COMMUNITY SKIN CANCER PREVENTION PROJECT

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The Community Skin Cancer Prevention Project will test an intervention directed at increasing outdoor solar protection behavior by means of a community-based randomized trial. Six New Hampshire communities will be randomly assigned to control or intervention status. The target group for behavior change is children between the ages of two and nine and their care givers. This Project will test the hypothesis that a multifaceted, community-wide intervention directed at health care professional, teachers, parents, and children will reduce the UV-light exposure behaviors among children in intervention communities compared to non-intervention control communities. Secondary hypotheses include that for intervention communities compared to controls: (a) public knowledge about the dangers of UV light exposure and how to prevent it will increase; b) professional knowledge about the dangers of UV light exposure and about how to provide preventive counseling will increase; c) professional activities to promote solar protection will increase. The Project builds on a tradition of community-based research. Intervention and evaluation methodologies are derived from preliminary work done at Dartmouth on working with primary care physicians, schools, and communities to enhance cancer controls, as well as the Preliminary work of our collaborators at the University of Newcastle, NSW, Australia. Outcome evaluation will be based on direct staff observation of 1200 children in public and day care settings prior to interventions, and cross-sectional groups of 1200 different children at each of two annual follow--up intervals as well as interviews with each child's caregiver done at the same time as these staff observations. Surveys of clinicians, school and day care administrators, and pharmacists knowledge, skills, and behavior relevant to solar protection will also be collected at the three evaluation intervals. The process and costs of the intervention will also be assessed. The Project will answer the question "can a community-wide intervention reduce ultraviolet light exposure among children, their parents, and other care givers over a two-year follow-up period?" and will provide to the National Cancer Institute and interested intermediaries a transportable community-based skin cancer prevention intervention of known efficacy and cost.