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Internet based computer tailored feedback on sunscreen use.

de Vries H, Logister M, Krekels G, Klaasse F, Servranckx V, van Osch L - J. Med. Internet Res. (2012)

Bottom Line: Low (N=196) educated respondents scored lower on knowledge (P<.003) but made more action plans (P<.03) than higher educated respondents (N=191).Lower educated respondents were significantly (P<.05) more positive about the advantages of the program.Third, a pro-active approach as conducted in our study is very well suited to reach various groups of people and is more likely to be successful than a reactive approach.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Health Promotion, School for Public Health and Primary Care, CAPHRI, Maastricht University, Maastricht, Netherlands. hein.devries@maastrichtuniversity.nl

ABSTRACT

Background: Skin cancer incidence rates signify the need for effective programs for the prevention of skin cancer and for helping skin cancer patients. Internet and computer tailored (CT) technology fosters the development of highly individualized health communication messages. Yet, reactions to Internet CT programs may differ per level of involvement and education level and remain understudied.

Objective: First, we identified perceptions concerning sunscreen use in Dutch adults and assessed differences in differences between the general public and skin cancer patients, and between low and high educated respondents. Second, we assessed program evaluations of these groups about a new Dutch CT Internet-based program promoting sunscreen use, and potential differences between groups

Methods: A cross-sectional research design was used. In total, 387 respondents participated and filled out an online questionnaire based on the I-Change Model assessing socio-demographics, history of skin cancer, sunscreen use, and beliefs about sunscreen use. The responses were fed into a computer program that generated personal tailored feedback on screen; next we assessed their program evaluations

Results: Of the 132 patients, 92 were female (69.7%) and 40 were male (30.3%). In the general population (N = 225), 139 (54.5%) respondents were female and 116 (45.5%) were male. Men (50.9 years) were 8 years older than women (43.1 years). Most patients were diagnosed with basal cell carcinoma (N = 65; 49.2%), followed by melanoma (N = 28; 21.2%) and squamous cell carcinoma (N = 10; 7.6%); 22% (N = 29) did not remember their skin cancer type. Patients had higher knowledge levels, felt significantly more at risk, were more convinced of the pros of sunscreen, experienced more social support to use sunscreen, had higher self-efficacy, and made more plans to use sunscreen than respondents without skin cancer (N=255; all P's< .01). Low (N=196) educated respondents scored lower on knowledge (P<.003) but made more action plans (P<.03) than higher educated respondents (N=191). The CT feedback was evaluated positively by all respondents, and scored a 7.8 on a 10 point scale. Yet, patients evaluated the CT program slightly more (P<.05) positive (8.1) than non-patients. (7.6). Lower educated respondents were significantly (P<.05) more positive about the advantages of the program.

Conclusions: First, involvement with skin cancer was reflected in more positive beliefs toward sunscreen use in patients in comparison with non-patients. Second, the CT Internet program was well accepted by both patients and non-patients, and low and high educated respondents, perhaps because higher educated respondents were more knowledgeable about sunscreen use and skin cancer. Third, a pro-active approach as conducted in our study is very well suited to reach various groups of people and is more likely to be successful than a reactive approach.

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Related in: MedlinePlus

Overview of the CT program.
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figure2: Overview of the CT program.

Mentions: The new CT program was based on the I-Change model to identify the most important factors to address, and previously conducted strategies and studies on other behaviors that yielded the format that could be used to develop the program [8,25]: such as the utilization of ipsative feedback (Dijkstra & De Vries, 1999), which items to address (van Osch et al., ), and how to use action plans (De Vries et al., 2006;2008; Van Osch et al., 2010). The program provided feedback on the following constructs: sun exposure, sunscreen behavior, type of skin, risk perception, attitudes, social support, self-efficacy, intention and action plans (see Figure 2). A first version was developed and piloted among 11 persons and patients, including one skin cancer expert in order to identify various barriers, such as inconsistencies, unnecessary jargon, and difficult framing. The results were used to improve the final CT program that was used in this study. Results from the pilot as well as from the sample showed that completing the final tailoring program took between 15–25 minutes, including time to read the advices. The time needed did not differ significantly between low- and highly-educated respondents. The process of the CT is summarized in Figure 2, and examples of the CT advices are provided in Table 1.


Internet based computer tailored feedback on sunscreen use.

de Vries H, Logister M, Krekels G, Klaasse F, Servranckx V, van Osch L - J. Med. Internet Res. (2012)

Overview of the CT program.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC3376524&req=5

figure2: Overview of the CT program.
Mentions: The new CT program was based on the I-Change model to identify the most important factors to address, and previously conducted strategies and studies on other behaviors that yielded the format that could be used to develop the program [8,25]: such as the utilization of ipsative feedback (Dijkstra & De Vries, 1999), which items to address (van Osch et al., ), and how to use action plans (De Vries et al., 2006;2008; Van Osch et al., 2010). The program provided feedback on the following constructs: sun exposure, sunscreen behavior, type of skin, risk perception, attitudes, social support, self-efficacy, intention and action plans (see Figure 2). A first version was developed and piloted among 11 persons and patients, including one skin cancer expert in order to identify various barriers, such as inconsistencies, unnecessary jargon, and difficult framing. The results were used to improve the final CT program that was used in this study. Results from the pilot as well as from the sample showed that completing the final tailoring program took between 15–25 minutes, including time to read the advices. The time needed did not differ significantly between low- and highly-educated respondents. The process of the CT is summarized in Figure 2, and examples of the CT advices are provided in Table 1.

Bottom Line: Low (N=196) educated respondents scored lower on knowledge (P<.003) but made more action plans (P<.03) than higher educated respondents (N=191).Lower educated respondents were significantly (P<.05) more positive about the advantages of the program.Third, a pro-active approach as conducted in our study is very well suited to reach various groups of people and is more likely to be successful than a reactive approach.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Health Promotion, School for Public Health and Primary Care, CAPHRI, Maastricht University, Maastricht, Netherlands. hein.devries@maastrichtuniversity.nl

ABSTRACT

Background: Skin cancer incidence rates signify the need for effective programs for the prevention of skin cancer and for helping skin cancer patients. Internet and computer tailored (CT) technology fosters the development of highly individualized health communication messages. Yet, reactions to Internet CT programs may differ per level of involvement and education level and remain understudied.

Objective: First, we identified perceptions concerning sunscreen use in Dutch adults and assessed differences in differences between the general public and skin cancer patients, and between low and high educated respondents. Second, we assessed program evaluations of these groups about a new Dutch CT Internet-based program promoting sunscreen use, and potential differences between groups

Methods: A cross-sectional research design was used. In total, 387 respondents participated and filled out an online questionnaire based on the I-Change Model assessing socio-demographics, history of skin cancer, sunscreen use, and beliefs about sunscreen use. The responses were fed into a computer program that generated personal tailored feedback on screen; next we assessed their program evaluations

Results: Of the 132 patients, 92 were female (69.7%) and 40 were male (30.3%). In the general population (N = 225), 139 (54.5%) respondents were female and 116 (45.5%) were male. Men (50.9 years) were 8 years older than women (43.1 years). Most patients were diagnosed with basal cell carcinoma (N = 65; 49.2%), followed by melanoma (N = 28; 21.2%) and squamous cell carcinoma (N = 10; 7.6%); 22% (N = 29) did not remember their skin cancer type. Patients had higher knowledge levels, felt significantly more at risk, were more convinced of the pros of sunscreen, experienced more social support to use sunscreen, had higher self-efficacy, and made more plans to use sunscreen than respondents without skin cancer (N=255; all P's< .01). Low (N=196) educated respondents scored lower on knowledge (P<.003) but made more action plans (P<.03) than higher educated respondents (N=191). The CT feedback was evaluated positively by all respondents, and scored a 7.8 on a 10 point scale. Yet, patients evaluated the CT program slightly more (P<.05) positive (8.1) than non-patients. (7.6). Lower educated respondents were significantly (P<.05) more positive about the advantages of the program.

Conclusions: First, involvement with skin cancer was reflected in more positive beliefs toward sunscreen use in patients in comparison with non-patients. Second, the CT Internet program was well accepted by both patients and non-patients, and low and high educated respondents, perhaps because higher educated respondents were more knowledgeable about sunscreen use and skin cancer. Third, a pro-active approach as conducted in our study is very well suited to reach various groups of people and is more likely to be successful than a reactive approach.

Show MeSH
Related in: MedlinePlus