Creation of New Sun Safety Messages for Canada Loraine Marrett, 1 Maria Chu 1 for the Ontario Sun Safety Working Group 1 Cancer Care Ontario 1 Building.

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Creation of New Sun Safety Messages for Canada

Loraine Marrett,1 Maria Chu1 for the Ontario Sun Safety Working Group

1Cancer Care Ontario

Building Consistent Messages: Knowledge to Practice

Canadian Public Health Association29 May 2014

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Outline• Sun Safety Messaging Background• Skin Cancer Prevention Strategy• Knowledge Translation • Objectives

1. Knowledge: Create messages• Evidence review and summary• Message format• Consensus process

2. Practice: Message utilization by national etc organizations• Uptake towards tailored interventions

• Conclusions

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• Between 1996 and 2006, Canadians increased their time in the sun without improving protective behaviours, suggesting sun safety strategies are not working.

• Consistent messages are a key component of strategy • National consensus on messages was last achieved in Canada

in 1994. Organizations have modified messages inconsistently since then.

• A broad consultation in 2008 concluded that messages in use did not always reflect current science and that there were gaps (e.g., vitamin D).

Why new sun safety messages?

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Skin Cancer Prevention Strategy

Ontario Sun Safety Working Group. Insight On Cancer (2010). Sun Exposure and Protective Behaviours in Ontario - An Ontario Report based on the 2006 Second National Sun Survey

Insight on Cancer, 2010Health Promotion Actions*:A . Develop personal skillsB. Build healthy public policyC. Strengthen community actionD. Create supportive environments E. Re-orient health services

*Based on Ottawa Charter for Health Promotion,1986

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Knowledge Translation

• “[A] dynamic and iterative process that includes synthesis, dissemination, exchange and ethically-sound application of knowledge to improve the health of Canadians, provide more effective health services and products and strengthen the health care system”- Canadian Institute of Health Research, 2014

Objectives of Sun Safety Messaging Project

Using knowledge translation principles:

1. Knowledge: Sun Safety message creation• Develop messaging to inform sun safe behaviours through

iterative evidence review process

2. Practice: Utilization of sun safety message recommendation document by national etc organizations in the creation of tailored interventions• Uptake of consistent messaging in informing tailored sun safety

interventions 6

Objective 1: Create messages

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Knowledge Creation based on evidence= Core of message creation

Knowledge translation Knowledge to practice (action)

Knowledge

PracticeKTClearinghouse (2013) Knowledge to Action Cycle

Levels of sun safety message creation

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Primary Studies

Consensus Process

Resulting message recommendation document

Action CycleSun safety message recommendation

document end-users

OSSWG*/Expert Panel draftExpert international consultationFocus groups Public health units

KTClearinghouse (2013) Knowledge to Action Cycle

*Ontario Sun Safety Working GroupUptake

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Approach to sun safety messaging revision

• The Ontario Sun Safety Working Group (OSSWG) leads the work, following these steps:

1. Identify gaps in existing messages;

2. Establish current evidence and draft revised messages and evidence packages across the message domains through expert consultation;

3. Focus testing of the tool as a foundation for programming among public health professionals and external review by international experts;

4. Host workshop to achieve consensus among national organizations; and

5. Disseminate final messages document.

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• Message recommendations document structured around seven topics:1. Main topic, with key actions: Exposure and time in the sun2. Shade3. Protective clothing and hats4. Eye protection5. Sunscreen6. Tanning equipment7. Vitamin D

Message recommendations documentDraft

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• Consistent with CDC’s MessageWorks & The Health Communication Unit’s toolkit to effective message (“What”? “So what?” and “Now what?”)

• Each topic contains concise sections summarizing:1. What should individuals know about the protective

measure or risk?2. Now what? What should they do?3. More details4. What does the evidence say?

Document preface states the overarching “so what” of the message recommendations.

Messaging layout

Centers for Disease Control and Prevention (n.d.) MessageWork Guidance The Health Communication Unit (2009). Overview of Developing Health Communication Campaigns Toolkit

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Messaging layout example

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Msg creation next step: Consensus process

1. Pre- consultation period• Invitation to representatives from end-user organizations across the country • Garner interest of participation in a national coordinating committee• Distribute draft document and feedback template for review prior to workshop

2. Consensus workshop• On-day event• Led by professional facilitator• National coordinating committee development

3. Post-workshop consultation period• Incorporate feedback from workshop• Discuss outstanding areas of disagreement• Consensus on document

Disseminate13

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Objective 2: Utilization by “all” organizations in sun safety

• Practical use of messages in outer Action Cycle

• Comprehensive uptake of messages to inform consistent tailored sun safety interventions

• Establish process for ongoing revision and consensus

KTClearinghouse (2013) Knowledge to Action Cycle

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Conclusions• Knowledge translation has informed revised sun safety messaging process

• New messages are structured to enhance uptake and to support

incorporation into specific health promotion programs—including short

summaries of the evidence behind messages.

• A formal collaboration of Ontario sun safety professionals and organizations

has successfully driven this project, despite very limited dedicated resources.

• Consistent sun safety public messaging is critical to success: getting buy-in

of the multitude of dermatology, optometry, cancer and public health

organizations at the national level will be key and presents a challenge, given

the absence of any national coordinating group for sun safety.

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AcknowledgementsExpert panel members• Dr. Antony Cullen, Distinguished Professor Emeritus, School of Optometry, University of Waterloo• Dr. Vitali Fioletov, Research Scientist—Ozone and UV studies, Environment Canada• Dr. Lynn From, Dermatologist and Dermatopathologist, Women’s College Hospital*• Dr. David Hanley, Division of Endocrinology and Metabolism, Professor, Medicine, Community Health

Sciences and Oncology, University of Calgary• Mr. George Kapelos, Associate Professor, Architectural Science, Ryerson University*• Dr. Loraine Marrett, Senior Scientist, Prevention and Cancer Control, Cancer Care Ontario and Professor,

Dalla Lana School of Public Health, University of Toronto (Co-Chair)*• Ms. Kaylene McKinnon, Public Health Nurse, Chronic Disease Prevention and Tobacco Control Team,

Middlesex-London Health Unit (Co-Chair)• Dr. Sami Qutob, Research Scientist, Consumer and Clinical Radiation Protection Bureau, Health Canada• Dr. Cheryl Rosen, Head, Division of Dermatology, Toronto Western Hospital, University Health Network

Hospitals and Mount Sinai Hospital, Professor, Department of Medicine, University of Toronto, and National Director, Sun Awareness Program, Canadian Dermatology Association*

• Dr. Thomas Tenkate, Director, School of Occupational and Public Health, Ryerson University*

*Also members of the Ontario Sun Safety Working Group

John Atkinson, Canadian Cancer SocietyDiane Desjardins, Ottawa Public HealthChantal Duhaime, Environment CanadaKatie Heckman, Melanoma Network of CanadaGina Ing, Toronto Public HealthMegan Laan, KFL&A Public HealthLilliana Marinko, Middlesex-London Health Unit

Safoura Moazami, Toronto Public HealthSonya Muntwyler, The Regional Municipality of HaltonSylvie Plumstead, Sudbury and District Health UnitNicole Ritz, City of Hamilton Public Health Services

Ontario Sun Safety Working Group

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Thank youQuestions?

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