Skin Cancer Knowledge Research Articles

A randomised test of printed educational materials about melanoma detection: Varying skin self-examination technique and visual image dose

Objective: Melanoma incidence and mortality rates continue to rise globally, making it essential for researchers to identify effective approaches to disseminating information to the public that improve key outcomes. This study compared two skin self-examination (SSE) educational strategies: the ABCDE (asymmetry, border irregularity, multiple colours, diameter greater than 6 mm and evolution over time) approach and the ugly duckling sign (UDS). Design: A randomised experiment testing different presentations of SSE techniques and visual image dose. Setting: The experiment took place at a shopping centre in the Midwest USA. Method: Participants ( N = 301) participated in the study in which they viewed brochures featuring one of two SSE training methods, ABCDE or UDS, along with a low, moderate or high dosage (frequency) of visual images. Results: The brochures improved willingness to perform SSE and skin cancer knowledge across all groups, with brochures featuring the UDS increasing willingness to perform SSE as visual image dose increased. Sensitivity and specificity outcomes were similar across all groups, with a slight advantage found for displaying a moderate visual image dose visualising the ABCDE condition (sensitivity = .63, specificity = .79). Conclusions: Overall, both the ABCDE and UDS approaches demonstrated utility in improving early skin cancer detection and education. A balanced presentation of typical and atypical nevi images seems to be an important consideration when presenting visual and written information about melanoma to laypersons.

Skin cancer preventative behaviors in state park workers: a pilot study.

Considering the potential for occupational sun exposure among state park workers, the purpose of this pilot study was to identify skin cancer knowledge, health beliefs, self-efficacy, and sun protection behaviors (SPBs) among state park employees. The current study used a cross-sectional survey research design with state park workers in a Southern state. Of the 94 possible employees who could have participated in the study, 87 completed the survey. Assessment of the participants' skin cancer knowledge demonstrated an average correct response rate of 68.8 %. While the vast majority (87.4 %) believed that skin cancer is a serious disease, a minority (42.5 %) believed they would develop skin cancer sometime during their lifetime, and even fewer (35.6 %) believed their risk was higher than average. Collectively, workers reported low levels of SPBs. The most commonly reported barriers to sun protection were "inconvenient," "too hot to wear," and "forget to protect." Half of the participants (50.6 %) were highly confident in their ability to wear long pants while in the sun. About the same proportion of participants was highly confident they could wear a wide-brimmed hat (21.8 %) and sunscreen (20.7 %). Based on available evidence, a need exists to develop individual and worksite programs and interventions to increase skin cancer prevention behaviors among this occupational group. This data could serve as a baseline to monitor and evaluate the efficacy of these interventions.

71 Patient education in stoma care; Impact of shortened hospital stay

71 Patient education in stoma care; Impact of shortened hospital stay

Effects of a short messaging service-based skin cancer prevention campaign in adolescents.

Skin cancer prevention emphasizes early adoption and practice of sun protection behaviors. Adolescence represents a high-risk period for ultraviolet radiation exposure, presenting an opportunity for intervention. The ubiquity of mobile phones among teens offers an engaging medium through which to communicate prevention messages. To evaluate a skin cancer prevention intervention using short messaging service (SMS, or text messages) to impact sun-related knowledge, beliefs, and behaviors among adolescents. The intervention was conducted in middle school youth (N=113) recruited in April or October 2012. Participants were English speakers, 11-14 years old, routinely carried a mobile phone, and completed a 55-minute sun safety education program. Participants were sent three sun safety-themed SMS messages each week for 12 weeks. Skin and sun protective knowledge, beliefs, behaviors, and post-intervention program satisfaction were collected and analyzed at baseline and end of intervention (April/June 2012; October 2012/January 2013). Paired responses were tested for equality using Wilcoxon signed-rank tests. Ninety-six students (85%) completed the study. At 12 weeks, significant positive changes were reported for sun avoidance during peak ultraviolet radiation, sunscreen application, wearing hats and sunglasses, and knowledge about skin cancer risk. Participants expressed moderately high satisfaction with the program, and 15% shared messages with family or friends. A brief, SMS-based intervention affected youth skin cancer prevention behaviors and knowledge. Future research will determine whether program effects were sustained at 24 weeks and explore how sun safety parenting practices inform these effects.

Sun protection education for diverse audiences: need for skin cancer pictures.

Sun protection education is needed for kidney transplant recipients, whose increased risk of skin cancer could be ameliorated with sun protection. Cognitive interviews with 24 participants equally stratified among non-Hispanic White, non-Hispanic Black, and Hispanic/Latino kidney transplant recipients were performed to evaluate a sun protection education workbook. Study participants were recruited over the phone using a registry of 700 kidney transplant recipients. Participants included 12 women and 12 men with a median age of 52. In 16 of the cognitive interviews with non-Hispanic Blacks and Hispanic/Latinos, pictures of skin cancer were requested by the participants in order to see the appearance of skin cancer. Kidney transplant recipients with skin of color did not consider themselves at risk to develop skin cancer and wanted to see examples of skin cancer occurring on people with skin of color. Based on these results, the workbook was modified to include pictures of squamous cell carcinoma on varying skin tones. Then, 8 participants evaluated the revised workbook in cognitive interviews and found the photographs acceptable and necessary to demonstrate the severity of skin cancer and personalize their risk of developing skin cancer. The participants progressed from having knowledge of skin cancer to believing that they could develop skin cancer because they observed skin cancers on people with their skin tone. Using pictures of skin cancers occurring on people with similar skin tone may heighten a kidney transplant recipients' sense of vulnerability and possibly improve the use of sun protection.

The German SCREEN project--design and evaluation of the communication strategy.

Skin cancer is the most common cancer in light-skinned populations worldwide. Primary and secondary preventive activities such as skin cancer screening are intended to reduce skin cancer burden. In 2003, a population-based skin cancer screening project [SCREEN (Skin Cancer Research to Provide Evidence for Effectiveness of Screening in Northern Germany)] was conducted in Northern Germany with more than 360,000 people screened. SCREEN was supported by a communication intervention that was aimed at informing the population about skin cancer, its risk factors and the screening intervention as well as preparing the health professionals for the project. Within SCREEN both physicians and practice nurses were educated in counselling. The aim of the present article is to describe and evaluate the communication strategy accompanying SCREEN. Two computer-assisted telephone interview surveys were performed in April/May 2003 and May 2004. Participants had to be members of the statutory health insurance and be aged 20 years. They were asked about knowledge of skin cancer, perception of physicians' performance and skin cancer screening in general. Data are mainly presented in a descriptive manner. For statistical analyses, Mann-Whitney U test and Pearson's chi-square test were used. Knowledge about sunburn in childhood and high ultraviolet exposure as skin cancer risk factors increased during SCREEN. Simultaneously, the awareness for early detection of skin cancer increased significantly from 41.3 to 74.0% (P < 0.001). A total of 21.5% of the interviewees participated in the skin cancer screening project, similar to the population-based participation rate reached. A comprehensive communication strategy accompanying a screening intervention improves the knowledge of potential screenees and may additionally increase the participation rate.

Skin cancer knowledge and sun protection behavior among nursing students.

The objective of this study was to determine skin cancer knowledge and sun protection behavior among nursing students. A total of 1178 nursing students in the Aegean Region of Turkey took part in this descriptive study. A score for knowledge on protection against skin cancer and a score for protective behavior against skin cancer were calculated. In this study, first year students sunbathed more in the middle of the day than fourth year students, and their knowledge of skin cancer was lower. No statistical difference was determined for protective behavior between the two groups. The knowledge levels and protective behavior of first year students were alarmingly low, but the average scores for knowledge and behavior of the fourth year university students were higher. The knowledge levels of the fourth year students were average but their protective behavior was insufficient. It was found that the knowledge levels and the levels of protective behavior of light-skinned students were higher. This study revealed that the knowledge levels and protective behavior of first year nursing students against the harmful effects of the sun and for protection against skin cancer were alarmingly low. It also showed that the knowledge levels of the fourth year nursing students were average, but that their protective behavior was very insufficient. These findings suggest that it is of extreme importance to acquire knowledge and behavior for protection against skin cancers in the education of nursing students.

The Skin Cancer and Sun Knowledge (SCSK) Scale: Validity, Reliability, and Relationship to Sun-Related Behaviors Among Young Western Adults.

Increasing public knowledge remains one of the key aims of skin cancer awareness campaigns, yet diagnosis rates continue to rise. It is essential we measure skin cancer knowledge adequately so as to determine the nature of its relationship to sun-related behaviors. This study investigated the psychometric properties of a new measure of skin cancer knowledge, the Skin Cancer and Sun Knowledge (SCSK) scale. A total of 514 Western young adults (females n = 320, males n = 194) aged 18 to 26 years completed measures of skin type, skin cancer knowledge, tanning behavior, sun exposure, and sun protection. Two-week test-retest of the SCSK was conducted with 52 participants. Internal reliability of the SCSK scale was acceptable (KR-20 = .69), test-retest reliability was high (r = .83, n = 52), and acceptable levels of face, content, and incremental validity were demonstrated. Skin cancer knowledge (as measured by SCSK) correlated with sun protection, sun exposure, and tanning behaviors in the female sample, but not in the males. Skin cancer knowledge appears to be more relevant to the behavior of young women than that of young males. We recommend that future research establish the validity of the SCSK across a range of participant groups.

Skin cancer knowledge, attitudes, and behaviors in collegiate athletes.

Outdoor athletes represent an important group at risk for skin cancer because they are routinely exposed to high levels of ultraviolet radiation. The purpose of this study was to assess current skin cancer knowledge, attitudes, and behaviors among collegiate athletes. A modified version of the Melanoma Risk Behavior Survey was completed by 343 athletes attending a Southern University in the USA, generating an 87% response rate. Survey results demonstrated that the majority of the athletes do not limit their sun exposure and reported low levels of sun protective behaviors. In addition, athletes lacked knowledge about skin cancer and sun protection. Eighty-three percent of the athletes stated that tanning beds improve one's overall health. Race was significantly associated with skin cancer knowledge, whereas, gender was found to be significantly associated with knowledge, attitudes, and behaviors towards skin cancer. Additionally, there was a significant relationship between knowledge and behavior, but not between attitude and behavior. This study highlights the need to educate athletes about the hazards of tanning to minimize UV exposure and promote sun protection habits. Moreover, athletes should be educated on the dangers of indoor tanning facilities and encouraged to avoid these facilities.

Comparison of Skin Cancer Knowledge, Attitude, and Protective Behavior in African American Students in East and West Coasts

Purpose and Background: African Americans, in comparison to other ethnic groups, are often diagnosed with melanoma at advanced stages, resulting in low survival rates. One of the strongest risk factors for all types of skin cancer is exposure to UV radiation from the sun. UV ray intensity is associated with latitude; lower latitudes have stronger UV rays than higher latitudes. This study examines and compares the knowledge, attitude, and protective behavior toward skin cancer among United States African American college students who live in two different latitudes, Maryland and southern California. Methods: We surveyed 360 African American students from two major universities in southern California and Maryland. Students were asked to fill out questionnaires that assessed their knowledge, attitude, and protective behavior regarding sun exposure. Results: More African American students from Maryland knew the direct link between UV/sun radiation exposure and the occurrence of skin cancer (p = 0.02), while those from California were significantly more knowledgeable about skin cancer risk factors such as sunbathing without sunscreen (p ? 0.001). Although students from Maryland were more concerned that exposure to the sun may give them skin cancer (p = 0.003) and more worried about the possibility of skin cancer (p &lt; 0.001), they were less likely to engage in sun protection behaviors such as using sunscreen (p = 0.001). Conclusion: Based on this study, efforts to increase sun protective behaviors through education regarding skin cancer risk factors in Maryland are warranted.

Longitudinal, mixed method study to look at the experiences and knowledge of non melanoma skin cancer from diagnosis to one year

BackgroundSkin cancer is the most common type of cancer in humans and the incidence is increasing worldwide. Our objective was to understanding the needs, experiences and knowledge of individuals with Non Melanoma Skin Cancer (NMSC) from diagnosis up until one year.MethodsPatients with NMSC completed questionnaires at diagnosis, treatment, 8 weeks post treatment and 12 months post diagnosis. Body image, psychological morbidity and Quality of Life (QOL) were assessed at each time point, with the exception of QOL that was not assessed at diagnosis. Knowledge of NMSC was assessed at baseline and 8 weeks. A sub-sample of participants was also interviewed to allow a more in-depth exploration of patients’ experiences.Results76 participants completed the initial questionnaire, of which 15 were interviewed. Patients were anxious about a diagnosis of skin cancer, however they were no more depressed or anxious than the general population. QOL significantly improved from diagnosis to 8 weeks and from diagnosis to one year. Knowledge of NMSC was poor and did not improve after treatment. Hairdressers were highlighted as playing an important role in raising awareness and encouraging individuals to seek medical help. Most participants were aware of the need to check their skin for suspicious lesions but were not sure what to look for. At one year participants had forgotten their experience and were not overly concerned about skin cancer.ConclusionThere is a need to raise awareness of the signs and symptoms of NMSC. Information on skin cancer needs to be tailored to the individual both at the start of treatment and during the follow up months, ensuring that participants’ needs and expectations are met. Targeting education at individuals in the community who regularly come into contact with skin should help in early identification of NMSC. This is important since skin cancer caught early is easily treatable and delay in presentation leads to larger and more complex lesions which impacts in terms of increased morbidity and increased health care costs.

Predictors of Sun-Related Behaviors Among Young Women: Comparisons Between Outdoor Tanners, Fake Tanners, and Tan Avoiders

Objective: Skin cancer incidence continues to rise as a tanned appearance remains desirable, particularly among young women. Fake tanning provides a tanned appearance without exposure to ultraviolet radiation. In order to advance our understanding of the factors that contribute to long-term behavior change, this study explores determinants associated with different types of tanning. Participants: The sample included 162 female students from the University of Adelaide, Australia, aged 18–26 years. Data were collected in July 2010. Methods: The current study measured differences in skin type, skin cancer knowledge, unrealistic optimism, appearance motivation, and sun-protective and sun exposure behaviors amongst outdoor tanners, fake tanners, and tan avoiders through an online survey. Results: Differences were observed for skin type, skin cancer knowledge, unrealistic optimism, sun protection, and sun exposure. Conclusions: A “one-size-fits-all” approach to skin cancer prevention may not be appropriate; type of tanning behavior may need to be considered in health promotion work.

A Preliminary Study of a Video Intervention to Inform Solid Organ Transplant Recipients About Skin Cancer

PurposeTo obtain preliminary evidence on the effect of a skin cancer prevention video for adult solid organ transplant recipients (SOTR) and informational brochures on outcomes of skin cancer knowledge, beliefs, prevention and detection behaviors, and personal agency (self-confidence/personal control) for behaviors. BackgroundSOTR have a high risk of skin cancer potentiated by life-long immunosuppressive therapy posttransplantation. Skin cancer in SOTR is aggressive and difficult to treat. Prevention and early detection are important for reducing risk and improving skin cancer outcomes, but methods to inform SOTR about their risk are understudied. MethodsA brief, evidence-based skin cancer informational video tailored to SOTR was evaluated using a quasi-experimental design that compared the outcome variables in two groups of SOTR seen in 4 transplantation clinics within 4–6 weeks posttransplantation. The video/brochure group (VBG) viewed the video once and received skin cancer information brochures. The brochure group (BG) received brochures only. Participants completed a survey on sun protection behavior (6 items; alpha = 0.75), personal agency (6 items; alpha = 0.64), beliefs (6 items; alpha = 0.60), skin cancer knowledge (6 items), and skin self-examination (SSE; 1 item) at baseline and 3 months postintervention. Data were analyzed using descriptive statistics and 2 × 2 analysis of variance. ResultsOf 113 participants, 90 completed both surveys (VBG, n = 46; BG, n = 44). Both groups had a significant increase in sun protective behavior (P < .001), skin cancer knowledge (P < .001), beliefs (P = .003), and personal agency (P = .003). There was no effect of either intervention on SSE. ConclusionBoth interventions effectively informed SOTR about skin cancer and sun protection, promoted favorable beliefs, and improved personal agency, but were not differentially effective, suggesting that the addition of the video may not be necessary or that the video may need to be viewed more than once. More in-depth SSE teaching strategies may be necessary.

The role of skin cancer knowledge in sun-related behaviours: A systematic review

Skin cancer is the most commonly diagnosed cancer in many Western countries. This systematic review provides a comprehensive overview of the relationship between skin cancer knowledge and sun-protective, exposure and tanning behaviours in the general population. A total of 34 studies, published in peer-reviewed journals over three decades, were reviewed and synthesised. Sun-protective behaviour was positively associated with skin cancer knowledge in most cases. Findings were inconsistent regarding other sun-related behaviours. Heterogeneity in measurement compromised the capacity to definitively link knowledge and sun-related behaviours. There is a need for development and utilisation of a standardised skin cancer knowledge scale, and guidelines are suggested.

Skin Cancer Knowledge and Skin Self-examinations in the Hispanic Population of North Carolina: The Patient's Perspective

Skin Cancer Knowledge and Skin Self-examinations in the Hispanic Population of North Carolina: The Patient's Perspective

Skin Cancer Knowledge, Beliefs, Self-Efficacy, and Preventative Behaviors among North Mississippi Landscapers

There are slightly over one million workers in the landscape service industry in the US. These workers have potential for high levels of solar ultraviolet radiation exposure, increasing their risk of skin cancer. A cross-sectional sample of 109 landscapers completed a self-administered questionnaire based on Health Belief Model (HBM). The participants correctly answered 67.1% of the knowledge questions, 69.7% believed they were more likely than the average person to get skin cancer, and 87.2% perceived skin cancer as a severe disease. Participants believed that the use of wide-brimmed hats, long sleeved shirts/long pants, and sunscreen was beneficial but reported low usage of these and other sun protective strategies. The primary barriers to using sun protection were “I forget to wear it” and “it is too hot to wear.” Of the HBM variables, perceived benefits outweighing perceived barrier (r = .285, P = .003) and self-efficacy (r = .538, P = .001) were correlated with sun protection behaviors. The reasons for absence of the relationship between perceived skin cancer threat and sun protection behaviors could be lack of skin cancer knowledge and low rate of personal skin cancer history.

Assessing hairdressers' knowledge of scalp and neck melanoma and their willingness to detect lesions and make referrals to dermatologists

Assessing hairdressers' knowledge of scalp and neck melanoma and their willingness to detect lesions and make referrals to dermatologists

Skin cancer surveillance behaviors among US Hispanic adults

Little skin cancer prevention research has focused on the US Hispanic population. This study examined the prevalence and correlates of skin cancer surveillance behaviors among Hispanic adults. A population-based sample of 788 Hispanic adults residing in 5 southern and western states completed an online survey in English or Spanish in September 2011. The outcomes were ever having conducted a skin self-examination (SSE) and having received a total cutaneous examination (TCE) from a health professional. The correlates included sociodemographic, skin cancer-related, and psychosocial factors. The rates of ever conducting a SSE or having a TCE were 17.6% and 9.2%, respectively. Based on the results of multivariable logistic regressions, factors associated with ever conducting a SSE included older age, English linguistic acculturation, a greater number of melanoma risk factors, more frequent sunscreen use, sunbathing, job-related sun exposure, higher perceived skin cancer risk, physician recommendation, more SSE benefits, and fewer SSE barriers. Factors associated with ever having a TCE were older age, English linguistic acculturation, a greater number of melanoma risk factors, ever having tanned indoors, greater skin cancer knowledge, higher perceived skin cancer severity, lower skin cancer worry, physician recommendation, more TCE benefits, and fewer SSE barriers. The cross-sectional design limits conclusions regarding the causal nature of observed associations. Few Hispanic adults engage in skin cancer surveillance behaviors. The study highlights Hispanic subpopulations that are least likely to engage in skin cancer surveillance behaviors and informs the development of culturally appropriate interventions to promote these behaviors.

Effect of Dermoscopy Education on the Ability of Medical Students to Detect Skin Cancer

To determine students' ability to discriminate benign vs malignant lesions and to assess attitudes regarding skin cancer examination (SCE). Second-year medical students at 1 institution participated in an SCE intervention for 2 consecutive years. Cohort 1 received intervention A, consisting of SCE teaching without a dermoscopy tutorial. Cohort 2 received intervention B, consisting of SCE teaching with a dermoscopy tutorial, access to online dermoscopy resources, and a dermoscope. Surveys before and after the lecture included an image-based test of 10 lesions to assess ability to differentiate benign from malignant lesions. There were 130 participants from cohort 1 and 131 participants from cohort 2 at the postintervention survey. At baseline, students in both groups reported similar attitudes regarding the value of SCE (P = .05) and intention to perform SCE on patients (P = .55). Overall, cohort 2 exhibited improvement (P < .001) from preintervention (52.0% correct) to postintervention assessments (63.0% correct), whereas cohort 1 did not (47.0% and 46.0% correct, respectively; P = .50). Although both groups improved (P < .001) in the diagnosis of the superficial spreading melanoma, cohort 2 improved in the diagnosis of the basal cell carcinoma (P < .001) and cohort 1 displayed deterioration in identifying the malignant nature of this lesion (P < .001). For the nodular melanoma, correct diagnosis decreased significantly in cohort 1 (P < .001) and negligibly in cohort 2 (P = .90). Students receiving the dermoscopy tutorial improve in diagnosis of cutaneous lesions compared with those not receiving the dermoscopy intervention. Teaching SCE with inclusion of dermoscopy may be an effective means of enhancing skin cancer knowledge.

Evaluating a Skin Cancer Education Program for the Deaf Community

Skin cancer is the most common, preventable, and treatable cancer, so public education has been a priority. Unfortunately, for the Deaf community, most skin cancer information is difficult to access, so tailored approaches are needed. Participants (N=136) were randomly assigned to view either a skin cancer education video in American Sign Language (n=75) or an alternate video (n=61). All participants completed skin cancer knowledge questionnaires at baseline, immediately post-intervention, and 2-month post-intervention. Control group participants could then transfer to the experimental condition, using their 2-month follow-up data as their baseline. Participants who saw the skin cancer video gained significantly more knowledge than control participants, demonstrating the video's effectiveness in increasing skin cancer control knowledge. There was no difference between the original experimental group and the delayed intervention group on knowledge gains.