A Tailored Internet Intervention for Skin Cancer Risk Reduction in Young Adults

描述(申请人提供)：皮肤癌是美国最常见的癌症，每年有100多万新确诊病例1。年轻人，特别是女性，患黑色素瘤的风险越来越大。导致年轻人患皮肤癌风险增加的原因之一是，美国青少年的皮肤保护率是所有年龄段中最低的2，而且随着他们步入成年，暴露在天然和人造紫外线辐射下的风险也增加了3。需要创新的干预措施来影响年轻人患皮肤癌的风险。与以前的干预不同，我们的皮肤癌风险降低干预将为每个参与者量身定做(或个性化)，并通过互联网提供。这项量身定做的干预措施将强调对外表的担忧，这被认为是年轻人暴露在紫外线下和缺乏皮肤保护的主要动机。这将在一定程度上通过使用显示紫外线损伤的个性化面部图像以及计算机化的年龄进程演示来实现。主要目的1.检验一种通过互联网提供的量身定制的干预措施的有效性，该干预措施旨在加强皮肤保护，减少患皮肤癌的中高风险年轻人的阳光暴露行为。参与者将被随机分配到量身定做的干预措施、皮肤癌基金会网站或仅限评估的情况下。目的2.评估社会人口学变量(性别、种族/民族、皮肤类型、皮肤癌家族史、教育程度、社会经济地位和地理位置)、外表意识、既往暴露和防护行为是否影响干预效果。目的3.评估整合模型4的结构(紫外线相关知识、风险感知、信念、规范、自我效能和意图)是否对干预效果起中介作用。这些中介物和行为结果将在基线以及基线后三周和三个月进行评估。在项目的第一阶段，将通过可接受性和可用性测试来开发和完善包括互动和多媒体材料在内的量身定做的干预措施。在第二阶段，将通过互联网进行随机对照试验，评估定制干预在改善紫外线暴露和防护行为方面的效果。我们还将建立干预效果的调解人和调解人。未来研究的目标将是加强量身定做的干预措施，例如，通过增加更多的联系人或互联网技术或功能，传播干预措施，评估效果的持久性，和/或使定制干预措施用于其他癌症危险行为或高危群体。 与公共健康相关：皮肤癌是美国最常见的癌症，每年新诊断的病例超过100万例。需要创新的干预措施才能对皮肤癌风险产生影响。拟议项目的目的是测试一种通过互联网提供的量身定做的干预措施，旨在减少中到高皮肤癌风险的年轻人的皮肤癌风险行为。

DESCRIPTION (provided by applicant): Skin cancer is the most common cancer in the US, with over a million new cases diagnosed yearly 1. Young adults, particularly women, are increasingly at risk of melanoma. Contributing to the increasing skin cancer risk among young adults is the fact that US adolescents have the lowest skin protection rates of all age groups 2 and also demonstrate increased exposure to natural and artificial UV radiation as they move into adulthood 3. Innovative interventions are needed to have an impact on skin cancer risk among young people. Unlike previous interventions, our skin cancer risk reduction intervention will be tailored (or personalized) to each individual participant and delivered via the Internet. The tailored intervention will emphasize appearance concerns, which are known to be the primary motivation for UV exposure and lack of skin protection among young adults. This will be accomplished in part through the use of personalized facial images showing UV damage as well as computerized age progression demonstrations. Primary Aim 1. To examine the efficacy of a tailored intervention delivered via the Internet designed to increase skin protection and decrease sun exposure behavior among young adults at moderate to high risk of developing skin cancer. Participants will be randomized to the tailored intervention, the Skin Cancer Foundation website, or an assessment only condition. Aim 2. To evaluate whether socio-demographic variables (sex, race/ethnicity, skin type, family history of skin cancer, education, socioeconomic status, and geographic locale), appearance consciousness, and past exposure and protective behaviors moderate intervention effects. Aim 3. To evaluate whether Integrative Model 4 constructs (UV-related knowledge, risk perception, beliefs, norms, self-efficacy, and intentions) mediate intervention effects. These mediators and the behavioral outcomes will be assessed at baseline as well as three weeks and three months post baseline. In the first stage of the project, the tailored intervention including interactive and multimedia materials will be developed and refined through acceptability and usability testing. In the second stage, the efficacy of the tailored intervention at improving UV exposure and protection behaviors will be evaluated in a randomized controlled trial conducted via the Internet. We will also establish moderators and mediators of intervention effects. The goals of future research would be to enhance the tailored intervention, for example, by adding additional contacts or Internet technologies or features, disseminate the intervention, assess the longevity of effects, and/or adapt the tailored intervention for use with other cancer risk behaviors or at risk groups. PUBLIC HEALTH RELEVANCE: Skin cancer is the most common cancer in the US, with over a million new cases diagnosed yearly. Innovative interventions are needed to have an impact on skin cancer risk. The purpose of the proposed project is to test a tailored intervention delivered via the Internet designed to reduce skin cancer risk behavior among young adults at moderate to high risk of developing skin cancer.