Field Application of Digital Technologies for Health Assessment in the 10,000 Families Study.

BACKGROUND: We field tested new-to-market portable, digital applications to assess hearing, pulmonary, and cognitive function to determine the feasibility of implementing these applications across a range of age groups in the pilot phase of the 10,000 Families Study (10KFS), a new Minnesota family-based prospective cohort study. METHODS: We followed manufacturer recommended protocols for audiometry (SHOEBOX Inc), spirometry (NuvoAir), and the digital clock drawing test (dCDT; Digital Cognition Technologies Inc). RESULTS: These digital devices were low cost and readily implemented in a 2.5-hour health fair visit with minimal training (2-3 hours) of study staff. To date, we have performed these measurements on 197 eligible 10KFS participants during an in-person clinic visit. A total of 37 children (age 4-17 years), 107 adults (18-64 years), and 53 seniors (≥65 years) were eligible to undergo hearing and pulmonary assessments. Children were less likely to successfully complete the hearing test (76%) compared with adults (86%) and seniors (89%). However, successful completion of the pulmonary assessment was high across all groups: 100% of children and seniors and 98% of adults. The dCDT was performed among those over the age of 40, and completion rates were 92% for those aged 41-64 and 94% for those ≥65 years. CONCLUSIONS: Our field testing indicates these digital applications are easy and cost-effective to implement in epidemiologic studies. IMPACT: Digital applications provide exciting opportunities to collect data in population studies. Issues related to data privacy, data access, and reproducibility of measurements need to be addressed before deploying digital applications in epidemiologic studies.See all articles in this CEBP Focus section, "Modernizing Population Science."

Compliance with restrictions on sale of indoor tanning sessions to youth in Minnesota and Massachusetts.

BACKGROUND: Minnesota and Massachusetts require parental permission, for persons younger than 16 or 18 years of age, respectively, for indoor tanning. OBJECTIVES: This report examines business practices and characteristics associated with sales of indoor tanning to underage girls. METHODS: Fifteen-year-old girls tried to purchase an ultraviolet tanning session in 200 indoor tanning businesses in the Minneapolis-St Paul and Boston areas without parental consent. Business characteristics were recorded. Later, businesses were interviewed by telephone about their facilities and practices. RESULTS: Eighty-one percent of businesses sold a session to an underaged buyer on at least one of two tries. Illegal purchases did not differ by state. Businesses least likely to sell were larger, dedicated to indoor tanning, required employee certification, and had a minimum age of sale for their business. However, businesses in each of these categories still sold tanning sessions to underaged adolescents at 44% to 62% of the visits. Employees who requested parental consent or age identification almost never sold a session. LIMITATIONS: Businesses in Minnesota and Massachusetts only were included. CONCLUSION: Minnesota and Massachusetts laws specifying a minimum age of sale for indoor tanning are ineffective.

Sanitarians' work with indoor-tanning businesses: findings from interviews in two major metropolitan areas.

In spite of health risks, indoor tanning is a popular practice and a growing industry. Although published studies indicate that tanning businesses' compliance with regulations is poor, no studies describe enforcement activity and the related knowledge and perceptions of environmental health professionals. As part of a larger study of indoor tanning in Minnesota and Massachusetts, both states with statutes that regulate tanning, the investigation reported in this paper involved interviews of 27 sanitarians in the Twin Cities and 30 sanitarians in the Boston metropolitan area about their awareness, experiences, and practices. Overall, Massachusetts performed better than Minnesota with respect to familiarity with regulations (93 percent versus 67 percent), routine business inspections (90 percent of agencies versus 27 percent), and priority given by agencies to indoor-tanning work-differences likely attributable to a stronger state statute. Participants in both states, however, recalled few aspects of the regulations and were able to identify few of the health risks associated with indoor tanning, and most reported receiving inadequate training. Various steps must be taken to improve environmental health work with tanning businesses, including educating the public, strengthening regulations, addressing resource issues, and training sanitarians.

Characteristics associated with use or intention to use indoor tanning among adolescents.

BACKGROUND: Indoor tanning is a popular behavior that may increase skin cancer risk. OBJECTIVE: To examine characteristics associated with use or intention to use indoor tanning among adolescents. METHODS: A telephone interview was conducted with 1273 adolescents, aged 14 to 17 years, in the Minneapolis-St Paul, Minn, and Boston, Mass, metropolitan areas. Questions included demographic and phenotypic characteristics, knowledge, attitudes, social factors, use of indoor tanning, and intention to tan indoors. RESULTS: Twelve percent of boys and 42% of girls had tanned indoors. Among nontanners, 22.4% planned to start, and 77.2% of tanners planned to continue tanning indoors. Nontanners and tanners at risk for future indoor tanning use were each significantly more likely to be female, less likely to use sun protection, less knowledgeable about skin cancer risks, more likely to agree that tans were attractive, and more strongly influenced by social factors compared with their low-risk counterparts. CONCLUSIONS: Our data suggest that intention to tan indoors may identify a group of adolescents at risk for adopting the behavior; prospective studies are needed for confirmation.