Neoplasms

Skin and Connective Tissue Diseases

All Conditions

Skin Neoplasms

Skin Diseases

Participants were given a packet of standard skin cancer prevention educational brochures and handouts from major professional organizations to review independently for 10-15 minutes.

Participants met with a trained counselor who reviewed any personalized feedback of risk derived from the baseline assessments (e.g., history of sunburns, self-reported UV exposure, protective behaviors). Counselors utilized the basic motivational interviewing skills of open-ended questions, reflection of participant statements, affirmations/positive feedback, and summation of major points throughout the discussion. These sessions took about 22 minutes.

Participants were shown a regular black and white photo and a black and white UV-filtered photo of their face. Participants were told that "Any dark, spotted, freckled, wrinkled, uneven, or pitted areas indicate existing underlying skin damage that is difficult to reverse. However, protecting the skin from UV radiation can prevent future damage." Participants were asked what they noticed about the photos, what their reactions were, and how this might affect their behavior. These sessions took 12 minutes on average.

Participants met with a trained counselor who reviewed any personalized feedback of risk derived from the baseline assessments (e.g., history of sunburns, self-reported UV exposure, protective behaviors). Counselors utilized the basic motivational interviewing skills of open-ended questions, reflection of participant statements, affirmations/positive feedback, and summation of major points throughout the discussion. In addition to baseline feedback, participants were also interviewed about the black \& white and UV-filtered photos of their faces. These sessions took about 25 minutes.

UV-Detect Photos

Motivational Interviewing

Education

Carolyn Heckman, PhD

The purpose of the proposed project is to investigate the efficacy and longevity of two novel approaches to changing skin protection behaviors: 1) UV-detect photos that reveal currently existing skin damage and 2) motivational interviewing (MI), a person-centered, yet directive counseling style used to enhance internal motivation to change health behaviors. The proposed investigations include a pilot study to refine the methodology; a small formal randomized controlled efficacy trial; and a dismantling study. These studies will also expand current knowledge and research in several major ways: 1) the use of UV-detect photos will enable highly salient and personalized feedback, 2) MI will be used in a previously untried health domain (skin cancer prevention), 3) objective skin color changes will be measured using state-of-the-art skin reflectance spectrophotometry, and 4) the proposed studies will test aspects of several major psychological theories (e.g., Transtheoretical Model, Prototype/Willingness Model) to identify moderators/mediators of outcome.

Teens and young adults are at high risk for overexposure to ultraviolet (UV) radiation, a leading factor in the development of skin cancer. The majority of these individuals continue to protect themselves minimally and tan intentionally, including significant increases in tanning booth use recently. Such care-free behaviors exist despite widespread education/awareness about UV radiation and skin cancer. The purpose of the proposed project is to investigate the efficacy and longevity of two novel approaches to changing skin protection behaviors: 1) UV-detect photos that reveal currently existing skin damage and 2) motivational interviewing (MI), a person-centered, yet directive counseling style used to enhance internal motivation to change health behaviors. The proposed investigations include a pilot study to refine the methodology; a small formal randomized controlled efficacy trial; and a dismantling study. These studies will also expand current knowledge and research in several major ways: 1) the use of UV-detect photos will enable highly salient and personalized feedback, 2) MI will be used in a previously untried health domain (skin cancer prevention), 3) objective skin color changes will be measured using state-of-the-art skin reflectance spectrophotometry, and 4) the proposed studies will test aspects of several major psychological theories (e.g., Transtheoretical Model, Prototype/Willingness Model) to identify moderators/mediators of outcome. Therefore, the studies should provide useful information about process and outcome for skin cancer prevention researchers and clinicians.

The Skin Savvy Study: A Behavioral Skin Cancer Prevention Intervention

The Sun Stage of Change (SOC) Scale has 4 items asking participants whether they have been protecting their skin for the past year (maintenance), if they protect their skin now (action), whether they intend to protect their skin in the next 30 days (preparation), whether they intend to protect their skin in the next year (contemplation), or none of the above (pre-contemplation).

National Cancer Institute (NCI)

Fox Chase Cancer Center

Associate Professor

Because discussing cancer risk and looking at photos of UV damage may be upsetting, participants were monitored for distress at the time of baseline/intervention and any participants, however, no participants exhibited undue anxiety or concern during their participation.

Education Control

UV-detect Photos

UV-detect Photos and Motivational Interviewing

Educational Control

Total

Age, Categorical

Age, Continuous

Sex: Female, Male

African American/Black

Asian-American/Pacific Islander

Caucasian/White

Hispanic/Latino

Other/Mixed

Race/Ethnicity, Customized

Stage of Change Scale

Sun Stage of Change at 3 Months

Sun Stage of Change at 12 Months

Overall Study

Wounds and Injuries

Sunburn

Photosensitivity Disorders

Burns

Dermatologic Agents

All Drugs and Chemicals

Sunscreening Agents

Protective Agents

Radiation-Protective Agents

Upon completion of the two-week baseline period and two-week standard intervention period, the two classrooms assigned to the Extended intervention condition will receive the "I wear sunscreen everyday" song-based video intervention daily for two additional weeks.

The two classrooms assigned to the Maintenance condition will continue to receive a two- minute window for sunscreen application, but no "I wear sunscreen everyday" song-based video instruction.

Change trajectories from Time 3-Time 4 (two-week follow up) will be compared by follow-up assignment condition and will provide preliminary information about dosing and maintenance effects.

All four classes (arms) will be shown (sitting on carpet, not participating) a 2-3 minute song-based video titled "I wear sunscreen everyday" in which they observe elementary age children applying sunscreen in a systematic fashion. Following the viewing, classes will be administered this video guided, song- based intervention while their teacher documents their independent participation using our classroom map data collection sheet.

"I wear sunscreen everyday" song-based video

Kristin Nord, MD

The overarching goal of this work is to pilot-test a song-based instructional video designed to help elementary school (kindergarten) age children independently apply sunscreen effectively (i.e., covers all needed areas), efficiently (i.e., can be accomplished in 2-3 minutes), consistently (i.e., continues to apply sunscreen routinely before recess both during and after the intervention), without impacting classroom function (i.e., no mess). The video is also designed to encourage use of hats and sunglasses. The outcomes of interest include identification of "gaps" in skills that are consistent for this age group (i.e., commonly miss application to the back of neck), areas of learning refinement (i.e., generalization of skills with different outfits on), and flexibility in terms of adapting practice (i.e., can they do it without the video). The investigators hope that this pilot project will pave the way for broader clinical / educational implementation of this intervention within schools.

The investigators will use an unblinded, open label, A-B design with a randomized follow-up period to evaluate the study objectives. The primary aim is to characterize the proportion of students (per class and total, or across classes) who productively engage in the in-classroom sunscreen application tasks when using the video guided sunscreen intervention (i.e., success is defined as any appropriate participation with video guided tasks, completing tasks and putting sunscreen away, sitting down by end of 2 minute, 42 second video intervention) relative to the proportion who achieve success (i.e., any appropriate effort to apply sunscreen, put away sunscreen and sit down within a two minute window) WITHOUT use of the video.

One hundred eight kindergarten students across four kindergarten classrooms (N = 27 per class) will complete a two-week baseline period in which the participants are provide a 2-minute window and allowed access to their sunscreen without instruction. Classroom teachers, trained to score our primary outcome (child does/does not complete this task within two-minute window), will evaluate outcomes for each child daily for two weeks (baseline period). Percentage of students who are able to complete this task is our primary endpoint. Change trajectories from beginning to end of the baseline period (Time 1/Day 1 - Time 2/Day 10) and from the beginning to end of treatment (Time 2 - Time 3) will be calculated for each class. The average percentage of the second week in the baseline period and the second week in the intervention period will be used to calculate the successful rate for each period with 95% confidence intervals.

To address a subsidiary aim, related to whether or not student competence with sunscreen application (systematic, % of body covered / body parts neglected, and completeness of coverage of face) is impacted by the video intervention, a randomly selected subset of students will be evaluated by a trained member of the study team for competence of application at Time 1,2, 3 and 4. Changes trajectories will be calculated by class for this subset of students.

At the study outset, all four classrooms will be randomized to either an "extended intervention" (EI) or "maintenance" (M) condition using a 1:1 randomization scheme. This will offer some descriptive, feasibility data regarding the tolerability of randomization by classroom, and a preliminary look at dose-response trends and short-term maintenance effects. Upon completion of the two-week baseline period and two-week standard intervention period, the two classrooms assigned to the EI condition will receive the video-based intervention for two additional weeks and the two classrooms assigned to the M condition will continue to receive a two- minute window for sunscreen application, but no video-based instruction. Change trajectories from Time 3-Time 4 (two-week follow up) will be compared by follow-up assignment condition and will provide preliminary information about dosing and maintenance effects.

Student, teacher, parent and administrator perceptions of the acceptability, value and utility of the intervention will be assessed at a single time point at the conclusion of the study.

Study Setting and Participants:

General Education Kindergarten students who meet all study eligibility requirements (i.e., including health requirements appropriate to the use of sunscreen) and who assent to participate and who receive parental consent to participate at Sedgwick Elementary School will be included in the present study. Special education students who are mainstreamed may also be considered eligible to participate via consensus from both parent and teacher.

Recruitment and screening: Recruitment efforts will include collaborative (research team + kinder teachers) efforts to provide parents an overview of the study goals and objectives, and to obtain consent/assent. The investigators will plan to have a parent-focused meeting in the weeks prior to the commencement of the study.

Intervention: The song-based video guided sun screen intervention is 2-3 minutes long, with 30 seconds allotted at the beginning for students to prepare their sunscreen materials and get ready, two minutes of instruction that guides their application of sunscreen to all exposed areas of skin starting with their head and working systematically down to their feet, and then 30 seconds of guided instruction for putting the sunscreen materials away and sitting back down at their desks.

Sun Safety Skills for Elementary School Students

Change in the proportion of kindergarten students who successfully complete independent self-application of sunscreen within the allotted 2.5 minute time window from baseline (Time 1) to posttreatment (Time 2). Successful completion of the sun screen task (i.e., Kinder Students' self-application of sunscreen within the 2.5 minute window allotted by the intervention) will be determined via direct observation by the classroom teacher. Teachers will be formally trained by the study staff to rate student performance (i.e., successful/not successful) with self-application of sunscreen per a manualized study protocol.

Teacher identified barriers, or the cognitive, emotional, behavioral, environmental, factors that interfered with a student's successful completion of the self-application of sunscreen task will be recorded by the classroom teacher daily during the sunscreen intervention. This descriptive outcome will be qualitative (i.e., teacher generated list).

Teacher, parents and administrators respond to a single item question, "In your opinion, how useful was this intervention in terms of getting students engaged in sun protective behavior?" This single item is modeled after utility questions used in health services research and educational research, and will be scored on an 11-point likert type scale, where "0" indicates not at all useful; and "10" indicates very useful.

Teacher, parents and administrators respond to a single item question "In your opinion, how valuable was this intervention to your overall curriculum? This single item is modeled after value questions used in health services and educational research and will be Responses will be scored on an 11-point likert type scale, where a score of "0" indicates not at all valuable and a score of "10" indicates very valuable.

Kinder students respond to a single item question "Did you like the sunscreen video? " As Kinder students are not proficient readers, this question will be read aloud to the class, and students will respond individually by casting a "secret ballot" in a voting booth set up in the classroom- -under the direct supervision of the study staff. "Yes" votes will be cast using a piece of paper with a happy face on it; "no" votes will be cast using a piece of paper with a sad face on it. In this way, students can respond individually to this question without having to read, tell their answer to the teacher, and without undue influence of their peers. Results will be tallied by class.

Stanford University

Clinical Professor

Photographs of the volunteers' facial skin will be taken in the Department of Dermatology at baseline using a modern skin analysis photo system (VISIA®, Canfield Scientific, Parsippany, NJ, USA) and afterwards a simulation of the participants' facial skin aging will be performed with the VISIA® photo analysis System.

artificial intelligence-based skin aging simulation

Electronic questionnaire about current sun-related knowledge and protective behaviours via link with smartphone before and after the skin aging simulation.

electronic questionnaire 1

Participants report their perception of the interventions and their motivation for improved sun protection by completing an electronic questionnaire after the skin aging simulation.

electronic questionnaire 2

Lara Valeska Maul, Dr. med.

This pilot study is to assess the knowledge, attitudes, and practices regarding skin cancer prevention in young adults and to determine the impact of artificial intelligence-based simulation of facial skin aging on their attitudes regarding skin cancer prevention.

In young adulthood an increasing UV-exposure often starts because of the belief that tanning increases attractiveness\]. Raising awareness and educating students and adults regarding practices for skin cancer prevention are critical since skin cancer is increasing rapidly worldwide. Skin cancer preventive interventions for adolescents are needed to improve their motivation for sun safety behavior. This pilot study is to assess the knowledge, attitudes, and practices regarding skin cancer prevention in young adults and to determine the impact of artificial intelligence-based simulation of facial skin aging on their attitudes regarding skin cancer prevention.

Computer-based Skin Aging Simulation for Skin Cancer Prevention

Computer-based Skin Aging Simulation for Skin Cancer Prevention: A Pilot Study

Change in VAS score regarding importance of UV- protection (0 = not important; 10 = extremly important)

Change in VAS score regarding rating of personal exposure to UV radiation (0 = no exposure; 10 = very high exposure)

Questionnaire asking for reduction of UV- exposure (yes/no)

Questionnaire asking for intensification of UV protection measures (yes/ no)

University Hospital, Basel, Switzerland

Rare Diseases

Carcinoma

Carcinoma, Squamous Cell

Melanoma

Carcinoma, Basal Cell

Neoplasms, Squamous Cell

Neoplasms, Basal Cell

Neoplasms, Glandular and Epithelial

Neoplasms by Histologic Type

Neuroendocrine Tumors

Neuroectodermal Tumors

Neuroectodermal Tumors, Primitive

Neoplasms, Germ Cell and Embryonal

Neoplasms, Nerve Tissue

Nevus, Pigmented

Nevus

Nevi and Melanomas

Neuroendocrine Tumor

Neuroepithelioma

Intervention Group A: Non-Hispanic White Population

Post determination of MC1R Genotypes, participants randomized to the intervention group, will receive personalized information about ways that they can protect themselves and their child from developing melanoma.

By the end of the study, all participants will have had the opportunity to receive information about their inherited risk.

Intervention Group B: Hispanic Population

Post determination of MC1R Genotypes, participants randomized to the intervention group, will receive personalized information about ways that they can protect themselves and their child from developing melanoma.

By the end of the study, all participants will have had the opportunity to receive information about their inherited risk.

Control Group A: Non-Hispanic White Population

Post determination of MC1R Genotypes, participants randomized to the control group, you will receive standard information about ways that they can protect themselves and their child from developing melanoma.

By the end of the study, all participants will have had the opportunity to receive information about their inherited risk. Participants randomized into the control group, by the end of the study will also have had the opportunity to receive personalized information about ways they can protect themselves and their child from developing melanoma.

Control Group B: Hispanic Population

Post determination of MC1R Genotypes, participants randomized to the control group, you will receive standard information about ways that they can protect themselves and their child from developing melanoma.

By the end of the study, all participants will have had the opportunity to receive information about their inherited risk. Participants randomized into the control group, by the end of the study will also have had the opportunity to receive personalized information about ways they can protect themselves and their child from developing melanoma.

Personalized information about ways that participants can protect themselves and their child from developing melanoma.

Personalized Information

Standard information about ways that participants can protect themselves and their child from developing melanoma.

Standard Information

After signing informed consent, a biologic sample (saliva) will be collected for the purpose of DNA extraction determination of MC1R genotypes. All participants who carry high risk MC1R genotypes and a proportion of those who carry low risk or no MC1R variants will be randomized to the control or intervention arm.

DNA Extraction Determination of MC1R Genotypes

Peter Kanetsky, Ph.D

The purpose of this study is to examine how different messages about risk of melanoma can impact the way people protect themselves against developing these diseases.

Using MC1R Genotype to Impact Melanoma Risk Behavior

Self-reported average hours spent outside during weekdays for the Non-Hispanic White Population

Self-reported average hours spent outside during weekdays for the Non-Hispanic White Population after they received the intervention

Self-reported average hours spent outside during weekends for the Non-Hispanic White Population

Self-reported average hours spent outside during weekends for the Non-Hispanic White Population after receiving the intervention

Self-reported number of red or painful sunburns for the Non-Hispanic White Population

Self-reported number of red or painful sunburns for the Non-Hispanic White Population after receiving the intervention

Self-reported number on a scale from 1=never to 5=always for outdoor intentional tanning for the Non-Hispanic White Population

Self-reported number on a scale from 1=never to 5=always outdoor intentional tanning for the Non-Hispanic White Population after receiving the intervention

Proportion who practiced wearing a hat for the Non-Hispanic White Population. This is a population predicted marginal proportion estimated by running a generalized estimating equation with the outcome modeled as a repeated binomial distribution (practiced the behavior often to always vs. sometimes, rarely, or never measured at both follow-ups) and using a logit link function. The model covariates included the baseline measure, any imbalanced baseline measures, predictors of missingness, and predictors of outcome.

Self-reported number of hours for seeking shade or using an umbrella outdoors for the Non-Hispanic White Population. This is a population predicted marginal proportion estimated by running a generalized estimating equation with the outcome modeled as a repeated binomial distribution (practiced the behavior often to always vs. sometimes, rarely, or never measured at both follow-ups) and using a logit link function. The model covariates included the baseline measure, any imbalanced baseline measures, predictors of missingness, and predictors of outcome.

Self-reported number of hours for seeking shade or using an umbrella outdoors for the Non-Hispanic White Population after receiving the intervention. This is a population predicted marginal proportion estimated by running a generalized estimating equation with the outcome modeled as a repeated binomial distribution (practiced the behavior often to always vs. sometimes, rarely, or never measured at both follow-ups) and using a logit link function. The model covariates included the baseline measure, any imbalanced baseline measures, predictors of missingness, and predictors of outcome.

Self-reported number of hours for wearing a shirt with sleeves outdoors for the Non-Hispanic White Population. This is a population predicted marginal proportion estimated by running a generalized estimating equation with the outcome modeled as a repeated binomial distribution (practiced the behavior often to always vs. sometimes, rarely, or never measured at both follow-ups) and using a logit link function. The model covariates included the baseline measure, any imbalanced baseline measures, predictors of missingness, and predictors of outcome.

Self-reported number of hours wearing a shirt with sleeves outdoors for the Non-Hispanic White Population after receiving the intervention. This is a population predicted marginal proportion estimated by running a generalized estimating equation with the outcome modeled as a repeated binomial distribution (practiced the behavior often to always vs. sometimes, rarely, or never measured at both follow-ups) and using a logit link function. The model covariates included the baseline measure, any imbalanced baseline measures, predictors of missingness, and predictors of outcome.

Self-reported number of hours for wearing sunglasses outdoors for the Non-Hispanic White Population. This is a population predicted marginal proportion estimated by running a generalized estimating equation with the outcome modeled as a repeated binomial distribution (practiced the behavior often to always vs. sometimes, rarely, or never measured at both follow-ups) and using a logit link function. The model covariates included the baseline measure, any imbalanced baseline measures, predictors of missingness, and predictors of outcome.

Self-reported number of hours wearing sunglasses outdoors for the Non-Hispanic White Population after receiving the intervention. This is a population predicted marginal proportion estimated by running a generalized estimating equation with the outcome modeled as a repeated binomial distribution (practiced the behavior often to always vs. sometimes, rarely, or never measured at both follow-ups) and using a logit link function. The model covariates included the baseline measure, any imbalanced baseline measures, predictors of missingness, and predictors of outcome.

Self-reported number of hours for wearing sunscreen outdoors for the Non-Hispanic White Population. This is a population predicted marginal proportion estimated by running a generalized estimating equation with the outcome modeled as a repeated binomial distribution (practiced the behavior often to always vs. sometimes, rarely, or never measured at both follow-ups) and using a logit link function. The model covariates included the baseline measure, any imbalanced baseline measures, predictors of missingness, and predictors of outcome.

Self-reported number of hours wearing sunscreen outdoors for the Non-Hispanic White Population after receiving the intervention. This is a population predicted marginal proportion estimated by running a generalized estimating equation with the outcome modeled as a repeated binomial distribution (practiced the behavior often to always vs. sometimes, rarely, or never measured at both follow-ups) and using a logit link function. The model covariates included the baseline measure, any imbalanced baseline measures, predictors of missingness, and predictors of outcome.

Participants with at least one indoor intentional tanning session for the Non-Hispanic White Population

Participants with at least one indoor intentional tanning session for the Non-Hispanic White Population after receiving the intervention

Self-reported number of hours of weekday sun exposure for the Hispanic Population

Self-reported number of hours of weekday sun exposure of the Hispanic population after receiving the intervention

Self-reported number of hours of weekend sun exposure for the Hispanic Population

Self-reported number of hours of weekend sun exposure for the Hispanic Population after receiving the intervention

Self-reported number of Sunburns for the Hispanic Population

Self-reported number of Sunburns for the Hispanic Population after receiving the intervention

Self-reported number on a scale from 1=never to 5=always intentional tanning for the Hispanic Population

Self-reported number on a scale from 1=never to 5=always outdoor intentional tanning for the Hispanic Population after receiving the intervention

Proportion who practiced wearing a hat Often to Always for the Hispanic Population. This is a population predicted marginal proportion estimated by running a generalized estimating equation with the outcome modeled as a repeated binomial distribution (practiced the behavior often to always vs. sometimes, rarely, or never measured at both follow-ups) and using a logit link function. The model covariates included the baseline measure, any imbalanced baseline measures, predictors of missingness, and predictors of outcome.

Proportion who practiced wearing a hat Often to Always for the Hispanic Population after receiving the intervention. This is a population predicted marginal proportion estimated by running a generalized estimating equation with the outcome modeled as a repeated binomial distribution (practiced the behavior often to always vs. sometimes, rarely, or never measured at both follow-ups) and using a logit link function. The model covariates included the baseline measure, any imbalanced baseline measures, predictors of missingness, and predictors of outcome.

Self-reported number of hours of seeking shade or using an umbrella for the Hispanic Population. This is a population predicted marginal proportion estimated by running a generalized estimating equation with the outcome modeled as a repeated binomial distribution (practiced the behavior often to always vs. sometimes, rarely, or never measured at both follow-ups) and using a logit link function. The model covariates included the baseline measure, any imbalanced baseline measures, predictors of missingness, and predictors of outcome.

Self-reported number of hours of seeking shade or using an umbrella for the Hispanic Population after receiving the intervention. This is a population predicted marginal proportion estimated by running a generalized estimating equation with the outcome modeled as a repeated binomial distribution (practiced the behavior often to always vs. sometimes, rarely, or never measured at both follow-ups) and using a logit link function. The model covariates included the baseline measure, any imbalanced baseline measures, predictors of missingness, and predictors of outcome.

Self-reported number of hours of wearing a shirt for the Hispanic Population. This is a population predicted marginal proportion estimated by running a generalized estimating equation with the outcome modeled as a repeated binomial distribution (practiced the behavior often to always vs. sometimes, rarely, or never measured at both follow-ups) and using a logit link function. The model covariates included the baseline measure, any imbalanced baseline measures, predictors of missingness, and predictors of outcome.

Self-reported number of hours of wearing a shirt with sleeves outdoors for the Hispanic Population after receiving the intervention. This is a population predicted marginal proportion estimated by running a generalized estimating equation with the outcome modeled as a repeated binomial distribution (practiced the behavior often to always vs. sometimes, rarely, or never measured at both follow-ups) and using a logit link function. The model covariates included the baseline measure, any imbalanced baseline measures, predictors of missingness, and predictors of outcome.

Self-reported number of hours of wearing sunglasses for the Hispanic Population. This is a population predicted marginal proportion estimated by running a generalized estimating equation with the outcome modeled as a repeated binomial distribution (practiced the behavior often to always vs. sometimes, rarely, or never measured at both follow-ups) and using a logit link function. The model covariates included the baseline measure, any imbalanced baseline measures, predictors of missingness, and predictors of outcome.

Self-reported number of hours of wearing sunglasses for the Hispanic Population after receiving the intervention. This is a population predicted marginal proportion estimated by running a generalized estimating equation with the outcome modeled as a repeated binomial distribution (practiced the behavior often to always vs. sometimes, rarely, or never measured at both follow-ups) and using a logit link function. The model covariates included the baseline measure, any imbalanced baseline measures, predictors of missingness, and predictors of outcome.

Self-reported number of hours of wearing sunscreen for the Hispanic Population. This is a population predicted marginal proportion estimated by running a generalized estimating equation with the outcome modeled as a repeated binomial distribution (practiced the behavior often to always vs. sometimes, rarely, or never measured at both follow-ups) and using a logit link function. The model covariates included the baseline measure, any imbalanced baseline measures, predictors of missingness, and predictors of outcome.

Self-reported number of hours of wearing sunscreen for the Hispanic Population after receiving the intervention. This is a population predicted marginal proportion estimated by running a generalized estimating equation with the outcome modeled as a repeated binomial distribution (practiced the behavior often to always vs. sometimes, rarely, or never measured at both follow-ups) and using a logit link function. The model covariates included the baseline measure, any imbalanced baseline measures, predictors of missingness, and predictors of outcome.

Participants with at least one indoor intentional tanning session for the Hispanic Population

Participants with at least one indoor intentional tanning session for the Hispanic Population after receiving the intervention

Self-reported average hours spent outside during weekdays among the children of the participants in the Non-Hispanic White Population

Self-reported average hours spent outside during weekends among the children of the participants in the Non-Hispanic White Population

Self-reported number of red or painful sunburns among the children of the participants in the Non-Hispanic White Population

Self-reported number of red or painful sunburns among the children of the participants in the Non-Hispanic White Population after receiving the intervention

Self-reported number of hours for outdoor intentional tanning among the children of the participants in the Non-Hispanic White Population

Self-reported number of hours for outdoor intentional tanning among the children of the participants in the Non-Hispanic White Population after receiving the intervention

Self-reported number of hours for wearing a hat outdoors among the children of the participants in the Non-Hispanic White Population

Self-reported number of hours for wearing a hat outdoors among the children of the participants in the Non-Hispanic White Population after receiving the intervention

Self-reported number of hours for seeking shade or using an umbrella outdoors among the children of the participants in the Non-Hispanic White Population

Self-reported number of hours for seeking shade or using an umbrella outdoors among the children of the participants in the Non-Hispanic White Population after receiving the intervention

Average Risk Participants children who wore a shirt with sleeves outdoors among the participants in the Non-Hispanic White Population

Self-reported number of hours wearing a shirt with sleeves outdoors among the children of the participants in the Non-Hispanic White High Risk Population

Self-reported number of hours wearing a shirt with sleeves outdoors among the children of the participants in the Non-Hispanic White High Risk Population after receiving the intervention

Self-reported number of hours for wearing sunglasses outdoors among the children of the participants in the Non-Hispanic White Average Risk Population

Self-reported number of hours wearing sunglasses outdoors among the children of the participants in the Non-Hispanic White Average Risk Population after receiving the intervention

Children of the participants in the Non-Hispanic White High Risk Population who wore sunglasses outdoors

Children of the participants in the Non-Hispanic White High Risk Population who wore sunglasses outdoors after receiving the intervention

Self-reported number of hours for wearing sunscreen outdoors among the children of the participants in the Non-Hispanic White Population

Self-reported number of hours wearing sunscreen outdoors among the children of the participants in the Non-Hispanic White Population after receiving the intervention

Self-reported number of hours of weekday sun exposure among the children of the participants in the Hispanic Population

Self-reported number of hours of weekday sun exposure among the children of the participants in the Hispanic Population after receiving the intervention

Self-reported number of hours of weekend sun exposure among the children of the participants in the Hispanic Population

Self-reported number of hours of weekend sun exposure among the children of the participants in the Hispanic Population after receiving the intervention

Self-reported number of hours of sun protection behaviors among the children of the participants in the Hispanic Population

Self-reported number of hours of sun protection behaviors among the children of the participants in the Hispanic Population after receiving the intervention

Self-reported number of hours of outdoor intentional tanning among the children of the participants in the Hispanic Population

Self-reported number of hours of outdoor intentional tanning among the children of the participants in the Hispanic Population after receiving the intervention

Self-reported number of Sunburns among the children of the participants in the Hispanic Population

Self-reported number of Sunburns among the children of the participants in the Hispanic Population after receiving the intervention

Children of participants in the Hispanic Population who wore a hat before receiving the intervention

Children of participants in the Hispanic Population who wore a hat after receiving the intervention

Self-reported number of hours of seeking shade or using an umbrella among the children of the participants in the Hispanic Population

Self-reported number of hours of seeking shade or using an umbrella among the children of the participants in the Hispanic Population after receiving the intervention

Children of the participants in the Hispanic Average Risk Population who reported wearing a shirt with sleeves outdoors

Children of the participants in the Hispanic Average Risk Population who reported wearing a shirt with sleeves outdoors, after receiving the intervention

Self-reported number of hours of wearing a shirt among the children of the participants in the Hispanic Population

Self-reported number of hours of wearing a shirt with sleeves outdoors among the children of the participants in the Hispanic High Risk Population after receiving the intervention

Children of the participants in the Hispanic Population who reported wearing sunglasses

Children of the participants in the Hispanic Population who reported wearing sunglasses, after receiving the intervention

Children of the participants in the Hispanic Average Risk Population wo reported wearing sunscreen

Children of the participants in the Hispanic Average Risk Population wo reported wearing sunscreen, after receiving the intervention

Self-reported number of hours of wearing sunscreen among the children of the participants in the Hispanic High Risk Population

Self-reported number of hours of wearing sunscreen among the children of the participants in the Hispanic High Risk Population after receiving the intervention

The Ponce Health Sciences University

University of South Florida

American Cancer Society, Inc.

H. Lee Moffitt Cancer Center and Research Institute

Post determination of MC1R Genotypes, participants in the average risk standard arm (control) received mailed materials containing information on (1) melanoma and skin cancer; and (2) melanoma prevention behaviors recommended by the American Academy of Dermatology. All participants received information on sun protection behaviors targeted at children.

MC1R Average Risk- Control- Non-Hispanic White Population

Participants in the average risk precision prevention arm (intervention) received mailed materials containing information on: (1) melanoma and skin cancer; (2) genetic risk for melanoma; (3) MC1R and its role in developing melanoma, their MC1R risk group, and interpretation of risk information; and (4) melanoma prevention behaviors in the context of genetic risk.

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
The Skin Savvy Study: A Behavioral Skin Cancer Prevention Intervention	NCT00709306	Skin Cancer Pre...	UV-Detect Photo... Motivational In... Education	18 Years - 24 Years	Fox Chase Cancer Center
Sun Safety Skills for Elementary School Students	NCT03752736	Sunburn Skin Cancer Pre...	"I wear sunscre...	5 Years - 7 Years	Stanford University
Computer-based Skin Aging Simulation for Skin Cancer Prevention	NCT04532437	Skin Aging	artificial inte... electronic ques... electronic ques...	18 Years - 35 Years	University Hospital, Basel, Switzerland
Using MC1R Genotype to Impact Melanoma Risk Behavior	NCT03509467	Melanoma (Skin) Squamous Cell C... Squamous Cell C... Skin Cancer Basal Cell Carc... Basal Cell Canc...	Personalized In... Standard Inform... DNA Extraction ...	18 Years -	H. Lee Moffitt Cancer Center and Research Institute
Using MC1R Genotype to Impact Melanoma Risk Behavior	NCT03509467	Melanoma (Skin) Squamous Cell C... Squamous Cell C... Skin Cancer Basal Cell Carc... Basal Cell Canc...	Personalized In... Standard Inform... DNA Extraction ...	18 Years -	H. Lee Moffitt Cancer Center and Research Institute
The Skin Savvy Study: A Behavioral Skin Cancer Prevention Intervention	NCT00709306	Skin Cancer Pre...	UV-Detect Photo... Motivational In... Education	18 Years - 24 Years	Fox Chase Cancer Center
Couple-focused Intervention for Sun Protection	NCT04549675	Skin Cancer Pre...	Sun Safe Partne... Generic Online ...	18 Years - 75 Years	Rutgers, The State University of New Jersey
Sun Safety Skills for Elementary School Students	NCT03752736	Sunburn Skin Cancer Pre...	"I wear sunscre...	5 Years - 7 Years	Stanford University
Basal Cell Carcinoma Chemoprevention Trial	NCT05212246	Basal Cell Carc...	5% Imiquimod cr... Placebo Vehicle...	18 Years -	VA Office of Research and Development
Using MC1R Genotype to Impact Melanoma Risk Behavior	NCT03509467	Melanoma (Skin) Squamous Cell C... Squamous Cell C... Skin Cancer Basal Cell Carc... Basal Cell Canc...	Personalized In... Standard Inform... DNA Extraction ...	18 Years -	H. Lee Moffitt Cancer Center and Research Institute
Skin Cancer Prevention in a Pediatric Population	NCT01464957	Skin Cancer	Semi-tailored n...	5 Years - 6 Years	University of Colorado, Denver

Spots Global Cancer Trial Database for skin cancer prevention