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Allan C Halpern - One of the best experts on this subject based on the ideXlab platform.
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Skin Cancer screening and Prevention in the primary care setting national ambulatory medical care survey 1997
2001Co-Authors: Susan A Oliveria, Paul J Christos, Ashfaq A Marghoob, Allan C HalpernAbstract:OBJECTIVE: To describe Skin Cancer Prevention and screening activities in the primary care setting and to compare these findings to other Cancer screening and Prevention activities. DESIGN: Descriptive study. SETTING/PATIENTS: National Ambulatory Medical Care Survey 1997 data on office-based physician visits to family practitioners and internists. MEASUREMENTS AND MAIN RESULTS: Data were obtained on 784 primary care visits to 109 family practitioners and 61 internists. We observed that the frequency of Skin Cancer Prevention and screening activities in the primary care setting was much lower than other Cancer screening and Prevention activities. Skin examination was reported at only 15.8% of all visits (17.4% for family practitioners vs 13.6% for internists, P>.1). For other Cancer screening, the frequencies were as follows: breast examination, 30.3%; Papanicolaou test, 25.3%; pelvic examination, 27.6%; and rectal examination, 17.9%. Skin Cancer Prevention in the form of education and counseling was reported at 2.3% of these visits (2.9% for family practitioners vs 1.5% for internists, P>.1), while education on breast self-examination, diet and nutrition, tobacco use, and exercise was 13.0%, 25.3%, 5.7%, and 17.9%, respectively. CONCLUSIONS: The results of this study indicate that the proportion of primary care visits in which Skin Cancer screening and Prevention occurs is low. Strategies to increase Skin Cancer Prevention and screening by family practitioners and internists need to be considered.
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Skin Cancer screening and Prevention in the primary care setting national ambulatory medical care survey 1997
2001Co-Authors: Susan A Oliveria, Paul J Christos, Ashfaq A Marghoob, Allan C HalpernAbstract:OBJECTIVE: To describe Skin Cancer Prevention and screening activities in the primary care setting and to compare these findings to other Cancer screening and Prevention activities.
Karen Glanz - One of the best experts on this subject based on the ideXlab platform.
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compensation behaviors and Skin Cancer Prevention
2018Co-Authors: Amy Bleakley, Deann Lazovich, Amy B Jordan, Karen GlanzAbstract:Introduction Skin Cancer Prevention guidelines recommend practicing multiple behaviors to protect against harmful ultraviolet rays, yet few adults report practicing more than one recommended behavior. This study examines the extent to which Skin Cancer Prevention behaviors are combined and may follow a pattern of compensation in which an individual's performance of one behavior (e.g., wearing sunscreen) precludes performing other protective behaviors (e.g., wearing a hat). Methods Data from qualitative semi-structured interviews (n=80) in 2015 and a quantitative online national survey (n=940) in 2016 with non-Hispanic white adults aged 18–49 years from the U.S. were used to examine combinations of Skin Cancer Prevention behaviors. Data were analyzed in 2017. Results Protective behaviors like wearing sunglasses and sunscreen were a common approach to Prevention, but protective, avoidant (i.e., seeking shade, avoiding outdoor tanning), and covering-up (i.e., wearing a hat, shirt) strategies were rarely used in combination. Regression analyses to determine correlates of protection, avoidance, and covering-up showed that age was positively associated with practicing each strategy; positive attitudes about tanning were negatively associated with avoidance and covering-up; and positive body image was positively associated with protection and negatively associated with avoidance. Demographics such as education, employment, and gender, but not Skin Cancer risk, were also related to the various strategies. Conclusions Although a full evaluation of compensation theory and Skin Cancer Prevention was limited by the available data, the results suggest that application of the theory may yield clues for how to improve sun protection behaviors.
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Effectiveness of a Targeted, Peer-Driven Skin Cancer Prevention Program
2016Co-Authors: For Lifeguards, Dawn Michelle Hall, Tom Elliott, Eric Nehl, Karen GlanzAbstract:Lifeguards working at outdoor pools typically receive high amounts of sun exposure, increasing their risk for developing Skin Cancer. This study evaluates the effectiveness of a targeted, peer-driven intervention for Skin Cancer Prevention among lifeguards. Nine pools received the targeted intervention, Pool Cool Plus, and five received the standard Pool Cool Prevention program. Lifeguards completed surveys at the begin-ning and end of the summer. Lifeguards in both the targeted intervention and standard program groups increased their sun safety practices and reported more sun-safe pool policies and environments. Sunburn rates decreased among lifeguards participating in Pool Cool Plus. Future research should test the feasibility and effectiveness of dis-seminating the Pool Cool Plus program. More than one million cases of basal and squamous cell Cancers are reported annually, and 62,480 people are expected to be diagnosed with melanoma in 2008 (American Cancer Society, 2008). Behavioral recommendations for primary pre-vention of Skin Cancer include wearing protective clothing, wearing sunglasses, and using sunscreen with a sun protection factor (SPF) of 15 or higher when out
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effects of tailored risk communications for Skin Cancer Prevention and detection the pennscape randomized trial
2015Co-Authors: Karen Glanz, Kathryn Volpicelli, Michael E Ming, Lynn M Schuchter, Christopher Jepson, Katrina ArmstrongAbstract:Background: Prevention and early detection measures for melanoma, such as sun avoidance and Skin examinations, are important, but are practiced inconsistently. In this replication of the Project SCAPE trial, we sought to determine whether tailored print materials were more effective at improving adherence than generic print materials for patients at increased risk of Skin Cancer. Methods: Participants were randomized to receive personalized mailed communications about their Skin Cancer risk and recommended sun protection, or generic mailings. Participants were Caucasian adults, at moderate or high risk for Skin Cancer, recruited in outpatient primary care. The main outcomes were overall sun protection behaviors and specific protective behaviors including use of sunscreen, shirt, hat, sunglasses, shade, and sun avoidance; recent sunburns; and Skin self-examination and provider Skin examination. Results: One hundred ninety-two (93.2%) subjects completed the study. Six outcome variables showed significant intervention condition effects in mixed effects models: overall sun protection behavior ( P = 0.025); sunscreen use ( P = 0.026); use of sunglasses ( P = 0.011); sunburns in the past three months ( P = 0.033); recency of last Skin self-exam ( P = 0.017); and frequency of Skin exams by health care provider ( P = 0.016). Conclusions: Relative to generic communications, tailored risk communications resulted in improved adherence to six Skin Cancer protective behaviors, including a composite sun protection behavior measure, sunburns, and health care provider Skin examinations. Impact: Tailored interventions can be more effective in improving patient Prevention behaviors than nontailored, generic information for patients at moderate to high risk of Skin Cancer. Cancer Epidemiol Biomarkers Prev; 24(2); 415–21. ©2014 AACR .
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randomized trial of tailored Skin Cancer Prevention for children the project scape family study
2013Co-Authors: Karen Glanz, Alana D Steffen, Elinor Schoenfeld, Karyn A TappeAbstract:This study evaluated a tailored intervention to promote sun protection in parents and their children, hypothesizing that the tailored intervention would lead to improved Skin Cancer Prevention behaviors compared to generic materials. Families were recruited through schools and community centers and were included if there was 1 child in Grades 1-3 at moderate to high risk for Skin Cancer. Participants were randomized into one of two intervention groups: a tailored intervention, in which they received personalized Skin Cancer education through the mail; or a control group who received generic Skin Cancer information materials. Before and after intervention, parents completed questionnaires about their and their children's Skin Cancer risk and Prevention knowledge and behaviors. Parents also completed 4-day sun exposure and protection diaries for their child and themselves. Tailored group participants demonstrated significantly greater positive changes in Prevention behavior after the intervention, including children's use of sunscreen, shirts, and hats, and parents' use of shade, and Skin examinations. Effect sizes were small and perceived benefits and social norms mediated intervention effects. Findings from this study support the efficacy of focusing tailored communications to families in order to change Skin Cancer Prevention practices in young children.
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melanoma genetic testing counseling and adherence to Skin Cancer Prevention and detection behaviors
2013Co-Authors: Karen Glanz, Kathryn Volpicelli, Peter A Kanetsky, Michael E Ming, Lynn M Schuchter, Christopher Jepson, Susan M Domchek, Katrina ArmstrongAbstract:Background: Little is known about the impact of knowledge of CDKN2A and MC1R genotype on melanoma Prevention behaviors like sun avoidance and Skin examination in the context of familial melanoma. Methods: A total of 73 adults with a family history of melanoma were randomly assigned to be offered individualized CDKN2A and MC1R genotyping results in the context of a genetic counseling session, or the standard practice of not being offered counseling or disclosure of genotyping results. Mixed effects or longitudinal logistic models were used to determine whether the intervention affected change in sun protection habits, Skin examinations and perception and beliefs related to melanoma risk, Prevention, and genetic counseling. Results: All participants in the intervention group who attended genetic counseling sessions chose to receive their test results. From baseline to follow-up, participants in the intervention group reported an increase in the frequency of Skin self-examinations compared to a slight decrease in the control group (p=0.002). Participants in the intervention group reported a smaller decrease in frequency of wearing a shirt with long sleeves than did participants in the control group (p =0.047). No effect of the intervention was noted for other outcomes. Conclusions: It is noteworthy that feedback of CDKN2A and MC1R genotype among families without known pathogenic CDKN2A mutations does not appear to decrease sun protection behaviors. Because of the limited number of families with known pathogenic CDKN2A mutations in this study, it is difficult to interpret the results as demonstrating a positive benefit of the intervention.
Susan A Oliveria - One of the best experts on this subject based on the ideXlab platform.
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Skin Cancer screening and Prevention in the primary care setting national ambulatory medical care survey 1997
2001Co-Authors: Susan A Oliveria, Paul J Christos, Ashfaq A Marghoob, Allan C HalpernAbstract:OBJECTIVE: To describe Skin Cancer Prevention and screening activities in the primary care setting and to compare these findings to other Cancer screening and Prevention activities. DESIGN: Descriptive study. SETTING/PATIENTS: National Ambulatory Medical Care Survey 1997 data on office-based physician visits to family practitioners and internists. MEASUREMENTS AND MAIN RESULTS: Data were obtained on 784 primary care visits to 109 family practitioners and 61 internists. We observed that the frequency of Skin Cancer Prevention and screening activities in the primary care setting was much lower than other Cancer screening and Prevention activities. Skin examination was reported at only 15.8% of all visits (17.4% for family practitioners vs 13.6% for internists, P>.1). For other Cancer screening, the frequencies were as follows: breast examination, 30.3%; Papanicolaou test, 25.3%; pelvic examination, 27.6%; and rectal examination, 17.9%. Skin Cancer Prevention in the form of education and counseling was reported at 2.3% of these visits (2.9% for family practitioners vs 1.5% for internists, P>.1), while education on breast self-examination, diet and nutrition, tobacco use, and exercise was 13.0%, 25.3%, 5.7%, and 17.9%, respectively. CONCLUSIONS: The results of this study indicate that the proportion of primary care visits in which Skin Cancer screening and Prevention occurs is low. Strategies to increase Skin Cancer Prevention and screening by family practitioners and internists need to be considered.
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Skin Cancer screening and Prevention in the primary care setting national ambulatory medical care survey 1997
2001Co-Authors: Susan A Oliveria, Paul J Christos, Ashfaq A Marghoob, Allan C HalpernAbstract:OBJECTIVE: To describe Skin Cancer Prevention and screening activities in the primary care setting and to compare these findings to other Cancer screening and Prevention activities.
Adele C Green - One of the best experts on this subject based on the ideXlab platform.
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letter to the editor in response to when to apply sunscreen a consensus statement for australia and new zealand
2019Co-Authors: Louise Baldwin, Rachel E. Neale, David C. Whiteman, Catherine M. Olsen, Louisa G Gordon, Monika Janda, Joanne F. Aitken, Adele C GreenAbstract:Whiteman et al (2019) highlighted the need for daily sunscreen application as a key component of effective Skin Cancer Prevention, in the article “When to apply sunscreen: a consensus statement for Australia and New Zealand.”1 This letter seeks to add to the work of the Sunscreen Summit Policy Group by reporting on a desktop review of current sunscreen policies. It assessed consistency in sunscreen recommendations in public‐facing policy documents, including which type of sunscreen to use, the amount of sunscreen to apply and when to reapply.
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Regular Sunscreen Use and Risk of Mortality: Long-Term Follow-up of a Skin Cancer Prevention Trial.
2019Co-Authors: Akiaja R. Lindstrom, Lena A. Von Schuckmann, Maria Celia Hughes, Adele C Green, Gail M. Williams, Jolieke C. Van Der PolsAbstract:Introduction Sunscreen is widely used to protect the Skin from harmful effects of sun exposure. However, there are concerns that sunscreens may negatively affect overall health. Evidence of the general safety of long-term regular sunscreen use is therefore needed. Methods The effect of long-term sunscreen use on mortality was assessed over a 21-year period (1993–2014) among 1,621 Australian adults who had participated in a randomized Skin Cancer Prevention trial of regular versus discretionary sunscreen use (1992–1996). In 2018, an intention-to-treat analysis was conducted using Cox proportional hazards regression to compare death rates in people who were randomized to apply sunscreen daily for 4.5years, versus randomized to use sunscreen at their usual, discretionary level. All-cause mortality and deaths resulting from cardiovascular disease, Cancer, and other causes were considered. Results In total, 160 deaths occurred in the daily sunscreen group compared with 170 deaths in the discretionary sunscreen group (hazard ratio=0.94, 95% CI=0.76, 1.17); 59vs 76 cardiovascular disease deaths (hazard ratio=0.77, 95% CI=0.55, 1.08), 63vs 58 Cancer deaths (hazard ratio=1.09, 95% CI=0.76, 1.57), and 45vs 44 deaths resulting from other causes (hazard ratio=1.02, 95% CI=0.67, 1.54) occurred respectively. Conclusions Regular use of a sun protection factor 16 sunscreen on head, neck, arms, and hands for 4.5years did not increase mortality.
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towards Skin Cancer Prevention and early detection evolution of Skin Cancer awareness campaigns in australia
2014Co-Authors: Michelle R Iannacone, Adele C GreenAbstract:Since the 1980s, Australia's mass-media campaigns promoting Skin Cancer awareness, namely Skin Cancer-preventative behaviors and early detection, have targeted the general community as well as high-risk groups, including outdoor workers, schoolchildren and youths. During that time, campaigns have evolved in tone and method of delivery. Their messages are today accompanied by policies, supportive environments such as shade and access to quality sun-protection products governed by national standards. Early detection of Skin Cancer has been the other aim of these campaigns, and recent downturns in incidence rates, especially in the young, and the shift to mostly thin melanomas at diagnosis in Australia, may partly reflect some campaign success. However, sustained efforts are required for long-lasting Skin Cancer control.
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lifetime cost effectiveness of Skin Cancer Prevention through promotion of daily sunscreen use
2012Co-Authors: Nicholas G Hirst, Louisa G Gordon, Adele C Green, Paul Anthony ScuffhamAbstract:Abstract Objectives Health-care costs for the treatment of Skin Cancers are disproportionately high in many white populations, yet they can be reduced through the promotion of sun-protective behaviors. We investigated the lifetime health costs and benefits of sunscreen promotion in the primary Prevention of Skin Cancers, including melanoma. Methods A decision-analytic model with Markov chains was used to integrate data from a central community-based randomized controlled trial conducted in Australia and other epidemiological and published sources. Incremental cost per quality-adjusted life-year was the primary outcome. Extensive one-way and probabilistic sensitivity analyses were performed to test the uncertainty in the base findings with plausible variation to the model parameters. Results Using a combined household and government perspective, the discounted incremental cost per quality-adjusted life-year gained from the sunscreen intervention was AU$40,890. Over the projected lifetime of the intervention cohort, this would prevent 33 melanomas, 168 cutaneous squamous-cell carcinomas, and 4 melanoma-deaths at a cost of approximately AU$808,000. The likelihood that the sunscreen intervention was cost-effective was 64% at a willingness-to-pay threshold of AU$50,000 per quality-adjusted life-year gained. Conclusions Subject to the best-available evidence depicted in our model, the active promotion of routine sunscreen use to white populations residing in sunny settings is likely to be a cost-effective investment for governments and consumers over the long term.
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regular sunscreen use is a cost effective approach to Skin Cancer Prevention in subtropical settings
2009Co-Authors: Louisa G Gordon, Jolieke C. Van Der Pols, Gail M. Williams, Paul Anthony Scuffham, Penelope Mcbride, Adele C GreenAbstract:In many developed countries, total costs to health systems for cutaneous basal cell carcinomas (BCCs) and squamous cell carcinomas (SCCs) are among the highest of all Cancers, yet the investment value of preventive measures remains unknown. Using primary data from a randomized controlled trial, we estimated the cost-effectiveness of a Skin Cancer Prevention initiative based on regular sunscreen use. Compared with usual practice (discretionary use), the sunscreen intervention cost an additional US$106,449 (2007) to prevent 11 BCCs, 24 SCCs, and 838 actinic keratoses among 812 residents over 5 years. These health outcomes required an annual average investment of US$0.74 per person and saved the Australian government a total of US$88,203 in health-care costs over the same period. Such community-based interventions promoting regular sunscreen use among Caucasians in subtropical settings can prevent Skin Cancer and related Skin tumors in practical ways and with great cost efficiency.
Ashfaq A Marghoob - One of the best experts on this subject based on the ideXlab platform.
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Skin Cancer screening and Prevention in the primary care setting national ambulatory medical care survey 1997
2001Co-Authors: Susan A Oliveria, Paul J Christos, Ashfaq A Marghoob, Allan C HalpernAbstract:OBJECTIVE: To describe Skin Cancer Prevention and screening activities in the primary care setting and to compare these findings to other Cancer screening and Prevention activities. DESIGN: Descriptive study. SETTING/PATIENTS: National Ambulatory Medical Care Survey 1997 data on office-based physician visits to family practitioners and internists. MEASUREMENTS AND MAIN RESULTS: Data were obtained on 784 primary care visits to 109 family practitioners and 61 internists. We observed that the frequency of Skin Cancer Prevention and screening activities in the primary care setting was much lower than other Cancer screening and Prevention activities. Skin examination was reported at only 15.8% of all visits (17.4% for family practitioners vs 13.6% for internists, P>.1). For other Cancer screening, the frequencies were as follows: breast examination, 30.3%; Papanicolaou test, 25.3%; pelvic examination, 27.6%; and rectal examination, 17.9%. Skin Cancer Prevention in the form of education and counseling was reported at 2.3% of these visits (2.9% for family practitioners vs 1.5% for internists, P>.1), while education on breast self-examination, diet and nutrition, tobacco use, and exercise was 13.0%, 25.3%, 5.7%, and 17.9%, respectively. CONCLUSIONS: The results of this study indicate that the proportion of primary care visits in which Skin Cancer screening and Prevention occurs is low. Strategies to increase Skin Cancer Prevention and screening by family practitioners and internists need to be considered.
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Skin Cancer screening and Prevention in the primary care setting national ambulatory medical care survey 1997
2001Co-Authors: Susan A Oliveria, Paul J Christos, Ashfaq A Marghoob, Allan C HalpernAbstract:OBJECTIVE: To describe Skin Cancer Prevention and screening activities in the primary care setting and to compare these findings to other Cancer screening and Prevention activities.