Melanoma incidence rates continue to increase worldwide, despite widespread efforts at primary prevention based on sun exposure avoidance education. Childhood sun exposure not only increases melanoma risk, but also establishes lifetime patterns of sun exposure and protection. In many areas where specific primary prevention efforts involving childhood education have been adopted, little impact on the overall melanoma burden has been realized. This is most likely because, as a wealth of previous study has shown, there is a disconnect between knowledge of 'safe'sun exposures and any resulting behavioral change. Our objective in this study is to test a novel classroom-based hands-on educational intervention to motivate youth to limit their sun exposure, and affect sun exposure behavior change. We have been conducting a SunSmart educational program in Los Angeles area schools for 5 years, and aim to use those established relationships to ensure the success of this study. We will recruit at least 1,575 students from at least 18 schools to participate in a randomized trial of the effect our Intervention, the UV Dosimetry Laboratory (in comparison to SunSmart alone) in changing sun exposure behavior. We will establish baseline sun exposure knowledge, attitudes and behavior, conduct the Intervention, then conduct follow-up to determine if UV exposure behavior changed in a subset of at least 315 students. We will obtain baseline and follow-up UV exposure data using dosimeters measuring real change in sun exposure behavior. Our proposed approach is innovative, incorporating students'scientific discovery and personal understanding of their own UV exposures in an active educational intervention, and verifying behavior change using dosimetry. Our pilot data suggests a high probability of success of both the approach and the intervention itself. The potential impact of this study is far-reaching, because it is being conducted amongst the largest population of school children (a potential target population of almost 700,000 school children) exposed to the highest levels of UV in the country.

Public Health Relevance

In this proposal, we aim to improve the effectiveness of sun exposure avoidance behaviors in children to greatly improve melanoma prevention efforts. We will conduct a randomized trial of a novel hands-on, science-based ultraviolet (UV) exposure lab activity in schools in Los Angeles. In a subset of children, we will determine sun exposure behavior change using dosimeters, rather than relying on self-report. Our pilot data indicate a strong probability of success of the Intervention, and our approach has enormous additional potential to impact melanoma prevention because we are conducting the study among children with the highest UV exposures in the country, who come from a student population of almost 700,000.

National Institute of Health (NIH)
National Cancer Institute (NCI)
Research Project (R01)
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Study Section
Psychosocial Risk and Disease Prevention Study Section (PRDP)
Program Officer
Patrick, Heather A
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University of Southern California
Public Health & Prev Medicine
Schools of Medicine
Los Angeles
United States
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Altieri, Lisa; Miller, Kimberly A; Huh, Jimi et al. (2018) Prevalence of sun protection behaviors in Hispanic youth residing in a high ultraviolet light environment. Pediatr Dermatol 35:e52-e54
Miller, Kimberly A; Piombo, Sarah E; Cho, Junhan et al. (2018) Prevalence of Tanning Addiction and Behavioral Health Conditions among Ethnically and Racially Diverse Adolescents. J Invest Dermatol 138:1511-1517
Escobedo, Loraine A; Crew, Ashley; Eginli, Ariana et al. (2017) The role of spatially-derived access-to-care characteristics in melanoma prevention and control in Los Angeles county. Health Place 45:160-172
Miller, Kimberly A; Huh, Jimi; Unger, Jennifer B et al. (2017) Correlates of sun protection behaviors among Hispanic children residing in a high UVR environment. Photodermatol Photoimmunol Photomed 33:75-83
Kamath, Sonia; Miller, Kimberly A; Cockburn, Myles G (2016) Current Data on Risk Factor Estimates Does Not Explain the Difference in Rates of Melanoma between Hispanics and Non-Hispanic Whites. J Skin Cancer 2016:2105250
Le Clair, Marie Z; Cockburn, Myles G (2016) Tanning bed use and melanoma: Establishing risk and improving prevention interventions. Prev Med Rep 3:139-44
Miller, Kimberly A; Langholz, Bryan M; Zadnick, John et al. (2015) Prevalence and predictors of recent skin examination in a population-based twin cohort. Cancer Epidemiol Biomarkers Prev 24:1190-8
Miller, Kimberly A; Huh, Jimi; Unger, Jennifer B et al. (2015) Patterns of sun protective behaviors among Hispanic children in a skin cancer prevention intervention. Prev Med 81:303-8
Miller, K A; Langholz, B M; Ly, T et al. (2015) SunSmart: evaluation of a pilot school-based sun protection intervention in Hispanic early adolescents. Health Educ Res 30:371-9
Lombardi, Christina; Heck, Julia E; Cockburn, Myles et al. (2013) Solar UV radiation and cancer in young children. Cancer Epidemiol Biomarkers Prev 22:1118-28

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