1
|
Walburn J, Foster L, Araújo-Soares V, Sarkany R, Weinman J, Sainsbury K, Morgan M. Acceptability and influence of a complex personalized intervention on changes in photoprotection behaviours among people with xeroderma pigmentosum. Br J Health Psychol 2023; 28:1113-1131. [PMID: 37414737 DOI: 10.1111/bjhp.12675] [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: 05/13/2022] [Revised: 05/05/2023] [Accepted: 05/23/2023] [Indexed: 07/08/2023]
Abstract
OBJECTIVES Rigorous photoprotection is the only means to prevent skin cancer in people with the rare condition of xeroderma pigmentosum (XP). We conducted a qualitative process evaluation of patient experiences and responses to a highly personalized, multi-component intervention, 'XPAND', designed to influence the psychosocial determinants of inadequate photoprotection among adults with XP. DESIGN Qualitative study of 15 patients following participation in a RCT. METHODS Semi-structured interviews explored acceptability, changes in photoprotection and attributions for behavioural changes. Analysis followed a framework approach. RESULTS Participants were overwhelmingly positive in their views of the quality and range of components of XPAND and the relevance to their personal photoprotection barriers. All participants reported improved adherence to at least one photoprotection activity and nearly two-thirds of participants noted improvements across multiple activities. Participants believed improvements in their photoprotection behaviours were influenced by different change mechanisms. Sunscreen application, was mainly facilitated by habit formation, prompted by text messages, whereas the wearing of a photoprotective face buff was influenced by strategies, learnt during one-to-one sessions, to overcome worry about looking different. Enhancement of general self-confidence and perceived support from XPAND described by participants facilitated change more broadly. CONCLUSIONS Exploration of responses to XPAND is required in the international XP population, followed by adaptation and evaluation to see if it could benefit other patient groups at higher risk of skin cancer. Implications for approaches to behaviour change include the acceptability of complex multidimensional interventions, the importance of dynamic personalization and the interactive nature of behaviour change mechanisms.
Collapse
Affiliation(s)
- Jessica Walburn
- School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | - Lesley Foster
- National Xeroderma Pigmentosum Service, Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - Vera Araújo-Soares
- Division of Prevention, Center for Preventive Medicine and Digital Health (CPD), Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Robert Sarkany
- National Xeroderma Pigmentosum Service, Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - John Weinman
- School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | - Kirby Sainsbury
- Faculty of Medical Sciences, Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | - Myfanwy Morgan
- School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| |
Collapse
|
2
|
McKenzie C, Nahm WJ, Kearney CA, Zampella JG. Sun-protective behaviors and sunburn among US adults. Arch Dermatol Res 2023; 315:1665-1674. [PMID: 36790452 PMCID: PMC9930066 DOI: 10.1007/s00403-023-02547-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 01/17/2023] [Accepted: 01/22/2023] [Indexed: 02/16/2023]
Abstract
Individuals can reduce the risk of developing skin cancer by minimizing ultraviolet sunlight exposure, though recent trends in sun-protective behaviors remain to be investigated. To evaluate sun-protective behaviors and sunburn among US adults. We analyzed data from the 2010, 2015, and 2020 National Health Interview Survey (NHIS), an annual, cross-sectional survey conducted by the US Census Bureau. Multivariable regression models were stratified by demographic variables and constructed to evaluate sun-protective behaviors and sunburn avoidance across time. From 2010 through 2020, US adults had significantly increased prevalence of seeking shade (p value, 0.003), wearing wide-brimmed hats (< 0.001), wearing long-sleeved shirts (< 0.001), using sunscreen (< 0.001), and avoiding sunburns (< 0.001) and significantly decreased prevalence of sun avoidance (< 0.001). Disparities in sun-protective behaviors also exist among different sexes, ages, education levels, and those reporting higher sun sensitivity. This cross-sectional study found that by 2020, US adults had an increased prevalence of wearing sun-protective clothing and sunscreen use, though decreased prevalence of sun avoidance. Although certain sun-protective behaviors have become more prevalent, the incidence of skin cancer continues to rise. Efforts to understand drivers of sun-protective behaviors and targeted intervention efforts are needed.
Collapse
Affiliation(s)
- Costner McKenzie
- The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, 555 Madison Ave, New York, NY, 10022, USA
| | - William J Nahm
- New York University Grossman School of Medicine, New York, NY, USA
| | | | - John G Zampella
- The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, 555 Madison Ave, New York, NY, 10022, USA.
| |
Collapse
|
3
|
Srour AM, Panda SS, Mostafa A, Fayad W, El-Manawaty MA, A. F. Soliman A, Moatasim Y, El Taweel A, Abdelhameed MF, Bekheit MS, Ali MA, Girgis AS. Synthesis of aspirin-curcumin mimic conjugates of potential antitumor and anti-SARS-CoV-2 properties. Bioorg Chem 2021; 117:105466. [PMID: 34775204 PMCID: PMC8566089 DOI: 10.1016/j.bioorg.2021.105466] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 10/31/2021] [Indexed: 12/16/2022]
Abstract
Series of piperidone-salicylate conjugates were synthesized through the reaction of 3E,5E-bis(arylidene)-4-piperidones with the appropriate acid chloride of acetylsalicylate in the presence of triethylamine. All the synthesized conjugates reveal antiproliferative properties against A431 (squamous skin) cancer cell line with potency higher than that of 5-fluorouracil. Many of the synthesized agents also exhibit promising antiproliferative properties against HCT116 (colon) cancer cell line, of which 5o and 5c are the most effective with 12.9, 9.8 folds potency compared with Sunitinib. Promising activity is also shown against MCF7 (breast) cancer cell line with 1.19, 1.12 folds relative to 5-fluorouracil. PI-flow cytometry of compound 5c supports the arrest of cell cycle at G1-phase. However, compound 5o and Sunitinib arrest the cell cycle at S-phase. The synthesized conjugates can be considered as multi-targeted tyrosine kinase inhibitors due to the promising properties against VEGFR-2 and EGFR in MCF7 and HCT116. CDOCKER studies support the EGFR inhibitory properties. Compounds 5p and 5i possessing thienylidene heterocycle are anti-SARS-CoV-2 with high therapeutic indices. Many of the synthesized agents show enhanced COX-1/2 properties than aspirin with better selectivity index towards COX-2 relative to COX-1. The possible applicability of the potent candidates discovered as antitumor and anti-SARS-CoV-2 is supported by the safe profile against normal (non-cancer, RPE1 and VERO-E6) cells.
Collapse
Affiliation(s)
- Aladdin M. Srour
- Department of Therapeutic Chemistry, National Research Centre, Dokki, Giza 12622, Egypt
| | - Siva S. Panda
- Department of Chemistry & Physics, Augusta University, Augusta, GA 30912, US
| | - Ahmed Mostafa
- Center of Scientific Excellence for Influenza Viruses, National Research Centre, Giza 12622, Egypt
| | - Walid Fayad
- Drug Bioassay-Cell Culture Laboratory, Pharmacognosy Department, National Research Centre, Dokki, Giza 12622, Egypt
| | - May A. El-Manawaty
- Drug Bioassay-Cell Culture Laboratory, Pharmacognosy Department, National Research Centre, Dokki, Giza 12622, Egypt
| | - Ahmed A. F. Soliman
- Drug Bioassay-Cell Culture Laboratory, Pharmacognosy Department, National Research Centre, Dokki, Giza 12622, Egypt
| | - Yassmin Moatasim
- Center of Scientific Excellence for Influenza Viruses, National Research Centre, Giza 12622, Egypt
| | - Ahmed El Taweel
- Center of Scientific Excellence for Influenza Viruses, National Research Centre, Giza 12622, Egypt
| | | | - Mohamed S. Bekheit
- Department of Pesticide Chemistry, National Research Centre, Dokki, Giza 12622, Egypt
| | - Mohamed A. Ali
- Center of Scientific Excellence for Influenza Viruses, National Research Centre, Giza 12622, Egypt
| | - Adel S. Girgis
- Department of Pesticide Chemistry, National Research Centre, Dokki, Giza 12622, Egypt,Corresponding author
| |
Collapse
|
4
|
Boyas JF, Woodiwiss JL, Nahar VK. Examining intentions to engage in sun protective behaviors among Latino day laborers: An application of the theory of planned behavior. Health Promot Perspect 2021; 11:351-359. [PMID: 34660231 PMCID: PMC8501480 DOI: 10.34172/hpp.2021.45] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 06/11/2021] [Indexed: 11/09/2022] Open
Abstract
Background: The past two decades has revealed an unprecedented increasing incidence of skin cancer within the Latinx population. Although Latino day laborers (LDLs) are at heightened risk for developing skin cancer because of the outdoor work in which they engage, there is limited research examining their intentions to engage in sun protective behaviors (SPBs). Therefore, this study sought to assess the explanatory power of the theory of planned behavior (TPB) to identify attitudinal, subjective norms, and perceived behavioral control factors associated with intentions to engage in SPB among LDLs. Methods: This cross-sectional retrospective study consists of a non-random convenience,community-based, sample of 137 LDLs residing in Mississippi and Illinois. Data were collected using a self-report survey centered on health practices and sun-protective behaviors. Results: Findings revealed that five significant factors shaped intentions to engage in SPBs, including barriers to engaging in SPBs (β =.30, P<0.001), benefits of engaging in SPBs (β =.27,P<0.001), education (β=0.20, P<0.01), and acculturation (β=0.18, P≤0.05). The independent variables tested in the model accounted for 42% of the change in intentions to engage in SPBs. Conclusion: This study demonstrates TPB’s usefulness for predicting future intentions to engage in SPBs among LDLs. Moreover, the strongest factor associated with predicting intentions to engage in SPBs among LDLs was perceived behavioral control. Thus, since SPBs are malleable, emphasis is placed on implementing interventions for this population that promote intentions and address perceived behavioral control.
Collapse
Affiliation(s)
- Javier F Boyas
- School of Social Work, University of Georgia, 279 Williams St., Athens, GA, 30602, USA
| | - Jana L Woodiwiss
- School of Social Work, University of Georgia, 279 Williams St., Athens, GA, 30602, USA
| | - Vinayak K Nahar
- Department of Dermatology, University of Mississippi Medical Center, 2500 N., State St., Jackson, MS 39216, USA
| |
Collapse
|
5
|
Robinson JK, Durst DA, Gray E, Kwasny M, Heo SY, Banks A, Rogers JA. Sun exposure reduction by melanoma survivors with wearable sensor providing real-time UV exposure and daily text messages with structured goal setting. Arch Dermatol Res 2021; 313:685-694. [PMID: 33185716 PMCID: PMC8116350 DOI: 10.1007/s00403-020-02163-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 10/19/2020] [Accepted: 10/30/2020] [Indexed: 12/25/2022]
Abstract
Despite knowledge of subsequent melanoma risk and the benefit of sun protection in risk reduction, melanoma survivors often do not engage in adequate sun protection and continue to sunburn at rates similar to individuals without a history of skin cancer. This novel intensive intervention provided a wearable UV sensor delivering real-time UV exposure with a smartphone and daily text messages. On days 1-10 (period 1), behavioral facilitation and outcome expectancies messages were provided. On day 10, participants reviewed and reflected on their daily UV exposure on the previous 10 days and set goals for improving sun protection. Then on days 11-21 (period 2) self-efficacy and self-regulation messages were provided. Sixty melanoma survivors were randomized (1:1) to receive structured or unstructured goal setting queries on day 10. Controlling for cloudy/rain conditions with less UV due to weather, there was a time effect with a significant decrease in UV exposure from periods 1-2 [period 1-2, F (59) = 22.60, p < 0.0001]. In this short-term study, melanoma survivors managed their daily UV exposure to stay below their maximum tolerated UV dose. ClinicalTrials.gov Protocol Record NCT0334796, date of registration Nov 15, 2017.
Collapse
Affiliation(s)
- June K Robinson
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, 645 N Michigan Ave, Suite 1050, Chicago, IL, 60611, USA.
| | - Dalya A Durst
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, 645 N Michigan Ave, Suite 1050, Chicago, IL, 60611, USA
| | - Elizabeth Gray
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Mary Kwasny
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Seung Yun Heo
- Department of Biomedical Engineering, Center for Bio-Integrated Electronics, Simpson Querrey Institute for Bionanotechnology, Northwestern University, Evanston, IL, USA
| | - Anthony Banks
- Department of Biomedical Engineering, Center for Bio-Integrated Electronics, Simpson Querrey Institute for Bionanotechnology, Northwestern University, Evanston, IL, USA
| | - John A Rogers
- Department of Biomedical Engineering, Center for Bio-Integrated Electronics, Simpson Querrey Institute for Bionanotechnology, Northwestern University, Evanston, IL, USA
| |
Collapse
|
6
|
A Randomized Trial of Precision Prevention Materials to Improve Primary and Secondary Melanoma Prevention Activities among Individuals with Limited Melanoma Risk Phenotypes. Cancers (Basel) 2021; 13:cancers13133143. [PMID: 34201795 PMCID: PMC8267659 DOI: 10.3390/cancers13133143] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 06/10/2021] [Accepted: 06/15/2021] [Indexed: 11/29/2022] Open
Abstract
Simple Summary Inherited genetic variation at the MC1R gene is associated with increased risk of melanoma among non-Hispanic whites (NHWs), especially among those with skin and pigmentation characteristics that are associated with average to lower melanoma risk, for whom MC1R genetic testing may reveal unrecognized melanoma risk. We conducted a randomized trial to examine whether providing MC1R genetic risk information together with precision prevention materials would increase primary and secondary melanoma preventive behaviors compared to providing generic prevention materials only. We found that among participants with MC1R variants associated with higher risk of melanoma, the intervention increased shade-seeking or using an umbrella, increased wearing sleeved shirts, and decreased sunburns among their young children. We conclude that MC1R genetic testing and precision prevention materials may increase the practice of some sun-protective behaviors. Abstract Inherited variation at MC1R is associated with elevated melanoma risk among non-Hispanic whites (NHWs). MC1R genetic testing may unmask previously unrecognized disease risk, especially among individuals with few melanoma phenotypic risk factors. We recruited NHW individuals with limited phenotypic risk factors from two primary care clinics in west-central Florida. Participants (n = 1134) were randomized within MC1R genotype risk group (average/higher) to receive mailed precision prevention (i.e., intervention) or generic prevention materials. Participants reported hours of weekday and weekend sun exposure, frequency of intentional outdoor tanning and sun protection behaviors, number of sunburns, indoor tanning episodes, and skin examinations at baseline, and after 6 and 12 months. Among MC1R higher-risk participants, the intervention increased the likelihood of often or always wearing a shirt with sleeves (OR = 1.49, p = 0.03) and seeking shade or using an umbrella (OR = 1.42, p = 0.046), and it decreased the number of sunburns among their young children (β = −0.13, p = 0.03). Intervention effects were not noted among MC1R average-risk participants. Moderation analyses identified intervention effects within subgroups in average-risk and higher-risk participants. Precision prevention information conveying MC1R testing results can increase the practice of some sun protection behaviors among at-risk individuals with limited melanoma risk phenotypes and may provide a cross-generational tool to counteract increasing incidence of melanoma.
Collapse
|
7
|
Lacson JCA, Zamani SA, Froes LAR, Mitra N, Qian L, Doyle SH, Azizi E, Balestrini C, Bishop DT, Bruno W, Carlos-Ortega B, Cuellar F, Cust AE, Elder DE, Gerdes AM, Ghiorzo P, Grazziotin TC, Gruis NA, Hansson J, Hočevar M, Höiom V, Holland EA, Ingvar C, Landman G, Larre-Borges A, Mann GJ, Molgo M, Moredo LF, Olsson H, Out-Luiting JJ, Perić B, Pjanova D, Puig S, Salas-Alanis J, Schmid H, Wadt KAW, Newton-Bishop JA, Kanetsky PA. Birth cohort-specific trends of sun-related behaviors among individuals from an international consortium of melanoma-prone families. BMC Public Health 2021; 21:692. [PMID: 33888076 PMCID: PMC8063451 DOI: 10.1186/s12889-021-10424-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 02/10/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Individuals from melanoma-prone families have similar or reduced sun-protective behaviors compared to the general population. Studies on trends in sun-related behaviors have been temporally and geographically limited. METHODS Individuals from an international consortium of melanoma-prone families (GenoMEL) were retrospectively asked about sunscreen use, sun exposure (time spent outside), sunburns, and sunbed use at several timepoints over their lifetime. Generalized linear mixed models were used to examine the association between these outcomes and birth cohort defined by decade spans, after adjusting for covariates. RESULTS A total of 2407 participants from 547 families across 17 centers were analyzed. Sunscreen use increased across subsequent birth cohorts, and although the likelihood of sunburns increased until the 1950s birth cohort, it decreased thereafter. Average sun exposure did not change across the birth cohorts, and the likelihood of sunbed use increased in more recent birth cohorts. We generally did not find any differences in sun-related behavior when comparing melanoma cases to non-cases. Melanoma cases had increased sunscreen use, decreased sun exposure, and decreased odds of sunburn and sunbed use after melanoma diagnosis compared to before diagnosis. CONCLUSIONS Although sunscreen use has increased and the likelihood of sunburns has decreased in more recent birth cohorts, individuals in melanoma-prone families have not reduced their overall sun exposure and had an increased likelihood of sunbed use in more recent birth cohorts. These observations demonstrate partial improvements in melanoma prevention and suggest that additional intervention strategies may be needed to achieve optimal sun-protective behavior in melanoma-prone families.
Collapse
Affiliation(s)
- John Charles A Lacson
- Department of Cancer Epidemiology, Division of Population Science, H. Lee Moffitt Cancer Center & Research Institute, 12902 Magnolia Dr., MRC 213, Tampa, FL, 33612, USA
| | - Shawn A Zamani
- Department of Cancer Epidemiology, Division of Population Science, H. Lee Moffitt Cancer Center & Research Institute, 12902 Magnolia Dr., MRC 213, Tampa, FL, 33612, USA
- Medical Research Council - Cancer Unit, Division of Clinical Medicine, University of Cambridge, Cambridge, Cambridgeshire, UK
| | | | - Nandita Mitra
- Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, PA, USA
| | - Lu Qian
- SWOG Statistics and Data Management Center, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Scarlet H Doyle
- Department of Cancer Epidemiology, Division of Population Science, H. Lee Moffitt Cancer Center & Research Institute, 12902 Magnolia Dr., MRC 213, Tampa, FL, 33612, USA
| | - Esther Azizi
- Department of Dermatology, Sheba Medical Center, Tel Hashomer, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Claudia Balestrini
- Servicio de Dermatología, Hospital Dr. Sótero del Río, Santiago de Chile, Chile
| | - D Timothy Bishop
- Institute of Medical Research at St James's, University of Leeds, Leeds, UK
| | - William Bruno
- Department of Internal Medicine and Medical Specialties, University of Genoa, Genoa, Italy
| | - Blanca Carlos-Ortega
- Departamento de Ciencias Básicas, Escuela de Medicina Universidad de Monterrey, Monterrey, Mexico
| | - Francisco Cuellar
- Melanoma Unit, Dermatology Department, Hospital Clinic Barcelona, Institut de Investigacions biomediques August Pi Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
- Consejo Nacional de Ciencia y Tecnología (CONACYT), Ciudad de México, Mexico
| | - Anne E Cust
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
- Melanoma Institute Australia, The University of Sydney, Wollstonecraft, New South Wales, Australia
| | - David E Elder
- Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Anne-Marie Gerdes
- Department of Clinical Genetics, University Hospital of Copenhagen, Copenhagen, Denmark
| | - Paola Ghiorzo
- Department of Internal Medicine and Medical Specialties, University of Genoa, Genoa, Italy
- Genetics of Rare Cancers, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Thais C Grazziotin
- Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
| | - Nelleke A Gruis
- Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Johan Hansson
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Marko Hočevar
- Institute of Oncology Ljubljana, Ljubljana, Slovenia
| | - Veronica Höiom
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Elizabeth A Holland
- Westmead Institute for Medical Research, The University of Sydney, Westmead, New South Wales, Australia
| | - Christian Ingvar
- Departments of Clinical Sciences and Surgery, Lund University Hospital, Lund, Sweden
| | - Gilles Landman
- Department of Pathology, Escola Paulista de Medicina, UNIFESP, São Paulo, Brazil
- Department of Pathology, AC Camargo Cancer Center, São Paulo, Brazil
| | - Alejandra Larre-Borges
- Unidad de Lesiones Pigmentadas, Cátedra de Dermatología, Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay
| | - Graham J Mann
- Melanoma Institute Australia, The University of Sydney, Wollstonecraft, New South Wales, Australia
- Westmead Institute for Medical Research, The University of Sydney, Westmead, New South Wales, Australia
- John Curtin School of Medical Research, Australian National University, Canberra, ACT, Australia
| | - Montserrat Molgo
- Pontificia Universidad Católica de Chile, Santiago de Chile, Chile
| | | | - Håkan Olsson
- Departments of Clinical Sciences and Surgery, Lund University Hospital, Lund, Sweden
| | - Jacoba J Out-Luiting
- Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Barbara Perić
- Institute of Oncology Ljubljana, Ljubljana, Slovenia
| | - Dace Pjanova
- Latvian Biomedical Research and Study Centre, Riga, Latvia
| | - Susana Puig
- Melanoma Unit, Dermatology Department, Hospital Clinic Barcelona, Institut de Investigacions biomediques August Pi Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
- Centro de Investigacion Biomedica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, Barcelona, Spain
- Departament de Medicina, Universitat de Barcelona, Barcelona, Spain
| | - Julio Salas-Alanis
- Departamento de Ciencias Básicas, Escuela de Medicina Universidad de Monterrey, Monterrey, Mexico
- Dystrophic Epidermolysis Bullous Research Association Mexico, Monterrey, Mexico
| | - Helen Schmid
- Westmead Institute for Medical Research, The University of Sydney, Westmead, New South Wales, Australia
| | - Karin A W Wadt
- Department of Clinical Genetics, University Hospital of Copenhagen, Copenhagen, Denmark
| | | | - Peter A Kanetsky
- Department of Cancer Epidemiology, Division of Population Science, H. Lee Moffitt Cancer Center & Research Institute, 12902 Magnolia Dr., MRC 213, Tampa, FL, 33612, USA.
| |
Collapse
|
8
|
Cifuentes Caballerón CE, Polanco García MJ, Castillo R. Conocimientos, actitudes y comportamiento de padres de familia sobre utilización de medidas fotoprotectoras en niños del área rural y urbana. REVISTA DE LA FACULTAD DE MEDICINA 2019. [DOI: 10.37345/23045329.v1i27.58] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023] Open
Abstract
Introducción: La sobreexposición solar se asocia al desarrollo de diversas enfermedades de la piel entre ellas, el cáncer de piel. Evitar la exposición solar utilizando diferentes medidas de fotoprotección ha resultado beneficioso para evitar el riesgo de cáncer. Objetivo: Este estudio evaluará la frecuencia con la cual los padres de familia utilizan medidas fotoprotectoras en sus hijos. Metodología: Este fue un estudio descriptivo-prospectivo en el que se realizó una encuesta pasada a los padres de familia de niños de 3-12 años. Resultados: Más de la mitad de los participantes (64%) reportaron usar métodos de protección solar en sus hijos. El método más utilizado fue la gorra, y prevenir quemaduras fue la razón primaria para utilizar medidas de protección solar. Discusión: Aunque el uso regular de métodos de protección solar para los niños es frecuente, el principal es el uso de gorra que no es un método ideal por sí solo.
Collapse
|
9
|
Ivanov NN, Swan A, Guseman EH, Whipps J, Jensen LL, Beverly EA. Medical Students' Knowledge, Attitudes, and Behaviors With Regard to Skin Cancer and Sun-Protective Behaviors. J Osteopath Med 2019; 118:444-454. [PMID: 29889933 DOI: 10.7556/jaoa.2018.098] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background Skin cancer is the most prevalent cancer in the United States. Training medical students about the importance of sun-protective behaviors is critical to reducing skin cancer rates. However, minimal research has explored osteopathic medical students' knowledge and behaviors with regard to the sun's effect on skin health. Objective To assess first-year osteopathic medical students' knowledge about skin cancer and UV radiation, attitudes toward tanning, and sun-protective behaviors to establish baseline values. Methods Using a descriptive, cross-sectional study design, the authors evaluated students' knowledge, attitudes, and behaviors through a quiz. Results A total of 121 first-year osteopathic medical students completed the quiz. The mean (SD) score was 74.6% (11.5%). Two-thirds of participants (n=82) correctly identified basal cell carcinoma as the most common skin cancer, and the majority identified the ABCDs (asymmetry, border irregularity, color, and diameter) of melanoma detection (96 [79.3%], 106 [87.6%], 108 [89.3%], and 94 [77.7%], respectively). Most participants were aware that cloud cover and swimming underwater do not provide UV ray protection (121 [100%] and 109 [90.1%], respectively), a fact that is often misconceived. Forty participants (33.1%) usually or always used some form of sun protection when outdoors. Forty-seven participants (38.8%) believed that a tan makes one look healthy, and 43 participants (35.6%) sunbathed with the intention of tanning. Conclusion Physicians are uniquely positioned to counsel patients regarding sun-protective behaviors. Thus, a medical school curriculum that includes education about the sun's effect on health is needed for the prevention and early recognition of skin cancer in future patients.
Collapse
|
10
|
Wu YP, Parsons BG, Nagelhout E, Haaland B, Jensen J, Zaugg K, Caputo H, Lensink R, Harding G, Yancey J, Klein SZ, Leachman SA, Tercyak KP. A four-group experiment to improve Western high school students' sun protection behaviors. Transl Behav Med 2019; 9:468-479. [PMID: 31094440 PMCID: PMC6520801 DOI: 10.1093/tbm/ibz021] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Multicomponent skin cancer preventive interventions for adolescents that aim to decrease ultraviolet radiation (UVR) exposure and sunburns are particularly needed given their intentional tanning and infrequent use of sun protection. The purpose of this study was to conduct an early-phase study within the Multiphase Optimization Strategy framework that experimentally tested four unique intervention components targeting high school students' skin cancer prevention behaviors. Schools (11 total, N = 1,573 students) were assigned to receive one of four interventions: skin cancer education (control), education plus a sunscreen activity (to illustrate sunscreen's UVR-blocking properties), or behavior change worksheet (sun protection goal setting and planning) or receipt of a personalized UV damage photograph (photograph of facial damage). Sun protection, sunburn, and tanning outcomes were assessed before intervention and at 1-month follow-up. Within- and between-intervention changes in outcomes were examined using generalized estimating equation modeling. All interventions were associated with significant improvements in sun protection. The photograph was superior in controlling intentional tanning and sunburn when compared to the behavior change worksheet (ps < .05). In contrast, the worksheet was associated with greater increases in sun protection use when compared with the photograph (ps < .05). In this experiment testing four skin cancer preventive intervention components that varied in approach, content, and interactivity, the behavior change worksheet was superior in improving sun protection use whereas the UV photograph was superior in controlling intentional tanning and sunburn. Future randomized trials to test combinations of these intervention components are needed, and could identify mechanisms underlying improved effects and demographic or behavioral moderators of intervention effects.
Collapse
Affiliation(s)
- Yelena P Wu
- Department of Dermatology, University of Utah, Salt Lake City, UT, USA
- Cancer Control and Population Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Bridget G Parsons
- Cancer Control and Population Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Elizabeth Nagelhout
- Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT, USA
| | - Benjamin Haaland
- Cancer Control and Population Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
- Population Health Sciences, University of Utah, Salt Lake City, UT, USA
| | - Jakob Jensen
- Cancer Control and Population Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
- Department of Communication, University of Utah, Salt Lake City, UT, USA
| | - Kelsey Zaugg
- Cancer Control and Population Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Heloisa Caputo
- Cancer Control and Population Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Riley Lensink
- Cancer Control and Population Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Garrett Harding
- Community Outreach and Prevention Education, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Jeffrey Yancey
- Community Outreach and Prevention Education, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Stephanie Z Klein
- Department of Dermatology, University of Utah, Salt Lake City, UT, USA
| | - Sancy A Leachman
- Department of Dermatology, Oregon Health & Science University, Portland, OR, USA
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
| | - Kenneth P Tercyak
- Cancer Prevention and Control Program, Georgetown Lombardi Comprehensive Cancer Center, NW Washington, DC, USA
| |
Collapse
|
11
|
Morgan M, Anderson R, Walburn J, Weinman J, Sarkany R. The influence of perceived medical risks and psychosocial concerns on photoprotection behaviours among adults with xeroderma pigmentosum: a qualitative interview study in the UK. BMJ Open 2019; 9:e024445. [PMID: 30782905 PMCID: PMC6377541 DOI: 10.1136/bmjopen-2018-024445] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND A high level of photoprotection is required by people with xeroderma pigmentosum (XP), a rare skin disease, to reduce skin cancer and other risks. However poor photoprotection is thought to be widespread. PURPOSE This study examines the influences on photoprotection behaviours in adults with XP. DESIGN Inductive qualitative study with semistructured interviews. Analysis employed a framework approach. SETTING National sample recruited through a specialist XP centre in London. METHODS Semistructured interviews at patients' homes. All transcripts were coded and themes charted for each participant. Comparisons within and across cases identified common themes and differing motivations and approaches to photoprotection. Credibility of interpretations assessed through patient/carer input and clinic adherence scores. PARTICIPANTS 25 adults (17 male, eight female) aged 16-63 years with diagnosed XP attending a specialist centre. 18 lived outside London. RESULTS Awareness of risks of ultraviolet radiation (UVR) and photoprotection was high. However, photoprotection behaviours varied according to perceived necessity and concerns. Three behavioural responses were identified: (1) 'dominated' by planning and routines to achieve a high level of photoprotection with significant activity restrictions and psychosocial impacts. (2) 'resistant' to photoprotection with priority given to avoiding an illness identity and enjoying a normal life. (3) Photoprotection' integrated' with an individual's life with little psychosocial impact. These responses were influenced by illness, personal and contextual factors including age, life stage and social support. Only the 'integrated' group achieved an equilibrium between perceived 'necessity' and 'concerns'. CONCLUSIONS The personal balance between perceived risks of UVR and social/psychological 'concerns' led to differing behavioural responses and contributes to an understanding of adaptation and normalisation in chronic illness. The study will also inform a series of individualised behavioural interventions to reduce measured UVR exposure among people with XP that are potentially applicable to other conditions with high risks of skin cancer.
Collapse
Affiliation(s)
- Myfanwy Morgan
- School of Cancer and Pharmaceutical Sciences, King’s College London, London, UK
| | - Rebecca Anderson
- School of Cancer and Pharmaceutical Sciences, King’s College London, London, UK
| | - Jessica Walburn
- School of Cancer and Pharmaceutical Sciences, King’s College London, London, UK
| | - John Weinman
- School of Cancer and Pharmaceutical Sciences, King’s College London, London, UK
| | - Robert Sarkany
- National Xeroderma Pigmentosum Service, Guy’s and St Thomas' NHS Foundation Trust, London, UK
| |
Collapse
|
12
|
Abstract
Malignant melanoma is an aggressive skin cancer with limited therapeutic options. Cancer is the second largest cause of death in society and one of the most difficult diseases to treat. Advances in biotechnology have enabled the current use of nanotechnology via the application of nanomaterials, especially as drug delivery systems for the transportation of very small particles. In this context, carbon nanotubes, with a potential role in the diagnosis and treatment of melanoma, are still an emerging research field. Their properties have been extensively studied for the use of antineoplastics drugs, as well as for DNA and RNA interference for the treatment of cancer. However, the most important challenge in nanomedicine is to decrease the toxicity and increase the biocompatibility of the nanomaterials used to transport therapeutic molecules. In this sense, this article addresses the recent advances in the use of carbon nanotubes in melanoma therapy and highlights the opportunities and challenges in this area. The advances and challenges involving these topics are essential to the success of nanoconjugate systems, and studies improving the comprehension of these nanosystems contribute to the development of specific antitumor therapies.
Collapse
|
13
|
Cotter G, DuHamel K, Schofield E, Jandorf L. Processes of Change for Colonoscopy: Limited Support for Use Among Navigated Latinos. J Racial Ethn Health Disparities 2018; 6:327-334. [PMID: 30302744 DOI: 10.1007/s40615-018-0528-4] [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: 03/19/2018] [Revised: 08/17/2018] [Accepted: 09/11/2018] [Indexed: 10/28/2022]
Abstract
This study assessed the role of the processes of change (POC), a construct of the transtheoretical model, in colorectal cancer (CRC) screening among Latinos. Latinos participate in CRC screening less often and are diagnosed with CRC at a later stage than whites. POC items were administered to 344 English- and Spanish-speaking Latinos at average risk for CRC who had not had a colonoscopy in the past 5 years and received a colonoscopy referral. POC were measured at three timepoints: following informed consent (T1) at time of referral, 2 weeks prior to scheduled colonoscopy (T2), and 1 month after scheduled colonoscopy (T3). Participants received patient navigation as part of a randomized controlled trial to promote screening colonoscopy. POC scores were examined for changes during the course of the intervention, and logistic regression models assessed the relationship between POC scores and CRC screening adherence. Total POC scores decreased between T1 and T2 (p = 0.03) but were unchanged between T1 and T3. CRC screening adherence was not significantly associated with POC scores or change in POC scores over time. The POC instrument was not found useful for predicting colonoscopy adherence among Latinos in conjunction with patient navigation. Total POC scores did not increase during a patient navigation intervention despite high colonoscopy completion rates.
Collapse
Affiliation(s)
- Gina Cotter
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, 1425 Madison Avenue, New York, NY, 10029, USA.,Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 641 Lexington Avenue, New York, NY, 10022, USA.,Perelman School of Medicine at the University of Pennsylvania, 3400 Civic Center Boulevard, Building 421, Philadelphia, PA, 19104, USA
| | - Katherine DuHamel
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 641 Lexington Avenue, New York, NY, 10022, USA.
| | - Elizabeth Schofield
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 641 Lexington Avenue, New York, NY, 10022, USA
| | - Lina Jandorf
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, 1425 Madison Avenue, New York, NY, 10029, USA
| |
Collapse
|
14
|
Wu YP, Mays D, Kohlmann W, Tercyak KP. Pediatric Predispositional Genetic Risk Communication: Potential Utility for Prevention and Control of Melanoma Risk as an Exemplar. J Genet Couns 2017; 26:887-893. [PMID: 28547663 PMCID: PMC5702278 DOI: 10.1007/s10897-017-0105-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 04/25/2017] [Indexed: 12/20/2022]
Abstract
Predispositional genetic testing among minor children is intensely debated due to the potential benefits and harms of providing this type of genetic information to children and their families. Existing guidelines on pediatric genetic testing state that predispositional testing could be appropriate for minors if preventive services exist that mitigate children's risk for or severity of the health condition in question. We use the example of hereditary melanoma to illustrate the rationale for and potential application of genetic risk communication for an adult-onset cancer to a pediatric population where childhood behaviors may reduce risk of disease later in life. We draw from the adult melanoma genetic risk communication and pediatric health behavior change literatures to suggest ways in which genetic test reporting and complementary education could be delivered to children who carry a hereditary risk for melanoma and their families in order to foster children's engagement in melanoma preventive behaviors. Genetic discoveries will continue to yield new opportunities to provide predispositional genetic risk information to unaffected individuals, including children, and could be delivered within programs that provide personalized and translational approaches to cancer prevention.
Collapse
Affiliation(s)
- Yelena P Wu
- Division of Public Health, Department of Family & Preventive Medicine, University of Utah, 375 Chipeta Way, Suite A, Salt Lake City, UT, 84108, USA.
- Huntsman Cancer Institute, Salt Lake City, UT, USA.
| | - Darren Mays
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, D.C, USA
| | | | - Kenneth P Tercyak
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, D.C, USA
| |
Collapse
|
15
|
Hedayati P, Shahgholian N, Ghadami A. Nonadherence Behaviors and Some Related Factors in Kidney Transplant Recipients. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2017; 22:97-101. [PMID: 28584545 PMCID: PMC5443003 DOI: 10.4103/ijnmr.ijnmr_220_15] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Kidney transplantation is the renal replacement therapy of choice for most patients with end-stage renal disease (ESRD), however, adherence to the recommended lifestyle is critical for a positive prognosis. The purpose of this study was to assess adherence to immunosuppressive therapy and lifestyle recommendations along with some related factors among kidney transplant patients. MATERIALS AND METHODS In this descriptive analytical study, all patients completed a questionnaire regarding medication intake and lifestyle recommendations (preventing of infection, self-monitoring, prevention of cardiovascular disease (CVD), and sun protection). The participants were divided into 4 groups according to the level of adherence (good, partial, poor, and nonadherent) indicated in their responses. RESULTS Most kidney recipients were adherent to their drug prescriptions, but were partial, poor, or nonadherent regarding lifestyle recommendations. Increased passage of time since transplantation and low family support and educational level resulted in nonadherence. Men showed greater adherence to medication intake than women. Patients with lower number of drugs and reported drug side-effects illustrated better adherence to medication intake. Women adhered to infection protection recommendations more than men, and older and married patients adhered to cardiovascular prevention recommendations more than others. However, younger patients showed greater adherence to self-monitoring recommendations, and singles, young individuals, and women were adherent to sun protection recommendations. CONCLUSIONS Nonadherence is common among kidney transplant recipients. Thus, it is necessary to determine patients who are at risk of nonadherence and to introduce more educational programs to improve their adherence and their quality of life (QOL).
Collapse
Affiliation(s)
- Pari Hedayati
- Student Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nahid Shahgholian
- Department of Critical Care Nursing, Kidney Diseases Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ahmad Ghadami
- Ulcer Repair Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| |
Collapse
|
16
|
Wu YP, Aspinwall LG, Conn BM, Stump T, Grahmann B, Leachman SA. A systematic review of interventions to improve adherence to melanoma preventive behaviors for individuals at elevated risk. Prev Med 2016; 88:153-67. [PMID: 27090434 PMCID: PMC4902721 DOI: 10.1016/j.ypmed.2016.04.010] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Revised: 04/07/2016] [Accepted: 04/12/2016] [Indexed: 12/20/2022]
Abstract
BACKGROUND AND OBJECTIVES To examine the effectiveness of behavioral interventions for melanoma prevention targeted to individuals at elevated risk due to personal and/or family history. METHODS Through literature searches in 5 search databases (through July 2014), 20 articles describing 14 unique interventions focused on melanoma prevention among individuals at elevated risk for the disease were identified. Interventions targeting only patients undergoing active treatment for melanoma were excluded. RESULTS The average study quality was moderate. The majority of interventions (6 out of 9, 66% of studies) led to improvements in one or more photoprotective behaviors, particularly for improvements in use of protective clothing (3 out of 5, 60% of studies), and frequency and/or thoroughness of skin self-examinations (9 out of 12, 75%). Fewer interventions (5 out of 14, 36%) targeted uptake of total body skin examinations (60% led to improvements). Also, fewer interventions targeted all three preventive behaviors (5 out of 14, 36%). CONCLUSIONS Findings suggest that future interventions should aim to improve adherence across multiple preventive behaviors, over a longer time period (past 8months post-intervention), and target high-risk children. Studies should include adequate sample sizes to investigate moderators and mediators of intervention effectiveness. Interventions may be strengthened by new techniques, such as incorporating family members (e.g., to improve thoroughness of skin self-examinations) and eHealth technology.
Collapse
Affiliation(s)
- Yelena P Wu
- Division of Public Health, Department of Family and Preventive Medicine, University of Utah, USA; Huntsman Cancer Institute, USA.
| | - Lisa G Aspinwall
- Huntsman Cancer Institute, USA; Department of Psychology, University of Utah, USA
| | - Bridgid M Conn
- Department of Pediatrics, Division of Adolescent and Young Adult Medicine, Children's Hospital Los Angeles, USA
| | - Tammy Stump
- Department of Psychology, University of Utah, USA
| | - Bridget Grahmann
- Division of Public Health, Department of Family and Preventive Medicine, University of Utah, USA
| | - Sancy A Leachman
- Huntsman Cancer Institute, USA; Department of Dermatology, Oregon Health & Science University, USA
| |
Collapse
|
17
|
Ho BK, Reidy K, Huerta I, Dilley K, Crawford S, Hultgren BA, Mallett KA, Turrisi R, Robinson JK. Effectiveness of a Multicomponent Sun Protection Program for Young Children: A Randomized Clinical Trial. JAMA Pediatr 2016; 170:334-42. [PMID: 26857829 PMCID: PMC5522744 DOI: 10.1001/jamapediatrics.2015.4373] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
IMPORTANCE Emphasizing sun protection behaviors among young children may minimize sun damage and foster lifelong sun protection behaviors that will reduce the likelihood of developing skin cancer, especially melanoma. OBJECTIVE To determine whether a multicomponent sun protection program delivered in pediatric clinics during the summer could increase summertime sun protection among young children. DESIGN, SETTING, AND PARTICIPANTS Randomized controlled clinical trial with 4-week follow-up that included 300 parents or relatives (hereafter simply referred to as caregivers [mean age, 36.0 years]) who brought the child (2-6 years of age) in their care to an Advocate Medical Group clinic during the period from May 15 to August 14, 2015. Of the 300 caregiver-child pairs, 153 (51.0%) were randomly assigned to receive a read-along book, swim shirt, and weekly text-message reminders related to sun protection behaviors (intervention group) and 147 (49.0%) were randomly assigned to receive the information usually provided at a well-child visit (control group). Data analysis was performed from August 20 to 30, 2015. INTERVENTION Multicomponent sun protection program composed of a read-along book, swim shirt, and weekly text-message reminders related to sun protection behaviors. MAIN OUTCOMES AND MEASURES Outcomes were caregiver-reported use of sun protection by the child (seeking shade and wearing sun-protective clothing and sunscreen) using a 5-point Likert scale, duration of outdoor activities, and number of children who had sunburn or skin irritation. The biologic measurement of the skin pigment of a child's arm was performed with a spectrophotometer at baseline and 4 weeks later. RESULTS Of the 300 caregiver-child pairs, the 153 children in the intervention group had significantly higher scores related to sun protection behaviors on both sunny (mean [SE], 15.748 [0.267] for the intervention group; mean [SE], 14.780 [0.282] for the control group; mean difference, 0.968) and cloudy days (mean [SE], 14.286 [0.282] for the intervention group; mean [SE], 12.850 [0.297] for the control group; mean difference, 1.436). Examination of pigmentary changes by spectrophotometry revealed that the children in the control group significantly increased their melanin levels, whereas the children in the intervention group did not have a significant change in melanin level on their protected upper arms (P < .001 for skin type 1, P = .008 for skin type 2, and P < .001 for skin types 4-6). CONCLUSIONS AND RELEVANCE A multicomponent intervention using text-message reminders and distribution of read-along books and swim shirts was associated with increased sun protection behaviors among young children. This was corroborated by a smaller change in skin pigment among children receiving the intervention. This implementable program can help augment anticipatory sun protection guidance in pediatric clinics and decrease children's future skin cancer risk. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT02376517.
Collapse
Affiliation(s)
- Byron K. Ho
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Katie Reidy
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Imelda Huerta
- Advocate Children’s Hospital, Park Ridge and Oak Lawn, Illinois
| | | | - Susan Crawford
- Advocate Children’s Hospital, Park Ridge and Oak Lawn, Illinois
| | - Brittney A. Hultgren
- Biobehavioral Health and Prevention Research Center, Pennsylvania State University, University Park
| | - Kimberly A. Mallett
- Biobehavioral Health and Prevention Research Center, Pennsylvania State University, University Park
| | - Rob Turrisi
- Biobehavioral Health and Prevention Research Center, Pennsylvania State University, University Park
| | - June K. Robinson
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois4Editor, JAMA Dermatology
| |
Collapse
|
18
|
Vera RE, Lamberti MJ, Rivarola VA, Rumie Vittar NB. Developing strategies to predict photodynamic therapy outcome: the role of melanoma microenvironment. Tumour Biol 2015; 36:9127-36. [PMID: 26419592 DOI: 10.1007/s13277-015-4059-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Accepted: 09/04/2015] [Indexed: 02/07/2023] Open
Abstract
Melanoma is among the most aggressive and treatment-resistant human skin cancer. Photodynamic therapy (PDT), a minimally invasive therapeutic modality, is a promising approach to treating melanoma. It combines a non-toxic photoactivatable drug called photosensitizer with harmless visible light to generate reactive oxygen species which mediate the antitumor effects. The aim of this review was to compile the available data about PDT on melanoma. Our comparative analysis revealed a disconnection between several hypotheses generated by in vitro therapeutic studies and in vivo and clinical assays. This fact led us to highlight new preclinical experimental platforms that mimic the complexity of tumor biology. The tumor and its stromal microenvironment have a dynamic and reciprocal interaction that plays a critical role in tumor resistance, and these interactions can be exploited for novel therapeutic targets. In this sense, we review two strategies used by photodynamic researchers: (a) developing 3D culture systems which mimic tumor architecture and (b) heterotypic cultures that resemble tumor microenvironment to favor therapeutic regimen design. After this comprehensive review of the literature, we suggest that new complementary preclinical models are required to better optimize the clinical outcome of PDT on skin melanoma.
Collapse
Affiliation(s)
- Renzo Emanuel Vera
- Biología Molecular, Universidad Nacional de Río Cuarto, Ruta 36 Km 601, Río Cuarto, 5800, Córdoba, Argentina
| | - María Julia Lamberti
- Biología Molecular, Universidad Nacional de Río Cuarto, Ruta 36 Km 601, Río Cuarto, 5800, Córdoba, Argentina
| | - Viviana Alicia Rivarola
- Biología Molecular, Universidad Nacional de Río Cuarto, Ruta 36 Km 601, Río Cuarto, 5800, Córdoba, Argentina
| | - Natalia Belén Rumie Vittar
- Biología Molecular, Universidad Nacional de Río Cuarto, Ruta 36 Km 601, Río Cuarto, 5800, Córdoba, Argentina.
| |
Collapse
|
19
|
Transtheoretical Model Constructs' Longitudinal Prediction of Sun Protection Over 24 Months. Int J Behav Med 2015; 23:71-83. [PMID: 26163352 DOI: 10.1007/s12529-015-9498-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE This research examined dynamic transtheoretical model (TTM) constructs for adopting sun protection practices. This secondary data analysis pooled four large population-based TTM-tailored intervention studies and examined use of constructs across three groups, organized by longitudinal progress: maintainers, relapsers, and stable non-changers. METHODS A total of 3463 adults, in the USA, who met criteria for unsafe sun exposure at baseline received a TTM-tailored computerized intervention at baseline, 6 months, and 12 months. The final analytic sample consisted of 1894 participants; the majority were female, White, married, and middle-aged. The three groups were assessed with reliable and valid scales assessing use of TTM constructs at baseline, 6 months, 12 months, and 24 months. Analyses included a MANOVA followed by a series of ANOVAs, with Tukey follow-up tests assessing differences in use of TTM constructs across the three groups at each timepoint. RESULTS Findings demonstrated that relapsers and maintainers were similar in their use of most TTM processes of change at baseline, with the exception of Consciousness Raising, Stimulus Control, Reinforcement Management, and Self-Liberation. CONCLUSIONS These findings suggest that although relapsers reverted to unsafe sun practices, their overall greater use of processes of change indicates that their change efforts remain better than that of stable non-changers.
Collapse
|
20
|
Blattner CM, Lal K, Murase JE. Non-traditional melanoma prevention strategies in the young adult and adolescent population. Dermatol Pract Concept 2014; 4:73-4. [PMID: 25396092 PMCID: PMC4230265 DOI: 10.5826/dpc.0404a15] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Accepted: 08/12/2014] [Indexed: 01/30/2023] Open
Affiliation(s)
| | - Karan Lal
- New York College of Osteopathic Medicine, Old Westbury, NY, USA
| | - Jenny E Murase
- Department of Dermatology, Palo Alto Foundation Medical Group, Palo Alto and Mountain View, CA, USA ; Department of Dermatology, University of California, San Francisco, San Francisco, CA, USA
| |
Collapse
|
21
|
Affiliation(s)
- Nicola Luigi Bragazzi
- School of Public Health, Department of Health Sciences (DISSAL), University of Genoa, Via Antonio Pastore, Genoa, Italy ; DINOGMI, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy
| |
Collapse
|