Randomized Trial of a Social Media-Delivered Intervention Targeting Indoor Tanning Users

项目摘要/摘要 黑色素瘤是最致命的皮肤癌，每年接受治疗的美国成年人人数接近 在过去15年中翻了一番，预计到2030年发病率将再次翻一番。这种增长在一定程度上是 归因于人造紫外线发射室内日光浴床的流行。尽管得到了众多 国家和国际卫生组织对人类致癌，近1000万美国人 每年使用室内日光浴床。据估计，美国所有新的黑色素瘤病例中有1/10和40万 每年的非黑色素瘤皮肤癌病例都直接归因于室内晒黑。最令人担忧的是，几乎 每5名年轻成年白人女性中就有1人从事高风险的室内晒黑，定义为使用室内晒黑床 一年至少十次，这与患黑色素瘤的风险显著增加有关。作为室内日光浴 在过去的二十年里，黑色素瘤在年轻女性中越来越受欢迎，最近已经成为 这一人群中最常见的癌症。2014年卫生局局长呼吁采取行动预防皮肤 癌症发现了一个关键的研究缺口，这与缺乏针对室内高风险的干预措施有关 晒黑和解决晒黑的潜在动机，包括“想要看起来有吸引力和健康的愿望，以及 符合社会美容标准“。此应用程序的目的是实现和测试干预 旨在鼓励高危晒黑者停止室内晒黑。干预在使用上是独一无二的 有说服力的技术和内容，以减少被认为是晒黑的压力，降低对晒黑的重视， 宣传积极的身体形象，而不是关注关于晒黑风险的信息。这个 干预将通过社交媒体网站Facebook的“秘密小组”功能进行。它的用途 将允许参与者之间基于组的互动，这可以促进更强大的 态度和行为的改变，并提供了一个平台，将干预嵌入个人的正常 例行程序。第一个建议的目的是从我们的初步干预中提炼现有的干预内容 使用用户生成的反馈进行研究。第二个目标是进行一项随机对照试验 对400名从事高危晒黑的年轻女性进行了干预。我们的主要假设是 与接受干预的参与者相比，接受干预的参与者在6个月的随访中报告的室内晒黑情况较少 那些参加Facebook控制组的人。我们的第三个目标将检验假想的心理社会 干预效果的调停者。这种干预具有很大的潜力，具有成本效益，广泛应用 传播并针对未来癌症发展的高危人群。如果有效，干预措施已经 有可能显著减轻黑色素瘤和其他皮肤癌日益增长的负担。

PROJECT SUMMARY/ABSTRACT The number of U.S. adults treated annually for melanoma, the most deadly form of skin cancer, has nearly doubled in the past 15 years and the incidence rate is projected to again double by 2030. This growth is partly attributed to the popularity of artificial ultraviolet-emitting indoor tanning beds. Despite recognition by numerous national and international health organizations as being carcinogenic to humans, nearly 10 million Americans use indoor tanning beds each year. An estimated 1 in 10 of all new U.S. cases of melanoma and 400,000 annual cases of non-melanoma skin cancer are directly attributable to indoor tanning. Most concerning, nearly 1 in 5 young adult white females engage in high-risk indoor tanning, defined as using indoor tanning beds at least ten times a year, which is associated with a substantially increased risk of melanoma. As indoor tanning gained popularity among young women over the past two decades, melanoma has recently become one of the most common cancers among this population. The 2014 Surgeon General's Call to Action to Prevent Skin Cancer identified a critical research gap related to an absence of interventions that target high risk indoor tanners and address underlying motives for tanning, including “the desire to look attractive and healthy and to conform to societal beauty standards”. The purpose of this application is to implement and test an intervention designed to encourage indoor tanning cessation among high-risk tanners. The intervention is unique in using persuasive techniques and content to reduce perceived pressure to be tan, reduce the value placed on tanning, and promote positive body image rather than focusing on information about the risks of tanning. The intervention will be delivered via the social media site Facebook through the “secret groups” feature. The use of Facebook groups will allow group-based interactions among participants, which can facilitate stronger changes in attitudes and behaviors, and provides a platform to embed the intervention into individuals' normal routines. The first proposed aim is to refine the existing intervention content from our preliminary intervention studies with user-generated feedback. The second aim is to conduct a randomized controlled trial of the intervention in a sample of 400 young women engaged in high-risk tanning. Our primary hypothesis is that participants who receive the intervention will report less indoor tanning at a 6-month follow-up compared to those who participate in a control Facebook group. Our third aim will examine hypothesized psychosocial mediators of the intervention effects. The intervention has strong potential for cost-effective, widespread dissemination and targets a group at high-risk for future cancer development. If effective, the intervention has the potential to significantly reduce the growing burden of melanoma and other skin cancers.