Tammy Stump

Northwestern University | NU · Department of Preventive Medicine

Ultraviolet radiation (UVR) exposure is the primary modifiable risk factor for melanoma. Wearable UVR sensors provide a means of quantifying UVR exposure objectively and with a lower burden than self-report measures used in most research. The purpose of this study was to evaluate the relationship between detected UVR exposure and reported sunburn o...

Background Little is known about how members of cancer-prone families think about genetic determinism and whether personal behavior can amplify or counter genetic risk for disease. Purpose Understanding how people think about the impact of personal behavior on disease risk may inform communications about genetic risks and their management. Method...

There is limited examination about coronavirus disease 19 (COVID-19)-related food handling concerns and practices that cause chemical or microbial contamination and illness, particularly among those with food insecurity. We investigated consumer food handling concerns and practices during the COVID-19 pandemic and whether they differed by food inse...

Objectives Concerns about COVID-19 transmission have led to greater engagement in unsafe food handling practices (i.e., practices that can cause illness due to chemical or microbial contamination of food). Despite public awareness that certain medical conditions exacerbate COVID-19 illness severity, little is known about whether these patients have...

Objective: We applied the ORBIT model to digitally define dynamic treatment pathways whereby intervention improves multiple risk behaviors. We hypothesized that effective intervention improves the frequency and consistency of targeted health behaviors and that both correlate with automaticity (habit) and self-efficacy (self-regulation). Method:...

Objective Associations between cancer beliefs and health behavior engagement are largely unexplored in cancer survivors, particularly among those with overweight and obesity. We investigated belief-behavior associations for cancer survivors, and whether obesity altered these associations. Methods Cancer survivors were identified from the National...

Objective Intensive behavioral obesity treatments face scalability challenges, but evidence is lacking about which treatment components could be cut back without reducing weight loss. The Optimization of Remotely Delivered Intensive Lifestyle Treatment for Obesity (Opt‐IN) study applied the Multiphase Optimization Strategy to develop an entirely re...

Predispositional genetic testing of children for adult-onset health risks is typically only used when prevention and screening measures have utility during childhood. Little is known about how children and their parents may use predispositional risk information, including whether it changes their interactions around risk-reducing prevention and scr...

Background Understanding multiple components of risk perceptions is important because perceived risk predicts engagement in prevention behaviors. Purpose To examine how multiple components of risk perceptions (perceived magnitude of and worry about risk, prioritization of the management of one’s risk) changed following genetic counseling with or w...

Background Melanoma survivors often do not engage in adequate sun protection, leading to sunburn and increasing their risk of future melanomas. Melanoma survivors do not accurately recall the extent of sun exposure they have received, thus, they may be unaware of their personal UV exposure, and this lack of awareness may contribute towards failure...

Objectives Precision behavioral medicine techniques integrating wearable ultraviolet radiation (UVR) sensors may help individuals avoid sun exposure that places them at-risk for skin cancer. As a preliminary step in our patient-centered process of developing a just-in-time adaptive intervention, this study evaluated reactions and preferences to UVR...

Objective: This paper examines how and why to improve care systems for disease management and health promotion for the growing population of cancer survivors with cardiovascular multi-morbidities. Method: We reviewed research characterizing cancer survivors' and their multiple providers' common sense cognitive models of survivors' main health th...

Purpose: This study investigated whether genetic counseling and test reporting for the highly penetrant CDKN2A melanoma predisposition gene promoted decreases in sun exposure. Methods: A prospective, nonequivalent control group design compared unaffected participants (N = 128, Mage = 35.24, 52% men) from (1) families known to carry a CDKN2A path...

Objectives: Obesity-related cancers (e.g., breast, colorectal, and endometrial) account for 40% of all US cancer diagnoses and disproportionately affect females. More than half of Americans are unaware that excess adiposity is a modifiable risk factor for certain types of cancers, and many do not perform healthy diet behaviors. It is unclear wheth...

BACKGROUND: Cancer survivors face an increased risk of cardiovascular events compared with the general population. Adopting a healthy lifestyle may reduce these risks, and guidelines encourage health-promotion counseling for cancer survivors, but the extent of physician adherence is unclear. METHODS: This mixed-method study surveyed 91 physicians,...

Wearable sensors can provide reliable, automated measures of health behaviors in free-living populations. However, validation of these measures is impossible without observable confirmation of behaviors. Participants have expressed discomfort during the use of ego-centric wearable cameras with first-person view. We argue that mounting the camera on...

Minutes of Unprotected Sun Exposure (MUSE) Inventory screenshots and notes.

One in five US adults will be diagnosed with skin cancer. As most skin cancers are attributable to sun exposure, this risk factor is an important target for research and intervention. Most sun exposure measures assess frequency of specific sun-protection behaviors, which does not account for the use of multiple, potentially overlapping sun-protecti...

Few studies have correlated counts of street users to walkability features or tested for temporal variations in use across the day. Trained observers counted street users for four streets that differed in walkability according to the Irvine-Minnesota audit. From 7 am to 7 pm weekdays, across four 2-hour observation periods, all four streets had sig...

Objective: To examine whether individual differences and day-to-day fluctuations in diabetes goal planning are associated with Type 1 diabetes (T1D) management during late adolescence, and whether lapses in daily diabetes goal planning are more disruptive to diabetes management among those with poorer executive functioning (EF). Method: Late ado...

Background: Prevalent co-occurring poor diet and physical inactivity convey chronic disease risk to the population. Large magnitude behavior change can improve behaviors to recommended levels, but multiple behavior change interventions produce small, poorly maintained effects. Objective: The Make Better Choices 2 trial tested whether a multicomp...

BACKGROUND Prevalent co-occurring poor diet and physical inactivity convey chronic disease risk to the population. Large magnitude behavior change can improve behaviors to recommended levels, but multiple behavior change interventions produce small, poorly maintained effects. OBJECTIVE The Make Better Choices 2 trial tested whether a multicomponen...

A CDKN2A/p16 mutation confers 28%–67% lifetime melanoma risk, a risk that may be moderated by ultraviolet radiation exposure. The aim of this study was to test whether melanoma genetic counseling and test disclosure conferred unique informational, motivational, or emotional benefits compared to family history-based counseling. Participants included...

Genetic testing of minors is advised only for conditions in which benefits of early intervention outweigh potential psychological harms. This study investigated whether genetic counseling and test reporting for the CDKN2A/p16 mutation, which confers highly elevated melanoma risk, improved sun protection without inducing distress. Eighteen minors (M...

Does street walkability and a new complete street renovation relate to street use and gender composition? We audited two mixed-walkability complete streets ("complete less-urban" and "complete-urban"), one low-walkable street, and one high-walkable street at pre-renovation and twice post-renovation. Complete street users increased, especially for t...

1582 Background: Predictive genetic testing for familial cancer may alert people to highly elevated risk prior to disease onset. Genetic test reporting has been shown to improve uptake of prophylactic screening and procedures, but whether test reporting also promotes increased performance of primary preventive behavior is unknown. Methods: Unaffect...

Background and objectives: To examine the effectiveness of behavioral interventions for melanoma prevention targeted to individuals at elevated risk due to personal and/or family history. Methods: Through literature searches in 5 search databases (through July 2014), 20 articles describing 14 unique interventions focused on melanoma prevention a...

It is unknown whether or why genetic test reporting confers benefits in the understanding and management of cancer risk beyond what patients learn from counseling based on family history. A prospective nonexperimental control group study compared participants from melanoma-prone families who underwent CDKN2A/p16 (p16) genetic testing (27 carriers,...

Two experiments were conducted to determine whether self-schema status moderates the effectiveness of an implementation intentions intervention on nutrition behavior among university students not meeting relevant dietary guidelines. In Experiment 1, students were asked to eat at least 2 servings of fruit and 3 of vegetables daily for a week. Implem...

The purpose of the current study was to examine changes in frequency of discussion about melanoma preventive behaviors among adults who received melanoma genetic test reporting and counseling and their children and grandchildren, correspondence of frequency of discussion with intentions, and content of discussions. Participants received CDKN2A/p16...

To determine whether receiving melanoma genetic test results undermines perceived control over melanoma prevention, control-related beliefs were examined among 60 adults from melanoma-prone families receiving CDKN2A/p16 test results (27 unaffected noncarriers, 15 unaffected carriers, 18 affected carriers; response rate at 2 years = 64.9 % of eligib...

Patients with chronic illness are often stigmatized, which can lead to distress and poorer health. To address these problems, researchers must be able to effectively measure disease stigma. In line with Weiner’s attribution theory (Weiner, 1985), we developed the Measure of Disease-Related Stigma (MDRS) to assess the cognitive, emotional, and behav...

Objectives: To examine development in illness perceptions of type 1 diabetes across adolescence and relationships with intelligence, diabetes responsibility, and diabetes outcomes. Methods: Illness perceptions were measured via the Illness Perceptions Questionnaire at 3 times, every 6 months in 213 adolescents (M age = 13.00; SD = 1.54) with typ...

Health care providers are accustomed to identifying populations for whom cost-related concerns may be a significant barrier, such as the poor, but few empiric data have been collected to substantiate such assumptions, particularly among insured patients. Patients with cancer from academic and community hospitals completed a questionnaire that inclu...

When making treatment decisions, cancer patients must make trade-offs among efficacy, toxicity, and cost. However, little is known about what patient characteristics may influence these trade-offs. A total of 400 cancer patients reviewed 2 of 3 stylized curative and noncurative scenarios that asked them to choose between 2 treatments of varying lev...

6021 Background: When making treatment decisions, cancer patients (pts) must make trade-offs between efficacy, toxicity (tox) and cost. However, little is known about how individual characteristics influence these decisions, particularly as many face high out of pocket costs. Methods: We presented cancer pts with hypothetical scenarios that asked t...

Purpose: Decision making for cancer patients can be difficult, as they face costly treatment with uncertain outcomes. Patients’ optimism, numeracy and perception of whether their family has already made sacrifices to pay for care may affect their choices. However, the relationships between these factors have not been well defined. Methods: We are...