When tailored feedback backfires: A skin cancer prevention intervention for adolescents

Problem. Skin cancers are the most common cancers in the U.S. Epidemiological studies suggest that prevention efforts should be directed at children and adolescents. The purpose of the present study was to evaluate the effects of an intervention that used tailored, personalized feedback letters to increase sun protection among adolescents. Methods. Ten high schools were randomized to one of two intervention conditions. One year following a school-based intervention, students in the Basic condition received only a coupon for free sunscreen. Students in the Enhanced condition received a coupon and a personalized letter with feedback about their risk levels and use of protection, and motivational messages based on their stage of change. Results. Significantly more students in the Basic condition returned the coupons than did those in the Enhanced condition. In a multivariate logistic regression, significant predictors of coupon return included condition, school grade, knowledge, and concern about sun protection. Conclusions. Tailored, personalized feedback letters as a booster intervention were not effective in enhancing sunscreen use in adolescents.