Measuring real time decision-making about UVR Protection

描述（由申请人提供）：开发干预措施以最大限度地提高紫外线辐射（UVR）防护的一致性，取决于对导致UVR防护每日变化的决策因素的更好理解。在这项研究中，我们使用人种学决策树模型来研究黑色素瘤一级亲属（fdr）关于防晒霜使用、遮阳和紫外线防护行为的决策。在第一阶段，我们将通过对25名黑色素瘤fdr的定性人种学访谈来生成模型，然后将为三种UVR保护结果构建一个复合决策模型。在第二阶段，我们将在60个森林保护区使用生态瞬时评估紫外线防护（超过14个夏季，每天下午1点和5点）来建立模型的有效性。考虑到这些预测因素对紫外线防护的重要性，我们将招募同等数量的女性和男性，以及同等数量的认为晒黑有高低优势的人。具体目标1是生成并建立解释黑色素瘤fdr中三种UVR保护行为（防晒霜使用、遮阳、使用防护服）决策的模型的有效性，具体目标2是检查实时评估的理论驱动的防晒维持（防晒霜使用、遮阳和使用防护服）的情感和认知预测因子。我们采用理论知情的方法进行决策，因此期望在第一阶段归纳确定的因素，以及从Witte的扩展并行处理模型和Rothman的健康行为维持理论中得出的黑色素瘤威胁、疗效信念和UVR保护满意度的受试者之间和受试者内部差异，将预测UVR保护行为。我们还将研究性别和晒黑态度作为这些影响的协变量。研究结果将增加我们对紫外线辐射保护行为维持的决策背景的理解，并指导新的干预策略，以减少黑色素瘤高风险人群紫外线辐射保护的行为不一致，并增加行为维持。公共卫生相关性：本研究将检查60名黑色素瘤患者的一级家庭成员的日常紫外线防护和防护决策，这些患者通过个人数字助理和录音叙述完成14天的日记。我们将采用定性和定量的研究策略，并确定紫外线辐射防护和决策的人与人之间和人与人之间的差异，这将为干预措施的发展提供信息，以增加黑色素瘤风险人群中紫外线辐射防护的维持。

DESCRIPTION (provided by applicant): The development of interventions to maximize consistency in ultraviolet radiation (UVR) protection rests on improved understanding of decision-making factors that contribute to daily variation in UVR protection. In this study, we use Ethnographic Decision Tree Modeling to examine decision-making regarding sunscreen use, shade-seeking, and UVR protection behavior in melanoma first-degree relatives (FDRs). In Phase I, we will generate the models via qualitative ethnographic interviews with 25 melanoma FDRs, and then will construct a composite decision-making model for each of the three UVR protection outcomes. In Phase II we will establish the validity of the models using ecological momentary assessment of UVR protection (over 14 summer days, at 1 pm and 5 pm daily) in 60 FDRs. We will recruit equal numbers of women and men, and equal numbers of those who perceive high and low advantages of tanning, given the importance of these predictors for UVR protection. Specific Aim I is to generate and establish the validity of the models explaining decision-making about three UVR protection behaviors (sunscreen use, shade-seeking, use of protective clothing) in melanoma FDRs, and Specific Aim II is to examine theory-driven affective and cognitive predictors of sun protection maintenance (sunscreen use, shade-seeking, and use of sun protective clothing) assessed in real time. We adopt a theory-informed approach to decision-making, and so expect that the factors identified inductively in Phase I, as well as between- and within-subject variation in melanoma threat, efficacy beliefs, and satisfaction with UVR protection drawn from Witte's Extended Parallel Processing Model and Rothman's theory of health behavior maintenance will predict UVR protection behaviors. We will also examine gender and tanning attitudes as covariates of these effects. The study findings will increase our understanding of the decision- making context for behavioral maintenance of UVR protection, and dictate novel intervention strategies to reduce behavioral inconsistency - and increase behavioral maintenance - of UVR protection in those at high risk for melanoma. PUBLIC HEALTH RELEVANCE: This study will examine daily UVR protection and decision-making about protection in 60 first degree family members of melanoma patients who complete 14-day diaries via personal digital assistants and audio-taped narratives. We will employ qualitative and quantitative research strategies and determine between and within- person variability in UVR protection and decision-making that will inform the development of interventions to increase UVR protection maintenance among those who are at risk for melanoma.