ABSTRACT
Background: Skin cancer is the most common type of cancer in the United States, and one in five Americans will develop a skin cancer at least once during their lifetime (U.S. Cancer Statistics Working Group, 2016). Analysis of current skin cancer prevention practices in a large academic university dermatology clinic revealed a lack of skin cancer risk stratification, targeted prevention messaging, and assessment of sun-protective behavior (SPB) use. An improvement project was initiated to evaluate the impact of a skin cancer prevention bundle (SCPB) on SPB use and sunburn frequency over a 2-month period.
Methods: Adult clinic patients 20-65 years old, at a moderate to high risk based on Brief Skin Cancer Risk Assessment Tool scores, received an SCPB consisting of personalized Brief Skin Cancer Risk Assessment Tool risk feedback, American Academy of Dermatology skin cancer prevention recommendations, and a brief American Academy of Dermatology skin cancer prevention video. A Sun Habits Survey and an assessment of perceived skin cancer risk were performed preintervention and postintervention.
Results: Thirty-eight participants (92.7%) completed the project. Outcome measures showing significant difference postintervention included Sun Protection Habits Index summary scores (p < .0001), sunburn frequency (p < .0001), and lifetime perceived risk of skin cancer (p = .007). Individual SPB habits of limiting midday ultraviolet exposure (p = .0004) and frequency of hat use (p = .01) also showed significant increases postintervention.
Conclusions and Implications: Use of the clinic-based SCPB improved SPB use and reduced sunburn frequency. The SCPB is being considered for clinic-wide implementation based on the findings. Further study with a larger number of participants and ongoing postclinic implementation evaluation is recommended to confirm results and fully assess the potential of the SCPB to improve patient outcomes and reduce skin cancer risk.