Table 1.
Core intervention components of the three arms
| Intervention strategy | Content | Mediating variables addressed | |
|---|---|---|---|
| PAE | • 14 text messages | • 1 text: welcoming participants to the study | • PAM components: |
| • 12 texts: reminders to conduct thorough skin self-examinations (TSSE), prompts to see a health care provider (HCP) for suspect lesions, messages highlighting key areas on targeting mediators and suggesting relevant website content (for example, demo of TSSE, risk factors for skin cancer) | |||
| Playing an active role in early detection | |||
| • 1 text: reminding participants about the 18-month survey | Self-efficacy re TSSE and asking HCP for skin exam | ||
| • Study website | • Information about skin cancer risk among survivors, and the key role that skin self-examinations and early detection (ED) play | ||
| Knowledge/awareness | |||
| Taking action | |||
| • Risk perception: re cancer status | |||
| • Information about how to conduct a self-examination and clinical images illustrating what to look for | |||
| • Information about how to ask a HCP for a skin exam: | • Barrier reduction | ||
| Printable checklist | |||
| Guide to discussion | |||
| • Information about preventive behaviors | |||
| • Interactive skin exam quizzes | |||
| • Tips for making ED a priority | |||
| • Lay summaries of research on the efficacy of skin exams | |||
| • Videos and links to additional resources about skin cancer | |||
| PAE + MD (Additional components/Mediators addressed) | • Physician activation packet | • Introduction letter describing intervention and encouraging MDs to do a full-body skin examination at the patient’s next visit | • Self-efficacy to perform a skin examination on the patient |
| • Guide to conducting a full skin cancer examination | |||
| • Information about survivors’ increased risk of skin cancer | |||
| • Access to the provider section of the ASK website, which houses additional resources including clinical images illustrating what to look for | |||
| • Study website | • Information about skin cancer risk among survivors, and the key roles that skin exams and early detection (ED) play | • Barrier reduction related to HCP provision of skin examination (for example, how to do exam; how to identify suspicious lesions) | |
| • Video demonstration of how to conduct a thorough clinical skin examination | |||
| • Summaries of research on the efficacy of skin exams | |||
| • Videos and links to additional resources regarding skin cancer | |||
| • Access to all participant website materials | |||
| PAE + MD + TD | • Telederm | • Participant given dermatoscope attachment | • Barrier reduction decrease wait times for dermatology review of lesions |
| • Website provides information about typical and atypical lesions | |||
| • As part of regular TSSE, participant takes photographs of suspect lesions and sends to study dermatologist | |||
| • Teledermoscopy report sent within 1 week, includes instructions to health care provider about needed follow-up or treatment |
Abbreviations: PAE, Patient Activation and Education, PAE + MD, PAE plus physician activation; PAE + MD + TD, PAE plus physician activation, plus teledermoscopy, PAM, Patient Activation Measure.