Grant Number:	1R01CA282219-01A1 Interpret this number
Primary Investigator:	Wu, Yelena
Organization:	University Of Utah
Project Title:	Multilevel Rct of Rural Community Sun Safety for Young Children in Sports
Fiscal Year:	2024

PROJECT SUMMARY Melanoma is the deadliest form of skin cancer, disproportionately affecting rural areas of the US and driving up a disproportionate cancer burden. Children living in these rural and underresourced communities commonly experience multiple health disparities, including increased risks for skin cancer over time. This is due to more frequent and intense outdoor exposures to harmful ultraviolet radiation (UVR) from the sun, where the chances of sunburn are substantially increased. Unfortunately, there are no evidence-based sun safety interventions with durable effects on protecting children in these settings, and especially while playing outdoors. How to safely promote young children's outdoor playtime while still adequately protecting them from harmful UVR exposure is a vexing research challenge in rural cancer control, and one that requires a multilevel public health approach to cancer prevention. In direct response to this need, we designed a multicomponent, multilevel sun safety intervention for young children (ages 3-6) enrolled in recreational sports programs across 2 rural states (UT, WV). Recreational sports programs are naturally-occurring opportunities for early cancer education and protection in an adult-supervised setting. Grounded in an ecologically-valid theory of shaping children’s health behavior, our intervention promotes recommended sun safety strategies and adaptations at the individual, social, and environmental levels. In a preliminary trial, we delivered this intervention in 2 rural communities' developmental baseball programs (among N=17 teams of female and male players). Intervention leagues, teams, coaches, and players evidenced significant improvements in key outcomes, and greater than among controls. Now, we propose a more stringent test of this intervention in a two-arm cluster-randomized trial in 16 counties in 2 rural states (UT, WV) matched for skin cancer burden and other community-level factors. The trial will address 16 leagues, 64 teams, 128 coaches, and 640 players: primary outcomes include directly-observed sun protection behaviors during recreational sports practices and games. Area-wide UVR and environmental scan data will be obtained from geocoded locations and considered in explanatory models. Secondary endpoints include parent-reported child sun protection and sunburn. Multilevel mechanisms, processes, and moderators of the intervention’s impact on child sun protection will be included, as well as intervention delivery-related effects to help guide future tailoring. This project has the potential to promote lasting changes in children's sun safety behaviors during a sensitive biological stage. It will do so in rural and medically underrepresented communities that are among the most in need of effective cancer control strategies, using approaches that can be scaled-up statewide and to other regions of the country to help reduce cancer disparities.





None