Comprehensive Sun Protection in Recreation: An Advanced Go Sun Smart Program

描述(由申请者提供)：高级Go Sun Smart(GSS)计划将开发和测试一种全面的、创新的阳光安全方法的有效性。先进的GSS是一种范式转变，它用一种新的策略来增强现有的防晒安全方法，使用基于运输理论(TT)的叙述性说服性信息，并针对全面的防晒行为。尽管取得了进展，但皮肤癌在美国的流行正在上升。需要一种新的方法。在过去的10年里，我们的团队在北美350多个主要针对员工的滑雪场实施并评估了成功的Go Sun Smart(GSS)计划，产生了11种出版物。在这个修改后的应用程序中，TT和叙事消息方面的两位专家，包括TT的发明者，加入了我们的团队。尽管GSS和其他活动，但大多数成年人不定期使用防晒霜，不在阳光照射前半小时涂抹，两个小时后没有重新涂抹，不戴宽边帽或防护服，不使用遮阳板，也不准确估计紫外线(UV)水平。高级GSS用基于TT的信息来增强过去的活动，以改变成年人的假期叙述，将阳光安全包括在内。度假计划包含无拘无束、有趣、无忧无虑的叙事，我们将通过电子邮件、网站、图形故事和其他旨在将阳光安全嵌入度假者叙事的材料来补充这些叙事。先进的GSS将针对下一代防晒安全行为，促进在紫外线暴露和重新使用前半小时涂抹足够的防晒霜，使用遮阳板、宽边帽和防护服，以及评估危险紫外线水平的简单方法。先进的GSS将我们的冬季高海拔GSS扩展到紫外线最高的春季/夏季环境。我们将使用前测-后测、分组随机对照设计，在40家配对的美国酒店和度假村中测试高级GSS的有效性，这些酒店和度假村是根据房间机架率和地区从不同的阶层中随机挑选出来的。符合条件的酒店和度假村将成为我们的合作伙伴协会、美国酒店和住宿协会以及国际酒店销售和营销协会的成员。参与的酒店/度假村将在三个实验年内分成三波。项目工作人员将在20家干预酒店/度假村与主要联系人经理合作，发送、链接、分发和张贴干预材料，就像最初的GSS试验一样。接受过数据收集程序培训的研究助理(RAS)将对每个酒店/度假村进行拦截调查(在这次重新提交的试点测试中，回应率为88%)，在春季和夏季接近夏至的前后测试中，每个酒店/度假村都有95名游客，夏至是一年中紫外线最高的时候。这些调查中的主要结果衡量标准是关于当前防晒措施(即使用SPF 15以上的防晒霜、涂抹前和再次涂抹)的报告，以及对帽子、衣服和遮阳物使用的观察。RAS还将对游客在酒店/度假村的防晒行为进行日常观察，作为次要措施。由于所有种族和收入群体的大多数美国人都会在户外度假，因此这一结果应该适用于美国民众。

DESCRIPTION (provided by applicant): The Advanced Go Sun Smart (GSS) Program will develop and test the efficacy of a comprehensive, innovative sun safety approach. Advanced GSS is a paradigm shift that augments existing sun safety approaches with a new strategy using narrative persuasive messages based on Transportation Theory (TT) and targeting comprehensive sun protection behaviors. Despite progress, the skin cancer epidemic is rising in the U.S. A new approach is needed. Over the past 10 years, our team has implemented and evaluated the successful Go Sun Smart (GSS) program at over 350 ski areas in North America targeted primarily at employees, resulting in 11 publications. In this revised application, two experts in TT and narrative messages, including TT's inventor, join our team. Despite GSS and other campaigns, most adults irregularly use sunscreen, do not apply it half- hour before sun exposure, fail to reapply it after two hours, do not wear wide-brimmed hats or protective clothing, do not use shade, and do not accurately estimate ultraviolet radiation (UV) levels. The Advanced GSS augments past campaigns with TT-based messages to alter adults' vacation narratives to include sun safety. Vacation schemas contain disinhibited, fun, carefree narratives that we will supplement with sun safety messages delivered in emails, web sites, graphic stories, and other materials intended to embed sun safety in vacationers' narratives. Advanced GSS will target next-generation sun safety behaviors promoting sufficient sunscreen application half-hour prior to UV exposure and reapplication, use of shade, wide-brimmed hats and protective clothing, and simple ways to assess dangerous UV levels. Advanced GSS extends our winter high- altitude GSS to spring/ summer environments when UV is highest. Using a pretest-posttest, group-randomized controlled design, we will test the efficacy of Advanced GSS at 40 pair-matched US hotels and resorts randomly selected from strata based on room rack rate and region. Eligible hotels and resorts will be members of our partner associations, The American Hotel and Lodging Association and Hospitality Sales and Marketing Association International. Participating hotels/resorts will be divided into three waves over three experimental years. Project staff will send, link, distribute, and post intervention materials at 20 intervention hotels/resorts working with a key contact manager, as in the original GSS trials. Research assistants (RAs), trained in data collection procedures, will conduct intercept surveys (which had an 88% response rate in a pilot test for this resubmission) with 95 visitors in each hotel/resort at pretest and posttest in the spring and summer in proximity to the summer solstice, the time of year with the highest UV. Primary outcome measures in these surveys are reports of current sun protection (i.e., use of SPF 15+ sunscreen, pre-application and reapplication) and observation of hat, clothing, and shade use. RAs also will make daily observations of sun protection behavior by visitors at the hotels/resorts as secondary outcome measures. Since most Americans of all ethnic and income groups recreate outdoors on vacation, the results should be generalizable to the US population.