DESCRIPTION (provided by applicant):
This application fits the broad Challenge Area (01): Behavior, Behavior Change, and Prevention (01); and specific Challenge Topic 01-CA-103: The role of health behaviors in cancer prevention. Skin cancer incidence is rising more rapidly than any other cancer, much of the risk is acquired prior to age 20, and Coloradoans are particularly at risk because of high altitude, sunny climate, and an outdoor lifestyle. While prior skin cancer prevention intervention research in adolescent populations has achieved some success, changes in behavior have been modest and a greater variety of approaches is needed to reach and be successful in all adolescent populations. The proposed project will take into account developmental issues relevant to young adolescents; focus on normative mechanisms and how they influence sun protection and tanning behaviors; enhance our conceptual understanding of how norms influence skin cancer risk behaviors among adolescents; utilize a narrative approach that has been successful in adolescent drug resistance research; and incorporate a participatory approach that will lead to an intervention that is locally relevant and engaging for adolescents. This will be accomplished through six research aims, utilizing two theoretical frameworks, Theory of Planned Behavior and Theory of Normative Social Behavior. Specific Aim 1 involves conducting qualitative "elicitation" interviews with adolescents to determine attitudes and norms related to both tanning and sun protection, and to identify narratives that could be developed into videos in Aim 4. In Specific Aim 2 we will develop a structured questionnaire to assess attitudes and norms related to sun protection and tanning, based on results from Aim 1. Specific Aim 3 includes administering the structured questionnaire to a sample of 300 adolescents age 10-14 and conducting analysis following the Theory of Planned Behavior and Theory of Normative Social Behavior to determine the relative importance of attitudes and norms on sun protection and tanning behavioral intentions. Specific Aim 4 will bring together the quantitative findings from Aim 3 with the narratives (personal stories) elicited in Aim 1 in the production of video narratives by local video arts students using a youth participatory process. In Specific Aim 5 we will collect both qualitative (focus group) and quantitative (questionnaire) data to assess the acceptability of the video narratives and the short-term cognitive changes associated with viewing the videos. In Specific Aim 6, the youth-produced videos will be disseminated through popular social networking Internet sites and email, and we will observe the reach of this method of dissemination. PUBLIC HEALTH RELEVANCE STATEMENT Adolescents represent an important group for skin cancer prevention. Sun exposure prior to the age of 20 has a strong relationship with development of skin cancer later in life. Additionally, skin cancer risk behaviors, such as failure to use sun protection and intentional tanning, increase during these years. While previous research has shown some success in changing sun protection and tanning behaviors in adolescents, a broader range of strategies is needed in order to reach all adolescent groups. The proposed research will focus specifically on the influence of norms on sun protection and tanning behaviors, and use a combination of qualitative and quantitative research with a youth participatory approach to develop, pilot test, and disseminate video narratives aimed at increasing sun protection and reducing tanning.
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