TOPLINE

A 4-week telehealth intervention, the family, lifestyles, actions, and risk education (FLARE), improved sun-protective behavior in children of melanoma survivors but did not reduce sunburn over time.

METHODOLOGY

• Researchers randomly assigned 364 melanoma survivor-child pairs to FLARE, a family-based behavioral intervention, or a skin cancer education program.
• Children were aged 8-17 years (mean age, 12.9 years; 51.9% girls) and had at least one sunburn in the previous year. Survivors had a mean age of 45.1 years, 62.6% were women, and 97.3% were non-Hispanic White.
• Both groups received a 4-week telehealth program; FLARE addressed familial risk education, structured problem-solving, and a family sun-protection plan, whereas the control group accessed reliable skin cancer information online.
• Researchers assessed children's sunburn occurrence at weeks 4 and 8 after the final session as the primary outcome; secondary outcomes were sun-protection behaviors and tanning.

TAKEAWAY

• Children in the FLARE group reported 0.17 fewer sunburns at week 4 but FLARE did not reduce sunburn more than standard education over the study period.
• Overall sun-protection behaviors improved more with FLARE than with standard education by week 8. FLARE produced greater gains in sun-protective behavior, including hat use, sunglasses use, shade seeking, avoidance of peak ultraviolet radiation, sunscreen use, and sunscreen reapplication than standard education. Avoidance of peak ultraviolet radiation was the only significant change over time.
• FLARE did not significantly affect intentional or unintentional tanning, both of which were uncommon at baseline.
• In both groups, the proportion of children reporting no sunburns in the previous month rose, by 24.0% with FLARE and 17.6% with the control condition.

IN PRACTICE

"FLARE did not significantly reduce child sunburn over time beyond an active educational intervention, despite improving child sun-protective behaviors," the authors wrote. These findings, they added, "suggest that family-based behavioral interventions can successfully change preventive behaviors but that additional strategies may be needed for those behavioral improvements to translate into sustained reductions in sunburn among children at elevated familial risk of melanoma."

SOURCE

The study was led by Yelena P. Wu, PhD, Huntsman Cancer Institute, University of Utah, Salt Lake City. It was published online on October 7 in JAMA Dermatology.

LIMITATIONS

The limitations included recruitment from one geographic area and a population with generally high socioeconomic status. Outcomes were self-reported and sunburn events were low in number.

DISCLOSURES

The American Cancer Society provided direct funding, and indirect support came from Huntsman Cancer Institute, Memorial Sloan Kettering Cancer Center, Georgetown Lombardi Comprehensive Cancer Center, the University of Utah Undergraduate Research Opportunities Program, and the Oregon Health and Science University Department of Dermatology; the Utah Population Database and Utah Cancer Registry, used for recruitment, were supported by the National Cancer Institute, the US Centers for Disease Control and Prevention, the University of Utah, and the Huntsman Cancer Foundation. Two authors reported receiving grants from the American Cancer Society, and another reported employment and stock options at SkinBit and having advisory or investigator relationships with other companies. Full disclosures are reported in the original source article.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.