DESCRIPTION (provided by applicant): Organ transplant recipients (OTR)-persons receiving donated solid organs such as kidneys, pancreases, livers, lungs, or hearts-are at exceptionally high risk of all types of skin cancer. Increased risk likely results from immune system changes brought on by life-long drug therapy required after transplantation. Sun exposure also plays a role in development of skin cancer. More than 230,000 OTR in the U.S. are up to 250 times more likely to develop skin cancer than the general public. With the long-term success of organ transplantation improving to 90%, more OTR will be at continued risk of skin cancer. Skin cancer (squamous cell cancer, basal cell cancer, or melanoma) has serious outcomes ranging from scarring and cosmetic disfigurement to death. In OTR, skin cancer is highly aggressive and hard to treat; therefore, prevention and detection are critical for improving survival. Behaviors known to lessen skin cancer risk and improve survival of skin cancer are sun protection and skin self-examination. Unfortunately, OTR do not receive adequate information on skin cancer prevention and detection from healthcare providers. The few OTR who have received verbal or written information retain some skin cancer knowledge, but there are only two existing studies of approaches to improve skin cancer prevention/detection behaviors (sun protection, skin examination) in OTR. These approaches were verbal information from physicians and written brochures. With funding from the NCI, we will first develop a new approach: a short video to provide skin cancer prevention and detection information that is tailored to OTR. We will then compare changes in sun protection and skin self-examination behaviors in two groups of OTR (132 total) who recently underwent transplantation and are being followed in outpatient OTR clinics: (1) 66 OTR who view the video plus receive skin cancer general information brochures and (2) 66 OTR who receive the brochures only. We also will evaluate the effect of the video approach on factors known to influence behavior change, specifically attitudes toward skin cancer, intention to engage in sun protection and skin self-examination behaviors, self confidence in performing the behavior, and personal control over doing the behavior. Findings from this study will help healthcare providers to better inform OTR about their high risk of skin cancer and options for risk- reducing behaviors. Findings also will provide more information about factors that may be important in skin cancer prevention and detection behavior change.
PUBLIC HEALTH RELEVANCE: Organ transplant recipients (e.g., receiving kidneys, lungs, pancreases, etc.) are at extremely high risk of skin cancer. They receive little information on skin cancer prevention and detection from healthcare providers. We will develop and evaluate a new information tool: a prevention/detection video tailored to these recipients.
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