Evaluation of Sun Protection Education for Kidney Transplant Recipients

本提案的目标是开发和评估一种防晒教育干预措施 用于肾移植受者（KTR）预防皮肤癌。肾移植是治疗 然而，对于终末期肾病患者，必需的终身免疫抑制治疗是 与发展中的皮肤癌，特别是鳞状细胞癌（SCC）有关。SCC影响19%的KTR 移植后3-8年，10-45%，20年61%。一些KTR的发展超过 一年内100例皮肤癌在美国大约10万名KTR中， 由于手术切除的毁容、对复发或扩散的焦虑和恐惧而损害生活质量 癌症，关心别人的反应。 对所有KTR进行关于防晒重要性的教育是必要的，包括少数民族， 包括38%的KTR。由国家肾脏基金会召集的焦点小组指出， 临床医生很少在移植后提供关于皮肤癌风险和预防的教育， 有效地教育患者，以促进防晒行为。接受者认为 SCC和发展SCC的个人风险调节个人的防晒行为，例如， 防晒霜，寻找阴凉处，避免故意晒黑。深色皮肤的人可能会认为 鉴于他们有限的个人晒伤经验，他们自己患皮肤癌的风险很低或没有， 以及针对少数民族的有限公共教育努力。 我们的KTR焦点小组研究探讨了防晒教育的最佳时间和形式。KTR 建议在移植后的第一个夏天之前提供防晒教育， 这本小册子可以与他们的医疗保健提供者一起阅读，并带回家与家人一起阅读。 拟议的试点研究通过开发和评估文化敏感， 为幼儿园和幼儿园印制防晒教育材料。我们将评估教育的有效性 材料在改变防晒行为与干预阶段，随机相等数量的 非西班牙裔白色、西班牙裔和黑人KTR接受干预和常规护理，并评估结局 与基线测量值相比，在3个月和6个月时测量。通过开发教育材料， 有效地增加防晒行为，我们将做好准备，发展一个互动的网络为基础的 系统向KTR分发材料。未来的研究将评估传播的最佳方法 通过打印或基于网络的交付，向美国移植中心提供防晒计划。

The goal of this proposal is to develop and evaluate a sun protection educational intervention for kidney transplant recipients (KTRs) to prevent skin cancer. Kidney transplantation is the treatment of choice for patients with end-stage renal disease, however, the requisite life-long immunosuppressive therapy is associated with developing skin cancer, especially squamous cell carcinoma (SCC). SCC afflicts 19% of KTRs between 3-8 years post-transplant,10-45% by 10 years, and 61% by 20 years. Some KTRs develop more than 100 skin cancers in 1 year. Among the approximately living 100,000 KTRs in the United States, many suffer impaired quality of life from disfigurement of surgical removal, anxiety and fear about the return or spread of the cancer, and concern about the reaction of others. Education about the importance of sun protection is necessary for all KTRs, including minorities who comprise 38% of living KTRs. Focus groups convened by the National Kidney Foundation indicate that clinicians rarely provide education after transplantation about skin cancer risk and prevention, nor do clinicians educate patients effectively enough to promote sun protective behaviors. Recipients' perceived importance of SCC and personal risk of developing SCC moderate an individual's sun protection behavior, e.g. applying sunscreen, seeking shade, and avoiding deliberate tanning. Darker-skinned individuals may perceive themselves as either at low or no risk for skin cancer given their limited personal experience with sunburns, and limited public education efforts focused on minorities. Our KTR focus group research examined the optimal time and format for sun protection education. KTRs recommended providing sun protection education before the first summer after transplantation and desired a booklet that can be reviewed with their health care provider and taken home to read with family. The proposed pilot study extends our research by developing and evaluating culturally sensitive, printed sun protection educational materials for KTRs. We will evaluate the effectiveness of educational materials in changing sun protection behavior with an intervention phase that randomizes equal numbers of non-Hispanic White, Hispanic and Black KTRs to the intervention and customary care, and evaluates outcome measures at 3 and 6 months in comparison to baseline measures. By developing educational materials that effectively increase sun protection behaviors, we will be well poised to develop an interactive web-based system to disseminate the material to KTRs. Future research will assess optimal approaches to disseminating a sun protection program to US transplant centers by print or web-based delivery.