Center for Health Behavior Research (CHBR)

This study uses a Hybrid Type 1 effectiveness-implementation design to adapt and test the effectiveness of two successful social incentive-based interventions, a gamification strategy and financial incentives donated to charity on the participants’ behalf, to increase physical activity among 225 low-income, mostly minority families in community settings.

Funded by the National Institutes of Health/National Heart, Lung, and Blood Institute
Grant number: R01-HL152430

The mission of the coalition is to listen to and engage and empower communities, organizations, and individuals to reduce cancer disparities by aligning resources, sharing information, inspiring research, and reducing barriers to the prevention, early detection, and treatment of cancer for all Philadelphians.

phillycancercollab.org

The study aims to investigate the effects of a ban on sunscreen ingredients containing oxybenzone or octinoxate in Hawaii. The ban was enacted in 2021 due to concerns about the chemicals’ impact on coral reefs. The study will involve surveys and observations before and after the ban to assess changes in sunscreen usage and product availability.

The University of Pennsylvania Prevention Research Center (UPenn PRC), led by Drs. Karen Glanz, Oluwadamilola “Lola” Fayanju, and Meghan Lane-Fall, has been awarded a core grant and supplement totaling $6.5 million from the Centers for Disease Control and Prevention (CDC) for the next five years. The national PRC Network includes 20 CDC-funded Centers in the 2024-2029 cycle. The goal of the PRC program is to fund academic research centers conducting community-based prevention and public health research.

A signature initiative of the UPenn PRC will be its 5-year core research project. Penn researchers will collaborate with colleagues at Thomas Jefferson University’s Sidney Kimmel Cancer Center (SKCC) to implement a study focused on improving communication between doctors and older patients with early-stage breast, rectal, or lung cancer. This hybrid effectiveness-implementation study will assess impact of the Best Case/Worst Case decision-making framework blended with geriatric assessment on patient outcomes and satisfaction. This will be the largest study of this promising communication strategy to date.

The UPenn PRC will build strong partnerships with community organizations, health departments, and Penn Medicine clinical practices to improve health outcomes and reduce disparities. The center will leverage state-of-the-art methods and technologies to conduct research, disseminate findings, and translate research into action.

For additional information, please visit the UPenn PRC website and follow us on Twitter @upennprc.

Funded by the Centers for Disease Control and Prevention
Grant Number:

The mission of the CEAR Core is to facilitate community-based research and community engagement, and enhance the translation of research and technological developments to key public health and community stakeholders. The CEAR Core is part of the Clinical and Translational Science Award (CTSA), which is funded by the National Institutes of Health (NIH) and awarded jointly to the University of Pennsylvania and The Children’s Hospital of Philadelphia.

The CEAR Core aims to build capacity for community-engaged research in the Penn community through providing links to relevant information and resources, training and seminars, consultation, and support for pilot research.

More information is available via the CEAR Core website.

Funded by the National Institutes of Health
Grant Number: UL1-RR0241343

The Cancer Control Program is a highly collaborative and transdisciplinary Program that focuses on identifying and analyzing the genetic, behavioral, and healthcare determinants of cancer susceptibility and outcomes in diverse and vulnerable populations and on developing, evaluating and implementing interventions to lower risk and improve cancer outcomes. The Cancer Control Program is one of two Population Science Research Programs of the Abramson Cancer Center. Program members work intra- and inter-programmatically to apply advances in science to population health and cutting-edge data analytics, address the cancer burdens and risk factors in our catchment area, and train the next generation of cancer control researchers.

The Cancer Control Program is a vibrant community of interactive population science investigators working across four interconnected aims to further research impacting our catchment area and beyond.

Program leaders:

Karen Glanz, PhD, MPH
George A. Weiss University Professor

Steven Joffe, MD, MPH
Founders Professor of Medical Ethics and Health Policy

Philly CEAL is a city-wide collaborative effort aimed at improving the health and well-being of Philadelphia communities. Philly CEAL is part of the NIH CEAL research network, which is designed to identify promising engagement and outreach practices that communicate trustworthy, science-based information to communities experiencing health disparities.

phillyceal.org

The NIH Implementing a Maternal Health and PRegnancy Outcomes Vision for Everyone (IMPROVE) initiative aims to reduce maternal mortality, improve pregnancy, perinatal and postpartum care, and to address the factors that have led to severe disparities in outcomes for marginalized groups.

The University of Pennsylvania (Penn) has created the Achieving Maternal Equity and Transforming Health through Implementation Science and Training (AMETHIST@Penn) Implementation Science Hub to support IMPROVE Maternal Health Research Centers of Excellence (CoEs) and other IMPROVE investigators and to coordinate with NIH Staff Scientists, Project Staff, and the Data Innovation and Coordinating Hub.

website

The study aim is to assess individuals’ risk perceptions, knowledge, and behaviors related to prevention of COVID-19, response to the pandemic, and psychological impacts of quarantine and/or diagnosis of COVID-19. Primary outcomes are: individuals’ behaviors, risk perceptions, knowledge, and behaviors related to prevention and the impact of the COVID-19 pandemic. Secondary outcomes are: changes in risk perceptions, knowledge, and behaviors about the COVID-19 pandemic over time, by geographic area, and by personal experience with the disease.

To address diet quality disparities in low-income families, policymakers and health experts recommend strategies such as financial incentives to promote consumption of fruits and vegetables (FVs). Real-time incentives for purchasing FV and variable incentives are promising, untested strategies to improve families’ diets and health. The goal of this study is to evaluate the effectiveness of financial incentives delivered in real-time at the point of purchase, on low-income consumers’ purchase of FVs, FV consumption,diet quality, and weight/BMI. Shoppers from 300 low-income families living in Philadelphia will be recruited. Adults must use SNAP or be SNAP-eligible, be the primary household shopper, shop at a participating store,and have at least one child aged 2-17 living in the home.

Funded by the Robert Wood Johnson Foundation
Grant Number: 76304

The UPenn Prevention Research Center (UPenn PRC), directed by Karen Glanz, PhD, MPH and Kevin Volpp, MD, PhD, was funded from 2014 – 2019. The UPenn PRC strengthened public and private sector community partnerships; improved understanding of how behavioral economics and public health strategies can reduce health risks and improved health in social-environmental contexts; and extended collaborative training, education, and communication in high-risk and underserved populations in Southeastern Pennsylvania.

The UPenn PRC core research study was a workplace weight loss study to evaluate environmental change strategies and incentives for decreasing obesity and preventing cardiovascular disease in employees of the City of Philadelphia, Independence Blue Cross, and the Southeastern Pennsylvania Transportation Authority (SEPTA).

The UPenn PRC team is dedicated to promoting well-being, health equity, research translation, and the development and evaluation of population-based and sustainable community health and clinical interventions. Faculty members from the Perelman School of Medicine, School of Nursing, Annenberg Public Policy Center, and The Wharton School are among the leadership of this Center.

Limited competition supplements, or Special Interest Projects (SIPs), are available through the PRC Network. These projects are awarded annually through the CDC and cover a variety of research topics.

For additional information, please visit the UPenn PRC website and follow us on Twitter @upennprc.

Funded by the Centers for Disease Control and Prevention
Grant Number: U48DP005053

CORE RESEARCH STUDY PUBLICATIONS:

• Glanz K, Shaw P, Kwong P, Choi J, Chung A, Zhu J, Huang Q, Hoffer K, Volpp K. Effect of Financial Incentives and Environmental Strategies on Weight Loss in The Healthy Weigh Study: A Randomized Clinical Trial. JAMA Network Open 2021;4(9): e2124132. doi:10.1001/jamanetworkopen.2021.24132
• Glanz K, Shaw P, Hoffer K, Chung A, Zhu J, Wu R, Huang E, Choi R, Volpp K. The Healthy Weigh study of lottery-based incentives and environmental strategies for weight loss: Design and baseline characteristics. Contemporary Clinical Trials, Jan 2019, Volume 76, pages 24-30.

The Cancer Prevention and Control Research Network Collaborating Center (SIP 14-011)

This Collaborating Center works with the Cancer Prevention and Control (CPCRN) network and local/state partners to accelerate the implementation of evidence-based cancer prevention and control in communities and enhance large-scale efforts to reach underserved populations, reduce cancer risk, improve screening utilization, reduce death from cancer, and ameliorate health disparities in the community and within health systems.

PROJECT LEAD: Karen Glanz

FUNDING CYCLE: Ongoing

PUBLICATIONS:

• Glanz K, Green S, Avelis J, Melvin CL. Putting Evidence Academies into action: Prostate cancer, nutrition, and tobacco control science. Preventive Medicine, Dec 2019; 129:105821.
• Ko LK, Jang SH, Friedman DB, Glanz K, Leeman J, Hannon PA, Shannon J, Cole A, Williams R. An Application of the Science Impact Framework to the Cancer Prevention and Control Research Network from 2014-2018. Preventive Medicine, Dec 2019; 129:105821.
• Leeman J, Glanz K, Hannon P, Shannon J. The Cancer Prevention and Control Research Network: Accelerating the implementation of evidence-based cancer prevention and control interventions. Preventive Medicine, Dec 2019; 129:105821.
• Leeman J, Askelson N, Ko L, Rohweder C, Avelis J, Best A, Friedman D, Glanz K, Seegmiller L, Stradtman L, Vanderpool R. Understanding the processes that Federally Qualified Health Centers use to select and implement colorectal cancer screening interventions: A qualitative study. Translational Behavioral Medicine, Feb 2019
• Arp Adams S, Rohweder CL, Leeman J, Friedman DB, Gizlice Z, Vanderpool RC, Askelson N, Best A, Flocke SA, Glanz K, Ko LK, Kegler M. Use of evidence-based interventions and implementation strategies to increase colorectal cancer screening in federally qualified health centers. Journal of Community Health, 2018; 43:1044-1052.

Led by Dr. Brian Saelens, this observational study is evaluating cross-sectional and longitudinal associations of neighborhood-level activity and nutrition environments with children’s weight status and obesity.

PUBLICATIONS:

• Saelens, BE, Glanz, K, Frank, LD, Couch, S, Zhou, C, Colburn, T, and Sallis, JF, Two-Year Changes in Child Weight Status, Diet, and Activity by Neighborhood Nutrition and Physical Activity Environment, The Obesity Society (Editor’s Choice), August 7, 2018
• Saelens BE, Sallis JF, Frank LD, Couch SC, Zhou C, Colburn T, Cain KL, Chapman J, Glanz K. Obesogenic neighborhood environments related to child and parent obesity: The Neighborhood Impact on Kids (NIK) Study. In Press, American Journal of Preventive Medicine, 2012.
• Frank LD, Saelens BE, Chapman J, Sallis JF, Kerr J, Glanz K, Couch SC, Learnihan V, Zhou C, Colburn T, Cain C. Objective assessment of obesogenic environments in youth: GIS methods and spatial findings from the Neighborhood Impact on Kids (NIK) Study. In Press, American Journal of Preventive Medicine, 2012.
• Frank LD, Saelens BE, Chapman J, Sallis JF, Kerr J, Glanz K, Couch SC, Learnihan V, Zhou C, Colburn T, Cain C. Objective assessment of obesogenic environments in youth: GIS methods and spatial findings from the Neighborhood Impact on Kids (NIK) Study. In Press, American Journal of Preventive Medicine, 2012.

Led by Dr. Jim Sallis, the primary goal of the project is to examine the association of built environment and food environment variables with behavioral and weight-related outcomes in adolescents aged 12 to 16 years. The forty-eight neighborhoods in King County, WA and Baltimore-Washington, DC being studied were selected based on walkability levels (e.g., combination of street connectivity, residential density, land use mix, retail floor area ratio) and median income levels. Study researchers examined and created formulas to measure walkability, pedestrian infrastructure, public recreation space, and nutrition environment quality. Researchers also examined crime and weather patterns; psychosocial variables; parent support; and perceived neighborhood, school, and home environments. Individual data was collected using accelerometers, GPS units, surveys, and food recalls. Overall, the study is evaluating the ability of a research model to explain the variation in physical activity levels, sedentary behavior, dietary patterns, and weight among adolescents, with an emphasis on neighborhood environment.

http://sallis.ucsd.edu/measure_tean.html&nbsp

This study is evaluating the impact of in-store healthy food marketing strategies on the sales and purchases of specific healthier items in six product categories (milk, frozen entrees, beverage checkout coolers, salty snacks, bread, and cheese).

If these strategies are found to be effective, they could be used widely to encourage the purchase of healthier items, complement food access initiatives, and reduce health disparities in obesity and other diseases.

For more information about this project, read about the Healthy Retail Solutions Pilot Study.

Funded by the National Institutes of Health/National Institute of Diabetes and Digestive and Kidney Diseases
Grant Number: R01-DK101629-01

The aim of the project was to identify neighborhoods with disproportionately high rates of advanced prostate cancer and describe patient and neighborhood level risk factors associated with high risk neighborhoods; develop a targeted educational intervention (using a mixed methods approach) about prostate cancer for men who live in high risk neighborhoods; test the impact of the targeted intervention on levels of knowledge, anxiety, and informed decision making about PCa screening; and observe the rates of PCa screening in the intervention and control groups.

Funded by the Department of Defense (Subcontract from Thomas Jefferson University)
Grant Number: PC140667 (Charnita Ziegler-Johnson, PI)

The purpose of this study is to evaluate the impact of a new supermarket in an underserved urban area on the neighborhood nutrition environment and the dietary intake of community residents.

Funded by the National Institutes of Health/National Institute of Diabetes and Digestive and Kidney Diseases (Subcontract from The University of Delaware; Co-PI: Allison Karpyn)
Grant Number: R01-DK102324

The primary objective of this project is to determine, before wide-scale implementation, to what degree sugar-sweetened beverage (SSB) warning labels increase consumers’ knowledge about the potential health harms of SSBs and reduce SSB intake. The study aims to evaluate which of several SSB labeling strategies most influences knowledge, beliefs, and purchase intentions. Additionally, it is examining how SSB warning labels influence snack and beverage purchases and intake among parents and children. Finally, the project is examining how repeated exposure to SSB warning labels influence parents’ purchasing behaviors over time.

Funded by the National Institutes of Health/National/National Institute of Diabetes and Digestive and Kidney Diseases
Grant Number: R01 DK 111558-01A1 (Christina Roberto, PI)

This project aims to investigate the reach, effectiveness, implementation, maintenance, and cost of an enhanced UV4.me intervention and implementation strategies in a large national randomized controlled trial with young adults at moderate to high risk of developing skin cancer.

Funded by The National Cancer Institute/National Institutes of Health
Grant Number: R01-CA-204271-01A1 (Carolyn Heckman, PI)

With funding from the Robert Wood Johnson Foundation, the purpose of this study was to develop and validate objective tools to evaluate nutrition environments. Objectives for the ongoing work in this project are to:

1. Develop a training module and a train-the-trainer program on how to use measures to evaluate community nutrition environments (retail and food service outlets)
2. Conduct training events when requested
3. Set up a consultation service to customize the measures, process data and create reports. Information about upcoming training events and other project information can be found at the NEMS website.

PUBLICATIONS:

• Voss C, Klein S, Glanz K, Clawson M. Nutrition Environment Measures-Vending (NEMS-V): Development, reliability and dissemination. Health Promotion Practice, 13 (4): 425-430, 2012.
• Honeycutt S, Davis E, Clawson M, Glanz K. Training and Dissemination of the Nutrition Environment Measures Surveys (NEMS). Preventing Chronic Disease, 2010; 7 (6).
• Glanz K. Measuring food environments: A historical perspective. American Journal of Preventive Medicine, 36(4S):S93-S98, 2009.
• Frank LD, Kerr J, Saelens B, Sallis J, Glanz K, Chapman J. Food outlet visits, physical activity, and body weight: Variations by gender and race-ethnicity. British Journal of Sports Medicine, 43: 124-131, 2009.
• Saelens BE, Glanz K. Measures of the food and physical activity environment: Instruments. American Journal of Preventive Medicine, 36(4S):166-170, 2009.
• Casey AA, Elliott M, Glanz K, Haire-Joshu D, Lovegreen SL, Saelens BE, Sallis JF, Brownson RC. Impact of the food environment and physical activity environment on behaviors and weight status in rural U.S. communities. Preventive Medicine, 47: 600-604, 2008.
• Kegler MC, Escoffery C, Alcantara I, Ballard D, Glanz K. A qualitative examination of home and neighborhood environments for obesity prevention in rural adults. International Journal of Behavioral Nutrition and Physical Activity,5:65 (at http://www.ijbnpa.org/content/5/1/65), 2008.
• Story M, Kaphingst K, Robinson-O’Brien R, Glanz K. Creating healthy food and eating environments: Policy and environmental approaches. Annual Review of Public Health, 29: 253-272, 2008.
• Glanz K, Sallis JF, Saelens BE, Frank LD. Nutrition Environment Measures Survey in Stores (NEMS-S): Development and evaluation. American Journal of Preventive Medicine, 32: 282-289, 2007.
• Saelens BE, Glanz K, Sallis JF, Frank LD. Nutrition Environment Measures Study in Restaurants (NEMS-R): Development and evaluation. American Journal of Preventive Medicine, 32: 273-281, 2007.
• Frank LD, Glanz K, McCarron M, Sallis J, Saelens B, Chapman J. The spatial distribution of food outlet type and quality around schools in differing built environment and demographic contexts. The Berkeley Planning Journal, 19: 31-47, 2006.
• Sallis JF, Glanz K. The role of built environments in physical activity, eating, and obesity in childhood. The Future of Children (Brookings/Princeton University), 16, 1: 89-108, 2006.
• Glanz K, Sallis JF, Saelens BE, Frank LD. Healthy nutrition environments: Concepts and measures. American Journal of Health Promotion, 19(5): 330-333, 2005.
• Glanz K, Hoelscher D. Increasing Fruit and Vegetable Intake by Changing Environments, Policy and Pricing: Restaurant-Based Research, Strategies, and Recommendations. Preventive Medicine, 29: S88-S93, 2004.
• Glanz K, Yaroch A. Strategies for Increasing Fruit and Vegetable Intake in Grocery Stores and Communities: Policy, Pricing, and Environmental Change. Preventive Medicine, 39: S75-S80, 2004.
• Steenhuis I, van Assema P, van Breukelen G, Glanz K. The effectiveness of nutrition education and labeling in Dutch supermarkets. American Journal of Health Promotion, 18:221-224, 2004.
• Glanz K, Shigaki D, Farzanfar, Pinto B, Kaplan B, Friedman RH. Participant Reactions to a Computerized Telephone System for Nutrition and Exercise Counseling. Patient Education and Counseling, 49: 1157-163, 2003.
• Booth S, Sallis J, Ritenbaugh C, Hill H, Birch L, Frank L, Glanz K, Himmelgreen D, Mudd M, Popkin B, Rickard K, St. Jeor S, Hays H. Environmental and societal factors affecting food choice and physical activity: Rationale, influences, and leverage points. Nutrition Reviews, 59, 3(II): 21-39, 2001.

The goal of this project is to assess the needs of adult residents of the Abramson Cancer Center (ACC) catchment area with an emphasis on understanding health disparities in cancer prevention, detection, and care and survivorship, and factors that facilitate or hinder cancer communication and preventive behaviors.

Funded by the National Cancer Institute
Grant Number: P30CA016520-40S3

This pilot study aims to develop a brief shared decision-making intervention which will be delivered by primary care providers (PCPs) to improve asthma control in Black adults receiving care in federally qualified health centers (FQHCs) in Philadelphia.

Funded by the National Institutes of Health/National Institute of Nursing Research
Grant Number: R21NR016507 (Maureen George, PI)

CHBR, The Food Trust, and Temple University’s Center for Obesity Research and Education collaborated to conduct pilot tests in 8 grocery stores to evaluate the effect of in-store marketing strategies on product sales within four product categories. Stores were randomly divided into control and intervention stores.

Project Goals:
Evaluate strategies to increase the sales of healthier items, in a profit-neutral or profit- generating manner, in supermarkets in low-income, ethnically diverse neighborhoods
Refine and pilot test the Grocery Marketing Environment Assessment, an observational tool to measure supermarket marketing environments

PUBLICATIONS:

• Weiss S, Davis E, Wojtanowski AC, Foster GD, Glanz K, Karpyn A. Consumer Taste Tests and Milk Preference in Low-Income, Urban Supermarkets. Public Health Nutrition, 16: 1-4, 2014.
• Glanz K, Bader MD, Iyer S. Retail grocery store marketing strategies and obesity: An integrative review. American Journal of Preventive Medicine, 42(5): 503-512, 2012.
• Foster G, Karpyn A, Wojtanowski A, Davis E, Weiss S, Brensinger C, Tierney A, Guo W, Brown J, Spross C, Leuchten D, Burns P, Glanz K.  Placement strategies to increase the sales of healthier products in supermarkets in low-income, ethnically-diverse neighborhoods: A randomized controlled trial.  American Journal of Clinical Nutrition, 99: 1359-1368, 2014.

Funded by the Robert Wood Johnson Foundation (RWJF) and its Healthy Eating Research Program, and the U.S. Department of Agriculture.

Evidence from behavioral economics suggests that people have short time horizons and difficulty trading off immediate gratification for delayed health benefits. Little is known, however, about whether financial incentives can be effective in encouraging higher levels of physical activity among older adults, particularly when they are in the form of social goals. The goal of this pilot randomized controlled trial was to test whether a financial incentive of a donation to achieve a social goal is more effective to motivate and sustain a daily walking habit than the same dollar value given to an older adult. We used a novel computer platform (Way to Health) with a digital pedometer-internet interface. Adults 65+ residing in a large retirement community were recruited to participate in this research study. This technology allowed for the wide dissemination of this intervention to promote a health habit with benefits to a wide range of older adults. The study pursued a new way of looking at an old problem and generated evidence that is scalable and promoted changes that are sustainable.

Funded by The Robert Wood Johnson Foundation Pioneer Grants

The purpose of the Perceived Food Environment Study was to develop and validate an instrument to evaluate perceived nutrition environment. Once the instrument was developed, survey completion data from two-hundred individuals residing in the Philadelphia area was used to ascertain instrument validity. Observed food environment data collected as part of on-going NEMS (Nutrition Environment Measures Survey) assessments in the greater Philadelphia area were used in the validation process. Data from this study explored the relationship between observed nutrition environment, perceived nutrition environment and eating behaviors.

Funded by the Abramson Cancer Center from state tobacco funds

This integrated project combines research and education to improve understanding and training related to environmental and behavioral factors that influence obesity. The primary aim of the research project was to document the association between characteristics of the nutrition and activity environments, dietary behaviors and physical activity among parents of young children, after adjusting for psychosocial and socioeconomic variables. The study built on an ongoing NIH-funded study that investigates the multilevel correlates of physical activity, nutrition, and obesity in children in forty Seattle and San Diego neighborhoods (Neighborhood Influences on Kids or NIK).

We conducted the Built Environment Assessment Training (BEAT) Institute between 2008-2012 to prepare young investigators and early-career practitioners to use both observational and self-report measures of nutrition and activity environments and related behavioral assessments. There was a BEAT Think Tank held in 2013.

http://www.med.upenn.edu/BEAT/

Funded by the United States Department of Agriculture

P60 Mission

1. Undertake transdisciplinary, translational research about the effects of biological, behavioral, social environmental, physical environmental, and health care factors on prostate cancer outcomes.
2. Establish a foundation for developing interventions that can be used to address disparities in prostate cancer outcomes, particularly as they apply to African American men.
3. Disseminate this information to at-risk populations and the clinical or public health community.

P60 Projects

1. The role of obesity in poor prostate cancer outcomes
2. The use of genetic markers, neighborhood factors, and patient factors to predict prostate cancer outcomes
3. How differences in treatment are affected by health care access and quality

P60 Cores
The center also included specialized cores that added support to the specific projects. These included research and community cores to assist with study guidance, patient outreach and recruitment, statistical modeling, and sharing results with the community at-large.

Contextual Analysis Core (CONAC)
CONAC provided the P60 projects with services for geospatial and network analysis to understand the role of neighborhood and other area-level factors on prostate cancer outcomes and disparities. Services include geocoding and mapping resources, integration of geospatial data, and integration of area-level data from census, public health, and built environment databases with project-specific data.

Prostate Cancer Community Engagement, Evaluation and Dissemination Core (Pro-CEED)
Pro-CEED provided consultation and assistance with the development of evidence-based strategies to ensure timely recruitment of subjects and implementation of study activities and to begin the process of translating the findings into action to reduce health disparities. To ensure community engagement from start to finish, the core developed community-based participatory strategies for disseminating the results from P60 projects to appropriate stakeholders.

Research Training Core (RESTRAC)
RESTRAC aimed to prepare individuals from diverse background to become leaders and members of effective research and dissemination teams in cancer disparities. The training and educational program provided short and intermediate training opportunities to offer future health disparities researchers the opportunity to develop skills in conducting cancer health disparities research. This training occured in a productive, supportive and team-oriented research environment with substantial interaction with primary mentors and content-area preceptors.

Administrative Core
The Administrative Core provided oversight to P60 by monitoring and evaluating progress, enhancing integration amongst projects and cores, and enhancing integration of research and dissemination.

Physical activity (PA), sedentary behavior (SB) and sleep are associated with cancer risk and cancer outcomes. However, measuring these behaviors accurately is difficult because self-reports are often unreliable, and objective monitoring is expensive, time consuming, and is often associated with poor compliance. The overall objective of this study was to improve the assessment of three health behaviors linked to cancer–physical activity (PA), sedentary behavior (SB) and sleep–and examine how objective measures of these behaviors are related to features of the built environment collected from multiple samples living in different geographic regions of the US. This was a 4-center collaborative pilot study being conducted at the University of Pennsylvania and three other TREC sites: University of California at San Diego, Washington University, and Harvard University. The UPenn site of the study was led by Dr. Karen Glanz in collaboration with Jonathan Mitchell, PhD.

The primary aim of this study was to evaluate the convergent validity of objective and self-reported data on physical activity, sedentary behavior, and sleep collected from multiple samples living in different geographic regions of the US.

Secondary aims of this study included:

Examining the feasibility and validity of a wrist mounted accelerometer to contemporaneously measure physical activity, sedentary behavior, and sleep.
Examining the feasibility of deploying and using GPS in an ethnically diverse cohort to develop GIS-matched measures of the built environment relevant to physical activity, sedentary behavior, and sleep.
Describing the inter- and independent patterns (e.g., volume, type) of objectively measured physical activity, sedentary behavior, and sleep among individuals with different cancer status (survivor vs. healthy), and investigating whether these patterns are related to characteristics of the built environment (e.g., neighborhood walkability) and time spent in different locations (e.g., in neighborhood vs. out of neighborhood).

The primary aims of this research project were to use and adopt novel methods to measure and model access to healthy foods and activity environments in an urban area and to engage community members in developing a demonstration project of policy and environmental change to increase access to healthy foods and improved activity environments.

Secondary aims included:

1. Using a mixed-methods approach to assess residents’ shopping and physical activity patterns and reported barriers and facilitators to healthy food access and physical activity
2. Creating a spatial model of healthy food availability using a valid and reliable observational measure of food environments
3. Applying cartographic modeling (raster GIS analysis) in novel ways to create healthy food and physical activity “landscapes”
4. Working with community members to design and evaluate a pilot intervention to address barriers to healthy food access and physical activity in two neighborhoods in urban Philadelphia
   

We also developed and conducted an advanced training institute to prepare young investigators and early-career practitioners to use both observational and self-report measures of nutrition and activity environments and related behavioral assessments. The Advanced Built Environment Assessment Training (BEAT-Plus) Institute added online instruction and train-the-trainer techniques to previously developed classroom training, computer labs, field work, and participatory methods.

PUBLICATIONS:

• Karpyn A, Tappe K, Hillier A, Cannuscio C, Koprak J, Glanz K. Where urban residents shop for produce. In press,Journal of Agriculture, Food Systems, and Community Development, 2015.
• Hillier A, Smith T, Cannuscio CC, Karpyn A, Glanz K. A discrete-choice approach to modeling food store access. In Press, Environment and Planning B, 2015.
• Lucan SC, Hillier A, Schechter CB, Glanz K. Objective and self-reported factors associated with food environment perceptions and fruit-and-vegetable consumption: A multilevel analysis. Preventing Chronic Disease, 2014; 11: 130324.
• Hillier A, Tappe K, Cannuscio C, Karpyn A, Glanz K. In an urban neighborhood, who is physically active and where?Women and Health, 54: 194-211, 2014.
• Cannuscio C, Hillier A, Karpyn A, Glanz K. The social dynamics of healthy food shopping and store choice in an urban environment. Social Science and Medicine, 122: 13-20, 2014.
• Cannuscio CC, Tappe K, Hillier A, Buttenheim A, Karpyn A, Glanz K. An assessment of the urban food environment and residents’ shopping behaviors in that environment. American Journal of Preventive Medicine, 45(5): 606-614, 2013.
• Hillier A, Cannuscio C, Griffin L, Thomas N, Glanz K. The value of conducting door-to-door surveys. In Press,International Journal of Social Research Methodology, 2013.

Funded by the United States Department of Agriculture

Led by Dr. David Asch and Dr. Kevin Volpp, the primary objectives of this project were to design, build, test, and refine an IT platform that will: 1) provide investigators an easily customized web-based platform to evaluate behavioral interventions to promote health, including the use of financial incentives, frequent feedback, visual approaches to information, and social networks; 2) provide older Americans, other members of the general public, and public and private sector organizations with a web portal which can facilitate participation in innovative research on behavioral approaches to improve health behavior at low incremental cost.

Funded by the National Institutes of Health/National Institute on Aging

Led by Dr. Kathryn Schmitz, evaluation of the intervention was guided by Dissemination of Innovation Model constructs that help explain dissemination success, including relative advantage, compatibility, complexity, trialability and observed results. Results of this pilot study were used to further revise PAL intervention delivery approach to develop a larger dissemination trial.

Funded by The National Institutes of Health

Philadelphia’s Communities Putting Prevention to Work (CPPW) goals were to:

1. Increase access to healthy, affordable foods
2. Decrease the availability of nutrient poor, calorie dense foods
3. Enhance opportunities for safe, structured physical activity.
   The ultimate aim was to decrease obesity prevalence and incidence and obesity-related morbidity and mortality

Through this funding, the Philadelphia Department of Public Health (PDPH) and its evaluation partners were poised to enhance evaluation efforts by augmenting BMI measured in children, adding physical activity and food intake measurements among children and adults, and broadening food environment assessments in corners stores and schools. For this enhanced evaluation, PDPH partnered with nationally renowned obesity prevention researchers, Dr. Gary Foster, Director, Center for Obesity Research and Education, Temple University, and Dr. Karen Glanz, Director, Center for Health Behavior Research, University of Pennsylvania.

We focused our efforts on two interventions:

1. The Healthy Corner Store Initiative, which engaged 1000 small corner stores across the city to sell nutritious foods
2. School Wellness Councils, which aimed to eliminate unhealthy competitive foods from 200 schools

The CHBR team led the collection of environmental measures including a NEMS-based food environment assessment of 200 corner stores and Standardized school food environment assessments in 100 K-8 schools. This enhanced evaluation achieved synergy across different evaluation components and took advantage of cross-sectoral collaboration between government, public education, community, and academia.

Funded by the Centers for Disease Control and Prevention

This project, led by Dr. Glanz, is a sub-project of Dr. Katrina Armstrong’s Go Grant: Comparative Effectiveness in Genomic Medicine. Increasing adherence to melanoma prevention behaviors among individuals with a familial predisposition to melanoma is an important public health goal. The role of genetic testing for CDKN2A/p16 and MC1R mutations in the management of families with a predisposition to melanoma is uncertain, in part because there is very little evidence about how testing and counseling affects patient concerns and adherence to preventive recommendations. This proof-of-principle study used a randomized trial design to provide early evidence about the comparative effectiveness of genetic testing and counseling on behavioral outcomes by requesting information about family medical history, sun exposure/protection behaviors and knowledge and risk perception of skin cancers as well as providing genetic counseling that includes genetic test results and feedback to those patients in the intervention arm.

Funded by the National Institutes of Health

The I-SIGHT study aimed to develop, implement, and evaluate an innovative e-health communication intervention to improve glaucoma treatment compliance among 250 patients recruited from two eye clinics in metropolitan Atlanta. The intervention was telephone-based and utilized interactive voice recognition technology. Further, it was individually-tailored to participants’ compliance knowledge, attitudes, and behaviors; health literacy; race and culture; and prescribed medication regimen. This research has the potential to have a significant impact on public health by testing a generalizable and affordable health promotion strategy to increase treatment compliance among diverse populations.

PUBLICATIONS:

• Glanz K, Beck AD, Bundy L, Primo S, Lynn MJ, Cleveland J, Wold JA, Echt KV. Impact of a health communication intervention to improve glaucoma treatment adherence: Results of the I-SIGHT Trial. In Press, Archives of Ophthalmology, June 11: 1-7, 2012.
• Stryker JE, Beck AD, Primo SA, Echt KV, Bundy L, Pretorius GC, Glanz K. An Exploratory Study of Factors Influencing Glaucoma Treatment Adherence. Journal of Glaucoma, 19: 66-72, 2010.

Funded by the National Institutes of Health

PennSCAPE (Skin Cancer Awareness, Prevention, and Education) builds on a previous study conducted by Dr. Glanz and others looking at the impact of sending tailored risk information and motivational intervention materials to increased-risk adults from a large primary care practice. The primary aim of the study was to evaluate the impact of tailored print materials on skin cancer prevention behaviors and skin self-examination among an adult population at moderate to high risk for skin cancer. This study also examined the relative yield and functioning of the two risk assessment tools (BRAT and Fears) for determining level of risk for skin cancer.

Funded by the National Cancer Institute (NCI), Pool Cool was a sun-safety education program especially designed for use at swimming pools. Its main objective was to increase awareness, motivation, and sun protection practices among children ages 5-10 who take swimming lessons, their parents, aquatics staff, and other pool users. The Pool Cool program has been evaluated in several studies, and the name Pool Cool has been used for multiple research projects.

Pool Cool Website

PUBLICATIONS:
Efficacy Trial

• Glanz K, Geller AC, Shigaki D, Maddoc JE & Isnec MR. A randomized trial of skin cancer prevention in aquatic settings: The Pool Cool program. Health Psychology, 21, 579-587, 2002.
• Geller A, Glanz K, Shigaki D, Isnec MR, Sun T & Maddock J. Impact of skin cancer prevention on outdoor aquatics staff: The Pool Cool program in Hawaii and Massachusetts. Preventive Medicine, 33, 155-161, 2001.

Dissemination and Diffusion

• Hall D, Escoffery C, Nehl E, Glanz K. Spontaneous diffusion of an effective skin cancer prevention program through web-based access to program materials. Preventing Chronic Disease, 7(6): 2010.
• Hall D, McCarty F, Elliott T & Glanz K. Lifeguards’ sun protection habits and sunburns: Association with sun-safe environments and skin cancer prevention program participation. Archives of Dermatology, 145(2), 139-144, 2009.
• Hall D, Elliott T, Nehl E & Glanz K. Effectiveness of a targeted, peer-driven skin cancer prevention program for lifeguards.International Journal of Aquatic Research and Education, 2, 287 – 297, 2008.
• Glanz K, Steffen A, Elliott T & O’Riordan D. Diffusion of an effective skin cancer prevention program: Design, theoretical foundations, and first-year implementation. Health Psychology, 24(5), 477-487, 2005.

Process Evaluation

• Rabin BA, Nehl E, Elliott T, Deshpande AD, Brownson RC, Glanz K. Individual and setting level predictors of the implementation of a skin cancer prevention program: a multilevel analysis. Implementation Science, 5:40, 2010.
• Elliott T, Glanz K & Nehl E. Characteristics of swimming pools with high rates of objectively measured sunscreen use.Journal of the American Academy of Dermatology, 60, 684-688, 2009.
• Escoffery C, Glanz K, Hall D & Elliott T. A multi-method process evaluation for a skin cancer prevention diffusion trial. Evaluation and the Health Professions. Evaluation Health Professional, 32, 184, 2009.
• Hall D, Dubruiel N, Elliott T & Glanz K. Linking agents’ activities and communication patterns in a study of the dissemination of an effective skin cancer prevention program. Journal of Public Health Management and Practice, 2009.
• Escoffery C, Glanz K & Elliott T. Process evaluation of the Pool Cool Diffusion Trial for skin cancer prevention across 2 years. Health Education Research, 23(4), 732-743, 2008.
• Glanz K, Isnec MR, Geller A & Spangler K. “Process evaluation of implementation and dissemination of a sun safety program at swimming pools.” In Steckler A, Linnan L (Eds.), Process Evaluation in Public Health Interventions (pp. 58-82). San Francisco: Jossey-Bass, 2002.

Methods and Validation

• Elliott T, Nehl E & Glanz K. A controlled trial of objective measures of sunscreen and moisturizing lotion. Cancer Epidemiology, Biomarkers & Prevention, 18(5), May 2009.
• Gies P, Glanz K, O’Riordan D, Elliott T, Nehl E. Measured occupational solar UVR exposures of lifeguards in pool settings.American Journal of Industrial Medicine, 52, 645-653, 2009.
• Glanz K, McCarty F, Nehl E, O’Riordan D, Gies P, Bundy L, Locke A & Hall D. Validity of self-reported sunscreen use by parents, children and lifeguards. American Journal of Preventive Medicine, 36(1), 63-69, 2009.
• O’Riordan DL, Nehl E, Gies P, Bundy L, Burgess K, Davis E & Glanz K. Validity of covering-up sun protection habits: Association of observations and self-report. Journal of the American Academy of Dermatology, 2009.
• Glanz K, Yaroch AL, Dancel M, Saraiya M, Crane LA, Buller DB, et al. Measures of sun exposure and sun protection practices for behavioral and epidemiologic research. Archives of Dermatology, 144, 217-222, 2008.
• O’Riordan DL, Glanz K, Gies P & Elliott T. A pilot study of the validity of self-reported ultraviolet radiation exposure and sun protection practices among lifeguards, parents and children. Photochemistry and Photobiology, 84(3), 774-778, 2008.
• Glanz K & Mayer J. Reducing ultraviolet radiation exposure to prevent skin cancer. American Journal of Preventive Medicine, 29(2),131-142, 2005.
• O’Riordan DL, Lunde KB, Urschitz J & Glanz K. A noninvasive objective measure of sunscreen use and reapplication.Cancer Epidemiology, Biomarkers & Prevention, 14(3), 722-726, 2005.

Other Related Publications

• Kim B, Glanz K, Nehl E. Vitamin D Beliefs and Associations with Sunburns, Sun Exposure, and Sun Protection. In Press,International Journal of Environmental Public Health, 2012.
• Glanz K, Buller DB & Saraiya M. Reducing ultraviolet radiation exposure among outdoor workers: State of the evidence and recommendations. Environmental Health, 6(22), 2007.
• Glanz K, Halpern AC & Saraiya M. Behavioral and community interventions to prevent skin cancer. Archives of Dermatology, 142, 356-360, 2006.
• Glanz K & Saraiya M. Using evidence-based community and behavioral interventions to prevent skin cancer: Opportunities and challenges for public health practice (Editorial). Preventing Chronic Disease: Public Health Research, Practice, and Policy, 2(2), 2005.
• Saraiya M, Glanz K, Briss PA, Nichols P, White C, Das D, et al. Interventions to prevent skin cancer by reducing exposure to ultraviolet radiation – A systematic review. American Journal of Preventive Medicine, 27, 422-466, 2004.

This center works with the CDC’s Healthy Brain Initiative Network to establish a research agenda to develop and disseminate messages that educate and empower the nation about cognitive health and other Road Map priorities, as well as train the next generation of leaders in public health and cognitive aging.

PROJECT LEADS: Jason Karlawish and Amy Jordan

FUNDING CYCLE: 2014-2019

PUBLICATIONS:

• Stites S, Largent E, Johnson R, Harkins K, Karlawish J. Effects of Self-Identification as a Caregiver on Expectations of Public Stigma of Alzheimer’s Disease. J Alzheimers Dis Rep. 2021 Jan 16;5(1):31-39.
• Balbim GH, Ashley Maldonado, Early A, Steinman L, Harkins K, Marquez D. Evaluation of Public Health Messages Promoting Early Detection of Dementia Among Adult Latinos With a Living Older Adult Parental Figure. Hisp Health Care Int. 2020 Sep;18(3):163-173.
• Zhong R, Sisti D, Karlawish J. A pragmatist’s guide to the assessment of decision-making capacity. The British Journal of Psychiatry. 2019 Mar 21;214(4):183-185.
• Largent E, Karlawish J, Grill J. Study partners: essential collaborators in discovering treatments for Alzheimer’s disease. Alzheimer’s Research & Therapy 10, 101 (2018).
• Hailu T, Cannuscio C, Dupuis R, Karlawish J. A Typical Day With Mild Cognitive Impairment. American Journal of Public Health. 2017 Jun 1; 107:6, pp. 927-928.

This 3-year study uses a mixed-methods strategy to assess knowledge, attitudes and beliefs of adults; develop effective messages; and test communication strategies for two categories of skin cancer risk behaviors among adults ages 18 to 49 years: indoor tanning and outdoor sun exposure.

PROJECT LEADS: Karen Glanz and Amy Jordan

FUNDING CYCLE: 2014-2019

PUBLICATIONS:

• Jordan A, Bleakley A, Alber J, Lazovich D, Glanz K. Developing and testing message strategies to reduce indoor tanning. American Journal of Health Behavior, 2020 May 1;44(3):292-301.
• Bleakley A, Jordan A, Strasser A, Lazovich D, Glanz K. Testing General Versus Specific Behavioral Focus in Messaging for the Promotion of Sun Protection Behaviors. Annals of Behavioral Medicine, Oct 2019, 54(2):108-118
• Calderón TA, Bleakley A, Jordan AB, Lazovich D, Glanz K. Correlates of sun protection behaviors in racially and ethnically diverse U.S. adults. Prevention Medicine Reports, Mar 2019; 13:346-353
• Bleakley A, Lazovich D, Jordan A, Glanz K. Compensation Behaviors and Skin Cancer Prevention, American Journal of Preventive Medicine, Dec 2018, 55(6): 848-855
• Bleakley A, Jordan A, Ellithorpe M, Lazovich D, Grossman S, Glanz K, A national survey of young women’s beliefs about quitting indoor tanning: implications for health communication messages, Translational Behavioral Medicine, Dec 2018, 8(6):898–906.
• Glanz K, Jordan A, Lazovich D, Bleakley A. Frequent Indoor Tanners’ Beliefs About Indoor Tanning and Cessation. American Journal of Health Promotion, July 2018; 33(2), 293–299.

This project is working with adolescent and young adult (AYA) survivors of childhood cancer and involves testing the impact of AYA STEPS (Self-management via Texting, Education and Plans for Survivorship). AYA STEPS is an innovative, technology-based intervention that provides customized care plans and a tailored mobile health application to enhance survivorship self-management.

PROJECT LEADS: Christine Hill-Kayser and Lisa Schwartz

FUNDING CYCLE: 2015-2018

PUBLICATIONS:

• Darabos K, Barakat L, Schapira M, Hill-Kayser C, Schwartz L. Association of Demographic and Cancer-Specific Factors on Health Behavior Recommendations Specific to Cancer Prevention and Control Among Adolescent and Young Adult Survivors of Childhood Cancer. J Adolesc Young Adult Oncol. 2020 Nov 18. doi: 10.1089/jayao.2020.0130. Online ahead of print.
• Schwartz L, Psihogios A, Henry-Moss D, Daniel LC, Ver Hoeve E, Velazquez-Martin B, Butler E, Hobbie W, Buchanan Lunsford N, Sabatino S, Barakat L, Ginsberg J, Fleisher L, Deatrick J, Jacobs L, O’Hagan B, Anderson L, Fredericks E, Amaral S, Houston K, Vachani C, Hampshire M, Metz J, Hill-Kayser C, Szalda D. Iterative development of a tailored mHealth intervention for adolescent and young adult survivors of childhood Cancer. Clinical Practice in Pediatric Psychology, Mar 2019; 7(1): 31-43.
• King-Dowling S, Psihogios AM, Hill-Kayser C, Szalda D, O’Hagan B, Darabos K, Daniel LC, Barakat LP, Fleisher L, Maurer LA, Velázquez-Martin B, Jacobs LA, Hobbie W, Ginsberg JP, Vachani CC, Metz JM, Schwartz LA. Acceptability and feasibility of survivorship care plans and accompanying mobile health intervention for adolescent and young adult survivors of childhood cancer. Pediatr Blood Cancer. 2021 Mar;68(3):e28884. doi: 10.1002/pbc.28884. Epub 2021 Jan 8. PMID: 33416214

This study is comparing the economic impact and health-related quality of life outcomes among children with cancer who were treated on Phase III clinical trials to those who receive non-trial standard treatment. Outcomes evaluated include survival, direct and indirect costs, and health-related quality of life. Findings will inform decision-making for children with cancer and their families who are considering taking part in therapeutic clinical trials.

PROJECT LEAD: Marilyn Schapira

FUNDING CYCLE: 2015-2017

PUBLICATIONS:

• Schapira MM, Barakat LP, Silber JH: Reply to Assessing clinical trial effects on outcomes among pediatric and adolescent and young adult (AYA) patients with cancer. Cancer. Oct 2020.
• Schapira MM, Stevens EM, Sharpe JE, Hochman L, Reiter JG, Calhoun SR, Shah SA, Bailey LC, Bagatell R, Silber JH, Tai E, Barakat LP. Outcomes among pediatric patients with cancer who are treated on trial versus off trial: A matched cohort study. Cancer. 2020 Aug 1;126(15):3471-3482. doi: 10.1002/cncr.32947. Epub 2020 May 26. PMID: 32453441.

This project involves developing, implementing, and evaluating a mentored experience (Philadelphia Health Leadership Institute – PHLI) to train community leaders in the Philadelphia Promise Zone to assess, intervene and evaluate a project addressing a chronic health problem.

PROJECT LEADS: Fran Barg and Heather Klusaritz

FUNDING CYCLE: 2015-2019

This 2-year project developed and disseminated an evidence base of culturally relevant messages and strategies to promote awareness about cognitive impairment to public health networks to increase detection and adoption of strategies to preserve cognitive health.

PROJECT LEADS: Jason Karlawish and Amy Jordan

FUNDING CYCLE: 2014-2016

PUBLICATIONS:

• Jordan A, Bleakley A, Harkins K, Hailu T, Cassidy K, Hachey S, Karlawish J, “Together Make a Visit; Together Make a Plan:” Messaging to Adult Children with Concerns about a Parent’s Memory Loss, Health Communication, Feb 2019; 1-12.
• Stites S, Harkins K, Rubright J, Karlawish J. Relationships Between Cognitive Complaints and Quality of Life in Older Adults With Mild Cognitive Impairment, Mild Alzheimer Disease Dementia, and Normal Cognition. Alzheimer Dis Assoc Disord. Oct-Dec 2018; 32(4):276–283.
• Stites S, Milne R, Karlawish J. Advances in Alzheimer’s imaging are changing the experience of Alzheimer’s disease. Alzheimer’s and Dementia: Diagnosis, Assessment and Disease Monitoring. Jan 2018, 10: 285-300
• Hailu T, Cannuscio C, Dupuis R , Karlawish J. A Typical Day with Cognitive Impairment. American Journal of Public Health, 2017, 107: 927-928.