David B Buller

Klein Buendel, Inc. · Research

Background: Underage drinking and related risky sexual behavior (RSB) are major public health concerns on United States college campuses. Although technology-delivered personalized feedback interventions are considered a best practice for individual-level campus alcohol prevention, there is room for improving the effectiveness of this approach wit...

Misinformation can undermine public health recommendations. Our team evaluated a 9-week social media campaign promoting COVID-19 prevention to mothers (n = 303) of teen daughters in January-March 2021. We implemented an epidemiological model for monitoring, diagnosing, and responding quickly to misinformation from mothers. Overall, 54 comments out...

BACKGROUND Underage drinking and related risky sexual behavior (RSB) are major public health concerns on United States college campuses. Although technology-delivered personalized feedback interventions (PFIs) are considered a best practice for individual-level campus alcohol prevention, there is room for improving the effectiveness of this approac...

Reducing exposure to ultraviolet radiation (UV) is crucial for preventing UV-induced diseases of the skin and eyes. Shade may offer significant protection from UV. More empirical research to quantify the UV protection offered from built shade is needed to guide disease prevention practices and confidence in investment in shade. This study quantifie...

Background Social media disseminated information and spread misinformation during the COVID-19 pandemic that affected prevention measures, including social distancing and vaccine acceptance. Objective In this study, we aimed to test the effect of a series of social media posts promoting COVID-19 nonpharmaceutical interventions (NPIs) and vaccine in...

In a social media campaign aimed at reducing mothers’ permissiveness for indoor tanning (IT) by their teenage daughters, a secondary analysis of campaign engagement effects on IT outcomes was performed. Mothers (n = 869) with daughters aged 14–17 were recruited in 34 states that did not ban IT by minors under age 18 for a randomized trial with foll...

Background: Individuals diagnosed with melanoma before the age of 40 years (young-onset melanoma survivors) and their first-degree relatives (FDRs) are a growing population at risk for developing recurrent melanoma or new melanomas. Regular surveillance using clinical skin examination (CSE) and skin self-examination (SSE) and engagement in prevent...

Few studies have examined comprehension and miscomprehension of genetic risk feedback for moderate-risk genes in the general population. We examined the prevalence and nature of accurate and inaccurate genetic risk feedback comprehension among those who received genetic testing for melanocortin-1-receptor (MC1R) gene variants that confer moderate m...

Increasing understanding of the risk and protective factors for adolescent nonmedical use of prescription drugs (NMUPD) could inform prevention efforts. Several correlates have been identified, including parental factors, perceptions about use and accessibility, social norms, and age. However, these constructs have rarely been simultaneously examin...

Background: A social media campaign for mothers aimed at reducing indoor tanning (IT) by of adolescent daughters reduced mothers' permissiveness toward IT in an immediate posttest. Whether the effects persisted at six months after the campaign remains to be determined. Methods: Mothers (N=869) of daughters aged 14-17 in 34 states without bans on...

Young melanoma survivors and their family are at increased risk for developing melanoma, but seldom engage in sun protection behaviors. Little is known about the role of family factors in sun protection. Our goals were: 1) examine correspondence between survivors and family sun protection, individual attitudes, and family attitudes and communicatio...

Family communication about skin cancer risk may motivate protective behaviors. However, it is unclear how widespread such communication might be. In this study, we describe prevalence and patterns (across environmental, personal, and behavioral factors) of family communication about skin cancer across N = 600 diverse (79% female, 48% Hispanic, 44%...

Introduction: Parents acquire information about human papillomavirus (HPV) vaccines online and encounter vaccine-critical content, especially on social media, which may depress vaccine uptake. Secondary analysis in a randomized trial of a Facebook-delivered adolescent health campaign targeting mothers with posts on HPV vaccination was undertaken wi...

Introduction Moving beyond numeric representations of risk perceptions, we examine cognitive causation, or superstitious thinking, and negative affect in risk as predictors of MC1R (i.e., moderate v. high risk) skin cancer genetic testing and responses to this testing. Methods Participants ( N = 496) completed baseline assessments using validated...

Public availability of genetic information is increasing; thus, efforts to improve diversity in basic and translational research in genomics is a top priority. Given the increasing U.S. incidence and mortality of melanoma, and the prevalence of common melanocortin-1 receptor (MC1R) gene melanoma risk variants in the general population, we examined...

U.S. HPV vaccine uptake remains below the Healthy People 2030 goal of 80% series completion. Parental concerns and misinformation about the efficacy and safety of the Human Papillomavirus (HPV) vaccine remain, and may be addressed by digital interventions tailored to their concerns. Reported here are results from a small scale randomized trial test...

An estimated 419 245 cases of skin cancer in the US each year are attributable to indoor tanning.¹ Efforts to increase regulations on indoor tanning continue, given its well-established association with melanoma and keratinocyte cancers as well as its popularity among adolescents and young adults. This Viewpoint provides an overview of legislative...

Indoor tanning (IT) increases risk of developing skin cancer. A social media campaign to reduce mother’s permissiveness toward their teenage daughters IT was evaluated. Mothers (N=869) of daughters aged 14-17 in 34 states without bans on IT by minors were enrolled in a randomized trial with assessments at baseline and 12-months follow-up in 2017-19...

The present study aimed to examine intra- and interpersonal associations between poor mental health and mother–daughter relationship closeness in a sample of 467 dyads. An Actor–Partner Interdependence Model was utilized to examine bidirectional processes between mothers (mean age = 42.64, SD = 6.5) and their adolescent daughters (mean age = 15.37,...

Objective: An online training in responsible marijuana vendor (RMV) practices was evaluated for effects on compliance with ID checking regulations. Method: A random sample of state-licensed recreational marijuana stores (n = 175) in Colorado and Washington State was selected in 2016-2017 and was enrolled in a randomized pretest-posttest controll...

Background Occupational sun protection is recommended by government health authorities. Sun safety policies and predictors of managers’ reports of sun safety actions were assessed. Methods Written policies from 21 state departments of transportation (DOTs) enrolled in a randomized trial to test methods for scaling‐up an occupational sun safety int...

Background: Successful methods for scaling-up evidence-based programs are needed to prevent skin cancer among adults who work outdoors in the sun. Methods: A randomized trial is being conducted comparing two methods of scaling-up the Sun Safe Workplaces (SSW) intervention. Departments of transportation (DOTs) from 21 U.S. states are participatin...

Background In some U.S. states, laws prohibit sales of recreational marijuana to intoxicated customers to prevent associated harms. In alcohol markets, training in responsible sales practices is one intervention to help reduce such sales to intoxicated customers. Similar training may be beneficial in the recreational cannabis market. Methods An on...

Objective Few studies have examined how health literacy impacts responses to genetic information. Methods We examined this issue among 145 English or Spanish-speaking adult primary care patients enrolled in a trial that offered testing for MC1R gene variants that confer moderately increased melanoma risk. We investigated whether health literacy sk...

Solar ultraviolet radiation (UV) exposure is the primary risk factor for skin cancer and children receive about one-quarter of lifetime UV exposure before age 18. Thus, skin cancer prevention is essential for children. The objective of this study was to test an intervention to facilitate implementation of district sun safety policies. Elementary sc...

Objective : Schools are an important setting for skin cancer prevention. An intervention for implementation of school sun safety policy, Sun Safety Schools (SSS), was evaluated. Methods : Primary schools (n=118) in California school districts that had already adopted a sun safety policy were enrolled in a study with a randomised controlled design....

BACKGROUND There is a need for interventions that promote healthy decision-making for teens that leverages the on-going impact of parental relationships through older adolescence and young adulthood. These interventions should maximize teen engagement as well as be easily accessible for families in terms of cost, duration, and logistics related to...

Background There is a need for interventions that promote healthy decision making among adolescents and leverage the ongoing impact of parental relationships through older adolescence and young adulthood. These interventions should maximize adolescent engagement and be easily accessible to families in terms of cost, duration, and logistics related...

Background: This study examined implementation of district sun safety policy in schools and tested correlates of implementation in California public school districts. Methods: Principals (N = 118) and teachers (N = 113) in California public elementary schools (N = 118) were recruited and completed a survey on sun protection policies and practice...

Background An economic evaluation of Sun Safe Schools intervention designed to aid California elementary schools with implementing sun safety practices consistent with local board–approved policy. Design Program cost analysis: intervention delivery and practice implementation. Setting California elementary schools (58 interventions and 60 control...

BACKGROUND Harnessing supportive influences in close relationships is an innovative and potentially effective strategy to improve sun protection behaviors. This pilot randomized controlled clinical trial evaluated the feasibility and preliminary impact of Sun Safe Partners Online, an online, couple-focused intervention to improve sun protection beh...

Background: Harnessing supportive influences in close relationships is an innovative and potentially effective strategy to improve sun protection behaviors. Objective: This pilot randomized controlled clinical trial evaluated the feasibility and preliminary impact of Sun Safe Partners Online, an online, couple-focused intervention to improve sun...

Objective: The purpose of this study was to measure compliance with age and personal ID regulations by state-licensed recreational marijuana stores in two states. Method: Recreational marijuana stores (N = 175) in Colorado and Washington State were each visited twice by pseudo-buyer assessment teams in September 2016 to April 2017. The observer...

Objective: The purpose of this study was to measure compliance with age and personal ID regulations by state-licensed recreational marijuana stores in two states. Method: Recreational marijuana stores (N = 175) in Colorado and Washington State were each visited twice by pseudo-buyer assessment teams in September 2016 to April 2017. The observer...

Background: The Melanocortin 1 Receptor (MC1R) contributes to pigmentation, an important risk factor for developing melanoma. Evaluating SNPs in MC1R and association with race/ethnicity, skin type, and perceived cancer risk in a New Mexico (NM) population will elucidate the role of MC1R in a multicultural population. Methods: We genotyped MC1R i...

Objective: Economic evaluation of an intervention promoting adoption of occupational sun protection actions by Colorado public sector employers. Methods: Randomized controlled trial with 2-year follow-up conducted during 2010 to 2013. Thirty-three intervention and 30 attention-control worksites in final economic sample. Twenty-four-month interve...

Background: Translational research in genomics has limited reach and requires efforts to broaden access and utility in diverse populations. Skin cancer is common and rates are rising, including among Hispanics. Germline variants in the melanocortin-1 receptor (MC1R) gene are common in the population and confer moderate risk for melanoma and basal...

Background: Outdoor workers experience chronic exposure to harmful ultraviolet radiation (UV) elevating their risk for skin cancer. Methods: A controlled randomized trial promoted the adoption of workplace sun safety policy and employee education at 98 public organizations in Colorado. A 2-year follow-up study with 68 organizations assessed the...

Objective: Electronic music dance events (EMDEs) at nightclubs attract young adults engaging in high-risk alcohol and other drug (AOD) use. Studies show that most patrons arrive at clubs in groups and that these peer groups influence drinking. Therefore, peer groups are a natural context for preventing risk behaviors. This article examined outcome...

The homophily principle, that perceived similarities among people produce positive reactions, is a cross-cultural, global phenomenon. This study aimed to test the prediction that photographs that depict models similar to the target population improve health communication by increasing perceived identification in three racial/ethnic populations. Thr...

In the United States, parents’ health beliefs affect HPV vaccination decisions. Our team acquired insights into mothers’ health beliefs from their reactions and comments to posts on HPV vaccination in a social media adolescent health campaign in a randomized trial (n = 881 mothers; 63.1% reported daughters had 1+ doses of the HPV vaccine) evaluatin...

This study examines effects of a randomized controlled trial for an online, family-based prevention program for older teens, Smart Choices 4 Teens, on alcohol use and related outcomes. Families (N = 411; teen age M = 16.4, SD = 0.5) were randomly assigned to the intervention or control condition in 2014–2015. Both intent to treat (ITT) and dosage m...

Mass media have changed dramatically over the past 25 years, yet they still remain an important channel for substance use prevention messages. Unfortunately, the large mass media substance use prevention campaigns, especially the National Youth Anti-drug Media Campaign, have not been found to be generally effective. Inadequacy of current theories o...

Purpose:: Implementation of employer sun safety actions was assessed in a 2-year follow-up to an occupational sun protection policy intervention. Design:: Two-year follow-up assessment in a randomized pretest-posttest controlled design. Setting:: Local government organizations with workers in public safety, public works, and parks and recreati...

The homophily principle that perceived similarities among people produce positive reactions is a cross-cultural, global phenomenon. The prediction that photographs depicting models similar to the target population improve health communication was tested. Three nationally-representative samples (n = 1,796) of adults who are disabled, seniors, or con...

Objective: Research in Responsible Beverage Service (RBS) training indicates that such training can prevent over-service of alcohol and reduce drunk driving. However, reviews of the RBS literature suggest that the quality of training methods and the stability of implementation are important factors in determining RBS training effectiveness. Most R...

Objective: Occupational skin cancer prevention is a priority because outdoor workers are exposed to high levels of ultraviolet radiation, the primary risk factor for skin cancer. Methods: A two-year follow-up assessment of the impact of Sun Safe Workplaces (SSW), a workplace sun safety program that promoted policy adoption and education, on empl...

Context: Six US states have implemented retail sales of recreational marijuana. Training in responsible sales practices has been effective in the alcohol market. An online responsible marijuana vendor (RMV) training was produced and implemented with stores in a randomized trial. Program: An online RMV training was developed through meetings with...

Importance Germline variants in the MC1R gene are common and confer moderate melanoma risk in those with varied skin types. Approaches to precision skin cancer prevention that include genetic information may promote risk awareness and risk reduction in the general population, including Hispanics. Objective To examine prevalence of interest in and...

Skin cancers, ie, melanoma and keratinocyte skin cancer, are the most common cancers.¹ The number of melanomas is expected to nearly double by 2030, tripling annual treatment costs in the United States.² Because skin cancer is strongly associated with UV radiation (UVR) exposure,¹ the Centers for Disease Control and Prevention recommend reducing un...

Introduction: Policy is a key aspect of school-based efforts to prevent skin cancer. We explored the extent and accuracy of knowledge among principals and teachers in California public school districts about the elements specified in their district's written sun safety policy. Methods: The sample consisted of California public school districts t...

Use of online panel vendors in research has grown over the past decade. Panel vendors are organizations that recruit participants into a panel to take part in web-based surveys and match panelists to a target audience for data collection. We used two panel vendors to recruit families (N = 411) with a 16- to 17-year-old teen to participate in a rand...

Taking vacations in sunny locations is associated with the development of skin cancer. This study tested a multi-component sun protection intervention based on diffusion of innovations theory and transportation theory designed to increase vacationers’ comprehensive sun protection, i.e., use of clothing, hats, and shade, and use, pre-application, an...

Overexposure to the sun is associated with an increased risk of melanoma and nonmelanoma skin cancer, but indications of improvements in sun protection behavior are poor. Attempts to identify emerging themes in skin cancer control have largely been driven by groups of experts from a single field. In December 2016, 19 experts from various discipline...

According to the Centers for Disease Control and Prevention and the US Surgeon General, sun protection policies for students are recommended for school-based skin cancer prevention.¹- 3 The California School Boards Association (CSBA) represents elected officials (boards) governing California public school districts, reviews its member districts’ bo...

Objectives: To test whether shade sails will increase the use of passive recreation areas (PRAs). Methods: We conducted a stratified randomized pretest-posttest controlled design study in Melbourne, Australia, and Denver, Colorado, in 2010 to 2014. We randomized a sample of 144 public parks with 2 PRAs in full sun in a 1:3 ratio to treatment or...

Purpose: To evaluate an intervention promoting adoption of occupational sun protection policies by employers in a randomized trial. Design: A randomized pretest-posttest controlled design with 2-year follow-up was conducted in 2010 to 2013. Setting: Local government organizations in Colorado who had outdoor workers in public works, public safe...

Background Limited translational genomic research currently exists to guide the availability, comprehension, and appropriate use of personalized genomics in diverse general population subgroups. Melanoma skin cancers are preventable, curable, common in the general population, and disproportionately increasing in Hispanics. Objective Variants in th...

Background: Exposure to solar ultra violet radiation (UVR) is a primary risk factor for skin cancer. Vacationers often fail to protect themselves from harmful UVR. Purpose: The study assessed the sun protection practices of resort guests in various outdoor leisure and recreation venues during warm-weather seasons. Method: 41 North American res...

Environments can be structured to reduce solar ultraviolet radiation (UV) exposure to prevent skin cancer. A prospective randomized trial is being conducted to test whether introducing shade sales in passive recreation areas (PRAs) in public parks will increase use and decrease UV exposure in the shaded compared to unshaded PRAs. Shade effects will...

During vacations, many individuals receive high-risk sun exposure that is associated with skin cancer. Vacationers in outdoor recreation venues (pretest n=4347; posttest n=3986) at warm-weather destination resorts in North America (n=41) were enrolled in a pair-matched, group-randomized pretest-posttest controlled quasi-experimental design in 2012-...

Background Indoor tanning elevates the risk for melanoma, which is now the most common cancer in US women aged 25-29. Public policies restricting access to indoor tanning by minors to reduce melanoma morbidity and mortality in teens are emerging. In the United States, the most common policy restricting indoor tanning in minors involves parents prov...

n February 2016, the World Health Organization (WHO) declared a global public health emergency in response to the potential pandemic of the Zika virus. To prevent transmission, WHO advises persons who travel to affected regions to avoid mosquito bites by wearing protective clothing, hats, and insect repellent. This advice is very similar to WHO’s r...

Objective: Four states are creating a regulated industry for the retail sale of cannabis products. This pilot study assessed refusal rates of sales to underage-appearing individuals without valid identification (ID) at retail outlets in Colorado. Method: State-licensed retail marijuana outlets (n = 20) in Colorado were included in the sample. Ps...

Context: Skin cancer is a preventable and commonly diagnosed cancer in the U.S. Excessive ultraviolet radiation exposure is a known cause of skin cancer. This article presents updated results of two types of interventions evaluated in a previously published Community Guide systematic review: multicomponent community-wide interventions and mass med...

Background Vacationing at sunny, warm weather locations is a risk factor for excessive solar ultraviolet (UV) radiation exposure and skin cancer. Objectives This study examined the association of environmental variables related to UV levels with vacationers' sun protection. Methods Vacationers at 41 summer resorts in 17 states and 1 Canadian Prov...

Background: Complementary and alternative medicine (CAM) practitioners, such as chiropractors, acupuncturists, and massage therapists, are a growing presence in the US health care landscape and already provide health and wellness care to significant numbers of patients who use tobacco. For decades, conventional biomedical practitioners have receiv...

The epidemiology of melanoma is complex, and individual risk depends on sun exposure, host factors, and genetic factors, and in their interactions as well. Sun exposure can be classified as intermittent, chronic, or cumulative (overall) exposure, and each appears to have a different effect on type of melanoma. Other environmental factors, such as c...

Interpersonal deception theory (IDT) explains the process and outcomes of deception in interpersonal conversations. It focuses on intentional, strategic communication behaviors by interacting senders and receivers in conversations, as well as the involuntary behavior that arises from their affective reactions and cognitions. Articulated are its cor...

Objective: Parents make the decisions regarding their children's health care. Unfortunately, many parents are misinformed about HPV and HPV vaccines. In order to help parents make an informed decision regarding HPV vaccination for their daughter, the GoHealthyGirls website was created for parents and their adolescent daughters. Usability testing w...

This study aimed to compare the validity, reliability and practicality of alternative portable methods for measuring erythemal UVR levels in passive recreation areas in public parks. UVR levels were measured for point in time comparisons between Solarmeter 6.5 handheld meters and time-stamped electronic dosimeters in a large central park in Melbour...

Objective: We address cancer communication by creating and assessing the impacts of a theatrical production, When Cancer Calls…(WCC…), anchored in conversations from the first natural history of a patient and family members talking through cancer on the telephone. Methods: A national study was conducted using a multi-site and randomized controll...

Objective: Sustainability of prevention programs is a public health goal. Methods: The effectiveness of Go Sun Smart, an occupational skin cancer prevention program, was evaluated 5 to 7 years out from the conclusion of a controlled randomized dissemination trial that compared an enhanced versus basic dissemination strategy at 53 ski areas enrol...

Introduction: Exposure to solar ultraviolet radiation during recreation is a risk factor for skin cancer. A trial evaluating an intervention to promote advanced sun protection (sunscreen pre-application/reapplication; protective hats and clothing; use of shade) during vacations. Materials and methods: Adult visitors to hotels/resorts with outdoo...

The field of interpretation is increasingly acknowledging the potential for strategic health promotion. The purpose of this paper is to introduce Go Sun Smart (GSS) Resorts, a sun safety program directed to guests recreating outdoors at destination resorts and parks in the United States and Canada. This paper aims to present a sun safety interventi...

Recent changes in policy and social norms related to marijuana use have increased its use and concern about how/where marijuana should be used. We aimed to characterize rules regarding marijuana and its use in homes. We recruited 1,567 US adults aged 18–34 years through Facebook advertisements to complete an online survey assessing marijuana use, s...

Skin cancer is the most common cancer in the United States. In July 2014, the U.S. Surgeon General issued a Call to Action to prevent skin cancer by reducing exposure to solar and non-solar ultraviolet radiation (UV), a primary risk factor. Policies in educational, occupational, and public spheres are an important component in these prevention effo...