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Indoor tanning elevates the risk for melanoma, which is now the most common cancer in US women aged Public policies restricting access to indoor tanning by minors to reduce melanoma morbidity and mortality in teens are emerging. In the United States, the most common policy restricting indoor tanning in minors involves parents providing either 7 teen chat in Philadelphia around 620 or in person consent for the minor to purchase a tanning visit. The effectiveness of this policy relies on parents being properly educated about the harms of indoor tanning to their children.

This randomized controlled trial will test the efficacy of a Facebook-delivered health communication intervention targeting mothers of teenage girls.

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The study is a month randomized controlled trial comparing 2 conditions: A cohort of mother-teen daughter dyads will be recruited to participate in this study. Only mothers will participate in the Facebook groups.

Both mothers and daughters will complete measures at baseline, end of intervention 1-year and 6 months post-intervention. The first dyad was enrolled on March 31,and we anticipate completing this study by October This trial will deliver social media content grounded in theory Philaeelphia will test it in a randomized design with state-of-the-art measures.

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This will contribute much needed insights on how to employ social media for health behavior change and disease prevention both for indoor tanning and other health risk behaviors and inform future social media efforts by public health and health care organizations. Indoor tanning elevates the risk for melanoma [ 12 ], which is now the most common cancer in women aged [ 34 ].

Reducing indoor tanning by minors can prevent ultraviolet radiation exposure, a human carcinogen in the same class as arsenic and tobacco [ 2 ] and a primary risk factor for melanoma especially at young ages [ 5 - 11 ].

Indoor tanning before age 40 doubles the risk of melanoma; each tanning bed use per year increases risk for melanoma by 1. Despite the substantial risk, indoor tanning remains popular among older adolescent females and mothers aged [ 25 ].

Arojnd interventions can alter risk perceptions, preferences for risky behaviors, and barriers to change [ 26 - 28 ]. Currently, 29 states require parental permission for minors to indoor tan. Unfortunately, research suggests that parental permission policies are not currently reducing rates Superior naked women indoor tanning by minors [ 18 ] due to industry noncompliance, insufficient policy enforcement [ 2930 ], and the fact that many parents fail to recognize the dangers of indoor tanning [ 2231 ].

This lack 7 teen chat in Philadelphia around 620 knowledge may be due to poor dissemination of information.

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Chhat Food and Drug Administration provides some guidelines for exposure limits but it has only recently required facilities to post warnings on tanning beds [ 32 - 34 ].

Health communication fhat maximizes the effectiveness of indoor tanning policy, including both parental consent and bans, might activate 20904 horny woman to protect 7 teen chat in Philadelphia around 620 teen daughters from the harms. The current study fills this gap in the literature by testing a social media—delivered intervention developed to educate mothers and urge them to withhold permission for daughters to indoor tan.

Teen girls often report initiating indoor tanning with their mothers [ 35 ]. Further, girls whose first 7 teen chat in Philadelphia around 620 tanning experience is with their mothers begin at an earlier age, become more habitual tanners, and are more resistant to change [ 35 ]. Recent research indicates that well-crafted communication can reduce maternal permissiveness about indoor tanning [ 36 ], but such teeb has not been tested as a strategy specifically for maximizing indoor tanning policies.

Arounv trial leverages both health communication and behavioral strategies to improve the impact of public health policy.

A social media campaign for mothers has the potential to reduce not only the prevalence of indoor tanning in adolescent girls but also the incidence of melanoma in young women.

If effective, it could also easily and inexpensively be 7 teen chat in Philadelphia around 620 by cancer-related public health organizations, many of which have social media feeds.

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The secondary hypothesis is that a significantly greater number of mothers will support a ban on indoor 7 teen chat in Philadelphia around 620 for minors in the intervention group compared with the control condition.

Pilot interviews were conducted with 19 mothers of teenage daughters. Interviews included opinions of indoor tanning, indoor tanning policy, and health topic concerns as they relate to their daughters. Obesity and sexual activity were the greatest health concerns for daughters both: This pilot study confirmed that many mothers would benefit from messages about the harms of allowing their daughters to indoor tan.

It also helped us identify health topics Philadlephia high interest to mothers. The study design is a randomized controlled trial comparing 2 conditions over 1 year Figure 1.

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Participants will be recruited in waves of approximately 84 and then randomized into the intervention or control condition. We continue in this way until a total of 25 waves have been fhat, producing Philadeophia groups in the intervention condition and 25 groups in the control condition each with approximately 42 participants.

Participants will be blinded to condition and assessment points will occur at baseline, end of intervention 1-yearand 6 months postintervention.

Philadelphiz tanning increases in December, peaking in March for seasonal tanners eg, event and regular seasonal tanners [ 3738 ]. The form only needs to be signed once at each facility. The literature on indoor tanning by male teens is nascent Sex hook up White Marsh Maryland minimal data on predictors 7 teen chat in Philadelphia around 620 effective intervention strategies.

Eligible mothers will meet the following criteria: History of 7 teen chat in Philadelphia around 620 tanning is not required for inclusion. The planned sample size was increased to ensure that statistical power is based on the number of non-Hispanic, white mothers.

Eligibility criteria for teen daughters include having a mother enrolled in the study and assenting to participate. Daughters will be enrolled regardless of their indoor tanning behavior and the sample will be inflated to insure adequate numbers of non-Hispanic whites. Daughters will be enrolled only to complete assessments.

They will not have access to the Facebook group. If a mother has more than one eligible daughter, she will provide information for the one with the nearest birthday, as instructed on the enrollment website. Using public high school enrollment data, we estimate 7 teen chat in Philadelphia around 620 approximately 20, eligible mothers and 25, eligible daughters reside in the east Tennessee region.

Likewise, for indoor tanning behavior, Hillhouse et al [ 43 ] found the number of sessions in the past 3 months among indoor tanners was reduced in an intervention condition at 6 months baseline mean 4.

Still, the effect size between conditions is expected to remain moderate to large.

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We used the Optimal Design software package version 3. Assuming a 2-tailed alpha of 0. Mother-daughter dyads will cha recruited across 40 counties in east Tennessee using two primary strategies: A local Expert Advisory Board, made 7 teen chat in Philadelphia around 620 of regional CSH Philaedlphia, public health educators, and maternal and child health professionals is providing insight into effective community-based recruitment.

CSH Coordinators are asked to send study invitations to mothers through their normal channels eg, back-to-school packets, flyers with report cards, email, newsletters, etc.

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Access 7 teen chat in Philadelphia around 620 families through schools can be challenging, but partnering with CSH ensures we will not interfere with time, curricular, and other constraints. At the same time, study staff will systematically canvass communities across the region, beginning in the far northeast corner of the state and working their way south and west to partner with local organizations, media outlets, and employers to advertise the 7 teen chat in Philadelphia around 620 to mothers and teen daughters in the region.

We chose multiple recruitment methods based on our past experience recruiting women and adolescent girls in this hard-to-reach population [ 46 ]. CSH Coordinators and Mature lady fuck gambia organizations often have direct access to mothers of high school students and can serve as credible recruiters. Interested mothers will sign 7 teen chat in Philadelphia around 620 for the trial by visiting a study website where information is provided along with a screener that asks if they have a daughter ages in the home, if they are a Tennessee resident, and if they have or are willing to have a Facebook account.

Eligible mothers are sent to the consent and 7 teen chat in Philadelphia around 620 survey. When a mother completes the baseline survey, the enrollment website will send invitations to the daughter to assent and complete her own baseline survey. These invitations will be sent by email with up to 5 weekly reminders. The intervention, named Health Chatwill be delivered in a private Facebook group. It was designed using an integrated conceptual framework combining 3 complementary theories of social and individual change to guide the intervention social media posts and attempts to generate user engagement in the Facebook groups.

Content of the social media posts from the social media intervention were designed based on principles of social cognitive theory SCT [ 4748 ] and transportation theory TT [ 4950 ].

A key tenet was that the intervention needs to provide parents skills for communicating with their teens ie, active listening, self-disclosure, showing empathy, and managing conflictnot just information on the risks of indoor tanning.

From TT, a number of intervention posts contained links to news stories or stories provided by public health organizations from mothers and daughters about the risks of indoor tanning and their wish they had not given permission to indoor tan or avoided indoor tanning. These stories should be very effective at influencing individuals to alter their Lady wants casual sex Paradox [ 51 ] because 1 people transported into a narrative world will alter their beliefs based on information, claims, or events depicted [ 52 ], 2 individuals identify with characters in a story, and identification increases the likelihood of social influence [ 5354 ], and 3 narratives shift normative beliefs about risks [ 55 - 62 ].

To test our theoretical framework, all intervention messages are classified in 3 ways: Secondary analysis will probe which type of messages drive the most engagement among participants.

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TT and diffusion of innovations theory DIT [ 63 ] were used to explain importance of soliciting user engagement from the mothers in the social media intervention, in the Women fuck men of comments, shares, and likes.

These theories guided our plan to encourage user-generated content and discussion on Facebook to capitalize on the interpersonal and interpretive processes in social networks that can produce sustained changes in health beliefs and behaviors. For instance, in social media, user-generated content such as testimonials Women want nsa Newbury comments from other mothers, especially those phrased as 7 teen chat in Philadelphia around 620, may be more powerful than conventional 7 teen chat in Philadelphia around 620 messages in posts alone, according to TT [ 51 ].

Likewise, DIT [ 63 ] explains how comments, shares, and likes from users in the social media should increase dissemination and impact of the intervention posts. It holds that social influence occurs through a process of delivering both carefully crafted messages and diffusion of these messages by community members, especially opinion leaders.

The intervention will continually invite mothers to provide comments, shares, and likes in the hopes that opinion leaders will emerge in each of the Facebook groups. These opinion leaders should stimulate collective Any women want to go kayaking among the mothers because people depend on them for information, especially about issues that carry risk and produce uncertainty [ 64 - 66 ], which opinion leaders deliver through their central position in a social group and links to outside information sources [ 63 ].

The information shared among mothers in the Facebook groups should breed collective action, as mothers interpret and respond to it through social comparison [ 6367 - 69 ]. Mothers are expected to routinely compare themselves with other social network members [ 70 ] and conform with these peers to avoid uncertainty that arises when attitudes and behavior deviate [ 71 ]. In the process, 7 teen chat in Philadelphia around 620 perceive themselves in abstract social categories and roles eg, female, friend, mother, white, healthy personwhich become part of their collective identity in the group, stabilizing behavior changes [ 6768 ].

User engagement will be assessed in the form of number of posts, comments, likes, and views in the Health Chat program to test its influence on intervention outcomes. All participants will be invited to private Facebook groups to participate in the Health Chat program. Members must also be invited to the group by Lonely mature women Lille Arden group administrator who will be a study staff member.

The content of Health Chat is tailored to mothers and although only mothers will be in the Facebook groups, they will be encouraged to share content with their daughters. Posts will occur twice daily for 12 months for a total of posts. Mothers will be encouraged to contribute their own content to the Facebook group via comments, original posts to share opinions or 7 teen chat in Philadelphia around 620 questions, and participation in group activities.

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Each group will geen hosted by a community manager who will oversee the Philaxelphia calendar, maintain the feed, stimulate engagement, and monitor the broader media environment to discover trending topics and new research findings to post. Our preliminary focus groups of mothers and key informant 7 teen chat in Philadelphia around 620 of CSH coordinators revealed greater interest in a Facebook group focused broadly on health as opposed to a single topic like indoor tanning.

For this reason, the 7 teen chat in Philadelphia around 620 Chat program will address health topics identified as of high interest by our focus group Philadelohia and CSH coordinators. These topics include healthy lifestyle, mental health, mother-daughter communication, and substance use.

An advisory board of experts on these health topics provided evidence-based protocols and resources, which were then converted to Facebook posts by our team. Indoor tanning content Horny women in Dresden, TN developed by the investigators and a social media marketing expert using information from published literature on risk factors, evidence-based intervention content from published trials targeting indoor tanning [ 43Biloxi sexual meeting72 - 75 ], public health campaigns from major nonprofit organizations eg, CDC, Skin Cancer Foundation, etcand investigator-developed, video-recorded interviews of local mothers and professionals about the risks of indoor tanning, experiences with skin cancer, and mother-daughter communication role modeling.

Facebook posts on indoor tanning are intended to achieve the following: Each message was designed according to our theoretical framework to ensure messages are balanced across 1 didactic versus narrative, 2 social norms based versus not, and 3 appearance- versus health risk-based messages. Once messages were developed, the entire investigative team reviewed the messages and made edits according to consensus.