Reducing UVR Exposure in Pregnant Women and Infants: A Pilot Study

Overview

Journal J Cancer Educ

Publisher Springer

Specialties Medical Education
Oncology

Date 2024 Nov 13

PMID 39537952

Authors

William J Tanguy

Kenneth P Tercyak

Yizhe Xu

Jonathan Chipman

Nathan Shen

Caroline Joung

Hannah L Brady

Marcelo M Sleiman Jr

Douglas Grossman

Lauren H Theilen

Yelena P Wu

Affiliations

Soon will be listed here.

Abstract

Sun protection during pregnancy is critical for both maternal and infant skin cancer prevention, yet gaps remain in addressing this behavior in pre and postnatal settings. This pilot study aimed to evaluate the feasibility and acceptability of a peer-led intervention for expectant mothers' sun protection behaviors for themselves and their newborns and examine the preliminary effects on mothers' skin cancer knowledge, attitudes, and sun protection behaviors for themselves and their infants. Expectant mothers were recruited from medical clinics and community settings and were asked to complete surveys and interviews. The intervention, informed by the Cognitive-Social Health Information Processing model, consisted of two peer coach-led remote sessions. The majority of mothers (81%) attended both intervention sessions and reported increased understanding of (88%) and improved sun protection practices for themselves (79%; such as wearing sunscreen and reapplying sunscreen while outside). Additionally, 89% agreed that SUNRISE content is beneficial for new mothers. Moreover, maternal self-efficacy for implementing sun protection, intention to implement sun-safe behaviors for their infants, and knowledge of infant skin cancer prevention also increased with large effect sizes (d = 0.8-1.3). Mothers reported significantly decreased barriers to sun safety pre- to post-intervention. Feasibility of recruitment and delivery of a peer-led intervention focused on sun safety in women and their infants was high, and the intervention was acceptable to participating women. Mothers improved their sun protection behaviors over time, and implementation of sun protection behaviors for their infants was high. Intervention efficacy with a larger and more diverse sample is warranted, with longer follow-up.

References

Fitzmaurice C, Abate D, Abbasi N, Abbastabar H, Abd-Allah F, Abdel-Rahman O . Global, Regional, and National Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life-Years for 29 Cancer Groups, 1990 to 2017: A Systematic Analysis for the Global Burden of Disease Study. JAMA Oncol. 2019; 5(12):1749-1768. PMC: 6777271. DOI: 10.1001/jamaoncol.2019.2996. View

Guy Jr G, Machlin S, Ekwueme D, Yabroff K . Prevalence and costs of skin cancer treatment in the U.S., 2002-2006 and 2007-2011. Am J Prev Med. 2014; 48(2):183-187. PMC: 4603424. DOI: 10.1016/j.amepre.2014.08.036. View

Wu S, Han J, Laden F, Qureshi A . Long-term ultraviolet flux, other potential risk factors, and skin cancer risk: a cohort study. Cancer Epidemiol Biomarkers Prev. 2014; 23(6):1080-9. PMC: 4151553. DOI: 10.1158/1055-9965.EPI-13-0821. View

Wagner C, Greer F . Prevention of rickets and vitamin D deficiency in infants, children, and adolescents. Pediatrics. 2008; 122(5):1142-52. DOI: 10.1542/peds.2008-1862. View

Paller A, Hawk J, Honig P, Giam Y, Hoath S, Mack M . New insights about infant and toddler skin: implications for sun protection. Pediatrics. 2011; 128(1):92-102. DOI: 10.1542/peds.2010-1079. View

Green A, Wallingford S, McBride P . Childhood exposure to ultraviolet radiation and harmful skin effects: epidemiological evidence. Prog Biophys Mol Biol. 2011; 107(3):349-55. PMC: 3409870. DOI: 10.1016/j.pbiomolbio.2011.08.010. View

McBride C, Emmons K, Lipkus I . Understanding the potential of teachable moments: the case of smoking cessation. Health Educ Res. 2003; 18(2):156-70. DOI: 10.1093/her/18.2.156. View

Harrison S, Buettner P, Maclennan R . The North Queensland "Sun-Safe Clothing" study: design and baseline results of a randomized trial to determine the effectiveness of sun-protective clothing in preventing melanocytic nevi. Am J Epidemiol. 2005; 161(6):536-45. DOI: 10.1093/aje/kwi081. View

Bray F, Verne S, Cervantes J, Balaban A, Bray E, Simmons B . Sun protection for infants: parent behaviors and beliefs in Miami, Florida. Cutis. 2017; 99(5):339-341. View

10.

Diehl K, Thoonen K, Breitbart E, Pfahlberg A, Gorig T . Sun Protection and Tanning Behaviors in Caregivers: Prevalence, Determinants, and Associations with Children's Behaviors. Int J Environ Res Public Health. 2022; 19(11). PMC: 9180203. DOI: 10.3390/ijerph19116876. View

11.

Bauer J, Buttner P, Wiecker T, Luther H, Garbe C . Interventional study in 1,232 young German children to prevent the development of melanocytic nevi failed to change sun exposure and sun protective behavior. Int J Cancer. 2005; 116(5):755-61. DOI: 10.1002/ijc.21081. View

12.

Benjes L, Brooks D, Zhang Z, Livstone L, Sayers L, Powers C . Changing patterns of sun protection between the first and second summers for very young children. Arch Dermatol. 2004; 140(8):925-30. DOI: 10.1001/archderm.140.8.925. View

13.

Geller A, Sayers L, Koh H, Miller D, Steinberg Benjes L, Crosier Wood M . The New Moms Project: educating mothers about sun protection in newborn nurseries. Pediatr Dermatol. 1999; 16(3):198-200. DOI: 10.1046/j.1525-1470.1999.00052.x. View

14.

Lutenbacher M, Elkins T, Dietrich M, Riggs A . The Efficacy of Using Peer Mentors to Improve Maternal and Infant Health Outcomes in Hispanic Families: Findings from a Randomized Clinical Trial. Matern Child Health J. 2018; 22(Suppl 1):92-104. PMC: 6153763. DOI: 10.1007/s10995-018-2532-z. View

15.

Wu Y, Stump T, Hay J, Aspinwall L, Boucher K, Deboeck P . The Family Lifestyles, Actions and Risk Education (FLARE) study: Protocol for a randomized controlled trial of a sun protection intervention for children of melanoma survivors. Contemp Clin Trials. 2023; 131:107276. PMC: 10529923. DOI: 10.1016/j.cct.2023.107276. View

16.

Sahler O, Varni J, Fairclough D, Butler R, Noll R, Dolgin M . Problem-solving skills training for mothers of children with newly diagnosed cancer: a randomized trial. J Dev Behav Pediatr. 2002; 23(2):77-86. DOI: 10.1097/00004703-200204000-00003. View

17.

Wu Y, Nagelhout E, Aspinwall L, Boucher K, Parsons B, Kohlmann W . A novel educational intervention targeting melanoma risk and prevention knowledge among children with a familial risk for melanoma. Patient Educ Couns. 2017; 101(3):452-459. PMC: 5935504. DOI: 10.1016/j.pec.2017.10.008. View

18.

Glanz K, Yaroch A, Dancel M, Saraiya M, Crane L, Buller D . Measures of sun exposure and sun protection practices for behavioral and epidemiologic research. Arch Dermatol. 2008; 144(2):217-22. DOI: 10.1001/archdermatol.2007.46. View

19.

Tripp M, Diamond P, Vernon S, Swank P, Mullen P, Gritz E . Measures of parents' self-efficacy and perceived barriers to children's sun protection: construct validity and reliability in melanoma survivors. Health Educ Res. 2012; 28(5):828-42. PMC: 3858122. DOI: 10.1093/her/cys114. View

20.

Hsieh H, Shannon S . Three approaches to qualitative content analysis. Qual Health Res. 2005; 15(9):1277-88. DOI: 10.1177/1049732305276687. View