SKIN CANCER PREVENTION IN NH MIDDLE SCHOOLS

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DESCRIPTION: Reducing ultraviolet light exposure in children and adolescents is a primary prevention approach to reducing the incidence of skin cancer. A multi-component community based intervention, "SunSafe," has been shown to be effective at improving the solar protection behaviors of children 2-9 years of age. Older children and adolescents present different challenges. Children in the middle school years are in transition to adulthood and beginning to establish their own health behaviors influenced by peer, school, community and family. In order to change youth solar protection interventions need to both target their health decisional process and influence peers and their local adult role models to practice and promote solar protection. In this proposal, over 3.5 years, we will: 1) Develop and validate new methodologies to determine youth solar protection behaviors on a same day recall; 2) Utilize same day recall, outdoor observation methods and surveys to assess at baseline early teenage sun protection behaviors and motivational factors; 3) Develop and implement a two year multi-component community-based "SunSafe in the Middle School Years" randomized control intervention to improve solar protection of children in the middle school years; and 4) Assess the impact of this new intervention on the solar protection intentions and observed behaviors of early adolescents in rural New Hampshire communities. The interventions for the middle school students will focus on school, community recreation and beach settings, primary care practices, and parents. The interventions are based on theories that include social influence, psychological factors and cognitive decisional factors in adolescence. Student teams will develop peer directed interventions that will complement community level interventions. Specific interventions will be directed at changing the solar protection promotion and self-protection behaviors of sports and community adult role models and counseling by primary care providers. The components of this community-based intervention seek to change local social norms about solar protection as well as influence individual adolescent decisions about solar protection through targeted messages. Evaluation of student sun protection behaviors is based on observation and diaries. The evaluation will also assess intermediate mediating variables in students and change in the health promotion and sun protection behaviors of adult role models.