Article by Glanz and her team receives honor from major nutrition journal

Karen Glanz, PhD, MPH

UPenn PRC Director Karen Glanz, MPH, PhD and her co-authors received the 2019 High-Impact Award from the Journal of Nutrition Education and Behavior (JNEB) for a highly cited paper published in 2016. The publication focuses on synthesizing the evidence about how researchers measure the presence of healthful food and beverage options are in food stores – an issue of growing public interest in efforts to promote healthy eating.

Read the paper here.

 

 

Glanz K., Johnson L., Yaroch A.L., Phillips M., Ayala G.X., Davis E.L.
Measures of Retail Food Store Environments and Sales: Review and Implications for Healthy Eating Initiatives J Nutr Educ Behav 2016; 48(3)

A call for answers for the ‘Three Identical Strangers’

UPenn PRC Director, Karen Glanz, MPH, PhD and Holly Fernandez Lynch of Penn’s Department of Medical Ethics and Health Policy, shine a light on the responsibilities of the research ethics community when it comes to deceptive experiments like the 1960’s study featured in Three Identical Strangers.

Read the article here.

The opinion piece was published in Stat News, just in time for the release of the documentary on CNN and a BAFTA nomination for the filmmakers. Penn News Today featured the article in their February 11, 2019 issue here.


Nominated for Best Documentary in 2019

Year in Review – 2018

As we begin the new year 2019, we’ve compiled some highlights of the past year at the UPenn Prevention Research Center.  Enjoy the video, and note some of our key accomplishments.

  • The University of Pennsylvania made great strides towards promoting the health of students and staff, both mentally and physically. We aim to continue to contribute to these efforts!

  • The UPenn PRC Director, Karen Glanz, spent 4 months on  a sabbatical at the University of Hawaii Cancer Center, where she became an expert voice in the debate over banning sunscreens with certain ingredients, thought to cause damage to coral reefs.

  • In November,  we explored the findings of tobacco control science research with experts from Penn and around the country. We saw broad acknowledgement of the epidemic of e-cigarette use, and learned more about the devices and the marketing of these products, and the policy options being considered.

We look forward to a healthy and productive 2019 and hope to help our community continue to advance chronic disease prevention for many healthy new years ahead!

 

Karen Glanz named Associate Director and Program Leader at the Abramson Cancer Center

Monday, November 26, 2018, Abramson Cancer Center director, Robert Vonderheide and deputy director, Katherine Nathanson announced the appointment of Karen Glanz, PhD, MPH as Associate Director for Community Engaged Research and Leader for the Cancer Control Program.

“Dr. Glanz is the George A. Weiss University Professor in the Perelman School of Medicine and the School of Nursing, as one of Penn’s distinguished Penn Integrates Knowledge (PIK) Professors. Dr. Glanz is director of the federally funded UPenn Prevention Research Center. Dr. Glanz is a behavioral scientist with public health expertise. Her basic and translational research in community and healthcare settings focuses on obesity, nutrition, and the built environment; reduction of health disparities; and novel health communication technologies. She has made important and sustained contributions to cancer prevention and control.  With more than 480 publications and designation as a Most Highly-Cited Author over the past 20 years (top 0.5% of authors in the field), Dr. Glanz’s scholarship has been consistently interdisciplinary and highly influential in advancing the science of understanding, predicting, and changing health-related behavior. Dr. Glanz is an elected member of the National Academy of Medicine, served on the US Task Force on Community Preventive Services for 10 years, and is a current member of the NHLBI Advisory Council.  Dr. Glanz has been a valued member of the Cancer Control Program at the ACC since 2009.”

The Cancer Control Program is a transdisciplinary Program composed of members who focus on the identification of the genetic, behavioral, and health care determinants of cancer susceptibility and the development and implementation of strategies to lower risk and improve outcomes.

Dr. Glanz will step into the role previously held by Marilyn Schapira, MD, MPH, Principal Investigator on the UPenn PRC Economic Impact of Clinical Trials for Childhood Cancer Project. Dr. Schapira will continue to work with the Cancer Control Program at Abramson Cancer Center and teach medicine at the Perelman School of Medicine.

How far will you go to prevent skin cancer? Penn researchers look at the options

A study was published in the American Journal of Preventive Medicine, where Penn researchers evaluate the beliefs in sun protection behaviors versus the risk of skin cancer.

It is known that practicing multiple behaviors against harmful UV rays, yet few adults report practicing more than one recommended behavior. This study examines how far a person is willing to go to prevent damage from UV rays, and which prevention measure is used most frequently.

Read the paper here

 

Bleakley A, Lazovich D, Jordan AB, Glanz K. Compensation Behaviors and Skin Cancer Prevention, American Journal of Preventive Medicine, Volume 55, Issue 6, December 2018, Pages 848-855

 

Read more about the Skin Cancer Communication Project here.

A 1-day conference on tobacco control and products in Philadelphia

This Evidence Academy will be a one-day conference designed to bring together researchers and health professionals, advocates, and policymakers, to accelerate the process of integrating research findings about tobacco prevention and control, into public health and clinical practice.

The Cancer Prevention and Control Research Network (CPCRN) and the UPenn Prevention Research Center (UPenn PRC) are funded by the Centers for Disease Control and Prevention (CDC) and the National Cancer Institute (NCI), and seek to improve health, reduce disparities, and bridge the gap between research and practice. This event is also sponsored by the Penn Medicine Abramson Cancer Center, a world leader in cancer research, patient care, and education.

November 16, 2018
8:00 a.m. to 5:00 p.m.
The Study at University City, 3700 Walnut Street, Philadelphia, PA

Featured Speakers

• Michael Amato, PhD
Methodologist and Research Investigator
Truth Initiative

• Michael Fiore, MD, MPH, MBA
Hilldale Professor of Medicine
University of Wisconsin

• Meghan Moran, PhD
Assistant professor in Department of Health, Behavior & Society
Johns Hopkins University Bloomberg School of Public Health

• Kurt Ribisl, PhD
Professor and chair in the Department of Health Behavior
University of North Carolina Gillings School of Global Public Health

• Robert Schnoll, PhD
Associate Professor in the Department of Psychiatry
University of Pennsylvania

• Andrew Strasser, PhD
Research Associate Professor of Behavioral Health in Psychiatry
University of Pennsylvania Perelman School of Medicine

• Anil Vachani, MD
Associate Professor of Pulmonary and Critical Care Medicine
University of Pennsylvania Perelman School of Medicine

• Jennifer Irvin Vidrine, PhD
Professor in the Department of Family & Preventive Medicine
University of Oklahoma Health Sciences Center

• Andrea Villanti, PhD, MPH
Associate Professor in the Department of Psychiatry
Vermont Center on Behavior & Health at the University of Vermont

View the event program

 

Evaluating Healthy Vending Policies for Youth in Four Cities – Report Now Available

Best Practices

Karen Glanz, PhD, MPH and her team recently conducted an evaluation of healthy vending policies and initiatives affecting youth in four cities.

  • Chicago Parks District in Chicago, Illinois
  • Mecklenburg County, North Carolina
  • Philadelphia, Pennsylvania
  • Springdale, Arkansas.

Vending machines are a common source for low nutrient, energy-dense snacks and beverages. Consequently, youth can easily access vending machines at many public spaces such as parks, recreation centers, and swimming pools. Increasing the availability of healthier options in vending machines is one way to influence healthier snacking behaviors. Furthermore, it is aligned with the CDC recommendation for communities to make healthier food and beverage options more readily available in public venues.

Many cities are beginning to adopt healthy vending policies in public areas, but more could be done to develop, implement, and evaluate these healthy vending polices is limited.

 

The Design

This study used a mixed-methods, multiple-case study design and included semi-structured interviews with multiple stakeholders from each city. The site visits at each city included surveys with adults using the vending machines and observations of the available products in vending machines. In addition to a review of documents, including nutrition standards, policies, requests for proposals (RFPs), vending contracts, sales data, and any existing evaluation tools were collected from each site.

The research findings are summarized in this report. It describes the major similarities and differences across four cites/counties who chose healthy vending practices. The report emphasizes what works and what doesn’t when developing, executing, and evaluating healthy vending policies and initiatives.


This research was supported by Healthy Eating Research, a national program of the Robert Wood Johnson Foundation.

 Evaluating Healthy Vending Policies for Youth in Four Cities

Karen Glanz, PhD, MPH; Julie Bromberg, MHS; Yasaman Mirafzali; Sarah Green, MPH

Is it dementia? Dr. Jason Karlawish helps you identify the signs

Aging happens differently for everyone and forgetting some details for daily tasks is not always cause for alarm. But there are signs that you or a loved one are showing signs of dementia or other diseases, like Alziemer’s. Dr. Jason Karlawish published an article with AARP as part of their Disrupt Dementia campaign.

Dr. Karlawish a researcher on the Healthy Brain Research Network and the Cognitive Aging Communication Project, both funded supplements to the UPenn Prevention Research Center. He also serves as the director of the Penn Memory Center.  Dr. Karlawish writes about what to look for and the risks involved with allowing the disease to progress without intervention.

Read about the signs to look for and his personal experience with an aging parent here. Tweet about your experiences, using the hashtag #DisruptDementia and tag @AARP and @jasonkarlwish.

Advances in Alzheimer’s imaging are changing the experience of Alzheimer’s disease

Stites, S.D., Milne, R., Karlawish, J.
Alzheimer’s and Dementia: Diagnosis, Assessment and Disease Monitoring

Volume 10, 1 January 2018, Pages 285-300

  • PRC Investigator, Dr. Jason Karlawish joined S.D. Stites and R. Milne to study how a bio marker-based diagnosis can help a patient during each stage of Alzheimer’s Disease. The stigma or shame that can come with the disease can affect how a patient feels about themselves. Dr. Karlawish and his colleagues explored how changes in the way a patient is diagnosed can help address these stigmas.

Read more about the Healthy Brain Research Network here.

Coverage of Hawaii’s ban on certain sunscreens and the risks involved

Preserve Marine Ecosystems

Hawaii proposed and then passed a bill banning sunscreens containing oxybenzone and octinoxate in order to “preserve marine ecosystems.” PRC director and Penn professor, Karen Glanz, PhD, MPH, co-authored an op-ed for the Honolulu Star-Advertiser titled, “Suncreens save lives, have limited impact on coral reefs.” Dr. Glanz was on a sabbatical for the first part of 2018, and served as a Visiting Professor at the University of Hawaii Cancer Center. Together with Kevin Cassel, president of the Hawaii Skin Cancer Coalition, the piece was published, March 29, 2018.

Acknowledging health factors and disparities

Glanz and Cassel start by acknowledging that sunscreen is a key factor in preventing skin cancer. Furthermore, they call on legislators to fund more research on the ingredients in sunscreen and the effects they have on Hawaii’s natural resources.

Their article caught the attention of the local media and they called on Dr. Glanz to present her views on the impact this decision could have on those at risk for skin cancer. In addition, they bring light to the higher price for sunscreens that don’t contain those ingredients. This could prevent people from purchasing those products. “The cost of these so-called reef-friendly products for sunscreen ranges anywhere from two times to as much as six to eight times as much as what is on the shelves now.” She points out that it isn’t just beachgoers that are affected, there are a number of jobs in Hawaii requiring people to work outside and they could be the most at risk.

Resources

READ the article here.
WATCH Karen’s interview with Hawaii News Now 
LISTEN to her interview with SiriusXM, Knowledge@Wharton with Dan Loney on May 17, 2018. 

Mahealani Richardson of Hawaii News Now interviewed Karen Glanz and Kevin Cassel on this topic and the story aired April 4, 2018. After Hawaii passes the legislation, Ms. Richardson shares an update.

Click here to see the story on Hawaii News Now.

 

Listen to Karen’s interview with Dan Loney at SiriusXM Knowledge@Wharton, (Wharton Business Radio) on May 17, 2018 HERE.

A national survey of young women’s beliefs about quitting indoor tanning: implications for health communication messages

Indoor tanning is a risk factor for skin cancer, particularly among young, white women. Our researchers found that persuasive health messages that encourage young women to quit indoor tanning should focus on their beliefs that it helps their appearance and mood, rather than the health risks.

20% of our nation’s young, white women indoor tan, knowing the risk of skin cancer. In November and December of 2015, a national online  survey was conducted with 279 non-Hispanic white women, ages 18-25 in the United States, who indoor tan.

This survey investigated the young women’s beliefs and attitudes as well as social influences that kept them from quitting.

“Young women were most concerned about skin damage and that quitting tanning might affect their mood,” says Amy Bleakley PhD, MPH, lead author of the study. “It was interesting that quitting tanning to prevent skin cancer did not motivate their intention to quit. Health messages that focus on appearance and mood instead of skin cancer may be more effective in encouraging young women to quit indoor tanning.”

Researchers suggest that health messages from doctors, parents and other loved ones aimed at discouraging indoor tanning should highlight the belief that quitting indoor tanning will reduce skin damage. In addition, messages should counter the belief that quitting will make them less happy. Finally, messages should highlight key people who would approve of them quitting indoor tanning.

Read the article here.

 

Amy Bleakley, Amy Jordan, Morgan E Ellithorpe, DeAnn Lazovich, Sara Grossman, Karen Glanz

Translational Behavioral Medicine, ibx007, https://doi.org/10.1093/tbm/ibx007
Published: March 15, 2018

 

Viewpoint Op Ed: Don’t let a single diagnosis define the patient

In the November 6, 2017 edition of The Philadelphia Inquirer, Karen Glanz, PhD, MPH, shares her father’s experience with health care and offers ideas on how we handle patients and their diagnosis in the future.

 

While shared and electronic medical records have many benefits, they carry unacknowledged risks. One is that the primary diagnosis becomes a patient’s identity, even when that diagnosis is in error and anxiety-provoking for the patient and family.

 

When my father was first hospitalized, he was a relatively healthy 93-year-old who could get around on his own, was mentally lucid, and could even drive. But one day he went to the emergency room weak and with jaundice. He had an obstructed biliary tract and needed a cholecystectomy, or gall bladder removal. During his treatment, the doctors examined the insides of his biliary tract using a technique called “biliary brushing” — and then informed me and my father that he had a “possible diagnosis” of pancreatic cancer.

 

The surgeon met with us and explained that at his advanced age, treatment for pancreatic cancer would be worse than the disease, and we mutually agreed that keeping a lookout for symptoms was the best approach. Dad put the cancer diagnosis out of his mind, because he had other more pressing concerns — getting back his strength, being able to eat again, and recovering from the rapid de-conditioning that occurs when a very old person is in a hospital bed for eight days.

Dad left the hospital greatly weakened and spent the next three months in a skilled nursing facility just down the hall from his apartment. I accompanied him on follow-up visits, first with the gastroenterologist. The physician assistant saw him first. When she opened up the medical record on a computer screen, she said, “I see you have pancreatic cancer.” He was taken by surprise, since he thought he was simply having a follow-up visit for the stent placed in his biliary tract. But the cancer was the headline on the medical record — the most important problem that defined him.

 

Other appointments followed, with the surgeon and oncologist. I asked them for more information about the pancreatic cancer diagnosis. What were his “numbers” or “levels” from the biliary brush cytology? Was there any staging information? As a public health professional teaching in medical and nursing schools, and conducting cancer control research, I wanted more information. I was promised specifics, but never received them, despite my persistence.

 

Dad’s next visit to the ER occurred a few months later, when he was incoherent after a fall from his bed in the skilled nursing facility. The first reaction by the ER doctors and nurses — he has pancreatic cancer. As it turned out, he had a hip fracture and internal bleeding. He was found to have a healthy enough heart to go ahead with a hip replacement, in the hope that he could walk again.

 

He never developed any symptoms of pancreatic cancer. There was one more hospitalization, nine months after the first one. He was a very weak 94-year-old and the ER doctors said, “I see he has pancreatic cancer.” This time it was pneumonia and a few days later he entered a residential hospice, where he spent his last five days receiving palliative care from a wonderful hospice team. Cause of death? Sepsis. Other significant conditions contributing to death? Probable pancreatic cancer.

 

Just a few decades ago, doctors were reluctant to tell a patient about a cancer diagnosis. Now the doctors — really, the records — couldn’t repeat the diagnosis often enough. I was troubled by the possible or probable pancreatic cancer diagnosis and how it dominated his electronic health record. And I was concerned that I never received much information to understand it. So I ordered and paid for his medical records.

 

It turns out that only the hospital records were provided; I did not receive images of his electronic health record. And it turned out that the pancreatic cancer diagnosis was cut-and-pasted from one record to the next. It was “possible biliary tract cancer or pancreatic cancer” but no definitive diagnosis was made. Apparently, though not written in the record, the imaging tests for further diagnosis were determined to be of little value, and thus were not done.

 

So was my father his pancreatic cancer? Probably not, and not even the doctors know the whole story. But it seemed like the system failed him, and me and our family. Caregivers are responsible for the accuracy of the records. Cut-and-paste doesn’t cut it. They are also responsible for putting diagnoses in appropriate clinical priority and for being sure that something does not get passed on as a dehumanizing label.

 

Sooner or later, everyone will become a patient. We need new ways to modify the medical record to preserve its link to the uniqueness of the patient, so the diagnosis doesn’t supersede the person.

 

Karen Glanz, PhD, MPH is George A. Weiss university professor of medicine and nursing at the University of Pennsylvania and director of the UPenn PRC.

 

Op ed via The Philadelphia Inquirer, Viewpoint