A randomized clinical trial will be conducted to test the effectiveness of an interactive health education program in promoting skin cancer prevention and regular skin examination behaviors in middle-aged and elderly populations. The program will be evaluated with high-risk skin cancer patients, medium-risk internal medicine patients, and low-risk wellness program participants. The study will take place in a tertiary care medical center, a primary care office practice, and over a corporate intranet. Both CD-ROM and network based versions of the multimedia program will be tested. Program content includes information about skin cancer rates, skin examination methods, assistance in identifying lesions, instruction in how to repair sun-damaged skin, and advice about preventive strategies, as well as linkages to Internet-based health education sites. Behavior change and behavioral self-management methods are included in the program. Social marketing principles have also been used to promote, enable, and maintain skin protective and skin screening behaviors. Outcome measures will include skin cancer knowledge measures, stage of change categorizations, and self-efficacy ratings, along with patient record data on use of diagnostic and treatment services and related costs.
