title: Protocol of a randomized controlled trial of sun protection interventions for operating engineers.
abstract: BACKGROUND
  Skin cancer are increasing and some types of skin cancer are among the most lethal cancers yet are easily preventable. However, sun protection interventions are rarely implemented among outdoor workers. Our prior work shows that Michigan Operating Engineers (heavy equipment operators) spend an average of 4-5 hours in the sun, about one-third reported getting sun burned at least once a summer, and over half burned more than once a summer. About three-quarters of the sample never or only sometimes used sun block.
  
  
  METHODS
  Using the Health Belief Model as a guide, this randomized controlled trial (RCT) will test the efficacy of four sun protection interventions targeting Operating Engineers: a) education only; b) education and mailed sunscreen; c) education and text message reminders; and, d) education, mailed sunscreen, and text message reminders. Participations in the study will be offered during regularly scheduled safety trainings at the Local 324 Training Center. Pre- and post-intervention surveys will be collected to determine changes in sunscreen use and sun burning, the primary dependent variables. The analyses will include: a) paired t-tests to determine changes over time (from pre-intervention to post-intervention) in outcome variables (sunscreen use and burning) separately in the 4 intervention groups, b) Repeated Measures Analysis of Variance (RM-ANOVA) to compare the changes in outcomes across the 4 groups, and c) t-tests on change scores as follow-ups to the RM-ANOVA to determine exactly which groups differ from each other.
  
  
  CONCLUSIONS
  Based on the outcome of this study, we will develop a RO1 for wider scale testing and dissemination in conjunction with the International Training Center which services North America (including the US, Mexico, and Canada). Wide scale dissemination of an efficacious sun protection intervention has the potential to substantially impact skin cancer rates among this population. The ultimate goal is for high reach, high efficacy, and low cost.
  
  
  BACKGROUND
  NCT01804595.
authors.affiliation: School of Nursing, Department of Otolaryngology and Psychiatry, University of Michigan, Ann Arbor VA Center for Clinical Management Research, 400 North Ingalls Building #3178, Ann Arbor, MI 48109-5482, USA. bump@umich.edu
authors.forename: Sonia A
authors.initials: SA
authors.lastname: Duffy
authors.forename: David L
authors.initials: DL
authors.lastname: Ronis
authors.forename: Andrea H
authors.initials: AH
authors.lastname: Waltje
authors.forename: Seung Hee
authors.initials: SH
authors.lastname: Choi
mesh_terms: D000704:Analysis of Variance; D060389:Construction Industry; D005500:Follow-Up Studies; D006266:Health Education; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008824:Michigan; D008960:Models, Psychological; D015397:Program Evaluation; D012107:Research Design; D012878:Skin Neoplasms / Q000517:prevention & control*; D013471:Sunburn / Q000517:prevention & control*; D013473:Sunscreening Agents / Q000627:therapeutic use*; D060145:Text Messaging
chemical_list: D013473:Sunscreening Agents