The skinny on skin: The role of skin‐aware professionals in skin cancer surveillance

Author:

Diehl Kyra1ORCID,Nelson Jacob1ORCID,Haddadin Olivia2,Stoos Elizabeth1,Shafer Autumn3,Mason Amy4,Girard Deb4,Malcolm Theresa4,Geller Alan C.5,Latour Emile6,Bailey Elizabeth7,Young Jade N.2ORCID,Zhao Hannah2,Gillespie Jordan2,Pfeifer Hailey2,Lee Claudia2,Shea Moira2,DeCampos‐Stairiker Mallory2,Smith Jake2,Becker Alyssa18,Bash Gina N.2ORCID,Sahni Vikram2,Fan Yichen2,Munoz Elena Paz2,Baron David2,Popovici Nadia2,Orfaly Victoria E.1,Baghoomian Wenelia2,Foltz Emilie19,Kahlen Kristen10,Savory Stephanie11,Jacobe Heidi11,Leachman Sancy A.112ORCID

Affiliation:

1. Oregon Health & Science University Department of Dermatology Portland Oregon USA

2. Oregon Health & Science University School of Medicine Portland Oregon USA

3. University of Oregon Eugene Oregon USA

4. IMPACT Melanoma Concord Massachusetts USA

5. Department of Social and Behavioral Sciences Harvard T.H. Chan School of Public Health Boston Massachusetts USA

6. Biostatistics Shared Resource Knight Cancer Institute, Oregon Health & Science University Portland Oregon USA

7. Department of Dermatology Stanford University School of Medicine Stanford California USA

8. John A. Burns School of Medicine University of Hawaii Manoa Hawaii USA

9. Washington State University Elson S. Floyd College of Medicine Spokane Washington USA

10. Memo Communications Seattle Washington USA

11. Department of Dermatology University of Texas Southwestern Medical Center Dallas Texas USA

12. Oregon Health & Science University, Knight Cancer Institute Portland Oregon USA

Abstract

AbstractBackgroundLicensed nonmedical, skin‐aware professionals (e.g., hairdressers, massage therapists, etc.) have the potential to identify skin cancer, but baseline knowledge may not be sufficient to accomplish this goal. Following educational intervention, self‐efficacy is one of the best surrogate metrics for behavior change. Curricula that increase knowledge and confidence levels can improve screening behaviors, but few have been tested for efficacy in this populationAimsWe assessed whether an online curriculum could reliably improve skin screening knowledge, attitudes, and behaviors of nonmedical professionalsPatients/MethodsSkin‐aware professionals were recruited through the Oregon Health Authority and IMPACT Melanoma TM. Participants completed a pre‐survey, online training module, post‐survey, and one‐year follow‐up survey. We evaluated participants' indicated levels of concern for suspicious and nonsuspicious lesions relative to “gold standard” physician ratings. We also assessed confidence and self‐reported behavior change regarding talking to clients about skin cancer and recommending they see a provider to evaluate suspicious lesionsResultsThe pre‐survey was completed by 9872 skin‐aware professionals; 5434 completed the post‐survey, and 162 completed the one‐year follow‐up survey. Participants showed a significant improvement in ability to indicate the correct level of concern for all lesion types in concordance with “gold standard” physician ratings (p < 0.001). Participants reported increased comfort levels in discussing health‐related topics with their clients posttrainingConclusionsOur training module effectively increased skin‐aware professionals' knowledge, confidence, and concern for malignant lesions. Skin‐aware professionals may serve as a valuable extension of the skin self‐exam, but additional studies are needed to evaluate the impact of these curricula long‐term, including potential downstream consequences

Funder

Knight Cancer Institute, Oregon Health and Science University

Publisher

Wiley

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