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Trials
Published in: Trials 1/2013

Open Access 01-12-2013 | Study protocol

Adolescent Cancer Education (ACE) to increase adolescent and parent cancer awareness and communication: study protocol for a cluster randomised controlled trial

Authors: Richard G Kyle, Iona Macmillan, Petra Rauchhaus, Ronan O’Carroll, Richard D Neal, Liz Forbat, Sally Haw, Gill Hubbard

Published in: Trials | Issue 1/2013

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Abstract

Background

Raising cancer awareness among adolescents has potential to increase their knowledge and confidence in identifying cancer symptoms and seeking timely medical help in adolescence and adulthood. Detecting cancer at an early stage is important because it reduces the risk of dying of some cancers and thereby contributes to improved cancer survival. Adolescents may also play an important role in increasing cancer communication within families. However, there are no randomised controlled trials (RCT) of the effectiveness of school-based educational interventions to increase adolescents’ cancer awareness, and little is known about the role of adolescents in the upward diffusion of cancer knowledge to parents/carers. The aim of this study is to determine the effectiveness of a school-based educational intervention to raise adolescent and parent cancer awareness and adolescent-parent cancer communication.

Methods

The Adolescent Cancer Education (ACE) study is a school-based, cluster RCT. Twenty secondary schools in the area covered by Glasgow City Council will be recruited. Special schools for adolescents whose additional needs cannot be met in mainstream education are excluded. Schools are randomised to receive a presentation delivered by a Teenage Cancer Trust educator in Autumn 2013 (intervention group) or Spring 2014 following completion of six-month follow-up measures (control group). Participants will be students recruited at the end of their first year of secondary education (S1) (age 12 to 13 years) and one parent/carer for each student, of the student’s choice. The primary outcome is recognition of cancer symptoms two weeks post-intervention. Secondary outcomes are parents’ cancer awareness and adolescent-parent cancer communication. Outcomes will be assessed at baseline (when adolescents are in the final term of S1), two-week, and six-month follow-up (when adolescents are in S2, age 13 to 14 years). Differences in outcomes between trial arms will be tested using multiple regression methods, adjusted for clustering by school. An audit of cancer-related and health-promotion activity within the school curriculum and environment during the RCT will be conducted at six-month follow-up to contextualise the intervention effect.

Discussion

Results from the ACE study will provide evidence about the public health effectiveness of a school-based intervention designed to increase adolescent and parent cancer awareness and adolescent-parent cancer communication.

Trial registration

ISRCTN75542411
Appendix
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Literature
1.
2.
Goyal S, Roscoe J, Ryder WD, Gattamaneni HR, Eden TO: Symptom interval in young people with bone cancer. Eur J Cancer. 2004, 40: 2280-2286. 10.1016/j.ejca.2004.05.017.CrossRefPubMed
3.
Eden T, Rogers M, Barker L, Morgan S, Smith S: Symptom interval in teenagers and young adults with cancer. Pediatr Blood Cancer. 2007, 49: 575-
4.
Fern LA, Campbell C, Eden TO, Grant R, Lewis I, Macleod U, Weller D, Whelan J: How frequently do young people with potential cancer symptoms present in primary care?. Br J Gen Pract. 2011, 61: e223-e230.CrossRefPubMedPubMedCentral
5.
Walter F, Webster A, Scott S, Emery J: The Andersen Model of Total Patient Delay: a systematic review of its application in cancer diagnosis. J Health Serv Res Policy. 2012, 17: 110-118. 10.1258/jhsrp.2011.010113.CrossRefPubMedPubMedCentral
6.
Macleod U, Mitchell ED, Burgess C, Macdonald S, Ramirez AJ: Risk factors for delayed presentation and referral of symptomatic cancer: evidence for common cancers. Br J Cancer. 2009, 101 (Suppl 2): S92-S101.CrossRefPubMedPubMedCentral
7.
Ramirez AJ, Westcombe AM, Burgess CC, Sutton S, Littlejohns P, Richards MA: Factors predicting delayed presentation of symptomatic breast cancer: a systematic review. Lancet. 1999, 353: 1127-1131. 10.1016/S0140-6736(99)02142-X.CrossRefPubMed
8.
Macdonald S, Macleod U, Mitchell E, Weller D, Campbell N, Mant D: Factors Influencing Patient and Primary Care Delay in the Diagnosis of Cancer: a Database of Existing Research and its Implications for Future Practice. 2004, Rockville, MD: Department of Health
9.
Tørring ML, Frydenberg M, Hansen RP, Olesen F, Hamilton W, Vedsted P: Time to diagnosis and mortality in colorectal cancer: a cohort study in primary care. Br J Cancer. 2011, 104: 934-940. 10.1038/bjc.2011.60. Erratum in: Br J Cancer 2011, 104:1930CrossRefPubMedPubMedCentral
10.
11.
Department of Health: Cancer Reform Strategy. 2007, London: Department of Health
12.
Government S: Detect Cancer Early Initiative: Draft Plan. 2011, Edinburgh: Scottish Government
13.
Andersen BL, Cacioppo JT: Delay in seeking a cancer diagnosis: delay stages and psychophysiological comparison processes. Br J Soc Psycho. 1995, 34: 33-52. 10.1111/j.2044-8309.1995.tb01047.x.CrossRef
14.
National Patient Safety Agency (NPSA)/Royal College of General Practitioners (RCGP): Delayed Diagnosis of Cancer. 2010, London: Thematic review NPSA National Reporting and Learning Service
15.
Weller D, Vedsted P, Rubin G, Walter FM, Emery J, Scott S, Campbell C, Andersen RS, Hamilton W, Olesen F, Rose P, Nafees S, van Rijswijk E, Hiom S, Muth C, Beyer M, Neal RD: The Aarhus statement: improving design and reporting of studies on early cancer diagnosis. Br J Cancer. 2012, 106: 1262-1267. 10.1038/bjc.2012.68.CrossRefPubMedPubMedCentral
16.
Kyle RG, Forbat L, Rauchhaus P, Hubbard G: Increased cancer awareness among British adolescents after a school-based educational intervention: a controlled before-and-after study with 6-month follow-up. BMC Publ Health. 2013, 13: 190-10.1186/1471-2458-13-190.CrossRef
17.
Government S: A Curriculum for Excellence. 2004, Edinburgh: ScottishGovernment
18.
19.
Kyle RG, Forbat L, Hubbard G: Cancer awareness among adolescents in Britain: a cross-sectional study. BMC Publ Health. 2012, 12: 580-10.1186/1471-2458-12-580.CrossRef
20.
Ward KD, Vander Weg MW, Read MC, Sell MA, Beech BM: Testicular cancer awareness and self-examination among adolescent males in a community-based youth organization. Prev Med. 2005, 41: 386-398. 10.1016/j.ypmed.2005.02.003.CrossRefPubMed
21.
Lechner L, Oenema A, de Nooijer J: Testicular self-examination (TSE) among Dutch young men aged 15–19: determinants of the intention to practice TSE. Health Educ Res. 2002, 17: 73-84. 10.1093/her/17.1.73.CrossRefPubMed
22.
Klein JF, Berry CC, Felice ME: The development of a testicular self-examination instructional booklet for adolescents. J Adolesc Health Care. 1990, 11: 235-239. 10.1016/0197-0070(90)90355-6.CrossRefPubMed
23.
Rouhani P, Parmet Y, Bessell AG, Peay T, Weiss A, Kirsner RS: Knowledge, attitudes and behaviors of elementary school students regarding sun exposure and skin cancer. Pediatr Dermatol. 2009, 26: 529-535. 10.1111/j.1525-1470.2009.00908.x.CrossRefPubMed
24.
Smith S, Case L, Fern L, Waterhouse K, Vaughan K, McCabe M: Poor Cancer Awareness in Young People in Greater Manchester Advocates the Need for Age-Specific Interventions to Raise Awareness. 2011, Liverpool, UK: NCRI Cancer Conference
25.
Wilcox B, Gillies P, Wilcox S, Reid D: Do children influence their parents’ smoking? An investigation of parental smoking behaviour and attitudes to health education. Health Educ J. 1981, 40: 5-10. 10.1177/001789698104000104.CrossRef
26.
Ellickson PL, Hawes JA: An assessment of active versus passive methods for obtaining parental consent. Eval Rev. 1989, 13: 45-55. 10.1177/0193841X8901300104.CrossRefPubMed
27.
28.
29.
Bandura A: Self-efficacy: the Exercise of Control. 1997, New York: WH Freeman and Company
30.
Bandura A: Self-efficacy: toward a unifying theory of behavioral change. Psychol Rev. 1977, 84: 191-215.CrossRefPubMed
31.
O’Leary A: Self-efficacy and health. Behav Res Ther. 1985, 23: 437-451. 10.1016/0005-7967(85)90172-X.CrossRefPubMed
32.
Cancer Research UK: Cancer Awareness Measure Toolkit V2.1. 2011, London: Cancer Research UK
33.
Janz NK, Becker MH: The Health Belief Model: a decade later. Health Educ Q. 1984, 11: 1-47. 10.1177/109019818401100101.CrossRefPubMed
34.
35.
Schwarzer R, Fuchs R: Changing risk behaviors and adopting health behaviors: the role of self-efficacy beliefs. Self-efficacy in Changing Societies. Edited by: Bandura A. 1995, New York: Cambridge University Press, 259-288.CrossRef
36.
Olson D, Gorall D, Tiesel J: Faces IV Package. 2004, Minneapolis, MN: Life Innovations
37.
Barnes HL, Olson DH: Parent-adolescent communication and the Circumplex Model. Child Dev. 1985, 56: 438-447. 10.2307/1129732.CrossRef
38.
Robin AL: Problem-solving communication training: a behavioral approach to the treatment of parent-adolescent conflict. Am J Family Ther. 1979, 7: 69-82. 10.1080/01926187908250319.CrossRef
39.
Riesch SK, Anderson LS, Krueger HA: Parent–child communication processes: preventing children’s health-risk behavior. J Spec Pediatr Nurs. 2006, 11: 41-56. 10.1111/j.1744-6155.2006.00042.x.CrossRefPubMed
40.
Gordon Rouse KA, Ingersoll GM, Orr D: Longitudinal health endangering behavior risk among resilient and non-resilient early adolescents. J Adolesc Health. 1998, 23: 297-302. 10.1016/S1054-139X(98)00019-6.CrossRefPubMed
41.
Jaccard J, Dittus PJ, Gordon VV: Maternal correlates of adolescent sexual and contraceptive behavior. Fam Plann Perspect. 1996, 28: 159-165. 10.2307/2136192.CrossRefPubMed
42.
Metzler CW, Noell J, Biglan A, Ary D, Smolkowski K: The social context for risky sexual behavior among adolescents. J Behav Med. 1994, 17: 419-438. 10.1007/BF01858012.CrossRefPubMed
43.
Guilamo-Ramos V, Jaccard J, Dittus P, Bouris A, Holloway I, Casillas E: Adolescent expectancies, parent-adolescent communication and intentions to have sexual intercourse among inner city, middle school youth. Ann Behav Med. 2007, 34: 56-66. 10.1007/BF02879921.CrossRefPubMed
44.
Kirkby DB, Baumler E, Coyle K, Basen-Engquist K, Parcel GS, Harrist R, Banspach SW: The ‘Safer Choices’ intervention: its impact on the sexual behaviors of different subgroups of high school students. J Adolesc Heal. 2004, 442: 452-
45.
Hutchinson MK, Jemmott JB, Jemmott LS, Braverman P, Fong GT: The role of mother-daughter sexual risk communication in reducing sexual risk behaviors among urban adolescent females: a prospective study. J Adolesc Health. 2003, 33: 98-107. 10.1016/S1054-139X(03)00183-6.CrossRefPubMed
46.
Villarruel AM, Cherry CL, Cabriales EG, Ronis DL, Zhou Y: A parent-adolescent intervention to increase sexual risk communication: results of a randomized controlled trial. AIDS Educ Prev. 2008, 20: 371-383. 10.1521/aeap.2008.20.5.371.CrossRefPubMedPubMedCentral
47.
Blake SM, Simkin L, Ledsky R, Perkins C, Calabrese JM: Effects of a parent–child communications intervention on young adolescents’ risk for early onset of sexual intercourse. Fam Plann Perspect. 2001, 33: 52-61. 10.2307/2673750.CrossRefPubMed
48.
Akers AY, Holland CL, Bost J: Interventions to improve parental communication about sex: a systematic review. Pediatrics. 2001, 127: 494-510.CrossRef
49.
Aiken LS, West SG, Woodward CK, Reno RR, Reynolds KD: Increasing screening mammography in asymptomatic women: evaluation of a second-generation, theory-based program. Health Psychol. 1994, 13: 526-538.CrossRefPubMed
50.
Zigmond AS, Snaith RP: The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983, 67: 361-370. 10.1111/j.1600-0447.1983.tb09716.x.CrossRefPubMed
51.
Herrmann C: International experiences with the Hospital Anxiety and Depression Scale - a review of validation data and clinical results. J Psychosom Res. 1997, 42: 17-41. 10.1016/S0022-3999(96)00216-4.CrossRefPubMed
52.
White D, Leach C, Sims R, Atkinson M, Cottrell D: Validation of the Hospital Anxiety and Depression Scale for use with adolescents. Br J Psychiatry. 1999, 175: 452-454. 10.1192/bjp.175.5.452.CrossRefPubMed
53.
Bonhauser M, Fernandez G, Püschel K, Yañez F, Montero J, Thompson B, Coronado G: Improving physical fitness and emotional well-being in adolescents of low socioeconomic status in Chile: results of a school-based controlled trial. Health Promot Int. 2005, 20: 113-122. 10.1093/heapro/dah603.CrossRefPubMed
54.
Magin PJ, Pond CD, Smith WT, Goode SM: Acne’s relationship with psychiatric and psychological morbidity: results of a school-based cohort study of adolescents. J Eur Acad Dermatol Venereol. 2010, 24: 58-64. 10.1111/j.1468-3083.2009.03354.x.CrossRefPubMed
55.
Moher D, Schulz KF, Altman D, CONSORT Group (Consolidated Standards of Reporting Trials): The CONSORT statement: revised recommendations for improving the quality of reports of parallel-group randomized trials. JAMA. 2001, 285: 1987-1991. 10.1001/jama.285.15.1987.CrossRefPubMed
56.
World Health Organization: School Health Promotion – Series 5: Regional guidelines: Development of Health Promoting Schools: a Framework for Action. 1996, Manila: World Health Organization
57.
Stewart-Brown S: What is the Evidence on School Health Promotion in Improving Health or Preventing Disease and, Specifically, What is the Effectiveness of the Health Promoting Schools Approach?. 2006, Copenhagen: World Health Organization Regional Office for Europe, Health Evidence Network
58.
Rechis R, Neal C, McGoldrick D: LIVESTRONG at school: changing classroom talk about cancer. J Cancer Educ. 2010, 25: 127-128. 10.1007/s13187-010-0039-4.CrossRefPubMed
59.
Wells M, Williams B, Treweek S, Coyle J, Taylor J: Intervention description is not enough: evidence from an in-depth multiple case study on the untold role and impact of context in randomised controlled trials of seven complex interventions. Trials. 2012, 13: 95-10.1186/1745-6215-13-95.CrossRefPubMedPubMedCentral
Metadata
Title
Adolescent Cancer Education (ACE) to increase adolescent and parent cancer awareness and communication: study protocol for a cluster randomised controlled trial
Authors
Richard G Kyle
Iona Macmillan
Petra Rauchhaus
Ronan O’Carroll
Richard D Neal
Liz Forbat
Sally Haw
Gill Hubbard
Publication date
01-12-2013
Publisher
BioMed Central
Published in
Trials / Issue 1/2013
Electronic ISSN: 1745-6215
DOI
https://doi.org/10.1186/1745-6215-14-286

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