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Wu YP, Stump TK, Hay JL, Buller DB, Jensen JD, Grossman D, Shen J, Haaland BA, Jones J, Tercyak KP. Protocol for a cluster-randomized trial of a school-based skin cancer preventive intervention for adolescents. Contemp Clin Trials 2024; 140:107494. [PMID: 38458557 PMCID: PMC11065585 DOI: 10.1016/j.cct.2024.107494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 02/06/2024] [Accepted: 03/05/2024] [Indexed: 03/10/2024]
Abstract
BACKGROUND Adolescents infrequently use sun protection and engage in intentional tanning more frequently compared to other age groups, leading to increased ultraviolet radiation (UVR) exposure that heightens skin cancer risk across the lifespan. High schools are therefore an ideal setting for offering skin cancer preventive interventions. Yet, there are limited UVR protection interventions for high school students, especially those that are personalized, tested using randomized designs, and include long-term outcome assessment to determine the durability of intervention effects. METHOD The Sun-safe Habits Intervention and Education (SHINE) cluster-randomized trial will test a novel, personalized intervention that targets high school adolescents' sun protection and tanning behaviors, and tracks their outcomes for up to one year following intervention. Enrolled high schools will be randomized to receive either the personalized SHINE intervention, which includes facial UVR photographs and sun protection action planning, or standard education using publicly available materials. Students in both conditions will receive information about skin cancer, sun protection, and skin self-examination. Outcome variables will include students' sun protection and tanning behaviors and sunburn occurrence. Potential moderators (e.g., race/ethnicity) and mediators (e.g., self-efficacy) will also be assessed and tested. CONCLUSIONS This trial examines the efficacy of a personalized intervention targeting sun protection and tanning of high school students. The project will lead to new scientific understanding of the theoretical mechanisms underlying outcomes and moderators of the intervention effects, which will inform future intervention tailoring to meet the needs of vulnerable subgroups.
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Affiliation(s)
- Yelena P Wu
- Department of Dermatology, University of Utah, 30 N. Mario Capecchi Dr., Salt Lake City, UT 84112, USA; Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope Drive, Salt Lake City, UT 84112, USA.
| | - Tammy K Stump
- Department of Dermatology, University of Utah, 30 N. Mario Capecchi Dr., Salt Lake City, UT 84112, USA; Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope Drive, Salt Lake City, UT 84112, USA.
| | - Jennifer L Hay
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10021, USA.
| | - David B Buller
- Klein Buendel, Inc., 1667 Cole Boulevard, Suite 220, Golden, CO 80401, USA.
| | - Jakob D Jensen
- Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope Drive, Salt Lake City, UT 84112, USA; Department of Communication, University of Utah, Salt Lake City, UT, USA.
| | - Douglas Grossman
- Department of Dermatology, University of Utah, 30 N. Mario Capecchi Dr., Salt Lake City, UT 84112, USA; Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope Drive, Salt Lake City, UT 84112, USA.
| | - Jincheng Shen
- Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope Drive, Salt Lake City, UT 84112, USA; Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA.
| | - Benjamin A Haaland
- Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope Drive, Salt Lake City, UT 84112, USA; Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA.
| | - Jacey Jones
- Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope Drive, Salt Lake City, UT 84112, USA.
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Russo R, King E, Elliott N. The formative evaluation and pre-testing of a SunSmart policy implementation support toolkit targeting sun safe hat-wearing in NSW primary schools. Health Promot J Austr 2024; 35:303-310. [PMID: 37208977 DOI: 10.1002/hpja.746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 04/05/2023] [Accepted: 05/09/2023] [Indexed: 05/21/2023] Open
Abstract
ISSUE ADDRESSED Strategies that support the implementation of the SunSmart program in primary schools are essential to optimising policy uptake. Evidence outlining the type of support required, however, is lacking. This project explored the usefulness of an implementation support approach to sun safe hat-wearing in schools. METHODS Formative research was undertaken with 16 primary schools in Greater Western Sydney to explore current sun protection behaviours and practices, perceived barriers and motivators of sun safe hat-wearing, and resource needs. Based on these insights, a resource toolkit was developed and tested in 14 demonstration sites. Follow-up interviews evaluated the usefulness of the toolkit and implementation support approach. RESULTS Sun safe hat-wearing practices varied among schools. Commonly reported motivators included school policies, role modelling, incentives and knowledge. Commonly reported barriers included negative social norms, forgetfulness, cost and lack of understanding. Formative insights informed the development of the 'Motivation, Access, Triggers' Model and a 23-resource toolkit. Following toolkit rollout, champions reported that the ability to select resources according to local needs was useful, and most found that the toolkit supported their school with sun safe hat-wearing. CONCLUSIONS A toolkit with local champions and leadership buy-in has the potential to improve policy implementation. The opportunity to prioritise resource selection enables schools to address their specific needs in line with their sun protection policy. SO WHAT?: The provision of policy implementation support can help schools overcome the challenges of transforming a written SunSmart policy into practice.
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Affiliation(s)
- Rachel Russo
- Cancer Council NSW, Woolloomooloo, New South Wales, Australia
| | - Elizabeth King
- Cancer Council NSW, Woolloomooloo, New South Wales, Australia
| | - Naomi Elliott
- Cancer Council NSW, Woolloomooloo, New South Wales, Australia
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Nouri N, Iravani P, Abtahi‐Naeini B. Sun protection behaviors among children aged 6-18 years old, the role of socioeconomic factors: A cross-sectional study. Health Sci Rep 2023; 6:e1727. [PMID: 38028698 PMCID: PMC10663172 DOI: 10.1002/hsr2.1727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 10/18/2023] [Accepted: 11/05/2023] [Indexed: 12/01/2023] Open
Abstract
Background and Aims Evaluation of sun protection behavior and related factors in children aged between 6 and 18 years in Isfahan, Iran. Methods This cross-sectional study was conducted at outpatient pediatric clinics affiliated with Isfahan University of Medical Sciences, Isfahan, Iran during the summer of 2021. A checklist was designed, and the interviewer used that to gather the required information including children's demographic characteristics, families' socioeconomic data, and sun-protective behaviors in children. Results The mean ± standard deviation (SD) age of children was 10.54 ± 3.61. Among the study population, 63.7% of children were male. The most common skin phototypes were II and III (33.5% each). 83.8% of children used at least one method of sun protection (94.5% of girls, 77.6% of boys, p < 0.001). Wearing long-sleeved clothes was the most frequent UV-protection method (48%), while sunscreen application was the least prevalent method (28.1%). Sun protection behaviors were more frequent among urban children (86.7%, p = 0.009) and children with wealthy families (94%, p = 0.035). Sun protection methods were used by most of the children whose mothers applied sunscreen on a daily basis (90.2%, p = 0.002) and all of the children whose mothers held a master's degree or above (100%, p = 0.004). Conclusion Children's sun protection behavior is directly associated with demographic characteristics, families' socioeconomic level and maternal usage of sun protection measures. It is necessary to provide information and education about sun protection methods and the risks of excessive sun exposure to families and children, as well as facilitate their access to these.
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Affiliation(s)
- Nikta Nouri
- School of MedicineIsfahan University of Medical SciencesIsfahanIran
| | - Parisa Iravani
- Pediatrics Department, School of MedicineIsfahan University of Medical SciencesIsfahanIran
| | - Bahareh Abtahi‐Naeini
- Pediatric Dermatology Division of Pediatric Department, Imam Hossein Children's HospitalIsfahan University of Medical SciencesIsfahanIran
- Skin Diseases and Leishmaniasis Research CenterIsfahan University of Medical SciencesIsfahanIran
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Monié A, Cournot M, Dumez J, Miquel J, Bertolotti A, Sultan-Bichat N. Evaluation of a school-based sun safety education program in Reunion Island, 2016-2017. Ann Dermatol Venereol 2023; 150:195-198. [PMID: 37385911 DOI: 10.1016/j.annder.2023.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 01/16/2023] [Accepted: 03/24/2023] [Indexed: 07/01/2023]
Abstract
BACKGROUND Sun exposure, especially during childhood, is the main environmental risk factor for skin cancers. This study evaluated the impact of the school-based sun safety education program "Living with the Sun" on the knowledge and behavior of primary school children regarding sun safety in Reunion Island. METHODS This multicenter, comparative intervention study was conducted in selected primary schools of Reunion during the 2016-2017 school year. The intervention consisted of an in-class slide-show presentation on sun safety, a teaching guide, and school trips during which children were offered sunscreen and were requested to wear sunglasses, a T-shirt, and a cap. The children completed a questionnaire before and after the intervention. The percentage of children wearing a cap in school playgrounds at the end of the school year was compared between paired intervention and control schools. RESULTS Seven hundred children from 7 Reunionese schools completed the questionnaire before and after the intervention. There was a statistically significant improvement in children's knowledge of sun safety, with differences between schools, teachers, school levels, and questionnaire responses. The percentage of children wearing a cap at the end of the school year was significantly higher in intervention schools compared to control schools. CONCLUSIONS Children's knowledge and behavior regarding sun safety improved significantly as a result of the intervention.
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Affiliation(s)
- A Monié
- Mission Soleil Réunion, Saint Paul, La Réunion, France
| | - M Cournot
- CHOR, Service de Cardiologie, Saint Paul, La Réunion, France
| | - J Dumez
- UFR La Réunion, Département de Médecine Générale, La Réunion, France; CIC-INSERM 1410, CHU Réunion, Service des Maladies Infectieuses - Dermatologie, Saint Pierre, La Réunion, France.
| | - J Miquel
- Mission Soleil Réunion, Saint Paul, La Réunion, France; CHU Réunion, Unité de Dermatologie - pédiatrique, Saint Pierre, La Réunion, France
| | - A Bertolotti
- Mission Soleil Réunion, Saint Paul, La Réunion, France; CIC-INSERM 1410, CHU Réunion, Service des Maladies Infectieuses - Dermatologie, Saint Pierre, La Réunion, France; CHU Réunion, Service des Maladies Infectieuses - Dermatologie, Saint Pierre, La Réunion, France
| | - N Sultan-Bichat
- Mission Soleil Réunion, Saint Paul, La Réunion, France; CHOR, Service de Dermatologie, Saint Paul, La Réunion, France
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Stătescu L, Cojocaru E, Trandafir LM, Ţarcă E, Tîrnovanu MC, Heredea RE, Săveanu CI, Tarcău BM, Popescu IA, Botezat D. Catching Cancer Early: The Importance of Dermato-Oncology Screening. Cancers (Basel) 2023; 15:3066. [PMID: 37370677 DOI: 10.3390/cancers15123066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 06/02/2023] [Accepted: 06/04/2023] [Indexed: 06/29/2023] Open
Abstract
The European Society for Medical Oncology experts have identified the main components of the long-term management of oncological patients. These include early diagnosis through population screening and periodic control of already diagnosed patients to identify relapses, recurrences, and other associated neoplasms. There are no generally accepted international guidelines for the long-term monitoring of patients with skin neoplasms (nonmelanoma skin cancer, malignant melanoma, precancerous-high-risk skin lesions). Still, depending on the experience of the attending physician and based on the data from the literature, one can establish monitoring intervals to supervise these high-risk population groups, educate the patient and monitor the general population.
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Affiliation(s)
- Laura Stătescu
- Department of Dermatology, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania
- 'Saint Spiridon' County Emergency Clinical Hospital, 700111 Iasi, Romania
| | - Elena Cojocaru
- Department of Morphofunctional Sciences I-Pathology, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Laura Mihaela Trandafir
- Department of Mother and Child Medicine-Pediatrics, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Elena Ţarcă
- Department of Surgery II-Pediatric Surgery, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Mihaela Camelia Tîrnovanu
- Department of Mother and Child Medicine-Obstetrics, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Rodica Elena Heredea
- Department of Clinical Practical Skills, "Victor Babeş" University of Medicine and Pharmacy, 300041 Timişoara, Romania
| | - Cătălina Iulia Săveanu
- Surgical Department, Discipline of Preventive Dentistry, Faculty of Dental Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Bogdan Marian Tarcău
- Department of Dermatology, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania
- 'Saint Spiridon' County Emergency Clinical Hospital, 700111 Iasi, Romania
| | | | - Doru Botezat
- Department of Preventive Medicine and Interdisciplinarity-Behavioral Sciences, Faculty of Medicine, "Grigore. T. Popa" University of Medicine and Pharmacy, 700115 Iași, Romania
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Turon H, Wolfenden L, Finch M, McCrabb S, Naughton S, O'Connor SR, Renda A, Webb E, Doherty E, Howse E, Harrison CL, Love P, Smith N, Sutherland R, Yoong SL. Dissemination of public health research to prevent non-communicable diseases: a scoping review. BMC Public Health 2023; 23:757. [PMID: 37095484 PMCID: PMC10123991 DOI: 10.1186/s12889-023-15622-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 04/06/2023] [Indexed: 04/26/2023] Open
Abstract
BACKGROUND Dissemination is a critical element of the knowledge translation pathway, and a necessary step to ensure research evidence is adopted and implemented by key end users in order to improve health outcomes. However, evidence-based guidance to inform dissemination activities in research is limited. This scoping review aimed to identify and describe the scientific literature examining strategies to disseminate public health evidence related to the prevention of non-communicable diseases. METHODS Medline, PsycInfo and EBSCO Search Ultimate were searched in May 2021 for studies published between January 2000 and the search date that reported on the dissemination of evidence to end users of public health evidence, within the context of the prevention of non-communicable diseases. Studies were synthesised according to the four components of Brownson and colleagues' Model for Dissemination of Research (source, message, channel and audience), as well as by study design. RESULTS Of the 107 included studies, only 14% (n = 15) directly tested dissemination strategies using experimental designs. The remainder primarily reported on dissemination preferences of different populations, or outcomes such as awareness, knowledge and intentions to adopt following evidence dissemination. Evidence related to diet, physical activity and/or obesity prevention was the most disseminated topic. Researchers were the source of disseminated evidence in over half the studies, and study findings/knowledge summaries were more frequently disseminated as the message compared to guidelines or an evidence-based program/intervention. A broad range of dissemination channels were utilised, although peer-reviewed publications/conferences and presentations/workshops predominated. Practitioners were the most commonly reported target audience. CONCLUSIONS There is a significant gap in the peer reviewed literature, with few experimental studies published that analyse and evaluate the effect of different sources, messages and target audiences on the determinants of uptake of public health evidence for prevention. Such studies are important as they can help inform and improve the effectiveness of current and future dissemination practices in public health contexts.
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Affiliation(s)
- Heidi Turon
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW, Australia.
- Hunter Medical Research Institute, New Lambton Heights, NSW, 2305, Australia.
| | - Luke Wolfenden
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, 2305, Australia
- Population Health, Hunter New England Local Health District, Wallsend, NSW, 2287, Australia
| | - Meghan Finch
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, 2305, Australia
- Population Health, Hunter New England Local Health District, Wallsend, NSW, 2287, Australia
| | - Sam McCrabb
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, 2305, Australia
| | - Shaan Naughton
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, 3220, Australia
| | - Sean R O'Connor
- School of Psychology, Queen's University Belfast, Malone Road, Belfast, BT9 5BN, Northern Ireland
| | - Ana Renda
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, 2305, Australia
- Population Health, Sydney Local Health District, Camperdown, NSW, 2050, Australia
| | - Emily Webb
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW, Australia
| | - Emma Doherty
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, 2305, Australia
- Population Health, Hunter New England Local Health District, Wallsend, NSW, 2287, Australia
| | - Eloise Howse
- The Australian Prevention Partnership Centre, Sax Institute, Glebe, NSW, 2037, Australia
| | - Cheryce L Harrison
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, VIC, 3168, Australia
| | - Penelope Love
- Faculty of Health, School of Exercise and Nutrition Sciences (SENS), Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, VIC, Australia
| | - Natasha Smith
- School of Health Sciences, Swinburne University of Technology, Hawthorn, VIC, 3122, Australia
| | - Rachel Sutherland
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, 2305, Australia
- Population Health, Hunter New England Local Health District, Wallsend, NSW, 2287, Australia
| | - Sze Lin Yoong
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, 2305, Australia
- Population Health, Hunter New England Local Health District, Wallsend, NSW, 2287, Australia
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, 3220, Australia
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Vogel RI, Luo X, Brown K, Jewett P, Dona AC, Nagler RH, Ahmed RL, Martinson BC, Lazovich D. A UVR-sensor wearable device intervention to reduce sun exposure in melanoma survivors: Results from a randomized controlled trial. PLoS One 2023; 18:e0281480. [PMID: 36763627 PMCID: PMC9916644 DOI: 10.1371/journal.pone.0281480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 12/12/2022] [Indexed: 02/11/2023] Open
Abstract
BACKGROUND Melanoma survivors are at increased risk of developing a second primary melanoma; however, some report sub-optimal sun behaviors and sunburns. We tested the effectiveness of a wearable device with ultraviolet radiation (UVR)-sensing technology to improve sun behaviors and reduce sunburns in cutaneous melanoma survivors. MATERIALS AND METHODS We conducted a randomized controlled trial using Shade 2, a commercially available wrist device that measures UVR. The intervention group received the device and mobile application notifications about their exposure and prompts to use sunscreen. The control group received the device and a separate research mobile application without information about their exposure or notifications. Participants wore the device for 12 weeks and self-reported sun behaviors before, during, and after the intervention. The primary outcome was a composite score of sun protection behaviors at week 12. RESULTS 386 participants were randomized (186 control, 182 intervention). Most were female and 5+ years past their first melanoma diagnosis. The average age was 56 years. Most (93%) completed the study, though 40% experienced device issues. No meaningful differences were observed in self-reported sun protection behaviors at week 12 (controls 3.0±0.5 vs. intervention 2.9±0.5, p = 0.06), any sunburn during the intervention period (controls 14.4% vs. intervention 12.7%, p = 0.75), or average daily objective UVR exposure (controls median 87 vs. intervention 83 J/m2, p = 0.43). CONCLUSION Wearing a device that measured and alerted melanoma survivors to UVR exposure did not result in different sun behaviors, exposure, or sunburns relative to controls. The technology needs refinement before further attempts to assess the effectiveness of self-monitoring UVR exposure. CLINICAL TRIALS REGISTRATION NCT03927742.
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Affiliation(s)
- Rachel Isaksson Vogel
- Department of Obstetrics, Gynecology and Women’s Health, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, Minnesota, United States of America
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, United States of America
- * E-mail:
| | - Xianghua Luo
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, United States of America
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Katherine Brown
- Department of Obstetrics, Gynecology and Women’s Health, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Patricia Jewett
- Department of Obstetrics, Gynecology and Women’s Health, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, Minnesota, United States of America
- Department of Medicine, Division of Hematology and Oncology, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Allison C. Dona
- Medical School, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Rebekah H. Nagler
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, United States of America
- Hubbard School of Journalism & Mass Communication, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Rehana L. Ahmed
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, United States of America
- Department of Dermatology, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Brian C. Martinson
- HealthPartners Institute, Bloomington, Minnesota, United States of America
- Center for Care Delivery and Outcomes Research, Minneapolis Veterans Affairs Health System, Minneapolis, Minnesota, United States of America
- Department of Medicine, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - DeAnn Lazovich
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, United States of America
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, United States of America
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Kus C, Kus MM, Keten HS, Ucer H, Guvenc N, Kus F, Yildirim HC, Akbayram HT. Knowledge and Protective Behaviors of Teachers on Skin Cancer: A Cross-Sectional Survey Study from Turkey. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10020291. [PMID: 36832420 PMCID: PMC9955452 DOI: 10.3390/children10020291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 01/29/2023] [Accepted: 01/30/2023] [Indexed: 02/05/2023]
Abstract
BACKGROUND People socialize and receive education and training for the first time outside the home at school, where their teachers act as role models. Teachers play a crucial role in instilling sun-protection habits in children. Avoiding the sun between 10 a.m. and 4 p.m., staying in the shade, wearing sun-protective clothing, wearing sunglasses, wearing hats, using sunscreen products, and using an umbrella are some of the sun-protection methods described in the literature. This study sought to assess teachers' skin cancer knowledge and attitudes (SC). METHODS In this cross-sectional study conducted between 21 September 2020, and 21 October 2020, 647 teachers from 30 schools in Kahramanmaras were included with their consent. The number of teachers employed at Kahramanmaras was 1863. Accordingly, the sample was found to be 641 with a 5% margin of error and a 99% confidence interval. Schools were selected by a simple random method. Teachers' knowledge and behaviors were assessed using a 25-point questionnaire designed by the literature data to gauge the level of SC knowledge. RESULTS Of the 647 teachers included in this study, 230 (35.5%) were male, and 417 (64.5%) were female. The mean age of the participants was 38.44 ± 8.79 (min = 22, max = 65) years. The knowledge level of the teachers about SC was 13.54 ± 4.48 (min = 0, max = 23). The internet (75.9%) was the most preferred source of information. SC knowledge level was significantly higher in those with SC in their families and birthmarks on their bodies. (p < 0.001, p = 0.042, respectively). The rate of precaution taken to protect from the sun was higher in those with higher knowledge (p = 0.032). Women, primary school teachers, those with skin type 1, those with multiple nevi, and those with a high level of SC knowledge used statistically significantly more sunscreen (p = 0.001, p = 0.003, p < 0.001, p = 0.037, p = 0.002, respectively). CONCLUSIONS It was found that the knowledge level of teachers about skin cancer and sun-protective behaviors was moderate. Correct behaviors increased as knowledge about SC grew. Information and recommendations made on the Internet should be made by experts. Additionally, health policymakers should implement projects aimed at improving teachers' knowledge and behaviors and, through them, teaching students about SC; as such projects would significantly contribute to both public health and health economics.
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Affiliation(s)
- Celal Kus
- Department of Family Medicine, Medical Faculty, Kahramanmaras Sutcu Imam University, Kahramanmaras 46050, Turkey
| | - Mine Mujde Kus
- Department of Dermatology and Venereology, Medical Faculty, Kahramanmaras Sutcu Imam University, Kahramanmaras 46050, Turkey
| | - Hamit Sirri Keten
- Department of Family Medicine, Medical Faculty, Gaziantep University, Gaziantep 27050, Turkey
| | - Huseyin Ucer
- Department of Family Medicine, Pazarcik Family Health Center (No. 1), Kahramanmaras 46050, Turkey
| | - Numan Guvenc
- Department of Family Medicine, Pazarcik Family Health Center (No. 2), Kahramanmaras 46050, Turkey
| | - Fatih Kus
- Department of Medical Oncology, Hacettepe University Medical School, Ankara 06230, Turkey
| | - Hasan Cagri Yildirim
- Department of Medical Oncology, Hacettepe University Medical School, Ankara 06230, Turkey
- Correspondence:
| | - Hatice Tuba Akbayram
- Department of Family Medicine, Medical Faculty, Gaziantep University, Gaziantep 27050, Turkey
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Raymond-Lezman JR, Riskin S. Attitudes, Behaviors, and Risks of Sun Protection to Prevent Skin Cancer Amongst Children, Adolescents, and Adults. Cureus 2023; 15:e34934. [PMID: 36938200 PMCID: PMC10016731 DOI: 10.7759/cureus.34934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/13/2023] [Indexed: 02/16/2023] Open
Abstract
Skin cancer is the most common cancer diagnosis worldwide. Many factors are involved in the development of skin cancers, but ultraviolet (UV) light exposure is the most modifiable. Our lifetime cumulative UV exposure may be a result of poor sun protection practices in childhood and adolescence. Modifying the attitudes and behaviors of children can be done in the classroom, at recreational activities, and at home. A review of the literature was conducted using Embase and PubMed to examine the relationship between attitudes and behaviors as they relate to sun protection strategies. Well-developed, standardized sun protection educational programs are needed to instruct children and adolescents. Individualized counseling from physicians or online programs is needed to help parents increase sun-safe standards for their children. Many young women utilize indoor tanning beds frequently, but many instructional programs increased their tanning bed usage. Time should be allotted at schools, sports practices, camps, and other outdoor activities for sunscreen reapplication. Many parents and children report the media is their primary source of information about sun safety. Media outlets may positively change attitudes and behaviors when reporting about sun safety. Parents and children need individualized programs or counseling to reduce ultraviolet (UV) exposure and increase sun protection. At-risk populations need tailored instruction, but few strategies have worked to decrease UV exposure.
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Affiliation(s)
- Jonathan R Raymond-Lezman
- Department of Foundational Sciences, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Clearwater, USA
| | - Suzanne Riskin
- Department of Foundational Sciences, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Clearwater, USA
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Association of Sun Safety Behaviors and Barriers with Sunburn History in College Students in a Region with High UV Exposure. Curr Oncol 2022; 29:9671-9680. [PMID: 36547173 PMCID: PMC9776479 DOI: 10.3390/curroncol29120759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 12/01/2022] [Accepted: 12/06/2022] [Indexed: 12/13/2022] Open
Abstract
Over five million cases of skin cancer are diagnosed each year in the United States with melanoma the third most common cancer in young adults. While publications have shown that sunburns increase the risk of developing melanoma throughout the lifetime including in adolescence and adulthood showing the importance of altering sun exposing behaviors throughout the lifetime, use of sun protection in college students remails low. In Fall 2019, an online survey of undergraduate students living on campus at a large southwestern university was conducted to determine the frequency of recent sunburns as well as sun protective behaviors and perceived knowledge of and barriers to sun protection. Associations between knowledge, behaviors, and barriers with self-reported sunburn were evaluated using logistic regression. Over 46% of 458 students reported at least one sunburn in the past three months and 21% reported having multiple sunburns in that period. Furthermore, 53% reported that they intentionally tanned their skin outdoors occasionally or more frequently, while 6.4% reported using an indoor tanning bed occasionally or more. Adjusted for skin sensitivity, recent sunburn history was associated with higher tanning activity scores and with high agreement that tanning was attractive (p < 0.01). This information can inform a more targeted series of intervention programming on the university campus.
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11
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Hanewinkel R, Janssen J, Hübner IM, Breitbart E, Isensee B. [Shaded places for skin cancer prevention in kindergartens and schools]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2022; 65:1324-1333. [PMID: 36302920 PMCID: PMC9612602 DOI: 10.1007/s00103-022-03616-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 10/13/2022] [Indexed: 12/03/2022]
Abstract
BACKGROUND Excessive UV radiation from the sun may lead to skin cancer, the most common type of cancer in Germany. Therefore, among other things, the World Health Organization recommends seeking shade during the midday hours from a UV index of 3 (3 to 5 = "moderate"). However, this important preventive measure can only be taken if sufficient shaded areas are available. The aim of the study is to record shaded areas in kindergartens and schools nationwide. METHODS An epidemiological cross-sectional study with two samples was carried out. Management of kindergartens and schools were surveyed using online questionnaires about the provision of shading measures at their educational institution from May to August 2020 and from April to July 2021, respectively. The primary outcome was to record the presence of various structural shading measures in the outdoor area of their educational institutions. The secondary outcome was to estimate the size of the shaded exterior area. RESULTS From the nationwide population, 1042 kindergartens (1.9%) and 713 schools (2.3%) participated. Compared to schools, kindergartens had sun protection measures in the outdoor area significantly more often (99% vs. 82%; p < 0.001) and were able to shade a significantly larger outdoor area (43% vs. 26%; p < 0.001). Assuming a minimum required shaded outdoor area of 1 m2 per person, 45% of the schools and 10% of the kindergartens did not have sufficient shaded outdoor areas (p < 0.001). CONCLUSION Almost every fifth school in Germany had no shaded places in the outdoor area. Against the background of climatic changes, an urgent high need for improvements seems obvious.
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Affiliation(s)
- Reiner Hanewinkel
- Institut für Therapie- und Gesundheitsforschung, IFT-Nord gGmbH, Harmsstr. 2, 24114, Kiel, Deutschland.
| | - Jana Janssen
- Institut für Therapie- und Gesundheitsforschung, IFT-Nord gGmbH, Harmsstr. 2, 24114, Kiel, Deutschland
| | - Inga-Marie Hübner
- Arbeitsgemeinschaft Dermatologische Prävention (ADP) e. V., Buxtehude, Deutschland
| | - Eckhard Breitbart
- Arbeitsgemeinschaft Dermatologische Prävention (ADP) e. V., Buxtehude, Deutschland
| | - Barbara Isensee
- Institut für Therapie- und Gesundheitsforschung, IFT-Nord gGmbH, Harmsstr. 2, 24114, Kiel, Deutschland
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12
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Alonso-Belmonte C, Montero-Vilchez T, Arias-Santiago S, Buendía-Eisman A. [Translated article] Current State of Skin Cancer Prevention: A Systematic Review. ACTAS DERMO-SIFILIOGRAFICAS 2022. [DOI: 10.1016/j.ad.2022.04.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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13
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Situación actual de la prevención del cáncer de piel: una revisión sistemática. ACTAS DERMO-SIFILIOGRAFICAS 2022; 113:781-791. [DOI: 10.1016/j.ad.2022.04.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 04/03/2022] [Accepted: 04/12/2022] [Indexed: 11/20/2022] Open
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14
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Cole SE, Hawkins M, Miller KA, Allen MW, Cockburn M. Correlation Between Objective Measures of Sun Exposure and Self‐reported Sun Protective Behavior and Attitudes in Predominantly Hispanic Youth. Photochem Photobiol 2022; 99:1037-1046. [DOI: 10.1111/php.13687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 07/31/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Sarah E. Cole
- Department of Population and Public Health Sciences Keck School of Medicine of the University of Southern California Los Angeles CA United States
| | - Makenzie Hawkins
- Department of Pediatrics University of Utah Salt Lake City UT United States
| | - Kimberly A. Miller
- Department of Population and Public Health Sciences Keck School of Medicine of the University of Southern California Los Angeles CA United States
- Department of Dermatology Keck School of Medicine of the University of Southern California Los Angeles CA United States
| | - Martin W. Allen
- MacDiarmid Institute for Advanced Materials and Nanotechnology, Department of Electrical and Computer Engineering University of Canterbury Christchurch New Zealand
| | - Myles Cockburn
- Department of Population and Public Health Sciences Keck School of Medicine of the University of Southern California Los Angeles CA United States
- Department of Dermatology Keck School of Medicine of the University of Southern California Los Angeles CA United States
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Lee Solano M, Robinson S, Allen MW, Reyes-Marcelino G, Espinoza D, Beswick B, Tse DH, Ding L, Humphreys L, Van Kemenade C, Dobbinson S, Smit AK, Cust AE. Effect of an interactive educational activity using handheld ultraviolet radiation dosimeters on sun protection knowledge among Australian primary school students. Prev Med Rep 2022; 25:101690. [PMID: 35127364 PMCID: PMC8800069 DOI: 10.1016/j.pmedr.2021.101690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 11/17/2021] [Accepted: 12/26/2021] [Indexed: 11/24/2022] Open
Abstract
This interactive educational activity incorporated handheld UV dosimeters. The intervention improved UV-related knowledge among primary school students. Knowledge about the UV Index improved the most. Knowledge about UV harms, sun protective clothing and behaviours also improved.
Ultraviolet radiation (UV) is the main cause of skin cancer, and children are a priority group for reducing UV exposure. We evaluated whether an interactive educational activity using handheld dosimeters improved UV-related knowledge among primary (elementary) school students. We conducted an uncontrolled before-after study among 427 students in grades 3–6 (ages 8–12 years) at five schools in the Greater Sydney region, Australia. Students used UV dosimeters to measure UV exposure, using the UV index scale, at different locations on their school grounds with and without different forms of sun protection, followed by an indoor classroom presentation and discussion. A 10-point anonymous questionnaire was completed by each student before and after the entire session (60–90 min). Before-after responses were compared using a generalised linear mixed model, adjusted for school, grade and gender. Overall, the mean raw scores increased from 6.3 (out of 10) before the intervention to 8.9 after the intervention, and the adjusted difference in scores was 2.6 points (95% confidence interval 2.4–2.8; p < 0.0001). Knowledge improved for all questions, with the greatest improvement for questions related to the UV Index (p < 0.05). The effect of the intervention was similar across different school, grade and gender groups. School and grade had no significant effect on mean survey scores, but girls scored an average 0.2 points higher than boys (95% confidence interval 0.1–0.4; p = 0.01). In conclusion, Australian primary school students had moderate knowledge about UV and sun protection, and knowledge improved significantly after a short interactive educational activity using handheld UV dosimeters.
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