A program that helps parents talk to their children about skin cancer risks may promote sun-safe behaviors, especially when parents and children have a high-quality relationship, according to a report in the August issue of Archives of Dermatology, one of the JAMA/Archives journals.
Approximately one in six individuals will develop skin cancer during his or her lifetime, according to background information in the article. The recent increase in skin cancer incidence has been attributed to various forms of high-risk sun exposure among young people, including sunbathing, inadequate use of sunscreen and other protective measures and the use of tanning beds or lamps. Recent preventive interventions have targeted children in school or community settings, but widespread rates of dangerous behaviors persist in young people.
Rob Turrisi, Ph.D., The Pennsylvania State University, University Park, and colleagues evaluated a parent-based intervention and assessed family characteristics that may contribute to the effectiveness of such a program in 469 parent-child pairs. Of those, 340 were assigned to the intervention group, in which parents received a handbook that encouraged them to communicate skin cancer risks, promote safe behaviors and discourage tanning, sunbathing and other high-risk activities. The other 129 were assigned to the control group. The children were all 9 to 12 years old, in fourth through sixth grade and from southern Idaho or eastern Tennessee. Forty-five days after parents in the intervention group received the handbook, children in both groups underwent an assessment in which they were asked questions about their sun-related habits and their family dynamics.
Among children who were in the intervention group, several family variables increased the effectiveness of the program. Children in the intervention who exhibited average levels of compliance--measured by how often they reported obeying their parents or following their parents' rules--had less frequent sunburns than those in the control group, but those with above-average compliance developed even fewer sunburns. Among children who reported that their parents had a low level of monitoring--for instance, that parents do not typically know where a child is or is going--the intervention had a larger effect on sunburn severity than among those who reported that their parents monitored them closely. The quality of the parent-child relationship, the child's level of compliance and the frequency of negative communication all affected sunbathing tendencies among those in the intervention group--the program was most effective in families with a high-quality parent-child relationship, a high level of compliance and a low level of negative communication.
The findings are consistent with current theories regarding effective parenting, the authors write. "Since the intervention was parent based, it follows that if the child feels that the parent encompasses many general positive qualities (e.g., the parent is warm, loving, trusting and a good listener and shows respect for the child), the child will be more likely to listen to his or her parents about issues such as skin cancer risks," they continue. "Furthermore, if the child is willing to comply with parental demands, the parent will have more influence in encouraging sun-safe behaviors and discouraging unsafe sun-related behaviors. Also, it is important that the parent does not exhibit negative communication patterns that can negate the effectiveness of positive communication.
"Finally, when parents are already aware of their child's activities, they are more capable of making sure that their child is adequately protected from the sun, which can prevent severe burns," they conclude. "Parents can be viable change agents for child behavior and the quality of the family relationship is critical to the success of such interventions."
(Arch Dermatol. 2006;142:1009-1014. Available pre-embargo to the media at http://www.jamamedia.org.)
Editor's Note: This study was supported by a grant from the American Cancer Society to Drs. Turrisi, Hillhouse and Robinson. Dr. Robinson has served as a consultant to 3M Pharmaceuticals. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
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