39:498-502