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SCAN! A pharmacy-based, sun safety feasibility study

https://doi.org/10.1016/j.japh.2020.10.004Get rights and content

Abstract

Objectives

Skin cancer is the most common form of cancer, and individuals from the medically underserved Appalachian region are at elevated risks for cancer morbidity and mortality. Skin cancer can be prevented by decreasing ultraviolet light exposure (sunscreen sun protection factor 30, shade, clothing, sunglasses, hats) and can be caught at an early treatable stage through a routine skin examination. The Skin Cancer Awareness Now! (SCAN!) pilot project promoted skin cancer prevention and screening in community pharmacies, using a dynamic communication model. The objectives of the study were to understand (1) the feasibility of the SCAN! and (2) the preliminary impact of the SCAN!

Methods

We conducted pre- and postintervention surveys of the SCAN!, a student pharmacist–led or pharmacy resident–led intervention in community pharmacies (n = 3).

Results

Participants (n = 90) had a mean age of 43.8 (SD= 18.4) years, were predominantly white (92.1%), without a college degree (65.6%), and had an average family income in the range of $25,000-$49,999, with approximately 16% falling below the poverty level. To begin, the SCAN! scored highly in attention (mean = 5.8), liking (mean = 6.1), comprehension (mean = 6.7), and intentions to be sun safe (mean = 6.0). Most improved in their knowledge of the amount of sunscreen needed per application for sun safety (66%, P < 0.01) and of melanoma features from pre- and postintervention (39%, P < 0.01). A multivariate analysis of variance indicated that knowledge and intentions improved (all P’s < 0.01). Interaction effects indicated that improvements in knowledge were greater for those in the rural pharmacy (P = 0.03), and improvements in perceived importance were greater for those in urban pharmacies (P = 0.01).

Conclusion

The SCAN! intervention was well received by the population. Our study provides evidence that community pharmacy is a novel venue for skin cancer prevention interventions, particularly for rural, medically underserved populations.

Section snippets

Background

Skin cancers are the most commonly diagnosed cancer in the United States.1 Each year, approximately 5.4 million cases of nonmelanoma skin cancer (including squamous and basal cell carcinomas) are diagnosed.1 Although melanoma is less common, it is more deadly with estimates of new cases and deaths in 2020 being 100,350 and 6850, respectively.1 The U.S. Preventive Services Task Force recommends that counseling for skin cancer prevention includes pediatric, adolescent, adult, and senior

Objectives

The purpose of this study was to assess the feasibility39 and preliminary impact of a novel skin cancer intervention in community pharmacy, Skin Cancer Awareness Now! (SCAN!). The DCM will serve as a framework for development of the intervention and as an assessment framework to help understand the preliminary impact of the intervention. We anticipate that our careful attention to behavioral theory and CLAS standards will ultimately yield a useful intervention.

Participants

Eligible individuals were aged 18 years and older and able to read/write in English. Potentially eligible participants were those presenting to the pharmacy counter for prescription drop-off/pick-up, medication counseling, or other current screening services (e.g., immunization, diabetes). Potential participants eligible for the study were recruited by pharmacists (n = 7) and student pharmacists/resident (n = 6) in participating pharmacies in West Virginia (n = 3). Student pharmacists completed

Results

A total of 90 participants (men: 15.5%; women: 84.5%) at Appalachian community pharmacies participated in a pilot study of the SCAN! intervention. The mean age was 43.8 (range 19-78) years. The average level of education fell in the range of “some college,” with education ranging from grade school to graduate degree. Some had missing data for family income or number of household members, making an assessment of poverty level difficult. The average family income fell in the range of

Discussion

Our study explored the feasibility and the preliminary impact of a novel pharmacy-based skin cancer intervention, SCAN!, among a medically underserved population in Appalachia. The ultimate goal of our intervention was to raise awareness about the benefits of skin cancer prevention and decrease the risk of cancer in a medically underserved community. To begin, we were able to recruit our population of interest in the study. Approximately 16% of our sample fell in the poverty range, and many had

Conclusion

The hallmarks of SCAN! were its acceptability and ease of administration among the community pharmacists, the student pharmacists, and the participants. The findings of increased sun safety knowledge, importance, and intentions, particularly for those most in need, suggest that this intervention warrants a larger scale application. The DCM helped to guide intervention design and analysis of its impact, evidencing the potential of this model for community pharmacy intervention, and was

Acknowledgments

We thank the following individuals for their contributions to the study: Inderjit Mehmi, MD; Treah Haggerty, MD; Lena Maynor, PharmD; Lauren Nicole Luci, PharmD; Sean Clark, PharmD; Michelle Amena, PharmD; Michael Mauk, PharmD; Lisa Hostutler, PharmD; Zachary Bryner; Emily Vince; Asa Rickets; Matthew Pletcher, PharmD; and Jared Lapkowicz, PharmD.

Kimberly M. Kelly, PhD, MS, Associate Professor, Pharmaceutical Systems and Policy, West Virginia University, Morgantown, WV

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  • Cited by (0)

    Kimberly M. Kelly, PhD, MS, Associate Professor, Pharmaceutical Systems and Policy, West Virginia University, Morgantown, WV

    Trupti Dhumal, MS, Teaching Assistant, Pharmaceutical Systems and Policy, West Virginia University, Morgantown, WV

    Virginia G. Scott, BSPharm, PhD, Professor and Director of Continuing Education, Pharmaceutical Systems and Policy, West Virginia University, Morgantown, WV

    Yves Paul Vincent Mbous, MEng, Teaching Assistant, Pharmaceutical Systems and Policy, West Virginia University, Morgantown, WV

    Marissa Chotiner, BS, Research Assistant, Pharmaceutical Systems and Policy, West Virginia University, Morgantown, WV

    Roxann Powers, MD, FACP, Professor, Dermatology, West Virginia University, Morgantown, WV

    Tara Whetsel, PharmD, Clinical Associate Professor, Clinical Pharmacy, West Virginia University, Morgantown, WV

    Fnu Safarudin, PharmD, Teaching Assistant, Pharmaceutical Systems and Policy, West Virginia University, Morgantown, WV

    Paul Cornelius, MBA, PharmD, Postdoctoral Fellow, The Janssen Pharmaceutical Companies of Johnson & Johnson, Horsham, PA

    Gretchen Garofoli, PharmD, Associate Professor, Clinical Pharmacy, West Virginia University, Morgantown, WV

    Disclosure: The authors declare no relevant conflicts of interest or financial relationships.

    Funding: West Virginia University Community Engagement Grant (grant number; 283).

    Previous presentation: Some content of this proposal was presented as an abstract at the annual meeting of the Society of Behavioral Medicine, March 8, 2019.

    Institutional review board approval: Protocol approval was sought and obtained from the institutional review board of West Virginia University.

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