Category: Social and Community Context
Sun-damaged skin and skin cancers increase in prevalence as women and men age. Effective interventions for younger persons exist in schools but motivation to enact prevention and early detection behaviors is low among many elderly.
Sun Sense | Skin Sense is a web-based portal promoting skin protection and skin screening behaviors in older persons. Board-certified dermatologists, primary care physicians, a health psychologist, and a developer of the trans-theoretical model of behavior change collaborated in the study. The program educates about risk factors for sun-damaged skin and provides examples of benign, pre-cancerous, and malignant lesions. Elderly models teach skin protection and skin examination strategies. Stage tailored interventions engage viewers and promote and maintain behavior change.
The program was evaluated in a randomized clinical trial with 526 subjects in an academic medical center. Interactive Media, Video, and Print interventions were compared. Outcomes measures included knowledge of skin cancer topics; self-efficacy for skin protection and skin examinations; stage categorizations for skin-related behaviors; performance of skin protection and skin examinations; and diagnostic and treatment costs.
Statistically significant increases in Knowledge, Attitude, and Behavior outcomes were found for all groups (p’s < 0.001). The highest levels on skin cancer information, lesion-name matching, and confidence ratings for skin protection and skin examination were found for the IM group. The proportion of subjects intending to Reduce Time in the Sun and to Use Clothing for Skin Protection increased significantly. Multivariate modeling of results and analyses of Follow-Up Survey data and Services Usage data are planned.
The the next iteration will use social network interventions to create communities linking skin cancer patients to elderly with pre-cancerous conditions and sun-damaged skin. Lesion pictures transmitted to dermatologists and communication of health benefits to targeted audiences via social media will enable skin screening and skin protection behaviors.
Lake Bluff, Illinois
Martin McCarthy is a psychologist with graduate training in experimental psychology, community psychology, and clinical psychology, and he completed a post-doctoral fellowship in health psychology at Northwestern University Medical School. He is founder and president of EduMedia Inc., a company that promotes health improvement in defined populations via education and behavior change strategies. His academic career was as Research Associate Professor in the Department of Preventive Medicine at the Feinberg School of Medicine at Northwestern University. During his time at Northwestern he developed and implemented studies focused on patient reported outcomes from medical and surgical treatments. Prior research appointments were at the Center for Geriatrics and Gerontology in the School of Public Health at Columbia University Medical School and in the Milhauser Laboratories at New York University Medical Center. With his colleagues he has published highly cited research in JAMA, Medical Care, the Journal of the American College of Surgeons, and aging journals. His EduMedia project have been funded by the National Cancer Institute and other NIH entities. Since retiring from Northwestern, Dr. McCarthy has maintained a part-time psychotherapy practice in Evanston, Illinois. He uses cognitive behavioral and motivational interviewing concepts in the design of EduMedia programs, and he includes research from the Northwestern Institute for Complex Organizations in designing social networking interventions to encourage and maintain health behavior change in population groups.
Clinical Assistant Professor
Northwestern University Medical School
Dr. Dunkas is a physician, a board certified psychiatrist, and a Life Fellow of the American Psychiatric Association. He is a clinical assistant professor in the Department of Psychiatry at the Feinberg School of Medicine of Northwestern University. He has maintained a practice in Chicago, Illinois and in Evanston, Illinois including many elderly women and men for more than 60 years. His role in the Sun Sense | Skin Sense project is to consult on engagement strategies to involve and motivate older persons to participate in skin protection and skin screening behaviors, and to assist in the development of communities of patients with skin cancers and other elderly with elevated risk for skin cancer and sun-damaged skin.