A Randomized Trial of a Multicomponent Intervention for Adolescent Sun Protection Behaviors
Open Access
- 1 February 2007
- journal article
- clinical trial
- Published by American Medical Association (AMA) in Archives of Pediatrics & Adolescent Medicine
- Vol. 161 (2), 146-152
- https://doi.org/10.1001/archpedi.161.2.146
Abstract
Objective To evaluate a multicomponent primary care–based intervention to increase sun protection behaviors among adolescents. Excessive sun exposure in childhood increases the lifetime risk of melanomas and other forms of skin cancer. Interventions to improve sun protection behaviors in childhood have been based primarily in school and community settings, with little attention to the role of primary care physicians. Design A 2-year randomized controlled trial. Setting Primary care physician offices and participant homes. Participants Eight hundred nineteen adolescents aged 11 to 15 years. Interventions At the study onset and the 12-month follow-up, the adolescents engaged in an office-based expert system assessment of sun protection behaviors followed by brief stage-based counseling from the primary care provider. Participants also received up to 6 expert system–generated feedback reports, a brief printed manual, and periodic mailed tip sheets. Participants randomized to the comparison condition received a physical activity and nutrition intervention. Main Outcome Measure A self-reported composite measure of sun protection behavior. Results A random-effects repeated-measures model indicated a greater adoption of sun protection behaviors over time in the intervention group compared with the control group. The intervention effect corresponded to between-group differences at 24 months in avoiding the sun and limiting exposure during midday hours and using sunscreen with a sun protection factor of at least 15. Secondary analysis indicated that, by 24 months, more adolescents in the intervention group had moved to the action or the maintenance stage of change than those in the control group (25.1% vs 14.9%; odds ratio, 1.74; 95% confidence interval, 1.13-2.68). Sun protection behavior was also found to be positively associated with the completion of more intervention sessions (P = .002). Conclusion Primary care counseling coupled with a minimal-intensity expert system intervention can improve adolescents' sun protection behaviors.Keywords
This publication has 18 references indexed in Scilit:
- Annual Report to the Nation on the Status of Cancer, 1975–2002, Featuring Population-Based Trends in Cancer TreatmentJNCI Journal of the National Cancer Institute, 2005
- Stage-based expert systems to guide a population of primary care patients to quit smoking, eat healthier, prevent skin cancer, and receive regular mammogramsPreventive Medicine, 2005
- Incidence of Basal Cell and Squamous Cell Carcinomas in a Population Younger Than 40 YearsJAMA, 2005
- Teen Reach: Outcomes From a Randomized, Controlled Trial of a Tobacco Reduction Program for Teens Seen in Primary Medical CarePublished by American Academy of Pediatrics (AAP) ,2005
- Interventions to prevent skin cancer by reducing exposure to ultraviolet radiationA systematic reviewAmerican Journal of Preventive Medicine, 2004
- Multiple Risk Expert Systems Interventions: Impact of Simultaneous Stage-Matched Expert System Interventions for Smoking, High-Fat Diet, and Sun Exposure in a Population of Parents.Health Psychology, 2004
- Randomized Controlled Community Trial of the Efficacy of a Multicomponent Stage-Matched Intervention to Increase Sun Protection among BeachgoersPreventive Medicine, 2002
- Transtheoretical individualized multimedia expert systems targeting adolescents' health behaviorsCognitive and Behavioral Practice, 1999
- The Pathogenesis of Melanoma Induced by Ultraviolet RadiationNew England Journal of Medicine, 1999
- Sunlight exposure, pigmentary factors, and risk of nonmelanocytic skin cancer. I. Basal cell carcinomaArchives of Dermatology, 1995