Modifying Young Adult Skin Cancer Risk and Protective Behaviors (UV4.me2):A Hybrid Type 2 Dissemination/Effectiveness Trial

摘要 皮肤癌是一种日益增长的流行病，与大多数癌症相比， 其发病率正在下降。虽然在很大程度上是可以预防的，但皮肤癌可能是致命的，令人衰弱的， 破坏和毁容美国青少年的皮肤保护率在所有年龄组中最低， 随着他们进入成年期，紫外线辐射（UV）暴露增加。因此，年轻人在 需要采取干预措施以降低患皮肤癌的风险。既往干预以增加皮肤保护和/或 减少年轻人的紫外线暴露在其传播和纵向有限 除了我们自己的评估外，以前没有针对这一群体的干预措施是基于互联网的。 我们的研究团队开发了一种基于网络的干预措施，发现它可以显着减少紫外线暴露 在一项近1000名年轻人的随机对照试验（RCT）中， 参与者从消费者研究小组招募。干预（UV4.me）是个性化定制的， 交互式和多媒体的性质，并基于行为预测的综合模型。类似于 在其他在线试验中，73%的合格个体完成了基线问卷，70%的随机个体完成了基线问卷， 参与干预的人访问了它，68%的人访问了它并完成了至少一个模块。然而，我们有一个 有机会增加参与，实施，并最终，UV4.me的影响。我们将这样做 通过添加参与者建议的几个关键互动功能/策略，我们的数据得到了 文献（即，通过创建一个移动的版本，在干预中加入激励措施， 和反馈特征、对等交互组件以及正在进行的新闻更新）。混合型2 传播效果项目的目的是在18-25岁的成年人中实施增强的UV4.me2 年的中度至高度发展皮肤癌的风险，并评估干预措施的有效性，在一个样本 通过向全国大众传播，在网上招募。本项目将使用RE-AIM 框架，以确定UV4.me2的范围，有效性，实施，维护和成本。球队 将从几个一般的在线来源招募个人（例如，非营利组织、社交媒体、商业）。我们的团队 已经招募了三个非营利组织来促进UV4.me2的吸收和商业护肤品 公司提供激励措施，鼓励来自美国各地的年轻人参与。为了评价 为了评估干预的有效性，参加研究的年轻人将随机接受增强的 UV4.me 2、原始UV4.me或美国癌症协会的皮肤癌电子小册子。总的来说， 该项目提出了一种新的方法来解决日益重要的公共卫生问题。独特的 一个非常适合的多学科和多机构的研究团队是由初级，中级和高级 这些研究人员以前曾在皮肤癌预防干预方面成功合作过。

Abstract Skin cancer is a growing epidemic, with almost five million US diagnoses annually, in contrast with most cancers, which are decreasing in incidence. Although largely preventable, skin cancers can be deadly, debilitating, damaging, and disfiguring. US adolescents have the lowest skin protection rates of all age groups and also engage in increased ultraviolet radiation (UV) exposure as they move into adulthood. Thus, young adults are in need of intervention to reduce their skin cancer risk. Prior interventions to increase skin protection and/or decrease UV exposure among young adults have been limited in their dissemination and longitudinal assessment, and no prior interventions targeted to this population have been internet-based besides our own. Our research team developed a web-based intervention that was found to significantly decrease UV exposure and increase skin protection behaviors among young adults in a randomized controlled trial (RCT) of nearly 1000 participants recruited from a consumer research panel. The intervention (UV4.me) is individually-tailored, interactive, and multimedia in nature, and based on the Integrative Model of Behavioral Prediction. Similar to other online trials, 73% of eligible individuals completed the baseline questionnaire, 70% who were randomized to the intervention accessed it, and 68% accessed it and completed at least one module. However, we have an opportunity to increase the engagement, implementation, and ultimately, the impact of UV4.me. We will do this by adding several key interactive features/strategies suggested by participants, our data, and supported by the literature (i.e., by creating a mobile version, adding incentives embedded in the intervention, a behavior tracking and feedback feature, peer interaction component, and ongoing news updates). This Hybrid Type 2 dissemination-effectiveness project's purpose is to implement the enhanced UV4.me2 with adults aged 18-25 years at moderate to high risk of developing skin cancer and evaluate the intervention's effectiveness in a sample recruited online through national dissemination to the general population. This project will use the RE-AIM framework to determine the reach, effectiveness, implementation, maintenance, and cost of UV4.me2. The team will recruit individuals from several general online sources (e.g., nonprofits, social media, commercial). Our team has already recruited three non-profit organizations to promote uptake of UV4.me2 and a commercial skincare company to offer incentives to encourage participation of young adults from across the US. In order to evaluate intervention effectiveness, young adults who enroll in the study will be randomized to either receive the enhanced UV4.me2, the original UV4.me, or a skin cancer e-pamphlet from the American Cancer Society. In summary, this project proposes a novel approach to address an issue of growing public health significance. The uniquely well-suited multidisciplinary and multi-institution research team is comprised of junior, mid-level, and senior investigators who have previously worked together successfully on skin cancer prevention interventions.