Public perception of predictive cancer genetic testing and research in Oregon.

The potential for using widespread genetic testing to inform health care has become a viable option, particularly for heritable cancers. Yet, little is known about how to effectively communicate the benefits and risks of both personal genetic testing and participation in biorepositories that aid scientific advancements. Nationwide efforts are engaging communities in large genetic studies to better estimate the population-wide prevalence of heritable cancers but have been met with hesitance or declination to participate in some communities. To successfully engage an Oregon population in longitudinal research that includes predictive genetic testing for pathogenic or likely pathogenic variants associated with an increased risk for cancer, researchers conducted 35 focus groups (two of which were held in Spanish) in 24 of Oregon's 36 counties to better understand knowledge and attitudes related to genetic testing and willingness to participate in longitudinal genetic research. A total of 203 adults (mean = 45.6 years; range 18-88), representing a range of education levels and prior knowledge of genetic research, participated in the focus groups. The majority (85%) of participants reported personal or family diagnoses of cancer (e.g., self, family, friends). A majority (87%) also reported a strong interest in cancer genetic testing and receiving genetic information about themselves. Nearly all focus groups (94%, 33 of 35 sites) included participant discussion citing their families (e.g., children, close relatives, and extended family members) as key motivators for participation in genetic research. For example, participants reported interest in increasing personal knowledge about their own and their families' cancer risks in order to respond proactively, if a pathogenic variant was found. While most focus groups (94%, 33 of 35 sites) included participant discussion describing barriers to predictive genetic, testing such as concerns about outcomes, the desire to learn about health risks in oneself mitigated or outweighed those fears for many participants. Other commonly reported concerns were related to potential mistrust of insurance companies, researchers, or institutions, or lack of knowledge about genetics, genetic testing, or genetic research. Participants, particularly in rural areas, highlighted critical factors for research recruitment, such as trust, personal interaction, public education about genetic research, and clear communication about study goals and processes. Our statewide findings reflect that public interest in predictive cancer genetic testing and cancer genetic research can surpass lack of knowledge of the complex topics, particularly when benefits for self and family are emphasized and when study considerations are well articulated.

The SHIELD (Safety & Health Improvement: Enhancing Law Enforcement Departments) Study: Mixed Methods Longitudinal Findings.

The SHIELD (Safety & Health Improvement: Enhancing Law Enforcement Departments) Study is a worksite wellness team-based intervention among police and sheriff departments assessing the program's effectiveness to reduce occupational risks and unhealthy lifestyle behaviors. The SHIELD program focused on improving diet, physical activity, body weight and sleep, and reducing the effects of unhealthy stress and behaviors, such as tobacco and substance abuse. The SHIELD team-based health promotion program was found to be feasible and effective at 6 months in improving diet, sleep, stress, and overall quality of life of law enforcement department personnel. Both intervention and control groups were followed for 24 months, and we report those durability findings, along with qualitative group interview results that provide insight into the changes of the long-term outcomes. Long-term effects were observed for consumption of fruits and vegetables, and there was some evidence for effects on tobacco and alcohol use. Assessment of dietary habits, physical activity behaviors, weight loss maintenance, and substance use is rare more than 1 year following an intervention, and in general, initial positive changes do not persist in prior research. The SHIELD program was feasible, effective, and durable for improving dietary changes.

Factors in adoption of a fire department wellness program: champ-and-chief model.

OBJECTIVE: To identify and evaluate determinants of fire departments' wellness program adoption. METHODS: The Promoting Healthy Lifestyles: Alternative Models' Effects fire service wellness program was offered for free to all medium-sized fire departments in Oregon and Washington. An invitation to participate was mailed to key fire department decision makers (chief, union president, and wellness officer). These key decision makers from 12 sites that adopted the program and 24 matched nonadopting sites were interviewed and results were analyzed to define adoption determinants. RESULTS: Three adoption requirements were identified: (1) mailer connection, (2) local firefighter wellness champion, and (3) willing fire chief, whereas a fourth set of organizational factors had little or no impact on adoption including previous and ongoing wellness activities, financial pressures, and resistance to change. CONCLUSIONS: Findings identified determinants of medium-sized fire service wellness program adoption.

Body mass index as a predictor of firefighter injury and workers' compensation claims.

OBJECTIVE: To determine the relationship between lifestyle variables including body mass index and filing a workers' compensation claim due to firefighter injury. METHODS: A cross-sectional evaluation of firefighter injury related to workers" compensation claims occurring 5 years after the original Promoting Healthy Lifestyles: Alternative Models' Effects study intervention. RESULTS: A logistic regression analysis for variables predicting filing a workers' compensation claim due to an injury was performed with a total of 433 participants. The odds of filing a compensation claim were almost 3 times higher for firefighters with a body mass index of more than 30 kg/m than firefighters with a normal body mass index (odds ratio, 2.89; P < 0.05). CONCLUSIONS: This study addresses a high-priority area of reducing firefighter injuries and workers' compensation claims. Maintaining a healthy body weight is important to reduce injury and workers' compensation claims among firefighters.