Sun Safety on the Slopes: A Health Communication Campaign Peter A. - - PowerPoint PPT Presentation

Sun Safety on the Slopes: A Health Communication Campaign

Peter A. Andersen, SDSU University of Connecticut April 29, 2010

Sun Safety for High Altitude Ski Area Employees and Guests

Collaborating Institutions

• Klein Buendel Institute
• San Diego State University
• California State University, Chico
• University of Colorado, Denver
• University of Kentucky
• University of Alabama Birmingham

Project Investigators

• David Buller, PhD, KB
• Peter Andersen, PhD, SDSU
• Mike Scott, PhD, CSU-Chico (Emeritus)
• Barbara Walkosz, PhD, CU-Denver
• Gary Cutter, PhD, UNR
• Mark Dignan, PhD, UK

Industry Partners

Presentation Overview

• Origins of Go Sun Smart
• Go Sun Smart Program
• Evaluation Design & Preliminary

Outcomes

• Subsequent study was a

translational study to over 400 NSAA resorts

Origins of Go Sun Smart

• More than 1 million cases of skin cancer

will be diagnosed in 2010 (68,720 cases and 8,650 deaths from melanoma).

• Number of cases of melanoma is rising.
• Lifetime risk of developing melanoma is 1

in 39 for men and 1 in 58 for women.

• Substantial sun exposure occurs at

work for over 9 million American in

• utdoor occupations.

Go Sun Smart I: Application Process

Initial idea – NCA 1996 Pilot survey of ski area guests – Winter 1997 (Buller, Andersen & Walkosz, 1998) Support from NSAA – 1998 (100+ western resorts invited) Initial application to NCI – November 1998 Additional Pilot Studies – Survey of Managers & Focus Groups with Employees Revised Application to NCI – June 1999 Go Sun Smart I Funded – 2000-04

Aims of Go Sun Smart I

• To develop and evaluate a worksite sun

safety program for the employees of a major outdoor recreation industry.

• To evaluate whether a worksite sun

safety program in an outdoor recreation industry elevates sun protection by guests and children at ski school.

Theoretical Model: Diffusion of Innovations

Knowledge Persuasion Decision Implementation Confirmation Individual & Social Characteristics

• -- personality
• -- adopter

categories Agenda setting Attitude Formation/Change Behavior Change

• Information
• Message Design
• Message Design

acquisition

• Innovation Characteristics
• Innovation trialability
• Source valence
• Source valence
• Self persuasion
• Self persuasion

Normative influences

• self efficacy
• Message design
• response efficacy
• Social identity
• coping strategies for barriers
• Social comparison
• Sublic commitment

Foundations of the Go Sun Smart Program

• Communication and social

marketing theories

– Learning, reinforcement & modeling – Positive expectations & norms – Soft fear appeals – Compatibility, trialability, simplicity – Self-persuasion

Foundations of the Go Sun Smart Program

• Message design strategies

– Exposure and repetition – Multiple channels – Prominence and intensity – Credibility (from managers & area procedures) – Sponsorship

Audiences for Go Sun Smart Program

• Ski Area Employees
• Ski Area Guests
• Ski School Students and Parents

Goals of the Go Sun Smart Program

• To teach employees key facts about sun

safety while working outdoors

• To help employees’ put their knowledge

about sun safety into action (reminders; strategies to overcome barriers)

• To encourage employees to promote sun

safety to coworkers and guests

Channels for Go Sun Smart Program

• Signage, brochures, and logo art
• Employee training
• Employee newsletters
• Electronic messages (email & website)
• On-site promotions

Sample Message Grid

Message Channel Theory Audience Image Ideas

Sun’s Mean: Use Sunscreen Large Poster Informational/ Reinforcement Guests/ Employees Angry sun illustration Promote Sunscreen re- application Table Tent Informational/ Reinforcement Guests/ Employees Lunchable image food tray with sunscreen in a compartment

Objective #1: Elevate Sun Safety on the employee/guest agenda Objective #2: Teach employees the information and skills that they lack to protect themselves effectively from the sun Message Channel Theory Audience Image Ideas

Hat + Sunglasses + Sunscreen = Logo Large Poster Clings Base Stake SCT Reinforcement Guests/ Employees Illustrations/Universal symbols/Logo Facts about sun safety/risk Medium Poster SCT Employees List of facts

Go Sun Smart Program

High Profile Poster #1

Horror Movie Spoof 18” x 24”

High Profile Poster #2

Raccoon Crossing 18” x 24”

High Profile Poster #3

Mountain Essentials 18” x 24”

High Profile Poster #4

Nirvana 18” x 24”

Medium-Sized Poster #1

L.I.F.T.O.P.S. 11” x 17”

Medium-Sized Poster #2

Don’t Fry, Reapply 11” x 17”

Medium-Sized Poster #3

Portable Protection 11” x 17”

Information Poster #1

Skin Cancer Statistics 10” x 22”

Information Poster #2

Exposure Statistics 10” x 22”

Information Poster #3

Canadian Skin Cancer Statistics 10” x 22”

Lift Base Stake Sign

Checklist of Sun Safety Items 18” x 24” corrugated plastic with spike into ground

Lift Pole Magnet

High UV Zone

Bathroom Low-Tack Decal #1

Mountain Experts for Employee Bathroom 5” x 7”

Bathroom Low-Tack Decal #2

Wear A Hat for Women’s Employee Bathroom

Bathroom Low-Tack Decal #3

Mountain Experts for Men’s Employee Bathroom 5” x 7”

Window Cling # 1

Add It Up

Window Cling # 2

Go Sun Smart Logo

Ski School Poster #1

Mini-Poster Quick Reminder 8.5” x 11”

Ski School Poster #2

Are Your Kids Sunproof Poster 11” x 17”

Ski School Poster #3

Hi Ski School Poster 10” x 22”

Ski School Brochure

Shade Your Day Brochure With Games

• n the Inside

Tri-fold 11x17

Website – www.gosunsmart.org

Features:

• Entry for Guests or Employees, including special

section of information for each side

• Information on “What To Do” and “What to Know”

in order to “Go Sun Smart”

• “Solar IQ” quiz, for visitors to see how much

they know about sun safety

• Frequently Asked Questions section
• Links to further resources

www.gosunsmart.org

Training Flip Chart & Handouts

Editions for Ski Patrol, Ski Instructors and General Employees

Guest Brochure

Tips For A Sun Smart Day On The Slopes Di-Fold Brochure

Post-It Notes

Water Bottle

Magnet

Featuring Logo 3” x 5”

Go Sun Smart Banner

Evaluation of Go Sun Smart

Guest Pretest (I n=1,447; C n=1,546) Ski Area Commitment Matching & Randomization of Ski Areas Employee Pretest (n=3,239) Employee Pretest (n=4,049) Go Sun Smart Program No Intervention Employee Posttest 1 (n=1,030) Guest Posttest (n=1,679) Employee Posttest 1 (n=1,088) Guest Posttest (n=1,846) Employee Posttest 2 Employee Posttest 2

Evaluation of Go Sun Smart

(continued)

• Pair-matched group-randomized

pretest-posttest controlled design with ski areas as unit of randomization

• Employee surveys
• Pretests distributed by resort contacts

with support from project staff in Fall 2001 as employees hired for season

• Posttests conducted by telephone

in Spring and Fall 2002

Employee Surveys

• Pretest: 7,288 surveys completed
• Posttest 1: 2,118 surveys completed
• Posttest 2: 1,732 surveys completed

Employee Profile 2001-2002

• Mean age = 36 years
• 34% female
• 96% white, non-Hispanic
• 89% had education beyond high

school

• 51% married/cohabitating
• 21% had children under 18
• 66% ski; 24% snowboard

Employee Profile

(continued)

• Average hours worked per week = 29
• 59% worked outdoors; 32% indoors;

9% both

• 90% worked 1+ previous seasons (79%

worked only in winter)

• 8% patrollers; 31% instructors; 11% lift
• perators; 16% administration; 10%

food/base services; 24% other

Implementation of Go Sun Smart by Ski Areas

Employees’ Awareness

• f Go Sun Smart
• Odds ratio = 8.27, p<.05

Employees’ Awareness of Go Sun Smart

(continued)

• Written:

OR=7.10, p<.05

• Spoken:

OR=1.45, p<.05

• Electronic:

OR=3.63, p<.05

Effect of Go Sun Smart on Employee Sunburning

• OR=1.44, p<.05
• OR=1.63, p<.05 controlling for gender,

pretest sunburns, age, job type, self- efficacy, and attitudes

Sunburning by Amount of Go Sun Smart Printed Items Observed

• Odds ratio = 1,46, p<.05

Guest Surveys

• Project staff conducted surveys with

guests on the chair lifts

• 2,993 completed pretest surveys
• 3,525 completed posttest surveys
• Guests under 18 and ski area

employees were ineligible

Guest Profile, Winter 2002

• Mean age: 40 years
• 27% female
• 69% college graduates
• 79% ski; 21% snowboard
• 5% beginner; 53% intermediate;

42% expert

Guest Exposure to Go Sun Smart Program

Observed Go Sun Smart Communication to Guests

Guest: Sun Protection Behavior

Methodology of Ski School Surveys

• Parents surveyed while waiting to pick

up children in afternoon

• 363 surveys were completed
• 188 at intervention ski areas
• 175 at control ski areas

Parent Exposure to Sun Protection Information at Ski School

Parent Exposure to Sun Protection Information

Child Sun Protection Behavior

Child Ever Sunburned While Skiing or Snowboarding

Conclusions

• Employees:
• GSS successful in reducing reported

sunburn by employees in general

• GSS displays a dose-response effect on

sunburning

• Guest:
• GSS messages reached guests but did not

improve reported sun protection

• Ski School Results:
• GSS messages reached parents

and may increase use of sunscreen with children

Future Project Activities

• Effects of Go Sun Smart on summer

behavior to be analyzed

• Revised Go Sun Smart Program

implemented with “control” ski areas in an interrupted time series evaluation design

• Long term institutionalization of Go Sun

Smart at “intervention” ski areas observed

Go Sun Smart II: Program Dissemination

Go Sun Smart II: Application Process

NSAA adopts Go Sun Smart as Partner Program– 2004 Application submitted to NCI to study GSS dissemination – February 2004 Go Sun Smart II Funded – 2004-09 (CA104876)

Go Sun Smart II: Trial Design

Manager Pretest (n=469) 69 Participating Ski Areas Randomization of Ski Areas Basic Dissemination Strategy (n=35) Enhanced Dissemination Strategy (n=33) Observation of GSS Use Observation of GSS Use Manager Posttest (n=334) Employee Posttest (n=2,261) Guest Posttest (n=3,380) Ski School Posttest (n=909)

Basic Dissemination Strategy NSAA Partner Program

Basic Program Features

• Displays at NSAA annual and

regional conferences

• Go Sun Smart Guidebook and

Catalogue

• Two starter packs of Go Sun Smart

materials sent in November/December and January

• Fact sheets and packing lists

Enhanced Dissemination Strategy

Enhanced Dissemination Strategy

• Personal visit with senior managers

at resort.

• Purpose:
• Reduce managers’ uncertainty about GSS.
• Build a relationship of credibility and trust for

program staff and GSS with ski areas.

• Obtain public commitment from them to use GSS.
• Help managers plan for use of GSS.
• Identify internal champions who could help

support GSS.

Enhanced Dissemination Strategy

(cont.)

• Periodic follow-up contacts by telephone

and email throughout ski season.

• Purposes: maintain compliance through

social support and nourishment of the interpersonal relationship with GSS staff.

Description of Participating Resorts

Characteristics Percent

Region: Northwest (n=9) California (n=8) Northern Rocky Mountains (n=6) Southwest (n=20) Northeast (n=19) Mid-Atlantic (n=8) 13 12 9 30 28 8 Resort size (n of employees): Less than 250 250-499 500 or more 32 38 30 Percent of females in key manager positions: Less than 25% 25% or more 48 52 Ownership type: Individual Private Ownership Multi-resort Corporate Ownership 76 24

Trial Schedule

• Resorts enrolled in waves over 3 ski seasons

– 28 in 2004 – 20 in 2005 – 21 in 2006

• Manager pretested in Oct. – Nov.
• Dissemination strategies implemented in Nov. – Mar.
• Go Sun Smart observed on-site in Feb. – Apr.
• Employee, guest and parent surveyed in Feb. – Apr.
• Managers posttested in Mar. – Apr.

Summary of Findings

• Go Sun Smart is adopted when distributed through an

industry professional association.

• Use is improved by theoretically-based communication

combining personal contact and follow-up.

• Continued industry promotion does not improve use.
• Program use declines in subsequent years but advantage of

personal contact persists.

• Employees and guests are exposed to messages when

program implementation is high.

• Recalling a message improves

employee’s and guests’ sun safety.

Go Sun Smart: It doesn’t stop there

• Sun Smart Workplaces: funded in 2009

– Develop and evaluate campaign to promote workplace policies to reduce sun exposure.

• Go Sun Smart and Resorts application: 2010

– Develop and evaluate program to reduce sunburning on vacation using transportation theory.

• Go Sun Smart Sustainability application: 2010

– Follow-up on 68 resorts in GSS II to test program sustainability and theoretic fidelity.