Intensive treatments that cure cancer can also cause significant later health problems, including second cancers. Skin cancers are the most common, and the most preventable, second cancers. The growing population of young adult cancer survivors (YACS) is the survivor group at greatest risk for secondary skin cancers, with a melanoma risk more than 2-fold greater than the general population. To reduce their skin cancer risk, YACS are counseled to limit their ultraviolet light (UVL) exposure by avoiding the sun, using sunscreen, and abstaining from artificial tanning, but the majority of YACS fail to practice recommended sun protection (SP). Building on research showing low intensity interventions that go beyond cancer prevention messages are effective in healthy young adults, we have developed a novel video intervention (SunSmart) to increase YACS' adherence to recommended SP. In Phase 1 of the study we will use qualitative and quantitative feedback from 10 YACS to guide final editing of two versions of the SunSmart education video. These videos are 1) The Information Video providing basic information about UVL risk and benefits of SP; and 2) The Information + Appearance Video which includes the full information video, along with additional content on the negative appearance consequences of UVL exposure. Procedures for delivering and assessing the intervention via mobile means will then be pre-tested with 5 YACS. In Phase 2, the efficacy of these educational interventions to change SP attitudes and behaviors will be investigated in a randomized controlled trial of 105 YACS (age 18-35). Participants will be randomized to one of three groups; 1) a control group that will view a sleep hygiene video, 2) the Information SunSmart group, or 3) the Information + Appearance SunSmart group. Participants' SP behaviors and beliefs will be assessed prior to the intervention and at two time points post-intervention.
Specific aims are to: 1) Refine existing SunSmart educational videos based on YACS' feedback, and pre-test web-based delivery and assessment of the intervention; 2) Determine efficacy of the SunSmart intervention in promoting SP behaviors compared to a control condition by delivering it to 105 YACS as a web/mobile intervention; 3) Collect preliminary data on whether addition of the appearance information improves results of the SunSmart intervention. The extent to which the intervention changes SP behavior through hypothesized mediating variables will also be explored. A new intervention that effectively promotes YACS' SP behaviors will make an important contribution to preventing future skin cancers in this growing and vulnerable population. Developing a brief web-based intervention based on empirically supported health promotion messages adapted for the unique needs of YACS will insure the intervention is effective, appealing and easily deliverable. By empirically evaluating effects of different health messages on YACS, this study furthers our understanding of processes affecting their behavior and will make an important contribution to future interventions promoting health behavior changes in this vulnerable population.
Young adult cancer survivors (YACS) are at very high risk for secondary skin cancer, but typically fail to practice the sun protection methods that can reduce their risk. To promote sun protection in this growing population, this study will develop and test an innovative video intervention that can be delivered to YACS either in medical settings or directly via web/mobile means. By increasing adherence to recommended sun protection, this intervention will prevent future skin cancers and eliminate the associated physical, emotional and economic costs in this vulnerable population of young cancer survivors.
