35250 Real-time feedback during an interactive online skin cancer training game “Whack-a-Mole” is key to increasing confidence in performing skin self-examination at home.

Abstract

Melanoma is the most lethal form of skin cancer (SK). Early melanoma detection has decreased mortality through skin self-examination (SSE) and dermatology full-body skin examinations. Although ABCD and UDS training increases melanoma identification skills, studies have shown that lacking self-confidence is the main barrier for performing SSE at home. This project compares the efficacy of various mole identification training strategies and explores the effect of real-time feedback on decision-making and self-confidence. We developed an online melanoma identification game that tests differences between training types and real-time feedback on mole identification. This online RCT tests a 4 (training: ABCD, UDS, both, control) by 3 (feedback: standard, motivational, control) factorial design on melanoma identification, self-efficacy, and SK prevention intentions. Real-time feedback was presented as standard and motivational. We recruited 1025 US adults. Our Whack-a-Mole gameplay integrates the same mechanics as Tinder (swipe left on safe moles and swipe right on malignant moles). Two-way ANCOVA was used for the analysis. ABCD training resulted in significantly higher melanoma identification than the control (P = .011). All training types resulted in significantly higher self-efficacy than the control (P = .007). All feedback elicited significantly higher levels of self-efficacy than the control (P = .001). Around 88% of participants intend to conduct SSE and wear sunscreen. Our data suggest that interactive ABCD and UDS training with real-time feedback may improve accuracy, ability, and self-confidence for melanoma identification and may lead to increase performing SSE at home. Overall, Whack-a-Mole is a novel efficacious tool for melanoma identification.