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Grant Details

Grant Number: 7DP2CA225433-02 Interpret this number
Primary Investigator: Linos, Eleni
Organization: Stanford University
Project Title: Targeted Advertising for Cancer Prevention
Fiscal Year: 2017
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My goal is to radically shift our approach to prevention. I want to leverage online advertising, social media and smartphone technology to create a rapid, effective and scalable platform for targeted prevention messages that actually shift health behaviors. I plan to start with skin cancer prevention, using tanning beds and melanoma as the proof-of-principle example. However, this work will be broadly generalizable to many other public health challenges where behaviors play a key role in the disease process. Over half of cancers are preventable through behavioral changes, vaccines, or medications.1,2 However the process of moving from scientific evidence to implementation is painfully slow. Recent Institute of Medicine and RAND reports estimate that only 50% of recommended health care practices are implemented, and this takes decades. The situation is even worse for preventive health care. Meanwhile, both melanoma and non-melanoma skin cancer (NMSC) rates continue to increase.3 4 In fact, incidence of skin cancer is higher than all other cancers combined. Indoor tanning is a class I carcinogen and a major, modifiable risk factor that accounts for over 450,000 new NMSC and over 10,000 melanomas each year.5 This is close to half a million potentially preventable skin cancers each year. Yet, tanning bed use remains common with 1 in 5 adolescents and over 40% of college students using tanning beds in the last year.5 Despite significant investment in prevention efforts, including well-designed campaigns by foundations focused on skin cancer prevention, our efforts to impact incidence of skin cancer have hit a brick wall. Technology to target health messages can get the right message to the right person at the right time. Social media and online search engines give us an unprecedented ability to target our health messages directly to those at highest risk. These platforms give us a way to direct a message precisely when teens are ? for example ? searching for a tanning salon.7,8 Over 90% of teens and young adults are online daily, and 92% engage with two or more devices simultaneously-including smartphones, tablets, PC and TV.9, 10 The most efficient way to reach the largest number of young adults is through the technology they are using, including: social media, online search engines and smartphones. Online advertising works to shift attitudes towards consumer brands, and shift purchasing behaviors. Therefore, this approach could be used to shift indoor tanning attitudes and behaviors. The advantages of leveraging advertising on social networking and search sites include: 1) unprecedented reach, 2) relatively low cost, and 3) the opportunity to target specific audiences. First, we will use a mixed-methods approach to learn which messages are most engaging. Then we will test which messages are most effective at shifting knowledge and self-reported tanning behaviors using two online randomized trial designs. Finally, we will run a large national trial to test whether these messages shift actual tanning bed use and melanoma incidence.

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Knowledge, Motivations, and Practices Regarding Indoor Tanning Among Men Who Have Sex With Men in the San Francisco Bay Area.
Authors: Morrison L. , Raymond H.F. , Katz K.A. , Simard J. , Admassu N. , Pascua N. , Linos E. .
Source: JAMA dermatology, 2019-07-01; 155(7), p. 852-854.
PMID: 31090875
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Facebook Advertising for Cancer Prevention: A Pilot Study.
Authors: Morrison L. , Chen C. , Torres J.S. , Wehner M. , Junn A. , Linos E. .
Source: The British journal of dermatology, 2019-04-10; , .
EPub date: 2019-04-10.
PMID: 30972743
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Physician mothers' experience of workplace discrimination: a qualitative analysis.
Authors: Halley M.C. , Rustagi A.S. , Torres J.S. , Linos E. , Plaut V. , Mangurian C. , Choo E. , Linos E. .
Source: BMJ (Clinical research ed.), 2018-12-12; 363, p. k4926.
EPub date: 2018-12-12.
PMID: 30541926
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Prevalence of Atopic Eczema Among Patients Seen in Primary Care: Data From The Health Improvement Network.
Authors: Abuabara K. , Magyari A. , McCulloch C.E. , Linos E. , Margolis D.J. , Langan S.M. .
Source: Annals of internal medicine, 2018-12-04; , .
EPub date: 2018-12-04.
PMID: 30508419
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Sunscreens, cancer, and protecting our planet.
Authors: Galamgam J. , Linou N. , Linos E. .
Source: The Lancet. Planetary health, 2018 11; 2(11), p. e465-e466.
PMID: 30396433
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One More Reason to Continue Drinking Coffee-It May Be Good for Your Skin.
Authors: Wehner M.R. , Linos E. .
Source: JAMA dermatology, 2018-12-01; 154(12), p. 1385-1386.
PMID: 30347020
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Using Social Media to Target Cancer Prevention in Young Adults: Viewpoint.
Authors: Sarkar U. , Le G.M. , Lyles C.R. , Ramo D. , Linos E. , Bibbins-Domingo K. .
Source: Journal of medical Internet research, 2018-06-05; 20(6), p. e203.
EPub date: 2018-06-05.
PMID: 29871850
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Natural history of lesions suspicious for basal cell carcinoma in older adults in Ikaria, Greece.
Authors: Wehner M.R. , Dalma N. , Landefeld C. , Pare-Anastasiadou A. , Koutelidas I. , Chren M.M. , Aji N. , Teng C.E. , Koenig B.A. , Tang J. , et al. .
Source: The British journal of dermatology, 2018 09; 179(3), p. 767-768.
EPub date: 2018-07-12.
PMID: 29741766
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Skin cancer prevention messages on Facebook: Likes, shares, and comments.
Authors: Nosrati A. , Pimentel M.A. , Falzone A. , Hegde R. , Goel S. , Chren M.M. , Eye R. , Linos E. , Pagoto S. , Walkosz B.J. .
Source: Journal of the American Academy of Dermatology, 2018 Sep; 79(3), p. 582-585.e1.
EPub date: 2018-03-05.
PMID: 29518459
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Geriatric Dermatology-A Framework for Caring for Older Patients With Skin Disease.
Authors: Linos E. , Chren M.M. , Covinsky K. .
Source: JAMA dermatology, 2018-07-01; 154(7), p. 757-758.
PMID: 29710117
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USPSTF Recommendations for Behavioral Counseling for Skin Cancer Prevention: Throwing Shade on UV Radiation.
Authors: Linos E. , Pagoto S. .
Source: JAMA internal medicine, 2018-05-01; 178(5), p. 609-611.
PMID: 29558531
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Dermatology on Instagram: An Analysis of Hashtags.
Authors: Park J.H. , Christman M.P. , Linos E. , Rieder E.A. .
Source: Journal of drugs in dermatology : JDD, 2018-04-01; 17(4), p. 482-484.
PMID: 29601627
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Indoor Tanning, Sunless Tanning, and Sun-Protection Behaviors Among Sexual Minority Men.
Authors: Gao Y. , Arron S.T. , Linos E. , Polcari I. , Mansh M.D. .
Source: JAMA dermatology, 2018-04-01; 154(4), p. 477-479.
PMID: 29490367
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Paid Family and Childbearing Leave Policies at Top US Medical Schools.
Authors: Riano N.S. , Linos E. , Accurso E.C. , Sung D. , Linos E. , Simard J.F. , Mangurian C. .
Source: JAMA, 2018-02-13; 319(6), p. 611-614.
PMID: 29450516
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Diversity in the dermatology workforce: 2017 status update.
Authors: Linos E. , Wintroub B. , Shinkai K. .
Source: Cutis, 2017 12; 100(6), p. 352-353.
PMID: 29360894
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Doctor fails: early warning signs of physician fatigue?
Authors: Linos E. , Admassu N. , Sabry-Elnaggar H. , Li P.M. , Choo E. .
Source: BMJ (Clinical research ed.), 2017-12-12; 359, p. j5503.
EPub date: 2017-12-12.
PMID: 29233842
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All-cause mortality in patients with basal and squamous cell carcinoma: A systematic review and meta-analysis.
Authors: Wehner M.R. , Cidre Serrano W. , Nosrati A. , Schoen P.M. , Chren M.M. , Boscardin J. , Linos E. .
Source: Journal of the American Academy of Dermatology, 2018 04; 78(4), p. 663-672.e3.
EPub date: 2017-11-13.
PMID: 29146125
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Acne, sexual orientation, and mental health among young adults in the United States: A population-based, cross-sectional study.
Authors: Gao Y. , Wei E.K. , Arron S.T. , Linos E. , Margolis D.J. , Mansh M.D. .
Source: Journal of the American Academy of Dermatology, 2017 11; 77(5), p. 971-973.
PMID: 29029907
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Types of Shade Vary in Protection Just Like Sunscreens.
Authors: Opene C. , Chren M.M. , Linos E. .
Source: JAMA dermatology, 2017-10-01; 153(10), p. 1070-1071.
PMID: 28636687
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Teens, Tweets, and Tanning Beds: Rethinking the Use of Social Media for Skin Cancer Prevention.
Authors: Falzone A.E. , Brindis C.D. , Chren M.M. , Junn A. , Pagoto S. , Wehner M. , Linos E. .
Source: American journal of preventive medicine, 2017 Sep; 53(3S1), p. S86-S94.
PMID: 28818251
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Correlation Among Cancer Incidence and Mortality Rates and Internet Searches in the United States.
Authors: Wehner M.R. , Nead K.T. , Linos E. .
Source: JAMA dermatology, 2017-09-01; 153(9), p. 911-914.
PMID: 28658470
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