Geller Alan C, Oliveria Susan A, Bishop Marilyn, Buckminster Marcia, Brooks Katie R, Halpern Allan C
Department of Dermatology, Boston University School of Medicine, DOB 801A, Boston, MA 02118, USA.
J Sch Health. 2007 Aug;77(6):312-8. doi: 10.1111/j.1746-1561.2007.00212.x.
We describe the planning, recruitment, key challenges, and lessons learned in the development of a study of the evolution of nevi (moles) among children in a school setting.
This population-based study of digital photography and dermoscopy of the child's back (overview, close-up, and dermoscopic images) and genetic specimens took place among fifth graders in the Framingham, Massachusetts School System. Schoolchildren and their parents completed baseline surveys on sun protection practices, sunburns, and past ultraviolet exposures, including summer and vacation experiences.
Prestudy outreach was conducted with children, parents, nurses, administrators, and pediatricians. Of the 691 Framingham families with a fifth grader (aged 10-11), 443 consented to complete surveys and undergo digital photography and dermoscopy during the school's routine scoliosis testing. Of the 443 families providing consent, 369 agreed to genetic testing. We identified key factors to consider when implementing school-based studies: (a) pilot studies to demonstrate feasibility, (b) inclusion of school administration and parents, (c) grassroots approach with multiple contacts, and (d) embedding research studies within preexisting school health services.
Launching an observational study within the school environment required an academic/school collaboration across numerous disciplines including dermatology, epidemiology, genetics, medical photography, school health, community health education, and most notably, the need for the presence of a full-time study nurse in the school. A large school system proved to be an excellent resource to conduct this first prospective study on the evolution of moles in US schoolchildren. The key challenges and lessons learned may be applicable to other investigators launching school-based initiatives.
我们描述了一项针对学校环境中儿童痣演变的研究在规划、招募、关键挑战及经验教训方面的情况。
这项基于人群的研究，对马萨诸塞州弗雷明汉姆学校系统五年级学生的背部进行数码摄影和皮肤镜检查（全貌、特写及皮肤镜图像）并采集基因样本。学童及其家长完成了关于防晒措施、晒伤及既往紫外线暴露情况的基线调查，包括夏季和假期经历。
在研究开展前与儿童、家长、护士、管理人员及儿科医生进行了沟通。弗雷明汉姆有691个家庭育有一名五年级学生（年龄在10 - 11岁），其中443个家庭同意在学校常规脊柱侧弯检测期间完成调查并接受数码摄影和皮肤镜检查。在这443个同意参与的家庭中，369个家庭同意进行基因检测。我们确定了开展基于学校的研究时需考虑的关键因素：(a) 进行试点研究以证明可行性；(b) 纳入学校管理层和家长；(c) 采用基层方法并进行多次沟通；(d) 将研究嵌入现有的学校健康服务中。
在学校环境中开展一项观察性研究需要跨多个学科的学术/学校合作，包括皮肤科、流行病学、遗传学、医学摄影、学校健康、社区健康教育，最显著的是学校需要有一名全职研究护士。一个大型学校系统被证明是开展这项关于美国学童痣演变的首次前瞻性研究的绝佳资源。关键挑战及经验教训可能适用于其他开展基于学校举措的研究者。
