The Cancer Clear & Simple Story: Developing a Cancer Prevention Curriculum for Rural Wisconsin Through a Community Partnership

Impact of a Cancer Health Education Curriculum Among Milwaukee Public High School Students

In Milwaukee and nationwide, cancer incidence, late-stage diagnosis, and mortality are notably higher among some racial/ethnic populations. Cancer education has the potential to impact cancer burden and reduce cancer disparities. In particular, the addition of a service-learning component to academic curriculums has been shown to improve student learning as well as positively impact the surrounding community. This study implemented a cancer health education curriculum (CHEC) at a Milwaukee public high school with the goal of addressing cancer knowledge, fear and fatalism beliefs, and risk behaviors. The curriculum included interactive learning sessions and a service-learning final project. Five-hundred twenty-one students also completed pre- and post-surveys assessing cancer knowledge, fear and fatalism, risk behaviors, cancer-related communication, and a qualitative question asking what they hoped to gain (pre) or did gain (post) from the course. Results indicate (1) a significant improvement in cancer knowledge (p < 0.0001), (2) a decrease in cancer fear and fatalism (p < 0.0001), (3) an increase in fruit consumption (p < 0.0001), (4) a decrease in screen time (p = 0.0004), and (5) an increase in how often students spoke with their family about cancer (p < 0.0001). Qualitative data reflect important gains such as increased interest in sharing their knowledge about cancer with their community. Providing cancer education and leveraging a service-learning requirement led to notable changes in high school students' cancer knowledge, fear and fatalism, and risk behaviors. Students also communicated more with family/friends about cancer. Such efforts could have broader implications for student, family, and community cancer burden.

Exploring Middle School Students' Perspectives on Utilizing Serious Games for Cancer Prevention Education: A Focus Group Study

BACKGROUND

Cancer in the United States is a leading cause of mortality. Educating adolescents about cancer risks can improve awareness and introduce healthy lifestyle habits. Public health efforts have made significant progress in easing the burden of cancer through the promotion of early screening and healthy lifestyle advocacy. However, there are limited interventions that educate the adolescent population about cancer prevention. Previous studies have demonstrated the effectiveness of serious games (SGs) to teach adolescents about healthy lifestyle choices, but limited research has examined the utility of using SGs to educate youth specifically on cancer prevention.

OBJECTIVE

This study aimed to investigate middle school students' preferences for the use of SGs for cancer prevention education. The study also characterized the students' perceptions of desired game design features for a cancer prevention SG.

METHODS

Focus groups were conducted to allow adolescents to review a game playbook and discuss gaming behaviors and preferences for a SG for cancer education. The game playbook was developed based on Cancer, Clear & Simple, a curriculum intended to educate individuals about cancer, prevention, self-care, screening, and detection. In the game, the player learns that they have cancer and is given the opportunity to go back in time to reduce their cancer risk. A focus group discussion guide was developed and consisted of questions about aspects of the playbook and participants' gaming experience. Adolescents were eligible to participate if they were 12 to 14 years, could speak and understand English, and had parents who could read English or Spanish. Each focus group consisted of five to ten adolescents. Focus groups were audio-recorded and professionally transcribed, then content and thematically analyzed by two study team members. Intercoder reliability (kappa coefficient) among the coders was reported as 0.97. Prevalent codes were identified and categorized into themes and subthemes.

RESULTS

A total of 18 focus groups were conducted with 139 participants from a Wisconsin middle school. Most participants had at least "some" gaming experience. Three major themes were identified: Educational Video Games, Game Content, and Purpose of Game. Participants preferred customizable characters and realistic storylines that allowed players to make choices that affect the characters' outcomes. Middle school students also preferred SGs over other educational methods such as lectures, books, videos, and websites. Participants desired SGs to be available across multiple platforms and suggested the use of SGs for cancer education in their school.

CONCLUSIONS

Adolescents consider SGs to be an entertaining tool to learn about cancer prevention and risk factors. The design preferences of adolescents should be considered to create a cancer education SG that is acceptable and engaging for youth.

CLINICALTRIAL