{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T15:52:20Z","timestamp":1791388340654,"version":"4.3.3"},"reference-count":48,"publisher":"American Medical Association (AMA)","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Dermatol"],"abstract":"\n Importance<\/jats:title>\n Children of melanoma survivors have a 2-fold increased lifetime risk of melanoma, yet they inconsistently practice sun protection and experience preventable sunburns.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To evaluate a telehealth-delivered behavioral intervention for skin cancer prevention among children of melanoma survivors.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This parallel-group randomized clinical trial assigned survivor-child dyads to the family, lifestyles, actions, and risk education (FLARE) intervention or a control condition between April 2020 and October 2023. Participants were recruited through a cancer registry and statewide and clinical databases. Eligible survivors had a confirmed melanoma diagnosis and at least 1 child aged 8 to 17 years with 1 or more sunburns during the previous year. Of 520 eligible survivors, 364 dyads enrolled, completed baseline assessment, and were randomized. Data were analyzed from 2025 to 2026.<\/jats:p>\n <\/jats:sec>\n \n Interventions<\/jats:title>\n Both conditions were telehealth education modules delivered over 4 weeks. FLARE included familial melanoma risk education and skills building that targeted child sun protection. The control included general skin cancer education on identifying reputable sources of health information.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n The primary outcome was child sunburn occurrence, which was evaluated as the change from baseline through the 2 postintervention assessments. Secondary outcomes included child sun-protective behaviors and tanning.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 364 survivor-child dyads were recruited and randomized (parents: mean [SD] age, 45.1 [6.2] years; 228 female individuals [62.6%]; children: mean [SD] age, 12.9 [2.6] years; 189 female individuals [51.9%]). The primary analysis, which included 364 dyads (180 FLARE [49.5%], 184 control [50.5%]) in the intention-to-treat analyses, found no significant between-group differences in rate of sunburn change across time. However, at the first postintervention assessment, child-reported sunburn occurrence was lower in the FLARE group compared with the control group (\n B<\/jats:italic>\n \u2009=\u2009\u22120.17; 95% CI, \u22120.30 to \u22120.04;\n P<\/jats:italic>\n \u2009=\u2009.01). Relative to the control group, FLARE participants demonstrated greater increases in child sun-protective behaviors from baseline through the second postintervention assessment (\n B<\/jats:italic>\n \u2009=\u20090.26; 95% CI, 0.14-0.38;\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001). No significant between-group differences were observed for intentional or unintentional tanning, which were infrequently reported at baseline.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this randomized clinical trial, FLARE failed to reduce child sunburn over time compared with an active educational control. Although FLARE improved sun-protective behaviors and was associated with lower child-reported sunburn immediately postintervention, additional strategies may be needed for sustained reductions in high-risk children.<\/jats:p>\n <\/jats:sec>\n \n Trial Registration<\/jats:title>\n \n ClinicalTrials.gov Identifier:\n NCT04201223<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamadermatol.2026.3877","type":"journal-article","created":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T15:00:23Z","timestamp":1791385223000},"source":"Crossref","is-referenced-by-count":0,"title":["Melanoma Prevention Among Children of Melanoma Survivors"],"prefix":"10.1001","author":[{"given":"Yelena P.","family":"Wu","sequence":"first","affiliation":[{"name":"Department of Dermatology, University of Utah, Salt Lake City"},{"name":"Huntsman Cancer Institute, University of Utah, Salt Lake City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tammy K.","family":"Stump","sequence":"additional","affiliation":[{"name":"Huntsman Cancer Institute, University of Utah, Salt Lake City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pascal R.","family":"Deboeck","sequence":"additional","affiliation":[{"name":"Department of Psychology, University of Utah, Salt Lake City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liberty A.","family":"Woodside","sequence":"additional","affiliation":[{"name":"Huntsman Cancer Institute, University of Utah, Salt Lake City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juliana","family":"Moyano","sequence":"additional","affiliation":[{"name":"Huntsman Cancer Institute, University of Utah, Salt Lake City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer L.","family":"Hay","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa G.","family":"Aspinwall","sequence":"additional","affiliation":[{"name":"Huntsman Cancer Institute, University of Utah, Salt Lake City"},{"name":"Department of Psychology, University of Utah, Salt Lake City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth M.","family":"Boucher","sequence":"additional","affiliation":[{"name":"Huntsman Cancer Institute, University of Utah, Salt Lake City"},{"name":"Department of Internal Medicine, University of Utah, Salt Lake City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas","family":"Grossman","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University of Utah, Salt Lake City"},{"name":"Huntsman Cancer Institute, University of Utah, Salt Lake City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathi","family":"Mooney","sequence":"additional","affiliation":[{"name":"Huntsman Cancer Institute, University of Utah, Salt Lake City"},{"name":"College of Nursing, University of Utah, Salt Lake City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sancy A.","family":"Leachman","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Knight Cancer Institute, Oregon Health and Science University, Portland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ken R.","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Population Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel E.","family":"Hancock","sequence":"additional","affiliation":[{"name":"Huntsman Cancer Institute, University of Utah, Salt Lake City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali P.","family":"Wankier","sequence":"additional","affiliation":[{"name":"Huntsman Cancer Institute, University of Utah, Salt Lake City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth P.","family":"Tercyak","sequence":"additional","affiliation":[{"name":"Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2026,10,7]]},"reference":[{"issue":"12","key":"doi260047r4","doi-asserted-by":"publisher","first-page":"2669","DOI":"10.1200\/JCO.2005.11.108","article-title":"Risk factors and individual probabilities of melanoma for whites.","volume":"23","author":"Cho","year":"2005","journal-title":"J Clin Oncol"},{"key":"doi260047r5","doi-asserted-by":"publisher","first-page":"147","DOI":"10.1016\/j.canep.2017.04.004","article-title":"Sun exposure and skin cancer, and the puzzle of cutaneous melanoma: a perspective on Fears et al. 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