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Cancer Control Research

Abstract

DESCRIPTION (provided by applicant): About 1 in 90 American children born in the late 1990's will develop malignant melanoma in their lifetimes. Sun exposure in childhood appears to be the most important preventable risk factor for this disease. This study will continue to follow a previously enrolled cohort (n=728) that participated in a randomized trial of a provider-delivered sun protection intervention while children were between the ages of 0 and 3 years. The study will also enroll an additional 900 children who are part of the same birth cohort from 1998. Subjects in both the original cohort and new cohort will be randomly assigned to intervention and control groups; the intervention group will receive a series of tailored newsletters aimed at increasing sun protection over a 3-year intervention period. This tailored intervention is based on the Precaution Adoption Process Model, which focuses on increasing personal perceptions of risk. The effectiveness of the intervention in increasing sun protection of children will be evaluated through telephone surveys of parents at four time-points (upon enrollment and 1, 2, and 3 years later), and through skin exams of all children at the same time-points. Skin exams will provide objective measures of sun exposure using spectrophotometry, assessment of freckling, and enumeration of moles (nevi). This evaluation will assess the long-term effectiveness of the previous provider delivered intervention, the effectiveness of the tailored intervention as a "booster" to the provider intervention, and the effectiveness of the tailored intervention alone. The study also includes a longitudinal study of mole development, which will assess the relationships between sun exposure, "host traits" (such as skin, hair, and eye color, tendency to burn vs. tan, tendency to freckle), and development of nevi, the strongest predictor for malignant melanoma. The study also includes a cost analysis, which will focus on the costs associated with intervention delivery, behavior change, and mole avoidance. If this intervention proves to be effective in increasing sun protection of children, cost and efficiency will be key factors in dissemination and adoption of the intervention.