Grant Number:	7DP2CA225433-02 Interpret this number
Primary Investigator:	Linos, Eleni
Organization:	Stanford University
Project Title:	Targeted Advertising for Cancer Prevention
Fiscal Year:	2017

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.




Qualitative exploration of melanoma awareness in black people in the USA.
Authors: de Vere Hunt I. , Owen S. , Amuzie A. , Nava V. , Tomz A. , Barnes L. , Robinson J.K. , Lester J. , Swetter S. , Linos E. .
Source: Bmj Open, 2023-01-11 00:00:00.0; 13(1), p. e066967.
EPub date: 2023-01-11 00:00:00.0.
PMID: 36631232
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Social Media for Public Health: Framework for Social Media-Based Public Health Campaigns.
Authors: de Vere Hunt I. , Linos E. .
Source: Journal Of Medical Internet Research, 2022-12-14 00:00:00.0; 24(12), p. e42179.
EPub date: 2022-12-14 00:00:00.0.
PMID: 36515995
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A Social Media‒Based Public Health Campaign Encouraging COVID-19 Vaccination Across the United States.
Authors: Hunt I.V. , Dunn T. , Mahoney M. , Chen M. , Nava V. , Linos E. .
Source: American Journal Of Public Health, 2022 09; 112(9), p. 1253-1256.
EPub date: 2022-07-07 00:00:00.0.
PMID: 35797502
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Impact of Sexual Harassment and Social Support on Burnout in Physician Mothers.
Authors: Linos E. , Lasky-Fink J. , Halley M. , Sarkar U. , Mangurian C. , Sabry H. , Linos E. , Jagsi R. .
Source: Journal Of Women's Health (2002), 2022 07; 31(7), p. 932-940.
EPub date: 2022-06-22 00:00:00.0.
PMID: 35730998
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Active Surveillance as a Management Option for Low-risk Basal Cell Carcinoma.
Authors: Linos E. , Chren M.M. .
Source: Jama Internal Medicine, 2021-08-01 00:00:00.0; 181(8), p. 1032-1033.
PMID: 34125141
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The Intersection of Work and Home Challenges Faced by Physician Mothers During the Coronavirus Disease 2019 Pandemic: A Mixed-Methods Analysis.
Authors: Halley M.C. , Mathews K.S. , Diamond L.C. , Linos E. , Sarkar U. , Mangurian C. , Sabry H. , Goyal M.K. , Olazo K. , Miller E.G. , et al. .
Source: Journal Of Women's Health (2002), 2021 04; 30(4), p. 514-524.
EPub date: 2021-03-23 00:00:00.0.
PMID: 33761277
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The Impact of the first COVID-19 shelter-in-place announcement on social distancing, difficulty in daily activities, and levels of concern in the San Francisco Bay Area: A cross-sectional social media survey.
Authors: Elser H. , Kiang M.V. , John E.M. , Simard J.F. , Bondy M. , Nelson L.M. , Chen W.T. , Linos E. .
Source: Plos One, 2021; 16(1), p. e0244819.
EPub date: 2021-01-14 00:00:00.0.
PMID: 33444363
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DYVIC: DYnamic VIrus Control in Peru.
Authors: Lossio-Ventura J.A. , Alatrista-Salas H. , Barrena K. , Linos E. , Nunez-Del-Prado M. , Talavera A. .
Source: Proceedings. Ieee International Conference On Bioinformatics And Biomedicine, 2020 Dec; 2020, p. 2264-2267.
EPub date: 2021-01-13 00:00:00.0.
PMID: 35462884
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Social media recruitment for mental health research: A systematic review.
Authors: Sanchez C. , Grzenda A. , Varias A. , Widge A.S. , Carpenter L.L. , McDonald W.M. , Nemeroff C.B. , Kalin N.H. , Martin G. , Tohen M. , et al. .
Source: Comprehensive Psychiatry, 2020 Nov; 103, p. 152197.
EPub date: 2020-08-12 00:00:00.0.
PMID: 32992073
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US Public Concerns About the COVID-19 Pandemic From Results of a Survey Given via Social Media.
Authors: Nelson L.M. , Simard J.F. , Oluyomi A. , Nava V. , Rosas L.G. , Bondy M. , Linos E. .
Source: Jama Internal Medicine, 2020-07-01 00:00:00.0; 180(7), p. 1020-1022.
PMID: 32259192
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Implications of the COVID-19 San Francisco Bay Area Shelter-in-Place Announcement: A Cross-Sectional Social Media Survey.
Authors: Elser H. , Kiang M.V. , John E.M. , Simard J.F. , Bondy M. , Nelson L.M. , Chen W.T. , Linos E. .
Source: Medrxiv : The Preprint Server For Health Sciences, 2020-07-01 00:00:00.0; , .
EPub date: 2020-07-01 00:00:00.0.
PMID: 32637974
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Sexual and Gender Minority Curricula Within US Dermatology Residency Programs.
Authors: Jia J.L. , Nord K.M. , Sarin K.Y. , Linos E. , Bailey E.E. .
Source: Jama Dermatology, 2020-05-01 00:00:00.0; 156(5), p. 593-594.
PMID: 32186684
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Development of a patient decision aid for the management of superficial basal cell carcinoma (BCC) in adults with a limited life expectancy.
Authors: Junn A. , Shukla N.R. , Morrison L. , Halley M. , Chren M.M. , Walter L.C. , Frosch D.L. , Matlock D. , Torres J.S. , Linos E. .
Source: Bmc Medical Informatics And Decision Making, 2020-04-29 00:00:00.0; 20(1), p. 81.
EPub date: 2020-04-29 00:00:00.0.
PMID: 32349762
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Association between financial links to indoor tanning industry and conclusions of published studies on indoor tanning: systematic review.
Authors: Adekunle L. , Chen R. , Morrison L. , Halley M. , Eng V. , Hendlin Y. , Wehner M.R. , Chren M.M. , Linos E. .
Source: Bmj (clinical Research Ed.), 2020-02-04 00:00:00.0; 368, p. m7.
EPub date: 2020-02-04 00:00:00.0.
PMID: 32019742
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Distinct Clinicopathological and Prognostic Features of Thin Nodular Primary Melanomas: An International Study from 17 Centers.
Authors: Dessinioti C. , Dimou N. , Geller A.C. , Stergiopoulou A. , Lo S. , Keim U. , Gershenwald J.E. , Haydu L.E. , Ribero S. , Quaglino P. , et al. .
Source: Journal Of The National Cancer Institute, 2019-12-01 00:00:00.0; 111(12), p. 1314-1322.
PMID: 30863861
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Association of Number of Indoor Tanning Salons With Neighborhoods With Higher Concentrations of Male-Male Partnered Households.
Authors: Chen R. , Hipp J.A. , Morrison L. , Henriksen L. , Swetter S.M. , Linos E. .
Source: Jama Network Open, 2019-10-02 00:00:00.0; 2(10), p. e1912443.
EPub date: 2019-10-02 00:00:00.0.
PMID: 31584678
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Gender Equity Improving among Award Winners and Leaders at the Society for Investigative Dermatology.
Authors: Shukla N. , Wehner M.R. , Morrison L. , Naik H.B. , Linos E. .
Source: The Journal Of Investigative Dermatology, 2019 Oct; 139(10), p. 2215-2217.
EPub date: 2019-08-22 00:00:00.0.
PMID: 31445922
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High Prevalence of Peripartum Depression Among Physician Mothers: A Cross-Sectional Study.
Authors: Choo E.K. , Girgis C. , Han C.S. , Simard J.F. , Adesoye T. , Linos E. , Mangurian C. , Physician Moms Group Study Group .
Source: The American Journal Of Psychiatry, 2019-09-01 00:00:00.0; 176(9), p. 763-764.
PMID: 31474130
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Decisions and repercussions of second victim experiences for mothers in medicine (SAVE DR MoM).
Authors: Gupta K. , Lisker S. , Rivadeneira N.A. , Mangurian C. , Linos E. , Sarkar U. .
Source: Bmj Quality & Safety, 2019 07; 28(7), p. 564-573.
EPub date: 2019-02-04 00:00:00.0.
PMID: 30718333
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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, 2019-05-15 00:00:00.0; , .
EPub date: 2019-05-15 00:00:00.0.
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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 00:00:00.0; , .
EPub date: 2019-04-10 00:00:00.0.
PMID: 30972743
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Motivations among sexual-minority men for starting and stopping indoor tanning.
Authors: Admassu N. , Pimentel M.A. , Halley M.C. , Torres J. , Pascua N. , Katz K.A. , Linos E. .
Source: The British Journal Of Dermatology, 2019-01-23 00:00:00.0; , .
EPub date: 2019-01-23 00:00:00.0.
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Physician mothers' experience of workplace discrimination: a qualitative analysis.
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Source: Bmj (clinical Research Ed.), 2018-12-12 00:00:00.0; 363, p. k4926.
EPub date: 2018-12-12 00:00:00.0.
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 00:00:00.0; , .
EPub date: 2018-12-04 00:00:00.0.
PMID: 30508419
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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 00:00:00.0; 154(12), p. 1385-1386.
PMID: 30347020
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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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Characteristics and Skin Cancer Risk Behaviors of Adult Sunless Tanners in the United States.
Authors: Dodds M. , Arron S.T. , Linos E. , Polcari I. , Mansh M.D. .
Source: Jama Dermatology, 2018-09-01 00:00:00.0; 154(9), p. 1066-1071.
PMID: 30046802
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Shingles and pneumonia and risk of cutaneous basal and squamous cell carcinoma.
Authors: Drucker A.M. , Li W.Q. , Cho E. , Li T. , Besdine R. , Qureshi A.A. , Linos E. .
Source: Journal Of The American Academy Of Dermatology, 2018-08-06 00:00:00.0; , .
EPub date: 2018-08-06 00:00:00.0.
PMID: 30092319
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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 00:00:00.0; 154(7), p. 757-758.
PMID: 29710117
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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 00:00:00.0; 20(6), p. e203.
EPub date: 2018-06-05 00:00:00.0.
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, 2018-05-09 00:00:00.0; , .
EPub date: 2018-05-09 00:00:00.0.
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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 Apr; 78(4), p. 663-672.e3.
EPub date: 2017-11-13 00:00:00.0.
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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 00:00:00.0; 154(4), p. 477-479.
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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 00:00:00.0; 17(4), p. 482-484.
PMID: 29601627
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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, 2018-03-20 00:00:00.0; , .
EPub date: 2018-03-20 00:00:00.0.
PMID: 29558531
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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, 2018-03-05 00:00:00.0; , .
EPub date: 2018-03-05 00:00:00.0.
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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 00:00:00.0; 319(6), p. 611-614.
PMID: 29450516
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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 00:00:00.0; 359, p. j5503.
EPub date: 2017-12-12 00:00:00.0.
PMID: 29233842
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Diversity in the dermatology workforce: 2017 status update.
Authors: Linos E. , Wintroub B. , Shinkai K. .
Source: Cutis, 2017 Dec; 100(6), p. 352-353.
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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.
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Types of Shade Vary in Protection Just Like Sunscreens.
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Source: Jama Dermatology, 2017-10-01 00:00:00.0; 153(10), p. 1070-1071.
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Correlation Among Cancer Incidence and Mortality Rates and Internet Searches in the United States.
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Source: Jama Dermatology, 2017-09-01 00:00:00.0; 153(9), p. 911-914.
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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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