Effects of Gain vs. Loss Frame Sun Protection Messages on Rural Indiana Adolescen

摘要皮肤癌是最常见的癌症类型，占美国癌症发病率的近50%，促进青少年的防晒是降低未来皮肤癌发病率的关键，因为青春期晒伤的数量会显著增加以后患黑色素瘤和基底细胞癌的风险。青少年报告的防晒率很低。只有大约20%和30%的青少年使用防护服和防晒霜，而其中75%以上的人每年至少经历一次晒伤。以前的防晒干预措施主要针对成年人、年幼的儿童及其父母，很少有研究针对青少年，尤其是14岁以上的青少年。他们对风险的低敏感性和对外表的同伴态度的高敏感性对促进防晒行为的努力提出了独特的挑战。研究需要确定促进青少年防晒行为的有效策略。先前的健康促进干预表明，基于前景理论的信息框架策略显著影响行为决策。先前针对大学生（最接近青少年的年龄组）的防晒干预证明，强调个人通过采取防晒行为将获得什么（即增益框架）的信息促进了防晒要求的行为，而强调个人不采取防晒行为将失去什么（即损失框架）的信息促进了使用防晒霜的行为。显然，两种框架都可以促进一些防晒行为，但尚不清楚哪种框架对青少年最有效。此外，目前尚不清楚哪个框架将最有效地促进使用防护服的行为，这现在被确定为青少年中预防黑色素瘤的主要手段。本研究旨在对印第安纳州农村高中学生（14-18岁，N = 400）进行得失框架信息的相对有效性检验，这些信息倡导使用防护服和防晒霜的防晒行为。学生们将被随机分配，要么接受一种干预，这种干预是根据他们采取防晒行为会得到什么来制定的，要么接受一种干预，根据他们不采取防晒行为会失去什么来制定的。比较两种干预措施在学生对防晒的态度、使用防晒的意愿以及干预后夏季的防晒行为。研究结果将告知哪种框架信息最适合青少年的哪种防晒行为，这一知识将为未来针对这一人群的有效干预措施的发展提供信息。预防皮肤癌发病率的增加是一项重要的公共卫生议程。皮肤癌是最常见的癌症类型，几乎占美国癌症发病率的50%（美国癌症协会，2006年）。降低未来皮肤癌发病率的关键是促进青少年的防晒，因为青少年时期晒伤的次数会显著增加以后患黑色素瘤和基底细胞癌的风险（Elwood & Jobson, 1997； Kricker等，1995；Gallagher等，1995；Weinstock等，1989；Westerdahl等，1994;Whiteman & Green, 1994）。青少年报告的防晒率很低。最新的全国青少年防晒实践代表性调查（Cokkinides et al., 2001; Davis et al., 2002）表明，不到三分之一的美国青少年持续使用防晒霜，而大多数人（75%）每年至少经历一次晒伤。需要进行研究，以确定促进青少年防晒的有效策略。

DESCRIPTION (provided by applicant): Effects of Gain vs. Loss Framed Sun Protection Messages on Rural Indiana Adolescents Abstract Skin cancer is the most common type of cancer, accounting for almost 50% of cancer incidences in the U.S. Pivotal to reducing the future rates of skin cancer is promoting sun protection among adolescents, because the number of sunburns during adolescence significantly increases the risk of developing melanoma and basal cell carcinoma later in life. The rate of sun protection reported by adolescents is poor. Only about 20% and 30% of adolescents use protective clothing and sunscreen, while over 75% of them experience at least one sunburn a year. Prior sun protection interventions have focused on adults and younger children and their parents, and little research has focused on adolescents, especially those who are at or over age 14. Their low sensitivity to risk and high sensitivity to peer attitudes concerning appearance presents a unique challenge to efforts to promote sun protection behaviors. Research needs to identify effective strategies for promoting sun protective behaviors among adolescents. Prior health promotion interventions indicate that message framing, a strategy based on prospect theory, significantly influences behavioral decisions. Prior sun protection interventions for college students, the most proximal age group to adolescents, evidenced that messages highlighting what the individual will gain by adopting sun protection behavior (i.e., gain frame) promoted the behavior of sunscreen request, while message emphasizing what the individual will lose by not adopting sun protection behavior (i.e., loss frame) promoted the behavior of using sunscreen. Apparently, both types of framing can promote some sun protection behaviors, but it is unknown which frame will be most effective for adolescents. Furthermore, it is unknown which frame will be most effective for promoting the behavior of protective clothing use, which is now determined as a primary means of protection against melanoma, among adolescents. This study proposes to examine the relative effectiveness of gain vs. loss framed messages advocating the sun protection behaviors of protective clothing use and sunscreen use on rural Indiana high school students (ages 14-18, N = 400). Students will be randomly assigned to receive either an intervention that is framed in terms of what they will gain by adopting sun protection behaviors, or an intervention that is framed in terms of what they will lose by not adopting sun protection behaviors. The two interventions will be compared in terms of students' attitudes towards sun protection, intentions to use sun protection, and sun protection behavior during the summer following the intervention. The results will inform which frame message is most appropriate for which sun protection behavior of adolescents, and this knowledge will inform future development of effective interventions for this population. /Relevance Preventing the increase in the incidence of skin cancer is a significant public health agenda. Skin cancer is the most common type of cancer, accounting for almost 50% of cancer incidences in the U.S (American Cancer Society, 2006). Pivotal to reducing future rates of skin cancer is promoting sun protection among adolescents because the number of sunburns during adolescence significantly increases the risk of developing melanoma and basal cell carcinoma later in life (Elwood & Jobson, 1997; Kricker et al., 1995; Gallagher et al., 1995; Weinstock et al., 1989; Westerdahl et al., 1994; Whiteman & Green, 1994). The rate of sun protection reported by adolescents is poor. The latest nationwide representative survey of adolescents' sun protection practices (Cokkinides et al., 2001; Davis et al., 2002) indicates that less than one third of U.S. adolescents use sun protection consistently, while the majority (75%) experience at least one sunburn a year. Research is needed to identify effective strategies for promoting sun protection practices among adolescents.