DESCRIPTION (provided by applicant): Skin cancer is the most common cancer in the US, with over a million new cases diagnosed yearly 1. Young adults, particularly women, are increasingly at risk of melanoma. Contributing to the increasing skin cancer risk among young adults is the fact that US adolescents have the lowest skin protection rates of all age groups 2 and also demonstrate increased exposure to natural and artificial UV radiation as they move into adulthood 3. Innovative interventions are needed to have an impact on skin cancer risk among young people. Unlike previous interventions, our skin cancer risk reduction intervention will be tailored (or personalized) to each individual participant and delivered via the Internet. The tailored intervention will emphasize appearance concerns, which are known to be the primary motivation for UV exposure and lack of skin protection among young adults. This will be accomplished in part through the use of personalized facial images showing UV damage as well as computerized age progression demonstrations. Primary Aim 1. To examine the efficacy of a tailored intervention delivered via the Internet designed to increase skin protection and decrease sun exposure behavior among young adults at moderate to high risk of developing skin cancer. Participants will be randomized to the tailored intervention, the Skin Cancer Foundation website, or an assessment only condition. Aim 2. To evaluate whether socio-demographic variables (sex, race/ethnicity, skin type, family history of skin cancer, education, socioeconomic status, and geographic locale), appearance consciousness, and past exposure and protective behaviors moderate intervention effects. Aim 3. To evaluate whether Integrative Model 4 constructs (UV-related knowledge, risk perception, beliefs, norms, self-efficacy, and intentions) mediate intervention effects. These mediators and the behavioral outcomes will be assessed at baseline as well as three weeks and three months post baseline. In the first stage of the project, the tailored intervention including interactive and multimedia materials will be developed and refined through acceptability and usability testing. In the second stage, the efficacy of the tailored intervention at improving UV exposure and protection behaviors will be evaluated in a randomized controlled trial conducted via the Internet. We will also establish moderators and mediators of intervention effects. The goals of future research would be to enhance the tailored intervention, for example, by adding additional contacts or Internet technologies or features, disseminate the intervention, assess the longevity of effects, and/or adapt the tailored intervention for use with other cancer risk behaviors or at risk groups. PUBLIC HEALTH RELEVANCE: Skin cancer is the most common cancer in the US, with over a million new cases diagnosed yearly. Innovative interventions are needed to have an impact on skin cancer risk. The purpose of the proposed project is to test a tailored intervention delivered via the Internet designed to reduce skin cancer risk behavior among young adults at moderate to high risk of developing skin cancer.

Relevance to Public Health Skin cancer is the most common cancer in the US, with over a million new cases diagnosed yearly. Innovative interventions are needed to have an impact on skin cancer risk. The purpose of the proposed project is to test a tailored intervention delivered via the Internet designed to reduce skin cancer risk behavior among young adults at moderate to high risk of developing skin cancer.