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Cancer Control Research

Abstract

The purpose of this project is to develop and evaluate strategies for the primary prevention of skin cancer. Skin cancers are the most common cancers today. Primary prevention, aimed at reducing unprotected sun exposure, is the best way to curb the rising skin cancer incidence rates. Most importantly, epidemiological evidence suggests that prevention efforts should focus on children and adolescents. This proposal contains two studies. The primary aim of study 1, "Skin Cancer Prevention for Adolescents," is to develop and evaluate the efficacy of an intervention that uses motivation and efficacy building strategies to increase the sun protection practices of high school students. Ten high schools with primarily a white student population will be randomly assigned to one of two conditions. The Basic Condition will employ an informational based classroom intervention. The Enhanced Condition will add components to the Basic intervention that are designed to influence more specifically motivation, perceptions of social norms favoring sun protection, and efficacy for using protection. We hypothesize that adolescents in the Enhanced condition, as compared to the Basic, will report more favorable attitudes toward sun protection and will show greater increases in measures of protection: use of sunscreen, protective clothing (hats), and shade. We will have multiple indicators of behavior change, including self-reports and requests for sunscreen and hats. Effects of the intervention will be measured over two summers. The overall aim of study 2," Skin Cancer Prevention Intervention with Day Care Providers," is to increase the suns protection practices of children's caregivers. Day care providers play an increasingly important role in our society, not only in caring for children, but also as serving as informational resources for parents. The primary aim of study 2 is to develop and evaluate a multi-component intervention for day care providers that is based on motivation and compliance enhancement strategies. Twenty-four day care centers will be matched on center characteristics and then randomly assigned to one of two conditions: Basic (information only) an Enhanced (motivation and compliance building). We hypothesize that caregivers in the Enhanced condition, as compared to the Basic, will more frequently advise parents about the need to use sun protection with their children and more frequently use sun protection for children under their care. Secondary aims include examining the effects of the intervention on the day care providers use of sun protection for themselves, and examining the role of organizational and psychosocial factors in providers' protection practices. We will have multiple measures of provider behavior including self-report, parent report, and behavioral observations.