Participants responded to 8 e-training satisfaction items (5-point scale, completely unsatisfied=1 to completely satisfied=5). We used REDCap reporting capabilities to assess e-training completion rates. This allowed us to determine the participant yield from each strategy. To assess e-training feasibility, we maintained detailed recruitment and enrollment records, coding how each potential participant learned of the study.
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REDCap is a secure, web-based software platform for supporting data capture for research studies, providing (1) an intuitive interface for validated data capture, (2) audit trails for tracking data manipulation and exporting, (3) automated export procedures for seamless data download to common statistical packages, and (4) procedures for data integration and interoperability with external sources. Using Research Electronic Data Capture (REDCap) tools hosted at the University of Arizona, we collected data at 4 time points: baseline (at enrollment), 1 week post training, 3 months post training, and 6 months post training. Specific aims of this study were as follows:
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Our goal was to develop and evaluate the feasibility of delivering online e-training on reducing the risk of skin cancer, to MTs within the context of a helping conversation. There is a need to assess the feasibility of providing such training to MTs, particularly considering the popular press stories of their involvement in early detection. The few existing skin cancer–focused in-person workshops and 1 online course do not include training for client-focused communication on reducing the risk of skin cancer. Some MTs receive education on skin cancer during primary training (60%) and continuing education (25%) however, the content, duration, and source of this education vary. Approximately 385,000 MTs and MT students nationwide, provided with training, have the potential to engage in helping conversations. MTs uniquely access most of a client’s skin, allowing VSA. Compared to primary care providers or dermatologists, MTs are more likely to have repeated and longer appointments that are oriented toward health promotion, thereby providing greater opportunities for helping conversations. Community partners who can implement helping conversations about reducing the risk of skin cancer include massage therapists (MTs). The Surgeon General’s Call to Action to Prevent Skin Cancer endorses community partnerships for reducing the risk of skin cancer. Helping conversations are context-specific and thus cost-effective and time efficient they have been used for other preventive behaviors but not in the context of risk reduction for skin cancer. A helping conversation consists of 4 steps: awareness, understanding, helping, and relating. One approach for delivering risk-reducing information on skin cancer is a structured “helping conversation,” a person-centered communication technique that emphasizes on active listening and motivational communication to encourage healthy behavior change.
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Skin lesions can be assessed using several approaches, one of which is the common asymmetry, border, color, diameter, evolving (ABCDE) rule. Early skin cancer detection decreases potential morbidity, mortality, and cost and can be carried out with viewable skin assessment (VSA) by health professionals or with skin self-examination (SSE) by consumers.
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Recommended primary prevention behaviors are as follows: avoid prolonged sun exposure during peak intensity, cover the skin with tightly woven protective clothing (eg, long sleeves/pants, wide-brimmed hats, and sunglasses), seek shade, apply/reapply sunscreen, and avoid all kinds of intentional tanning. Protecting the skin from ultraviolet radiation reduces the risk of skin cancer. Fortunately, the skin cancer burden can be abated through primary prevention and early detection. Skin cancer costs exceed billions of dollars annually. The incidence of melanoma, the most fatal form of skin cancer, increases by about 3% each year among persons aged >50 years. Over 5.4 million nonmelanoma skin cancers are treated annually. Skin cancer, the most common cancer in the United States, poses a serious public health burden.