Communication Intervention with Melanoma Families

描述(申请人提供)：黑色素瘤是一种比较常见的癌症，在美国的发病率稳定或上升。最近的研究发现，除了公认的日光照射环境风险因素外，遗传因素也是导致风险的重要因素。自我检查是一种潜在的方法，可以及早发现黑色素瘤并进行治疗，减少阳光暴露，特别是在儿童时期，是降低黑色素瘤发病率的具体方法。这两种行为减少风险的行为都需要推广，特别是在有黑色素瘤家族风险的人身上。我们建议通过现有的基于人群的登记来识别黑色素瘤病例，以向病例和家庭成员传递行为和沟通信息。我们将随机安排家庭接受基于网络的干预，通过强调沟通、支持、关于风险的信息和改变与风险相关的健康行为来帮助他们通过黑色素瘤的诊断、治疗和康复经验。这种与癌症相关的行为改变干预模式可能与许多不同形式的家族性癌症相关。 这项随机试验的主要目的是通过互动电子通信方法进行干预，改善黑色素瘤患者、一级亲属和0-18岁儿童的父母的阳光暴露和自我检查行为。二次干预的目的包括根据我们的行为模型确定这项干预对二次结果的影响，确定亲属用户亚群的特征并将这些特征与结果联系起来，检查该干预方案的可接受性，以及确定干预剂量和干预效果之间的关系。交流的基本问题是确定对黑色素瘤患者、一级亲属和父母及子女的黑色素瘤风险和家庭沟通的看法和理解，以及与暴露相关风险、一般健康风险和健康相关生活质量的关系，并确定风险信息框架对进行筛查和减少阳光暴露行为意图的影响。

DESCRIPTION (provided by applicant): Melanoma is a relatively common cancer, with stable or rising rates in the United States. Recent studies have identified genetics as an important contributor to risk, in addition to the well-established environmental risk factor of sun exposure. Self-examination is a potential method of identifying melanoma early enough to treat, and reducing sun exposure, especially in childhood, is a specific method of reducing risk of melanoma incidence. Both of these behavioral risk reduction behaviors need to be promoted, especially in individuals at familial risk for melanoma. We propose to identify cases of melanoma via an existing population-based registry to deliver behavioral and communications messages to the case and family members. We will randomize families to receive a Web-based intervention to help them through the experience of melanoma diagnosis, treatment, and recovery by emphasizing communications, support, information about risk, and changing health behaviors related to risk. This model of cancer-related behavior change intervention is potentially relevant to many different forms of familial cancer. The main aim of the randomized trial is to improve the sun exposure and self-examination behaviors of melanoma cases, first degree relatives, and the parents of children 0-18 via an intervention delivered through interactive electronic communication methods. Secondary intervention aims include determining the effects of this intervention on secondary outcomes from our behavioral model, identifying characteristics of user subgroups of relatives and relating these to outcomes, examining the acceptability of this intervention package, and determining the relationship between dose of intervention and effect of intervention. Aims addressing basic issues in communications are to identify perceptions and understanding of melanoma risk and family communication in melanoma cases, first degree relatives and parent and children, and relation to exposure related risk, general health risk, and health-related quality of life and to determine the effects of risk information framing on intentions to perform screening and sun exposure reduction behaviors.