Randomized Trial of Tailored Skin Cancer Prevention for Children: The Project SCAPE Family Study

Abstract

This study evaluated a tailored intervention to promote sun protection in parents and their children, hypothesizing that the tailored intervention would lead to improved skin cancer prevention behaviors compared to generic materials. Families were recruited through schools and community centers and were included if there was 1 child in Grades 1–3 at moderate to high risk for skin cancer. Participants were randomized into one of two intervention groups: a tailored intervention, in which they received personalized skin cancer education through the mail; or a control group who received generic skin cancer information materials. Before and after intervention, parents completed questionnaires about their and their children's skin cancer risk and prevention knowledge and behaviors. Parents also completed 4-day sun exposure and protection diaries for their child and themselves. Tailored group participants demonstrated significantly greater positive changes in prevention behavior after the intervention, including children's use of sunscreen, shirts, and hats, and parents' use of shade, and skin examinations. Effect sizes were small and perceived benefits and social norms mediated intervention effects. Findings from this study support the efficacy of focusing tailored communications to families in order to change skin cancer prevention practices in young children.

Acknowledgments

This work was supported by grant CA 76419 from the National Cancer Institute. Dr. Karen Glanz's effort was supported in part by a Distinguished Scholar Award from the Georgia Cancer Coalition.

The authors acknowledge the contributions of Martin Weinstock, Gabriela Layi, Jeanne Kidd, and Jennifer Chee in the development and conduct of this trial.

Notes

Note. No statistically significant differences were found between completers and noncompleters.

^a Sample sizes smaller for some items because of missing data.

^b Chi-square tests were used to assess relationships for categorical variables and t tests for continuous variables; no significant differences were found.

^a Means calculated with adjustment for covariates: location and risk group. Mixed models were used unless otherwise stated with p value indicating the significance of the Time × Intervention term.

^b Because of missing data, ns for separate analyses were lower.

^c Range of values: 1 (rarely) to 4 (always).

^d Range of values: 1 (1 or less) to 6 (6hours per day).

^e Range of values: 1 (none) to 5 (5 or more sunburns).

^f Proportion adjusted for covariates. Model was a generalized linear model with binomial distribution using generalized estimating equations.

^a Means calculated with adjustment for covariates: location and risk group. Mixed models were used unless otherwise stated with p value indicating the significance of the Time × Intervention term.

^b Because of missing data, ns for separate analyses were lower.

^c Range of values: 1 (rarely) to 4 (always).

^d Range of values: 0 (none) to 9 (all exposed body parts).

^e Range of values: 1 (1 or less) to 6 (6hours per day).

^f Range of values: 0 (none) to 3 (3 or more sunburns).

^g Proportion adjusted for covariates. Model was a generalized linear model with binomial distribution using generalized estimating equations.

^a Means calculated with adjustment for covariates: risk group and location.

^b Range of values: −100 to 100 change scores (i.e., Percentage Used at Follow-Up–Percentage Used at Baseline).

^c For some analyses, ns are lower because scores were not calculated when respondent stayed indoors.

^d F test result for intervention effect from the generalized linear model.

^e Range of values: −7 to 7hours (i.e., Follow-Up Hours – Baseline Hours).