Barriers and Facilitators to Melanoma Prevention and Control Behaviors Among At-Risk Children
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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.
KeywordsMelanoma 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.
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 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.
- 1.Howlader, N., Noone, A. M., Krapcho, M., Garshell, J., Miller, D., Altekruse, S. F., Kosary, C. L., et al. (2015). SEER Cancer Statistics Review, 1975–2013. http://seer.cancer.gov/csr/1975_2013/.
- 3.Siegel, R. L., Miller, K. D., & Jemal, A. (2015). Cancer statistics, 2015. CA: A Cancer Journal for Clinicians, 65(1), 5–29.Google Scholar
- 6.US Department of Health, and and Human Services. (2014). The surgeon general’s call to action to prevent skin cancer. Washington, DC: Department of Health and Human Services.Google Scholar
- 9.American Academy of Dermatology. (2017). Prevent skin cancer. https://www.aad.org/public/spot-skin-cancer/learn-about-skin-cancer/prevent.
- 10.World Health Organization. (2016). Sun protection. http://www.who.int/uv/sun_protection/en/.
- 18.American Society of Clinical Oncology. (2016). Familial malignant melanoma. In What are the screening options for familial melanoma? Alexandria, VA: American Society of Clinical Oncology.Google Scholar
- 19.Skin Cancer Foundation. (2016). Melanoma causes and risk factors. In Children: A special case. New York: Skin Cancer Foundation.Google Scholar
- 27.Miles, M. B., Huberman, A. M., & Saldaña, J. (2013). Qualitative data analysis: A methods sourcebook (3rd Aufl). Thousand Oaks, CA: Sage.Google Scholar
- 29.Saldaña, J. (2012). The coding manual for qualitative researchers (Vol. 14). Thousand Oaks, CA: Sage.Google Scholar
- 31.United States Cancer Statistics (2015) 1999–2012 incidence and mortality Web-based Report. Atlanta: US Department of Health and Human Services. https://nccd.cdc.gov/uscs/cancersrankedbystate.aspx.