Department of Dermatology, University of Utah, Salt Lake City, UT, USA.
Huntsman Cancer Institute, 2000 Circle of Hope Drive, Salt Lake City, UT, 84112, USA.
J Community Health. 2018 Oct;43(5):993-1001. doi: 10.1007/s10900-018-0516-y.
Melanoma prevention is essential for children who are at elevated risk for the disease due to family history. However, children who carry a familial risk for the disease do not optimally adhere to recommended melanoma preventive behaviors. The current study sought to identify perceived barriers to and facilitators of children's engagement in melanoma preventive behaviors among children at elevated risk for melanoma due to family history of the disease (i.e., having a parent with a history of melanoma) from both parents' and childrens' perspectives. Qualitative methods were employed and consisted of separate focus group discussions with children (ages 8-17 years, n = 37) and their parents (n = 39). Focus group transcripts were coded using content analysis. Parents and children reported a number of barriers and facilitators, including on the individual (e.g., knowledge and awareness, preferences), social (e.g., peer influences, family modeling and communication), and contextual (e.g., healthcare provider communication) levels. The identified categories of barriers and facilitators both confirm and extend the literature documenting the reasons children who are at elevated risk for melanoma do not engage in melanoma prevention and control behaviors. Programs aiming to decrease melanoma risk among children of melanoma survivors could help families address their barriers to preventive behavior implementation and build on facilitators. Melanoma survivors and their children could benefit from support on their interactions with healthcare providers, schools, peers, and other caregivers about melanoma prevention.
黑色素瘤预防对于那些因家族史而患有该疾病风险较高的儿童至关重要。然而，患有家族性黑色素瘤风险的儿童并不能最佳地遵守推荐的黑色素瘤预防行为。本研究旨在从父母和儿童的角度确定患有黑色素瘤（即父母一方有黑色素瘤病史）的儿童在参与黑色素瘤预防行为方面的感知障碍和促进因素。采用定性方法，包括对患有黑色素瘤风险的儿童（年龄 8-17 岁，n=37）及其父母（n=39）进行单独的焦点小组讨论。焦点小组的转录本使用内容分析法进行编码。父母和儿童报告了许多障碍和促进因素，包括个人层面（例如，知识和意识、偏好）、社会层面（例如，同伴影响、家庭示范和沟通）和环境层面（例如，医疗保健提供者的沟通）。确定的障碍和促进因素类别既证实了也扩展了记录儿童因黑色素瘤风险较高而不参与黑色素瘤预防和控制行为的原因的文献。旨在降低黑色素瘤幸存者子女患病风险的项目可以帮助家庭解决预防行为实施的障碍，并利用促进因素。黑色素瘤幸存者及其子女可以从与医疗保健提供者、学校、同伴和其他照顾者关于黑色素瘤预防的互动中受益。
