Study protocol of a randomized controlled trial to improve cancer prevention behaviors in adolescents and adults using a web-based intervention supplemented with SMS

BMC Public Health

Maria Luisa López⁴  Goretti Faya-Ornia²  Santiago López¹  Maria Olivo del Valle³  Alberto Lana⁴ 

[1] Department of Nursing, University of Cantabria, Faculty of Nursing, Avda. de Valdecilla s/n, 39008 Santander, Spain;Department of Anglo-German and French Philology, University of Oviedo, Faculty of Philosophy and Letters, C/Teniente Alfonso Martínez s/n, 33011 Oviedo, Spain;University Institute of Oncology of Asturias, Central University Hospital of Asturias, C/Emilio Rodríguez Vigil s/n,33006 Oviedo, Spain;Department of Preventive Medicine and Public Health, Faculty of Medicine and Health Sciences, University of Oviedo, Avda. Julián Clavería s/n, 33006 Oviedo, Spain

关键词: Psychological;    Models;    Neoplasms/prevention and control;    Prevention and control;    Health education;    Behavior control/methods;    Health behavior;    Cellular phone;    Internet;    Randomized controlled trial;    Adolescent;   

Others  :  1162324
DOI  :  10.1186/1471-2458-13-357

 received in 2013-02-19, accepted in 2013-04-10,  发布年份 2013

【 摘 要 】

Background

The overall number of cancer cases is increasing and, therefore, strengthening cancer prevention has become a priority. The institutions responsible for its control establish guidelines for primary prevention. These include recommendations, such as: not smoking, following a healthy diet, doing daily physical exercise or avoiding overweight. Adolescence is a period of adoption and/or consolidation of health behaviors, and both school- and family-based interventions have proven effective to improve them. Furthermore, online and mobile phone educational interventions are encouraging. Consequently, the main aim of this study is to assess the efficacy of an intervention in which these requirements (school, family, the Internet and SMS) are combined to prevent behavioral cancer risk.

Methods

This protocol describes the design and implementation of a complex online program that includes a randomized controlled trial put into practice in two countries: Spain and Mexico. Adolescents and adults of their environment (relatives and teachers) who voluntarily participate will be randomly assigned to the experimental group or to the control group once they have completed the online pre-test. The experimental group members will have free access to a tailor-made and interactive website (http://www.alertagrumete.com webcite). During the academic year, this website will be periodically updated with different school and leisure activities related to the avoidance of risk behaviors. To encourage participation, the program includes a competition that gives rewards to the winners. SMS are also sent to students to stimulate the adoption of healthy behaviors and as a reminder of participation. Finished the intervention, an online post-test is performed in both groups and the impact on the risk behaviors is therefore assessed.

Discussion

The program is pioneer, since it combines many components which have already proven effective in previous researches. Moreover, it aims to compare efficacy in two countries with different socio-economic levels to find out if these approaches are equally effective in countries with a lower income level. However, the vertiginous evolution of the Internet and mobile phones may make this tool less attractive for adolescents, who may prefer social networks and other mobile phone applications which are nowadays massively used by their peers.

Trial registration

ISRCTN27988779

【 授权许可】

   
2013 Lana et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

【 参考文献 】

• [1]Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D: Global cancer statistics. CA Cancer J Clin 2011, 61:69-90.
• [2]Gil-Villa F: La cara social del cáncer. Barcelona: Octaedro; 2012.
• [3]Mariotto AB, Yabroff KR, Shao Y, Feuer EJ, Brown ML: Projections of the cost of cancer care in the United States: 2010–2020. J Natl Cancer Inst 2011, 103:117-128.
• [4]American Cancer Society: Cancer Facts & Figures 2012. Atlanta: American Cancer Society; 2012.
• [5]Gotay CC: Cancer prevention: major initiatives and looking into the future. Expert Rev Pharmacoecon Outcomes Res 2010, 10:143-154.
• [6]Ott JJ, Ullrich A, Mascarenhas M, Stevens GA: Global cancer incidence and mortality caused by behavior and infection. J Public Health (Oxf) 2011, 33:223-233.
• [7]Parkin DM, Boyd L, Walker LC: 16. The fraction of cancer attributable to lifestyle and environmental factors in the UK in 2010. Br J Cancer 2011, 105(Suppl 2):S77-81.
• [8]Kushi LH, Doyle C, McCullough M, Rock CL, Demark-Wahnefried W, Bandera EV, Gapstur S, Patel AV, Andrews K, Gansler T, Society AC: Nutrition and Physical Activity Guidelines Advisory Committee: American Cancer Society Guidelines on nutrition and physical activity for cancer prevention: reducing the risk of cancer with healthy food choices and physical activity. CA Cancer J Clin 2010, 2012(62):30-67.
• [9]World Cancer Research Fund - American Institute for Cancer Research: Food, Nutrition, Physical Activity, and the Prevention of Cancer: a Global Perspective. Washington DC: AICR; 2007.
• [10]Romaguera D, Vergnaud AC, Peeters PH, van Gils CH, Chan DS, Ferrari P, Romieu I, Jenab M, Slimani N, Clavel-Chapelon F, Fagherazzi G, Perquier F, Kaaks R, Teucher B, Boeing H, von Rüsten A, Tjønneland A, Olsen A, Dahm CC, Overvad K, Quirós JR, Gonzalez CA, Sánchez MJ, Navarro C, Barricarte A, Dorronsoro M, Khaw KT, Wareham NJ, Crowe FL, Key TJ: Is concordance with World Cancer Research Fund/American Institute for Cancer Research guidelines for cancer prevention related to subsequent risk of cancer? Results from the EPIC study. Am J Clin Nutr 2012, 96:150-163.
• [11]Printz C: Following cancer prevention guidelines may lower risk of death from all causes. Cancer 2011, 117:3871.
• [12]Boyle P, Autier P, Bartelink H, Baselga J, Boffetta P, Burn J, Burns HJ, Christensen L, Denis L, Dicato M, Diehl V, Doll R, Franceschi S, Gillis CR, Gray N, Griciute L, Hackshaw A, Kasler M, Kogevinas M, Kvinnsland S, La Vecchia C, Levi F, McVie JG, Maisonneuve P, Martin-Moreno JM, Bishop JN, Oleari F, Perrin P, Quinn M, Richards M: European Code Against Cancer and scientific justification: third version (2003). Ann Oncol 2003, 14:973-1005.
• [13]Siegel R, Naishadham D, Jemal A: Cancer statistics, 2012. CA Cancer J Clin 2012, 62:10-29.
• [14]Moore MA, Tokudome S: Primary cancer prevention in the post-genome era. Asian Pac J Cancer Prev 2002, 3:183-184.
• [15]Werch CE, Bian H, Carlson JM, Moore MJ, Diclemente CC, Huang IC, Ames SC, Thombs D, Weiler RM, Pokorny SB: Brief integrative multiple behavior intervention effects and mediators for adolescents. J Behav Med 2011, 34:3-12.
• [16]Busch V, De Leeuw RJ, Schrijvers AJ: Results of a multibehavioral health-promoting school pilot intervention in a Dutch secondary school. J Adolesc Health 2012, 1054-139(12):00313-8.
• [17]Albreht T, McKee M, Alexe DM, Coleman MP, Martin-Moreno JM: Making progress against cancer in Europe in 2008. Eur J Cancer 2008, 44:1451-1456.
• [18]Rooke S, Thorsteinsson E, Karpin A, Copeland J, Allsop D: Computer-delivered interventions for alcohol and tobacco use: a meta-analysis. Addiction 2010, 105:1381-1390.
• [19]Irish-Hauser S, Goldberg JP, Wilde P, Bers M, Ioannone L, Economos CD: Comparison of online and face-to-face dissemination of a theory-based after school nutrition and physical activity training and curriculum. J Health Commun 2010, 15:859-879.
• [20]Nguyen B, Kornman KP, Baur LA: A review of electronic interventions for prevention and treatment of overweight and obesity in young people. Obes Rev 2011, 12:e298-314.
• [21]Buendía-Eisman A, Arias-Santiago S, Moreno-Giménez JC, Cabrera-León A, Prieto L, Castillejo I, Conejo-Mir J: An Internet-based programme to promote adequate UV exposure behaviour in adolescents in Spain. J Eur Acad Dermatol Venereolin press
• [22]Cremers HP, Mercken L, Oenema A, de Vries H: A web-based computer-tailored smoking prevention programme for primary school children: intervention design and study protocol. BMC Public Health 2012, 12:277. BioMed Central Full Text
• [23]Bannink R, Joosten-van Zwanenburg E, van de Looij-Jansen P, van As E, Raat H: Evaluation of computer-tailored health education ('E-health4Uth') combined with personal counselling ('E-health4Uth + counselling') on adolescents' behaviours and mental health status: design of a three-armed cluster randomised controlled trial. BMC Public Health 2012, 12:1083. BioMed Central Full Text
• [24]Arnaud N, Bröning S, Drechsel M, Thomasius R, Baldus C: Web-based screening and brief intervention for poly-drug use among teenagers: study protocol of a multicentre two-arm randomized controlled trial. BMC Public Health 2012, 12:826. BioMed Central Full Text
• [25]Black AD, Car J, Pagliari C, Anandan C, Cresswell K, Bokun T, McKinstry B, Procter R, Majeed A, Sheikh A: The impact of eHealth on the quality and safety of health care: a systematic overview. PLoS Med 2011, 8:e1000387.
• [26]Carson KV, Brinn MP, Labiszewski NA, Esterman AJ, Chang AB, Smith BJ: Community interventions for preventing smoking in young people. Cochrane Database Syst Rev 2011., 7CD001291
• [27]de Vries H, Mudde A: Predicting stage transitions for smoking cessation applying the Attitude - Social influence - Efficacy Model. Psychology & Health 1998, 13:369-385.
• [28]Prochaska JO, Di Clemente CC: Transtheorical Therapy toward a more integrative model of change. Psychother Theory Res Pract 1982, 19:276-287.
• [29]López ML, García-Cueto E, Fernández JM, López S, Del Valle Md Mdel O, Cueto A: Validation of a questionnaire to evaluate the attitude towards primary prevention advice from the European code against cancer. Eur J Cancer Prev 2003, 12:157-164.
• [30]Doll R, Peto R: The causes of cancer: quantitative estimates avoidable risk of cancer in the United States. J Natl Cancer Inst 1981, 66:1191-1308.
• [31]Harvard Report on Cancer Prevention: Volume 1: causes of human cancer. Cancer Causes Control 1996, 7(Suppl 1):3-59.
• [32]Bessems KM, Van Assema P, Martens MK, Paulussen TG, Raaijmakers LG, de Vries NK: Appreciation and implementation of the Krachtvoer healthy diet promotion programme for 12- to 14- year-old students of prevocational schools. BMC Public Health 2011, 11:909. BioMed Central Full Text
• [33]Waters E, de Silva-Sanigorski A, Hall BJ, Brown T, Campbell KJ, Gao Y, Armstrong R, Prosser L, Summerbell CD: Interventions for preventing obesity in children. Cochrane Database Syst Rev 2011., 12CD001871
• [34]Foxcroft DR, Tsertsvadze A: Universal school-based prevention programs for alcohol misuse in young people. Cochrane Database Syst Rev 2011., 5CD009113
• [35]Prochaska JO, Velicer WF, Redding C, Rossi JS, Goldstein M, DePue J, Greene GW, Rossi SR, Sun X, Fava JL, Laforge R, Rakowski W, Plummer BA: Stage-based expert systems to guide a population of primary care patients to quit smoking, eat healthier, prevent skin cancer, and receive regular mammograms. Prev Med 2005, 41:406-416.
• [36]Jackson CA, Henderson M, Frank JW, Haw SJ: An overview of prevention of multiple risk behaviour in adolescence and young adulthood. J Public Health (Oxf) 2012, 34(Suppl 1):i31-40.
• [37]Organisation for Economic Co-operation and Development: Programme for International Student Assessment. OECD: Database; 2010. http://pisa2009.acer.edu.au/interactive.php webcite
• [38]Instituto Nacional de Estadística: Encuesta sobre Equipamiento y Uso de Tecnologías de la Información y Comunicación en los hogares. Instituto Nacional de Estadística: ; 2011. http://www.ine.es/jaxi/menu.do?type=pcaxis&path=/t25/p450&file=inebase webcite
• [39]Secretaría de Educación Pública: Sistema Educativo de los Estados Unidos Mexicanos, principales cifras, ciclo escolar 2010–2011. Dirección General de Planeación y Programación: México, D.F; 2011.
• [40]Schneider F, van Osch L, de Vries H: Identifying factors for optimal development of health-related websites: a delphi study among experts and potential future users. J Med Internet Res 2012, 14:e18.
• [41]Catalano RF, Fagan AA, Gavin LE, Greenberg MT, Irwin CE Jr, Ross DA, Shek DT: Worldwide application of prevention science in adolescent health. Lancet 2012, 379:1653-1664.