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Providers’ Experiences with a Melanoma Web-Based Course: a Discussion on Barriers and Intentions

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Abstract

Primary care visits provide an opportunity for skin examinations with the potential to reduce melanoma mortality. The INFORMED (INternet curriculum FOR Melanoma Early Detection) Group developed a Web-based curriculum to improve primary care providers’ (PCPs’) skin cancer detection skills. This study details feedback obtained from participant focus groups, including the feasibility of implementing in other PCP practices. Practicing PCPs at Henry Ford Health System and Kaiser Permanente Northern California completed the curriculum. Feedback sessions were conducted with standardized questions focusing on four domains: (1) overall impressions of the curriculum, (2) recommendations for improvement, (3) current skin examination practices, and (4) suggestions for increasing skin screening by PCPs. Discussions at each site were audio recorded, transcribed verbatim, and de-identified. Providers (N = 54) had a positive impression of the Web-based curriculum, with suggestions to provide offline teaching aids and request assistance. Despite having improved confidence in diagnosing malignant lesions, many providers felt a lack of confidence in performing the screening and time constraints affected their current practices, as did institutional constraints. Providers intended to increase discussion with patients about skin cancer. The accessibility, effectiveness, and popularity of the curriculum indicate potential for implementation in the primary care setting. Participating providers noted that institutional barriers remain which must be addressed for successful dissemination and implementation.

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Acknowledgments

This study was developed by the INFORMED (Internet Course of Melanoma Early Detection) Group, which, in addition to the authors listed, includes Waqas Shaikh, MD MPH; Lingling Li, PhD; Stephen Dusza, DrPH; Ashfaq Marghoob, MD; Elizabeth Quigley, MD; Jacqueline M. Goulart, MD; Shoshana Landow, MD; Michelle Groesbeck, BS; Richard Krajenta, MS; Kimberly Marcolivio, MEd; Monica Sokil, RD; and E. Margaret Warton, MPH.

Conflict of Interest

The authors declared that they have no competing interests.

Funding Sources

This study was funded by a Team Science Award from the Melanoma Research Alliance, with the National Cancer Institute-supported HMO Cancer Research Network (U24 CA171524) and National Cancer Institute-mentored Training for Dissemination and Implementation Research (R25 CA171994). The sponsors had no role in the design and conduct of the study; in the collection, analysis, and interpretation of data; or in the preparation, review, or approval of the manuscript.

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Authors and Affiliations

  1. Stritch School of Medicine, Loyola University Chicago, 2160 1st Avenue, Maywood, IL, 60153, USA

    Angela J. Jiang

  2. Department of Dermatology, Henry Ford Hospital, 3031 W Grand Boulevard, Suite 800, Detroit, MI, 48202, USA

    Melody J. Eide

  3. Department of Public Health Sciences, Henry Ford Hospital, One Ford Place, Detroit, MI, 48202, USA

    Melody J. Eide & Gwen L. Alexander

  4. Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA, 94612, USA

    Andrea Altschuler & Maryam M. Asgari

  5. Department of Social and Behavioral Sciences, Harvard School of Public Health, 677 Huntington Ave, Kresge Building, Boston, MA, 02115, USA

    Alan C. Geller

  6. Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA

    Suzanne W. Fletcher

  7. 208 Boulder Bluff, Chapel Hill, NC, 27516, USA

    Suzanne W. Fletcher

  8. Dermatology Service, Memorial Sloan-Kettering Cancer Center, 16 East 60th Street, New York, NY, 10022, USA

    Allan C. Halpern

  9. Dermatoepidemiology Unit, Veterans Affairs Medical Center, 830 Chalkstone Avenue, Providence, RI, 02908, USA

    Martin A. Weinstock

  10. Department of Dermatology, Rhode Island Hospital, 593 Eddy Street, Providence, RI, 02903, USA

    Martin A. Weinstock

  11. Departments of Dermatology and Community Health, Brown University, Providence, RI, 02912, USA

    Martin A. Weinstock

Authors
  1. Angela J. Jiang
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  2. Melody J. Eide
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  3. Gwen L. Alexander
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  4. Andrea Altschuler
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  5. Maryam M. Asgari
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  6. Alan C. Geller
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  7. Suzanne W. Fletcher
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  8. Allan C. Halpern
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  9. Martin A. Weinstock
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Corresponding author

Correspondence to Melody J. Eide.

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Jiang, A.J., Eide, M.J., Alexander, G.L. et al. Providers’ Experiences with a Melanoma Web-Based Course: a Discussion on Barriers and Intentions. J Canc Educ 32, 272–279 (2017). https://doi.org/10.1007/s13187-015-0910-4

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  • DOI: https://doi.org/10.1007/s13187-015-0910-4

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