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

Hubbard, Gill; Kyle, Richard G.; Neal, Richard D.; Marmara, Vincent; Wang, Ziyan; Dombrowski, Stephan U.

Abstract

Background: Skin cancer rates are increasing. Interventions to increase adolescent sunscreen use and skin self-examination (SSE) are required.
Methods: 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.
Results: 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).
Conclusions: 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.

Citation

Hubbard, G., Kyle, R. G., Neal, R. D., Marmara, V., Wang, Z., & Dombrowski, S. U. (2018). Promoting sunscreen use and skin self-examination to improve early detection and prevent skin cancer: quasi-experimental trial of an adolescent psycho-educational intervention. BMC Public Health, 18(1), https://doi.org/10.1186/s12889-018-5570-y

• Journal Article Type: Article
• Acceptance Date: May 16, 2018
• Online Publication Date: May 29, 2018
• Publication Date: 2018-12
• Deposit Date: Jun 4, 2018
• Publicly Available Date: Jun 4, 2018
• Journal: BMC Public Health
• Publisher: BMC
• Peer Reviewed: Peer Reviewed
• Volume: 18
• Issue: 1
• DOI: https://doi.org/10.1186/s12889-018-5570-y
• Keywords: Skin cancer, Skin self-examination, Adolescence
• Public URL: http://researchrepository.napier.ac.uk/Output/1195726
• Contract Date: Jun 4, 2018