Study of health outcomes in school children: Key challenges and lessons learned from the Framingham Schools' natural history of nevi study Journal Article


Authors: Geller, A. C.; Oliveria, S. A.; Bishop, M.; Buckminster, M.; Brooks, K. R.; Halpern, A. C.
Article Title: Study of health outcomes in school children: Key challenges and lessons learned from the Framingham Schools' natural history of nevi study
Abstract: Background We describe the planning, recruitment, key challenges, and lessons learned in the development of a study of the evolution of nevi (moles) among children in a school setting. Methods This population-based study of digital photography and dermoscopy of the child's back (overview, close-up, and dermoscopic images) and genetic specimens took place among fifth graders in the Framingham, Massachusetts School System. Schoolchildren and their parents completed baseline surveys on sun protection practices, sunburns, and past ultraviolet exposures, including summer and vacation experiences. Results Prestudy outreach was conducted with children, parents, nurses, administrators, and pediatricians. Of the 691 Framingham families with a fifth grader (aged 10-11), 443 consented to complete surveys and undergo digital photography and dermoscopy during the school's routine scoliosis testing. Of the 443 families providing consent, 369 agreed to genetic testing. We identified key factors to consider when implementing school-based studies: (a) pilot studies to demonstrate feasibility, (b) inclusion of school administration and parents, (c) grassroots approach with multiple contacts, and (d) embedding research studies within preexisting school health services. Conclusions Launching an observational study within the school environment required an academic/school collaboration across numerous disciplines including dermatology, epidemiology, genetics, medical photography, school health, community health education, and most notably, the need for the presence of a full-time study nurse in the school. A large school system proved to be an excellent resource to conduct this first prospective study on the evolution of moles in US schoolchildren. The key challenges and lessons learned may be applicable to other investigators launching school-based initiatives. © 2007, American School Health Association.
Keywords: child; united states; outcome assessment; prospective study; prospective studies; sunscreen; dermoscopy; nevus; health survey; epiluminescence microscopy; outcome assessment (health care); pilot study; pilot projects; public health; leisure; photography; sunlight; sunscreening agents; sunburn; massachusetts; school health service; seasons; health surveys; school health services; school nurses; season; holidays
Journal Title: Journal of School Health
Volume: 77
Issue: 6
ISSN: 0022-4391
Publisher: American School Health Association  
Date Published: 2007-08-01
Start Page: 312
End Page: 318
Language: English
DOI: 10.1111/j.1746-1561.2007.00212.x
PUBMED: 17600588
PROVIDER: scopus
DOI/URL:
Notes: --- - "Cited By (since 1996): 8" - "Export Date: 17 November 2011" - "Source: Scopus"
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  1. Allan C Halpern
    396 Halpern