Crane Lori A, Deas Ann, Mokrohisky Stefan T, Ehrsam Gretchen, Jones Richard H, Dellavalle Robert, Byers Tim E, Morelli Joseph
Department of Preventive Medicine and Biometrics, University of Colorado at Denver and Health Sciences Center, 4200 East 9th Avenue, Box B-119, Denver, CO 80262, USA.
Prev Med. 2006 Mar;42(3):162-70. doi: 10.1016/j.ypmed.2005.11.007. Epub 2005 Dec 27.
This study evaluated the behavioral impact of a skin cancer prevention program in which health care providers delivered advice and materials to parents of infants over a 3-year period from 1998 to 2001.
Fourteen offices of a large managed care organization in Colorado were randomly assigned to the intervention or control groups. 728 infants and their parents were recruited within 6 months of birth. At intervention offices, health care providers attended orientation sessions, prompts for delivering sun protection advice were placed in medical records, and parents received sun protection packets at each well-child visit between 2 and 36 months of age.
Based on provider self-report and exit interviews of parents, providers in the intervention group delivered approximately twice as much sun protection advice as providers in the control group. Annual telephone interviews of parents indicated small but statistically significant differences in parent sun protection practices favoring the intervention. Skin exams revealed no significant differences in tanning, freckling, or number of nevi. Behavioral differences between groups appeared to grow over the 3 years of follow-up.
This intervention strategy was successful in increasing the delivery of sun protection advice by health care providers and resulted in changes in parents' behaviors. While the behavioral effect was probably not strong enough to reduce risk for skin cancer, the effect may increase as children age and have more opportunities for overexposure to the sun.
本研究评估了一项皮肤癌预防计划的行为影响，在1998年至2001年的3年期间，医疗保健提供者向婴儿家长提供建议和材料。
科罗拉多州一个大型管理式医疗组织的14个办公室被随机分配到干预组或对照组。728名婴儿及其家长在出生后6个月内被招募。在干预办公室，医疗保健提供者参加了培训课程，在病历中设置了提供防晒建议的提示，家长在孩子2至36个月大的每次健康检查时都会收到防晒资料包。
根据提供者的自我报告和对家长的出院访谈，干预组的提供者提供的防晒建议大约是对照组提供者的两倍。对家长的年度电话访谈表明，在家长的防晒行为方面存在微小但具有统计学意义的差异，有利于干预组。皮肤检查显示在晒黑、雀斑或痣的数量方面没有显著差异。两组之间的行为差异在3年的随访中似乎有所增加。
这种干预策略成功地增加了医疗保健提供者提供的防晒建议，并导致了家长行为的改变。虽然行为效果可能不足以降低皮肤癌风险，但随着孩子年龄增长，有更多机会过度暴露在阳光下，这种效果可能会增强。
