Journal of Community Health

, Volume 43, Issue 5, pp 993–1001 | Cite as

Barriers and Facilitators to Melanoma Prevention and Control Behaviors Among At-Risk Children

  • Yelena P. Wu
  • Bridget G. Parsons
  • Ryan Mooney
  • Lisa G. Aspinwall
  • Kristin Cloyes
  • Jennifer L. Hay
  • Wendy Kohlmann
  • Douglas Grossman
  • Sancy A. Leachman
Original Paper


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.


Melanoma Barriers Prevention Children Disease risk 



We thank Sara Turner and Eddie Zamora for their assistance with focus group facilitation; Lenora Olson for her feedback on the focus group protocol; the Huntsman Cancer Institute Communications team for assistance with graphic design for the study materials; and Jingsong Zhao for assistance with data entry.


This work was supported, in part, by an early career award from the Primary Children’s Hospital Foundation (to Y.P.W.), the F. Marian Bishop grant through the Department of Family and Preventive Medicine at the University of Utah (to Y.P.W.), and the Office of Communications and Genetic Counseling Shared Resource supported by funds in conjunction with grant P30 CA042014 awarded to Huntsman Cancer Institute. In addition, this work was supported by the National Cancer Institute of the National Institutes of Health (K07CA196985) and the Huntsman Cancer Foundation (Y.P.W.); and National Cancer Institute R01 CA158322 (L.G.A., S.A.L.). Effort by Dr. Leachman was supported in part by the Oregon Health and Science University Knight Cancer Institute. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. No funders were involved in the design, conduct, analysis, interpretation of data, or writing of the current manuscript.

Compliance with Ethical Standards

Conflict of interest

Sancy Leachman serves on a Medical and Scientific Advisory Board for Myriad Genetics, for which she has received an honorarium. She collaborated with Myriad to validate an assay that is unrelated to research reported here. The other authors declare that they have no conflict of interest.

Informed Consent

Informed consent and parental permission was obtained from all parent participants included in the study and assent was obtained from all child participants.

Research Involving Human Participants

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Yelena P. Wu
    • 1
    • 2
  • Bridget G. Parsons
    • 2
  • Ryan Mooney
    • 1
  • Lisa G. Aspinwall
    • 3
  • Kristin Cloyes
    • 4
  • Jennifer L. Hay
    • 5
  • Wendy Kohlmann
    • 2
  • Douglas Grossman
    • 1
    • 2
  • Sancy A. Leachman
    • 6
  1. 1.Department of DermatologyUniversity of UtahSalt Lake CityUSA
  2. 2.Huntsman Cancer InstituteSalt Lake CityUSA
  3. 3.Department of PsychologyUniversity of UtahSalt Lake CityUSA
  4. 4.College of NursingUniversity of UtahSalt Lake CityUSA
  5. 5.Department of Psychiatry and Behavioral SciencesMemorial Sloan-Kettering Cancer CenterNew YorkUSA
  6. 6.Department of Dermatology & Knight Cancer InstituteOregon Health & Science UniversityPortlandUSA

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