Evaluation of Sun Protection Education for Kidney Transplant Recipients

该提案的目标是开发和评估防晒教育干预措施。 用于肾移植受者(KRR)以预防皮肤癌。肾移植是治疗肾脏疾病的一种方法。 终末期肾病患者的选择，然而，终生必需的免疫抑制治疗是 与皮肤癌，特别是鳞状细胞癌(SCC)的发展有关。19%的KMR患者患有鳞癌 移植后3-8年，10年后10-45%，20年后61%。一些KDR的发展超过了 一年内发生100例皮肤癌。在美国大约100,000名在世的KRR中，许多人遭受 因手术切除而受损的生活质量，对复发或扩散的焦虑和恐惧 癌症，以及对他人反应的担忧。 关于防晒重要性的教育对所有KRR来说都是必要的，包括那些 占在世KPR的38%。国家肾脏基金会召集的焦点小组表示， 临床医生很少在移植后提供皮肤癌风险和预防方面的教育，临床医生也是如此 对患者进行足够有效的教育，以促进防晒行为。受助人感知的重要性 鳞癌和患鳞癌的个人风险调节个人的防晒行为，例如应用 涂防晒霜，找阴凉处，避免故意晒黑。深色皮肤的人可能会感觉到 考虑到他们有限的晒伤经历，他们要么皮肤癌风险很低，要么没有皮肤癌风险， 有限的公共教育努力侧重于少数族裔。 我们的KTR焦点小组研究调查了防晒教育的最佳时间和形式。KTRS 建议在移植后第一个夏天之前进行防晒教育，并希望 一本小册子，可以与他们的医疗保健提供者一起审查，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对文化敏感的、 为KRR印制防晒教材。我们将评估教育的有效性 通过干预阶段改变防晒行为的材料随机选择相同数量的 非西班牙裔白人、西班牙裔和黑人KRR接受干预和常规护理，并评估结果 与基线措施相比，3个月和6个月的措施。通过开发教育材料， 有效地增加防晒行为，我们将有备无患地开发基于网络的交互式 系统，将材料传播给KTRs。未来的研究将评估传播的最佳方法 通过打印或网络递送的方式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.