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An Appearance-Based Intervention to Reduce Teen Skin Cancer Risk

基于外表的干预措施可降低青少年皮肤癌风险

基本信息

批准号：
8601051
负责人：
JOEL J. HILLHOUSE
金额：
$ 50.2万
依托单位：
EAST TENNESSEE STATE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2010
资助国家：
美国
起止时间：
2010-07-01 至 2015-12-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8601051
关键词：
15 year old Adolescence Adolescent Adult Affect Age Appearance Arsenic Asbestos Attitude Award Behavior Behavioral Belief Cancer Prevention Intervention Categories Clinical Cognitive Cutaneous Melanoma Data Development Diagnosis Ensure Female Female Adolescents Frequencies Funding Future Goals Group Affiliation Health Health behavior change High School Student High-Risk Cancer Hour Human Incidence International Agencies International Agency for Research on Cancer Internet Intervention Malignant Neoplasms Mediation Meta-Analysis Methods Modeling Morbidity - disease rate Mothers Motivation Mustard Mustard Gas Online Systems Pamphlets Participant Pattern Peer Group Pilot Projects Population Predisposition Prevalence Prevention program Process Randomized Controlled Trials Recruitment Activity Reporting Research Resistance Risk Risk Behaviors Risk Factors Sampling Site Skin Aging Skin Cancer Skin Carcinoma Skin tanning Solid Staging Subgroup Sun Exposure Sunbathing Techniques Technology Teenagers Test Result Testing The Sun Theoretical model Time Tobacco UV Radiation Exposure Woman Work Youth base cancer risk cost cost effective dosage eleventh grade experience follow-up high school improved innovation interest melanoma mortality ninth grade protective behavior prototype public health relevance skills skin cancer prevention social social cognitive theory sound success sun protection tenth grade theories twelfth grade user-friendly web site

项目摘要

DESCRIPTION (provided by applicant): The International Agency for Research in Cancer (IARC) has recently assigned indoor tanning to its highest cancer risk category, "carcinogenic to humans", joining asbestos, tobacco, arsenic and mustard gas. A comprehensive meta-analysis concluded that the risk of melanoma increased by 75% when indoor tanning is initiated before 30 years old. Melanoma incidence is rising faster than any other cancer with an estimated 60,000 diagnoses annually in the US. Despite this, indoor tanning is gaining tremendous popularity, especially among youth. Recent reviews report approximately 10% of US adolescents under the age of 15 have used indoor tanning in the past year, with prevalence among older adolescent females estimated at 25-40%. There is evidence that female indoor tanning use increases dramatically from freshman to senior years of high school (HS) making high school a critical time period for anti-tanning interventions to be implemented. This proposal assesses the efficacy of a skin cancer prevention program that will be delivered via the Internet to a nationally representative sample of high school teens in a randomized controlled trial. The anti-tanning intervention has proven success in reducing UV risk behaviors across multiple trials and multiple sites over the past 8 years with adult samples when delivered via a booklet. Our research will identify HS females at risk for future UV risk behavior (i.e., current users plus women indicating strong intentions to initiate indoor tanning in the next 6 months), and provide them with persuasive information on the appearance damaging effects of UV exposure, delivered via an attractive, user friendly website. The intervention is based on proven theories of health behavior change (i.e., behavioral alternatives model, social cognitive theory, theory of reasoned action and protection motivation theory), and formative research in high school samples. A national, award-winning web development team will produce the website which will be beta tested with groups of teen tanners to ensure congruence with current teen culture, values and beliefs. The research team has successfully worked with the web-development team and with teen testers to produce and modify a prototype of the intervention which has proven to be relevant and of interest to teen tanners in pilot studies. The proposal uses practices that ensure intervention fidelity and assessments of intervention dosage. We will follow these women from HS through post-HS to examine whether the intervention is able to reduce the overall frequency of long-term UV exposure. The intervention is cost-effective, can be easily disseminated and is likely to be engaging for the targeted teen audience. If successful, wide dissemination of this intervention is likely to substantially reduce indoor tanning initiation and use in high school teens and thus the future occurrence of and mortality from melanoma and non- melanoma skin cancers in this population. The investigative team has the experience and skills needed to successfully complete all aspects of the research, and the approach has been used successfully in previously funded projects. The study is innovative. It will be the first anti-tanning intervention directed at high school students, the first appearance-focused intervention targeting HS tanners, the first Internet-delivered intervention focusing on skin cancer risk behavior in teens, and the first using a nationally representative sample. There is a strong rationale for the use of an appearance-based, Internet delivered intervention with long-term follow-up targeting high school students. High school represents a critical developmental stage for both melanoma risk (i.e., risk appears to increase with indoor tanning in youth) and for the development of regular, frequent intentional UV exposure through tanning. Empirical results testing our conceptual model of teen tanning provides evidence that changing the key cognitive variables in the intervention will reduce tanning motivations and behaviors in teens. An Internet-delivered intervention can be easily and cheaply disseminated, and will be well received by the targeted teen population.

描述（由申请人提供）：国际癌症研究机构 (IARC) 最近将室内晒黑列为最高癌症风险类别，即“对人类致癌”，与石棉、烟草、砷和芥子气一起。一项综合荟萃分析得出的结论是，30 岁之前开始室内晒黑，患黑色素瘤的风险会增加 75%。黑色素瘤发病率的上升速度比任何其他癌症都要快，美国每年估计有 60,000 例黑色素瘤被诊断出来。尽管如此，室内晒黑越来越受欢迎，尤其是在年轻人中。最近的评论报告称，大约 10% 的 15 岁以下的美国青少年在过去一年中使用过室内日光浴，其中年龄较大的青少年女性的患病率估计为 25-40%。有证据表明，从高中一年级到高中四年级，女性室内晒黑的使用急剧增加，这使得高中成为实施抗晒黑干预措施的关键时期。该提案评估了皮肤癌预防计划的有效性，该计划将在一项随机对照试验中通过互联网向全国代表性的高中青少年样本提供。过去 8 年中，通过小册子提供的成人样本进行了多次试验和多个地点，事实证明，抗晒黑干预措施在减少紫外线风险行为方面取得了成功。我们的研究将确定未来有紫外线风险行为风险的 HS 女性（即当前用户以及表示在未来 6 个月内开始室内晒黑的强烈意愿的女性），并通过一个有吸引力的、用户友好的网站向她们提供有关紫外线照射对外观损害影响的有说服力的信息。该干预措施基于经过验证的健康行为改变理论（即行为替代模型、社会认知理论、理性行动理论和保护动机理论）以及高中样本的形成性研究。一个屡获殊荣的全国性网络开发团队将制作该网站，该网站将与青少年制革商团体进行 Beta 测试，以确保与当前青少年文化、价值观和信仰保持一致。研究团队与网络开发团队和青少年测试人员成功合作，制作并修改了干预原型，事实证明该原型与试点研究中的青少年制革商相关且感兴趣。该提案采用确保干预保真度和干预剂量评估的做法。我们将跟踪这些女性从 HS 到 HS 后的情况，以检查干预措施是否能够降低长期紫外线暴露的总体频率。该干预措施具有成本效益，易于传播，并且可能会吸引目标青少年受众。如果成功，这种干预措施的广泛传播可能会大大减少高中青少年室内晒黑的开始和使用，从而减少该人群未来黑色素瘤和非黑色素瘤皮肤癌的发生和死亡率。研究团队拥有成功完成研究各个方面所需的经验和技能，并且该方法已在之前资助的项目中成功使用。该研究具有创新性。这将是第一个针对高中生的抗晒黑干预措施，第一个针对 HS 晒黑者的以外表为中心的干预措施，第一个针对青少年皮肤癌风险行为的互联网提供的干预措施，也是第一个使用全国代表性样本的干预措施。使用基于外表的互联网提供的干预措施以及针对高中生的长期随访是有充分理由的。高中是黑色素瘤风险（即青少年室内晒黑风险似乎增加）和通过晒黑进行定期、频繁的故意紫外线暴露的关键发展阶段。测试我们的青少年晒黑概念模型的实证结果提供了证据，表明改变干预中的关键认知变量将减少青少年的晒黑动机和行为。通过互联网提供的干预措施可以轻松且廉价地传播，并将受到目标青少年群体的好评。