Hewitt M, Denman S, Hayes L, Pearson J, Wallbanks C
Nottingham Community Health NHS Trust, Nottingham NG8 3EY, UK.
Health Educ Res. 2001 Oct;16(5):623-33. doi: 10.1093/her/16.5.623.
The aim of the study was to assess the effectiveness of 'Sun-safe', a computer-based resource designed to promote skin cancer awareness and educate children, aged 10-11 years, about the effects of excessive exposure to the sun and associated skin cancer preventive behaviours. Effectiveness was measured by changes in knowledge, attitudes and behavioural intentions using a self-completed questionnaire. A cluster, controlled evaluation design was used. Twelve schools were randomly allocated to the intervention arms of the study (workbook or computer), with a further four schools acting as controls (no intervention). One school allocated to the computer group had serious technical problems with their computers on the day of the intervention and had to be excluded from the study, leaving six schools in the workbook group and five in the computer group. One class in each of the 15 schools participated. The questionnaire was administered before the intervention, the day after and 6 weeks thereafter. The primary outcome measures were changes in mean scores at 6 weeks. In all, 376 children, 83% of the roll, completed both pre- and 6-week tests. Mixed-model analysis, allowing for pre-intervention score and the cluster effect, showed significant increases in knowledge scores in all three groups [workbook 2.36, 95% confidence interval (CI): 1.66 to 3.05; computer 1.73, 95% CI: 1.00 to 2.46; control 0.93, 95% CI: 0.11 to 1.74], but only the workbook group was significantly better than the control group (1.43, 95% CI: 0.36 to 2.50) and there was no significant difference between the intervention groups (0.63, 95% CI: -0.38 to 1.63). With regard to attitudes, both interventions showed significantly greater increases in scores than the control group, but there was no significant difference between them (workbook 2.37, 95% CI: 1.27 to 3.47; computer 1.92, 95% CI: 0.76 to 3.09; control -0.01, 95% CI: -1.28 to 1.27). Although the mean increases for behavioural intentions scores were small (workbook 0.66, 95% CI: 0.26 to 1.05; computer 1.11, 95% CI: 0.70 to 1.51; control 0.08, 95% CI: -0.37 to 0.52), those for the intervention groups were significantly better than the control group, but were not significantly different from each other. The evaluation showed significant improvements in knowledge, attitudes and behavioural intentions, which were still present 6 weeks after the intervention. This suggests that interventions employing the Sun-safe workbook and computer-based resources could be most usefully put into effect in the week before the start of the summer holidays.
该研究的目的是评估“阳光安全”项目的有效性。“阳光安全”是一种基于计算机的资源，旨在提高对皮肤癌的认识，并教育10至11岁的儿童了解过度暴露于阳光下的影响以及相关的皮肤癌预防行为。通过使用自我填写问卷来测量知识、态度和行为意图的变化，以此衡量该项目的有效性。研究采用了整群对照评估设计。12所学校被随机分配到研究的干预组（练习册组或计算机组），另有4所学校作为对照组（无干预）。分配到计算机组的一所学校在干预当天计算机出现严重技术问题，不得不被排除在研究之外，最终练习册组有6所学校，计算机组有5所学校。15所学校中的每个学校各有一个班级参与。问卷在干预前、干预后一天及干预后6周进行发放。主要结局指标是6周时平均得分的变化。共有376名儿童（占在册人数的83%）完成了干预前和6周后的测试。考虑到干预前得分和整群效应的混合模型分析显示，所有三组的知识得分均有显著提高[练习册组2.36，95%置信区间（CI）：1.66至3.05；计算机组1.73，95%CI：1.00至2.46；对照组0.93，95%CI：0.11至1.74]，但只有练习册组显著优于对照组（1.43，95%CI：0.36至2.50），干预组之间无显著差异（0.63，95%CI：-0.38至1.63）。关于态度，两种干预措施的得分增幅均显著高于对照组，但两者之间无显著差异（练习册组2.37，95%CI：1.27至3.47；计算机组1.92，95%CI：0.76至3.09；对照组-0.01，95%CI：-1.28至1.27）。虽然行为意图得分的平均增幅较小（练习册组0.66，95%CI：0.26至1.05；计算机组1.11，95%CI：0.70至1.51；对照组0.08，95%CI：-0.37至0.52），但干预组的得分显著优于对照组，且两组之间无显著差异。评估显示，知识、态度和行为意图均有显著改善，且在干预后6周仍保持。这表明，采用“阳光安全”练习册和基于计算机的资源进行干预，在暑假开始前一周实施可能最为有效。
