Crane LA, Asdigian NL, Barón AE, Aalborg J, Marcus AC, Mokrohisky ST, Byers TE, Dellavalle RP, Morelli JG. (2012). Mailed intervention to promote sun protection of children: a randomized controlled trial. American Journal of Preventive Medicine, 43 (4), 399-410.
Colorado Kids Sun Care Program
|Program Title||Colorado Kids Sun Care Program|
|Purpose||Designed to increase awareness and promote sun protection behavior and practices. (2012)|
|Program Focus||Awareness building and Behavior Modification|
|Population Focus||Caregivers and School Children|
|Age||Children (0-10 years)|
|Race/Ethnicity||American Indian, Asian, Black, not of Hispanic or Latino origin, Hispanic or Latino, Pacific Islander, White, not of Hispanic or Latino origin|
|Setting||Clinical, Community, Suburban, Urban/Inner City|
|Funded by||NCI (Grant number(s): R01-CA-74592)|
|User Reviews||(Be the first to write a review for this program)|
Materials required for implementation include:
-- Year 1 Parent Cover Letters
-- Year 1 Parent Newsletters
-- Year 2 Kids Newsletter
-- Year 2 Parent Cover Letters
-- Year 2 Parent Newsletters
-- Year 3 Child Cover Letters
-- Year 3 Kids Newsletters
-- Year 3 Parent Cover Letters
-- Year 3 Parent Newsletters
-- Intervention protocol
For costs associated with this program, please contact: Lori Crane. (See products page on the RTIPs website for developer contact information.)
A longitudinal randomized controlled trial evaluated the effects of the intervention on parentchild dyads who were assigned to an intervention group or a no-treatment control group. The study targeted outcomes related to sun protection behavior (wearing protective clothing, wearing a hat, staying in the shade, using sunscreen, and avoiding midday sun) and sun exposure. Intervention participants received the mailed newsletter intervention. The control group received a letter each spring inviting them to complete data collection.
Study recruitment was conducted through community sites, pediatric offices, and Kaiser Permanentea large managed care organization in the Denver, Colorado, area. Interested participants were asked to contact the study team to receive information about the study and to participate in an enrollment interview to assess phenotypes related to skin cancer risk. Parents provided written informed consent, and children ages 7 years old and older provided written assent for participation.
Study participants were 867 Colorado children and their parents. Demographic data were presented for 686 children who were age 6 at the beginning of the 3-year study and their parents. Of these children, half (53%) were female. Seventy-five percent of their parents had a college education or higher, and 36% of households earned $100,000 or more. Of the 867 children in the study, outcome analyses were conducted using the 78% (677) who were White and not of Hispanic or Latino origin (i.e., those at highest risk for skin cancer).
Participating parents completed four telephone interviews using a computer-assisted telephone interview system with live interviewers. Baseline interviews were conducted between June and September, with follow-up interviews conducted during the same months each year thereafter for 3 years. The timing of interviews was balanced across the intervention and comparison groups. The interviews took approximately 20 to 30 minutes and solicited information on the parents sun protection behaviors and the childs level of sun exposure. Parents were asked about sunny days when their child was outside for 15 minutes or longer between 11:00 a.m. and 3:00 p.m. and the frequency of their child (1) wearing clothes covering most of the arms and legs, (2) wearing a hat, (3) staying in the shade, and (4) using sunscreen. Parents responded using a 5-point Likert-type scale from 1 (never) to 5 (all of the time). Parents were also asked how many days per week their child is usually outside between 11:00 a.m. and 3:00 p.m. for more than 15 minutes and for how long the child is outside. Parent responses provided an estimate of the number of weekly outside hours during midday (range=024). Midday sun scores were then recalculated on a 15 scale. A composite measure of sun protection behavior was created by summing scores on the fıve sun protection behaviors (wearing clothing covering most of the arms and legs, wearing a hat, staying in the shade, using sunscreen, and avoiding midday sun), with higher scores reflecting more frequent sun protection behavior.
Children completed four skin exams, one at baseline and one at follow-up each year for 3 years thereafter, at a Kaiser Permanente facility or at the University of Colorado Health Sciences Center. Appointments for 10-minute exams were available throughout the day to accommodate parent and child schedules. All skin exams were conducted by a doctor or nurse who looked for signs of sun exposure like moles, freckles, and tanning. Parents were asked whether their child had any severe sunburns (defıned as blistering) or other sunburns each year. Participants from both study conditions who attended a skin exam received a letter informing them of the average nevus count among children examined in that year and the nevus count for their child.
- The sun protection behavior composite score was greater for the intervention group from baseline to the year 1 (p=.01), year 2 (p<.001), and year 3 (p<.001) follow-up compared with the control group.
- The average intervention effect from baseline across the three follow-up periods was greater for the intervention group than the control group for the sun protection behavior composite score (p<.001).
- The average intervention effect from baseline across the three follow-up periods was greater for the intervention group than the control group for each sun protection behavior: wearing protective clothing (p=.01), wearing a hat (p=.02), staying in the shade (p=.002), using sunscreen (p<.001), and avoiding the midday sun (p=.04).
- Parents in the intervention group reported fewer nonsevere child sunburns compared with parents in the control group at the year 1 follow-up (p=.003). These group differences were not significant at the year 2 or year 3 follow-up. However, averaged across all follow-up periods, intervention group parents reported fewer nonsevere sunburns than parents in the control group (p=.02).
- Parents in the intervention group reported fewer severe child sunburns compared with parents in the control group at the year 3 follow-up (p=.02). These group differences were not significant at the year 1 or year 2 follow-up.
- Averaged across all follow-up periods, group differences were significant for measures of cognitive mediators. Specifically, parents in the intervention group were more aware than control group parents regarding skin cancer risk factors (p<.001), perceived fewer barriers to practicing sun protection strategies (p<.001), and considered these strategies to be more effective in reducing skin cancer (p=.005). Parents in the intervention group also demonstrated a signifıcantly greater shift toward higher PAPM stage for use of long clothing (p<.001) and midday sun avoidance (p<.001) compared with parents in the control group. Nearly all of these outcomes were significant at the year 1, year 2, and year 3 follow-up.
Please click on the related program(s) to review.
Block the Sun, Not the Fun in that:
- They are by the same developer/investigator with the same theoretical basis, focus but have different materials that are designed for different target audiences.
Kaiser Kids Sun Care Program in that:
- They share intervention material.
(Be the first to write a review for this program)