While sustained academic and community partnerships can improve relationships between research partners, they could also influence study outcomes. Research on this issue is limited. We conducted a trial (2010-15) to test two implementation strategies for an evidence-based intervention to promote colorectal cancer (CRC) screening at community organizations in Los Angeles (N = 17). For both strategies, trained community health advisors (CHAs) recruited Filipino Americans (N = 673) who were non-adherent to CRC screening guidelines. The main study outcome was CRC screening status of participants at 6-month follow-up. This case study compares outcomes among organizations that had participated in our prior effectiveness trial and new organizations with which we had no prior relationship. Using multilevel logistic regression with multiple imputation for missing outcomes, we compared CRC screening rates among previous versus new partners controlling for study condition and organizational, CHA and participant characteristics. Screening rates were substantially higher among participants of previous versus new partner organizations in unadjusted analysis (77% versus 55%, OR 2.8, p = 0.12), after adjusting for organization-level variables (81% versus 42%, OR 7.5, 95% CI [2.0-28.7], p = 0.003) and after additionally adding CHA and participant level factors to the model (79% versus 47%, OR 5.9, CI [1.3-27.3], p = 0.02). Analyses using complete cases and assuming not-screened for missing outcomes indicated similar differences in screening rates (30 and 33 percentage points, respectively). Study outcomes that are achieved with long-term community partners may not be generalizable to new partners. However, inclusion of new community partners is important for external validity of dissemination efforts in community settings. NCT01351220 (ClinicalTrials.gov).

Purpose and objectives

Children eat less than recommended amounts of vegetables. Repeated taste exposure can increase children's acceptance of initially disliked vegetables. However, implementation of this strategy is lacking. We conducted a pilot study to assess the feasibility of implementing an evidence-based intervention to promote liking of initially disliked vegetables among children enrolled in a YMCA summer camp.

Intervention approach

We adapted a research-tested intervention to promote child liking of vegetables for implementation in small groups. In summer 2015, 50 children aged 7 to 12 years were invited to taste 5 initially disliked vegetables daily for 10 days.

Evaluation methods

Children rated how much they liked vegetables on a 5-point emoji-like faces Likert scale at baseline and 2- and 4-week follow-up. The mean ratings for liked and initially disliked vegetables were estimated over time using mixed effects modeling.

Results

We achieved excellent participation of parents and children; however, we experienced nonstudy-related attrition caused by disenrollment of some children from the weekly camp program. The average liking increased over time (linear trend, P = .003) for the 5 targeted vegetables but not for the other nontargeted vegetables, as predicted.

Implications for public health

This pilot study suggests that repeated vegetable tasting opportunities offered by community programs may be a practical strategy for introducing low-income, young children to new or initially disliked vegetables. The study demonstrates the feasibility of implementing a health promotion strategy that has the potential to improve population health in a community setting in an underresourced neighborhood.

Background: UV radiation has been considered the major environmental causative factor for melanoma. Our previous limited epidemiologic study suggested additional causative factors for early age onset melanoma in females. Methods: Melanoma and non-melanoma skin cancer case and population information were retrieved from various cancer registries and public domains. Age-specific and age-standardized incidence rates were calculated and compared between genders and age groups; and correlated with average daily UV index. Results: The current study further compared the age and gender-specific incidence rates for melanoma and non-melanoma skin cancer (NMSC) from the Netherlands (N), UK and Nordic (NOR) countries, and confirmed a peak gender difference at age 20-24 (the peak age for pregnancy) for melanoma in all countries examined( N, RR = 2.40, 95% CI 2.12, 2.72; UK, RR = 2.10, 95% CI: 1.84, 2.38; NOR, RR = 2.14, 95% CI: 2.16, 2.68) which was not observed (N, RR = 0.98, 95% CI: 0.65-1.49; NOR, RR = 1.01, 9%% CI: 0.74, 1.37) or less obvious (UK, RR = 1.36, 95% CI: 1.15, 1.61) in NMSC. We further analyzed the relationship between UV index (UVI) and gender-specific and age-standardized melanoma incidence rates from 14 selected countries and regions, where most populations are Caucasians and have light hair color, and discovered that there was a significant correlation between the male incidence rates and UVI (Pearson’s coefficient r = 0.67, p = 0.009), but only modest and non-significant correlation (r = 0.45, p = 0.109) between the female incidence rates and UVI. Conclusions: These results suggest that UV radiation exhibits a limited effect on development of melanoma in females compared to males. To our knowledge, this study is the first to describe a non-significant association of UV radiation with female melanoma development. This extensive study suggests that melanoma is a gender-enhanced cancer whose development is heavily impacted by gender-specific factors including theimmune changes and hormones

Background

Cutaneous melanoma (CM) incidence rates continue to increase, and the reasons are unknown. Previously, we reported a unique age-specific sex difference in melanoma that suggested additional causes other than solar ultraviolet (UV) radiation.

Objective

This study attempted to understand whether and how UV radiation differentially impacts the CM incidence in men and women.

Methods

CM data and daily UV index (UVI) from 31 cancer registries were collected for association analysis. A second dataset from 42 US states was used for validation.

Results

There was no association between log-transformed female CM rates and levels of UVI, but there was a significant association between male rates and UVI and a significant association between overall rates and UVI. The 5-year age-specific rate-UVI association levels (represented by Pearson's coefficient ρ) increased with age in men, but age-specific ρ levels remained low and unchanged in women. The significant rate-UVI association in men and nonassociation in women was validated in a population of white residents of the United States.

Limitations

Confounders, including temperature and latitude, are difficult to separate from UVI.

Conclusions

Ambient UVI appears to be associated with melanoma incidence in males but not in females.