Ultraviolet light exposure, both indoors and out, is now recognized as a significant contributor to increasing skin cancer rates. The problem of inadequate sun protection and increasing tan seeking behaviors in high school students has been well documented. However, effective community level interventions have not been developed for this population. A new educational approach of demonstrating """"""""risk-to-appearance"""""""" from UV exposure offers promise to change these behaviors. We propose to use our experience in community sun protection interventions to address these risk behaviors of high school students. Intervention components will need to be directed both at the outdoor sun protection behaviors of both genders and females who are intentional tanners using indoor tanning lights. Before conducting a multi-community randomized control trial we submit there are unique issues in this age group that require better understanding and pilot testing of intervention components. First, the current cross-sectional information on high school female indoor tanning behavior is insuffi cient to develop the content and timing of interventions. Second, the effectiveness of adolescent """"""""risk-to-appearance"""""""" interventions needs to be tested at the high school level. Third, the documented importance of parental influence in high school, particularly maternal role modeling of tanning, indicates to us that a parental component of adolescent risk-to appearance interventions needs to be developed and pilot tested. Therefore, we propose to conduct 2 sets of studies to: 1) determine the predictors and patterns of tan seeking (indoor and outdoor) behaviors in a prospective study of high school females who currently use indoor tanning or are at risk of adopting the behavior; and 2) develop and pilot test """"""""risk-to-appearance"""""""" interventions for adolescents and their parents to change indoor and outdoor UV exposure behaviors to be rigorously tested in a subsequent pr oposal. In these development activities, we will include objective measures of skin color to determine if this methodology is feasible as an outcome measure in a subsequent community study.
