Promoting sunscreen use and skin self-examination to improve early detection and prevent skin cancer: quasi-experimental trial of an adolescent psycho-educational intervention

• Published in: BMC public health Vol. 18; no. 1; p. 666
• Main Authors: Hubbard, Gill, Kyle, Richard G, Neal, Richard D, Marmara, Vincent, Wang, Ziyan, Dombrowski, Stephan U
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 29.05.2018; BioMed Central; BMC
• Subjects: Adolescence; Adolescents; Analysis; Cancer; Cancer prevention; Child development; Control methods; Data processing; Experimental design; Health aspects; Health behavior; Illnesses; Intervention; Melanoma; Methods; Motivation; Pediatrics; Prevention; Public health; Qualitative analysis; Qualitative research; Quasi-experimental methods; Schools; Skin cancer; Skin care; Skin self-examination; Statistical analysis; Statistical tests; Students; Sun; Sun screens; Sunburn & sun tanning; Sunscreen; Sunscreening agents; Teenagers; Variance analysis; Young adults; United Kingdom; United Kingdom > UK; United States > US; Adolescence; Skin self-examination; Skin cancer
• ISSN: 1471-2458; 1471-2458
• DOI: 10.1186/s12889-018-5570-y

Skin cancer rates are increasing. Interventions to increase adolescent sunscreen use and skin self-examination (SSE) are required. Quasi-experimental design; 1 control and 4 intervention group schools in Scotland, UK. Participants were 15-16 year old students on the school register. The intervention was a theoretically-informed (Common-Sense Model and Health Action Process Approach) 50-min presentation, delivered by a skin cancer specialist nurse and young adult skin cancer survivor, to students in a classroom, supplemented by a home-based assignment. Outcome variables were sunscreen use intention, SSE intention/behaviour, planning, illness perceptions and skin cancer communication behaviour, measured 2 weeks pre- and 4 weeks post- intervention using self-completed pen and paper survey. School attendance records were used to record intervention up-take; students self-reported completion of the home-based assignment. Pearson's chi-square test, analysis of variance, and non-parametric Wilcoxon Signed Ranks Test were used to measure outcomes and associations between variables. Focus groups elicited students' (n = 29) views on the intervention. Qualitative data were analysed thematically. Five of 37 invited schools participated. 639 (81%) students in intervention schools received the intervention; 33.8% completed the home-based assignment. 627 (69.6%) of students on the school register in intervention and control schools completed a questionnaire at baseline; data for 455 (72.6%) students were available at baseline and follow-up. Focus groups identified four themes - personal experiences of skin cancer, distaste for sunscreen, relevance of SSE in adolescence, and skin cancer conversations. Statistically significant (p < 0.05) changes were observed for sunscreen use, SSE, planning, and talk about skin cancer in intervention schools but not the control. Significant associations were found between sunscreen use, planning and 2 illness perceptions (identity and consequence) and between SSE, planning and 3 illness perceptions (timeline, causes, control). It is feasible to promote sunscreen use and SSE in the context of an adolescent school-based psychoeducation intention. Further research is required to improve study uptake, intervention adherence and effectiveness. ISRCTN11141528.