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PURPOSE/OBJECTIVES: To investigate cancer surveillance behaviors of women at risk for hereditary breast and ovarian cancer (HBOC) who presented for clinical BRCA cancer susceptibility testing, specifically to describe cancer surveillance behaviors and reasons for not engaging in behaviors, compare surveillance behaviors with existing surveillance guidelines, and evaluate associations of cancer surveillance behaviors with BRCA results. DESIGN: Cross-sectional, descriptive. SETTING: Genetic risk-assessment programs in a National Cancer Institute-designated comprehensive cancer center and a community cancer center, both in the southwestern region of the United States. SAMPLE: Purposive sample of 107 at-risk women. METHODS: Self-report survey. MAIN RESEARCH VARIABLES: Breast and ovarian cancer surveillance behaviors and BRCA test results. FINDINGS: Ninety percent of participants had a personal history of breast cancer; 84% had a negative BRCA result. About 60% of participants engaged in at least the minimum recommended breast cancer surveillance behaviors, but 70% had suboptimal ovarian cancer surveillance behaviors. Lack of physician recommendation was the most frequently reported reason for not having surveillance procedures. BRCA results were not associated with the breast cancer surveillance categories and the ovarian cancer surveillance recommendations. CONCLUSIONS: Although most participants were not carriers of a mutation, the presence of other risk factors for breast and ovarian cancer dictates continued cancer surveillance. At-risk women may not be informed adequately about cancer surveillance. IMPLICATIONS FOR NURSING: Healthcare providers should be aware of changing breast and ovarian cancer surveillance recommendations and counsel their at-risk patients accordingly. [ABSTRACT FROM AUTHOR]

Background: Vietnamese Americans have a relatively high risk of developing diabetes at younger ages, yet there are no published studies exploring their risk perceptions., Objective: This mixed methods study describes perceived diabetes risk in the context of an underserved population., Methods: This study was guided by the Common-Sense Model of Self-Regulation. Snowball sampling was used to recruit 10 Vietnamese Americans with prediabetes and achieve data saturation. Qualitative and quantitative descriptive methodologies with data transformation were used to analyze data from semistructured interviews and questionnaires to explore the dimensions of perceived diabetes risk., Results: Participants were between the ages of 30 and 75 years with diversity also noted in diabetes risk factors. The 3 risk perception domains from qualitative data were risk factors, disease severity, and preventing diabetes. The main perceived diabetes risk factors were eating habits (including cultural influences), sedentary lifestyle, and family history of diabetes. Quantitative data supported qualitative findings of a low-to-moderate level of perceived diabetes risk. Despite the lower levels of perceived diabetes risk, Vietnamese Americans do believe that the severity of diabetes is a "big concern.", Conclusions: Vietnamese Americans with prediabetes have a low-to-moderate level of perceived diabetes risk. Understanding the perceived diabetes risk in this population provides a foundation for diabetes prevention interventions that consider cultural influences on diet and exercise., (©Angelina Nguyen, Marylyn Morris McEwen, Lois J Loescher. Originally published in the Asian/Pacific Island Nursing Journal (https://apinj.jmir.org), 14.04.2023.)

Decision simulation technology is known to augment health practitioner education and training; little is known about its use for educating lay health practitioners about cancer prevention. We report the development and evaluation of a decision simulation component of a skin cancer risk reduction electronic training (e-training) for massage therapists (MTs). Simulation facilitated tracking and analysis of MTs' selected dialog options leading to client-focused helping conversations (MT conversations intended to encourage client pro-health behavior) regarding skin cancer risk reduction. The tracking also enabled further assessment of the e-training competencies. We constructed five decision simulation cases in the DecisionSim™ online platform, mimicking MT-client encounters pertaining to skin cancer risk reduction, allowing MTs to apply training knowledge to initiate a helping conversation. We scored each simulation by tracking conversation pathways via selected dialog options (optimal, feedback required, suboptimal), analyzing total scores and real time spent on each case. MTs rated satisfaction with the simulations on a 5-point Likert scale. Eighty-one MTs completed the simulations in an average of 2.7 min. Most (91%) MTs selected feedback required or suboptimal dialog options for at least one of the five cases, often incorrectly choosing conversation statements reflecting their own feelings. The majority (86%) agreed/strongly agreed that they enjoyed the simulations (mean score 4.31); 92% found the simulations helpful to include in the training (mean score 4.36). Decision simulations integrated into e-training are useful for assessing lay practitioners' practical application of cancer risk reduction knowledge and skills and use of appropriate helping conversations., (© 2021. American Association for Cancer Education.)

Objectives: To describe the recruitment strategies and lessons learned when enrolling African American parents/caregivers of school-aged children (ages 6-12 years) in an online survey of physical activity. With physical activity serving as a modifiable behavioral risk factor for several chronic diseases (obesity and cardiovascular diseases), little is understood regarding the influences on African Americans' physical activity participation to develop culturally appropriate physical activity interventions. Gaining a better understanding of physical activity influences is possible through research, yet recruiting and enrolling African Americans in health research is a challenge., Methods: Over a three-month period, a multidimensional approach (distribution of flyers, community partnerships, network sampling, African American researcher, effective communication, and data collection procedures) was used for study recruitment., Results: We exceeded our recruitment goal of 105 participants. A total of 127 African American parent/caregivers of school-aged children enrolled, which included both females/mothers ( n  = 87, 69%) and males/fathers ( n  = 40, 31%). Network sampling was the single most effective recruitment strategy for reaching this population. Lessons learned in this study includes considering participant burden and their comfort with technology, as well as gaining community trust., Discussion: Lessons learned in recruiting African American parents provides a guide for future research. Efforts are needed to further increase the representation of African American males in health research.

Objective: To investigate consumer preference and willingness to pay for mobile teledermoscopy services in Australia., Methods: Consumers who were taking part in a randomised controlled trial comparing mobile teledermoscopy and skin self-examination were asked to complete a survey which incorporated a discrete choice experiment (DCE) and a contingent valuation question. Responses were used to determine their willingness to pay for mobile teledermoscopy services in Australia and their overall service preferences., Results: The 199 consumers who responded were 71% female and had a mean age of 42 years (range, 18-73). The DCE results showed that consumers prefer a trained medical professional to be involved in their skin cancer screening. Consumers were willing to pay AUD 41 to change from a general practitioner reviewing their lesions in-person to having a dermatologist reviewing the teledermoscopy images. Additionally, they were willing to pay for services that had shorter waiting times, that reduced the time away from their usual activities, and that have higher accuracy and lower likelihood of unnecessary excision of a skin lesion. When asked directly about their willingness to pay for a teledermoscopy service using a contingent valuation question, the majority (73%) of consumers selected the lowest two value brackets of AUD 1-20 or AUD 21-40., Conclusion: Consumers are willing to pay out of pocket to access services with attributes such as a dermatologist review, improved accuracy, and fewer excisions., (© 2021 The Author(s) Published by S. Karger AG, Basel.)

Background: Stress resulting from intimate partner violence (IPV) on pregnant women causes and sustains poor health and contributes to poor pregnancy and birth outcomes. Appropriate interventions to reduce stress in this population of women are warranted., Objective: To present a systematic review and the state of the science of evidence on alternate nostril breathing (ANB) as a holistic intervention for stress reduction for pregnant survivors of IPV, framed by complex adaptive systems theory and psychoneuroimmunology., Data Sources: Eight databases and reference lists of potential articles., Study Eligibility Criteria: Randomized controlled trials published between January 2013 and July 2019., Participants: Adults., Intervention: ANB., Study Appraisal and Synthesis Method: PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines., Results: ANB is effective in reducing stress, as measured by psychological and biological indicators., Limitations: Studies were limited in ethnic and gender diversity, most of the populations being Asian Indian and predominately male., Conclusions: Use of ANB as a safe and effective holistic intervention for stress reduction shows promise, but research in pregnant survivors of IPV is limited., Implications: Stress reduction benefits may be significant for pregnant survivors of IPV and their fetuses, with minimal risk.

Introduction: Text messaging is an effective way to reach large populations with health promotion support. This study aims to establish the optimal text messaging intervention to achieve behavior change in young adults at risk of skin cancer., Study Design: Latin square crossover RCT., Setting/participants: Participants were women and men aged 18-40 years living in Queensland, Australia who owned a smartphone and had ≥2 skin cancer risk factors., Intervention: Participants were enrolled from December 2018 to February 2019 and completed an eligibility survey. Eligible participants were randomized to 4 different text message interventions using a Latin square design with varying personalization, interactivity, and message frequency (February 2019‒July 2019). Each intervention lasted for 1 month; between interventions, participants had a 1-week washout period in which they completed an online questionnaire. Participants completed a 6-month follow-up online survey in January 2020., Main Outcome Measures: Measures included self-reported sun protection habits and sunburns., Results: A total of 277 (71.2% response rate) participants completed the 6-month follow-up. The sun protection habits index was significantly higher in all the 4 text messaging interventions (p<0.01 for each intervention) than at baseline, with similar sun protection habits improvements among all interventions (p=0.27). Sunburn rates decreased significantly over time (p<0.01 each intervention), with all the 4 interventions achieving reductions in sunburn rates during the intervention periods (p=0.78). Overall, the sunburn rates decreased from 40.3% at baseline to 7.0% at the end of the intervention, and at 6-month follow-up, it remained significantly below baseline levels at 23.5% (p<0.01)., Conclusions: Regular text messaging interventions result in significantly increased sun protection and decreased sunburn in young adults., Trial Registration: This study is registered at the Australian and New Zealand Clinical Trials Registry ACTRN12618001299291., (Copyright © 2021 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.)

Purpose: 1) Provide background information on the PhD-DNP dual doctoral degree, specifically historical perspectives and existing programs; 2) Describe one PhD-DNP program as an exemplar to illustrate program data challenges and solutions; and 3) Discuss the national landscape of the dual doctoral degree program., Principal Results: PhD-DNP dual doctoral degree programs have existed for 10 years; there are five known programs nationally. Reported here for one dual doctoral degree program are data collected from the program's inception (2010) through 2019. These data include demographic program characteristics, time to degree, and achievements during and after the program. Challenges pertaining to mentorship, progression to degree, socialization and student productivity also are described. Strategies for moving the dual degree forward nationally depend on a collaborative effort for data generation and collection from existing PhD-DNP programs. These data can be instrumental for seeking funding for dual doctoral degree programs., Conclusions: The dual PhD-DNP degree has not yet gained a foothold nationally. There is demand for the program by nursing doctoral students and availability of these programs is slowly increasing. National nursing leaders and organizations can consider developing metrics and collecting data that will lend support to future funding initiatives for the dual degree., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Background: Nursing doctoral education now includes an option with a growing national interest: the PhD-DNP dual degree. Although programs have existed for 10 years, little is known about experiences of dual PhD-DNP degree nursing students (DDNS) during doctoral education, including their perceptions of mentorship during coursework, comprehensive exams, and dissertation readiness., Objective: To explore and describe the experiences of DDNS during hybrid dual doctoral education at one Southwestern university., Method: Using a qualitative descriptive design, DDNS (n = 4) at a Southwestern university were interviewed about their experiences during coursework and comprehensive examinations., Results: Three categories fundamental to DDNS were identified through an inductive and deductive iterative process: coursework experiences, including the key findings of in-betweenness and isolation; mentorship; and comprehensive examination experience. Categories of dissertation readiness and DDNS recommendations were inductively derived., Conclusion: Current interest in the PhD-DNP dual degree underscores the importance of knowing more about the experiences of DDNS. The key findings of in-betweenness and isolation have previously not been described in the nursing literature and need to be considered for the DDNS. Facilitators and inhibitors, mentorship experiences, and mentor attributes affect progression of DDNS through coursework. Strategies for success for DDNS, faculty and program success are provided., Competing Interests: Declaration of competing interest The authors have no conflicts of interest to disclose. This work was funded by the University of Arizona Graduate College., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Background and Purpose: Skin cancer, the most commonly diagnosed cancer in the United States, is a serious health care concern. Early skin cancer detection improves prognosis; most common early detection approach is a comprehensive clinical skin examination (CSE). A CSE consists of skin cancer risk assessment, head-to-toe skin examination, and skin lesion assessment. Nurse practitioners (NPs) currently lack adequate training and confidence to conduct CSE. The goal of this systematic review was to learn more about published interventions targeting CSE training for primary care NPs and/or other primary care providers. The findings were categorized based on the established procedures for intervention development., Methods: The databases PubMed, Google Scholar, CINAHL, and Web of Science were searched. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, 10 articles were selected for data extraction., Conclusions: There is a paucity of articles that report rigorously developed interventions aimed at educating primary care NPs to conduct CSE. Existing CSE interventions were not tested for efficacy or effectiveness, and the implementation methods were weak or not reported. A synthesis of the review findings revealed inadequately reported sample characteristics, vague intervention goals, unspecified frequency or duration of interventions, and lack of standardized intervention protocols., Implications for Practice: This review builds a foundation for more rigorously developed interventions to improve CSE and provides guidance for NPs to select education on CSE and other clinical foci. Future research will guide the development and evaluate the effectiveness of CSE education, which ultimately could improve skin cancer prognosis interventions and lack of standardized intervention protocols.

Introduction: The purpose of this systematic review was to explore perceived diabetes risk with foci on prediabetic persons and Asian Americans. Persons with prediabetes and of Asian descent are at higher risk for developing diabetes, but little is known about their perceived diabetes risk. Method: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guided this systematic review. Electronic searches were conducted in three databases. The authors conducted eligibility determination, data extraction, synthesis, and evaluation. Twelve articles were selected. Results: Key findings include (1) limited studies including Asian populations, (2) a low percentage of persons in the general population with moderate to high levels of perceived diabetes risk, (3) a lack of congruency between actual and perceived diabetes risk in the general population, and (4) no interventions effectively changing the level of perceived diabetes risk. Discussion: More studies regarding perceived diabetes risk are needed, especially with a focus on Asian Americans.

Background: Skin self-examinations supplemented with mobile teledermoscopy might improve early detection of skin cancers compared with naked-eye skin self-examinations. We aimed to assess whether mobile teledermoscopy-enhanced skin self-examination can improve sensitivity and specificity of self-detection of skin cancers when compared with naked-eye skin self-examination., Methods: This randomised, controlled trial was done in Brisbane (QLD, Australia). Eligible participants (aged ≥18 years) had at least two skin cancer risk factors as self-reported in the eligibility survey and had to own or have access to an iPhone compatible with a dermatoscope attachment (iPhone versions 5-8). Participants were randomly assigned (1:1), via a computer-generated randomisation procedure, to the intervention group (mobile dermoscopy-enhanced self-skin examination) or the control group (naked-eye skin self-examination). Control group and intervention group participants received web-based instructions on how to complete a whole body skin self-examination. All participants completed skin examinations at baseline, 1 month, and 2 months; intervention group participants submitted photographs of suspicious lesions to a dermatologist for telediagnosis after each skin examination and control group participants noted lesions on a body chart that was sent to the research team after each skin examination. All participants had an in-person whole-body clinical skin examination within 3 months of their last skin self-examination. Primary outcomes were sensitivity and specificity of skin self-examination, patient selection of clinically atypical lesions suspicious for melanoma or keratinocyte skin cancers (body sites examined, number of lesions photographed, types of lesions, and lesions missed), and diagnostic concordance of telediagnosis versus in-person whole-body clinical skin examination diagnosis. All primary outcomes were analysed in the modified intention-to-treat population, which included all patients who had a clinical skin examination within 3 months of their last skin self-examination. This trial was registered with the Australian and New Zealand Clinical Trials Registry, ACTRN12616000989448., Findings: Between March 6, 2017, and June 7, 2018, 234 participants consented to enrol in the study, of whom 116 (50%) were assigned to the intervention group and 118 (50%) were assigned to the control group. 199 participants (98 participants in the intervention group and 101 participants in the control group) attended the clinical skin examination and thus were eligible for analyses. Participants in the intervention group submitted 615 lesions (median 6·0 per person; range 1-24) for telediagnosis and participants in the control group identified and recorded 673 lesions (median 6·0 per person; range 1-16). At the lesion level, sensitivity for lesions clinically suspicious for skin cancer was 75% (95% CI 63-84) in the intervention group and 88% (95% CI 80-91) in the control group (p=0·04). Specificity was 87% (95% CI 85-90) in the intervention group and 89% (95% CI 87-91) in the control group (p=0·42). At the individual level, the intervention group had a sensitivity of 87% (95% CI 76-99) compared with 97% (95% CI 91-100) in the control group (p=0·26), and a specificity of 95% (95% CI 90-100) compared with 96% (95% CI 91-100) in the control group. The overall diagnostic concordance between the telediagnosis and in-person clinical skin examination was 88%., Interpretation: The use of mobile teledermoscopy did not increase sensitivity for the detection of skin cancers compared with naked-eye skin self-examination; thus, further evidence is necessary for inclusion of skin self-examination technology for public health benefit., Funding: National Health and Medical Research Council (Australia)., (Copyright © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license. Published by Elsevier Ltd.. All rights reserved.)

Background: Previous cross-sectional research indicates high acceptance of mobile teledermoscopy-enhanced skin self-examination (SSE) by consumers based on the technology acceptance model (TAM) domains: perceived usefulness, ease of use, compatibility, attitude and intention, subjective norms, facilitator, and trust. However, no study has assessed this outcome longitudinally among people who actually used the technology in their own homes., Methods: Participants were living in Brisbane, Australia, aged 18 years or older, and at high risk of skin cancer. Participants randomly assigned to the intervention group (n = 98) completed a self-administered questionnaire on mobile teledermoscopy acceptance for skin cancer detection both before use and after performing mobile teledermoscopy-enhanced SSE in their homes. The survey included a 25-item scale assessing seven TAM domains. Item scores ranged from 5 (strongly agree) to 1 (strongly disagree). Participants also answered survey questions on satisfaction with use of teledermoscopy, and a 9-item "thoughts about melanoma" scale that measures cancer worry., Results: Participants were 19-73 years old, had high skin cancer risk, blue or grey eyes (53.1%), fair or very fair skin (88.8%), and previous skin cancer treatments (61.2%). Participants were more accepting of mobile teledermoscopy at baseline: mean TAM score of 4.15 (SE 0.05); their level of acceptance decreased significantly after teledermoscopy use: mean score 3.94 (SE 0.05; p = 0.001). In linear regression analysis, the decrease in TAM scores was similar across demographic and skin cancer risk categories. Ninety-two percent (n = 90) of participants agreed that mobile teledermoscopy was easy to use. The mean score of the "thoughts about melanoma" scale did not change significantly from baseline to follow-up., Conclusion: Consumers had high TAM scores before they used mobile teledermoscopy within a randomised control trial. At the end of the intervention period, TAM scores decreased, although participants' average score still indicated "agreement" that mobile teledermoscopy was acceptable., (© 2020 S. Karger AG, Basel.)

Background: Skin cancer, the most common cancer in the United States, is costly and potentially deadly. Its burden can be reduced by early detection and prevention activities. The scope of skin cancer requires going beyond traditional health care providers to promote risk reduction. Partnering with the nonbiomedical workforce, such as massage therapists (MTs), may reach more individuals at risk. MTs see much of their clients' skin and are amenable to performing skin cancer risk reduction activities during massage appointments., Objective: The objective of this study is to describe the Massage Therapists Skin Health Awareness, Referral, and Education protocol, presenting an overview of our systematic approach to developing rigorous e-training for MTs to enable them to be partners in skin cancer risk reduction. We also describe procedures for usability and feasibility testing of the training., Methods: We developed an integrated electronic learning system that includes electronic training (e-training) technology, simulated client interactions, online data collection instruments, and in-person assessment of MTs' application of their training., Results: A total of 20 participants nationally scored the e-training as high for usability and satisfaction. We have screened an additional 77 MTs in Arizona for interest and eligibility, and currently have 37 enrolled participants, of whom 32 have completed the Web-based training., Conclusions: The structured and rigorous development approach for this skin cancer risk reduction and brief behavioral intervention e-training for MTs begins to fill a gap in skin cancer risk reduction research. Iterative usability testing of our asynchronous Web-based training resulted in positive participant response. Our e-training approach offers greater learner accessibility, increased convenience, and greater scalability than the few existing programs and has the potential to reach many MTs nationally., International Registered Report Identifier (irrid): DERR1-10.2196/13480., (©Lois J Loescher, Kelly M Heslin, Laura A Szalacha, Graciela E Silva, Myra L Muramoto. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 15.05.2019.)

The incidence of skin cancer is raising in Hispanics/Latinos, which is a concern for Hispanics/Latinos living in Arizona, a state with a high amount of ultraviolet radiation exposure. There is a dearth of research on skin cancer prevention education for Hispanic/Latino adolescents in high school. Using a community-based participatory research (CBPR) framework, academic and community partners conducted a project to adapt an existing efficacious skin cancer prevention program, Project Students are Sun Safe (SASS) and the current SASS online training model, for dissemination to predominantly Hispanic/Latino students attending high schools in rural southeastern Arizona, located along the Arizona-Mexico border. We assessed the feasibility of training some of these students as peer educators (n = 16) to implement the "Border SASS" lesson to their peers in high school classrooms (n = 198). Border SASS training and the classroom lesson were feasible for, and highly acceptable to, peer educators and classroom students. These students significantly improved skin cancer prevention knowledge scores and self-reported skin cancer prevention behaviors over a 3- to 4-month period post training and the intervention implementation. Here we report on the following: (1) academic-community partnership and adaptation of the SASS training model for rural Hispanic high school students, (2) training of the high school peer educators, (3) administration of the SASS lesson by the trained peer educators to high school students, and (4) further evaluation of peer educator training and classroom student outcomes.

Objective: The aim of the study is to evaluate healthcare practitioners' views on and satisfaction with (i) digital image acquisition and storage and (ii) store-and-forward teledermoscopy services for the diagnosis of skin cancer in their clinical practice., Methods: An online survey was conducted among 59 healthcare practitioners (GPs ( n =17), dermatologists ( n =22), dermatology registrars ( n =18), a dermatology research fellow ( n =1) and a plastic surgeon ( n =1)) to assess usability of digital image acquisition and storage for when the imaging process is conducted by the healthcare practitioners themselves, or by their patients. The study identifies the enablers and barriers of this emerging mode of medical practice. A thematic analysis was used to extract key themes from open-ended responses, which involved identifying themes and patterns within and across participants., Results: Thirty-four healthcare practitioners (58%) had previously used a mobile dermatoscope within their practice. Participants most appreciated its use in their practice for lesion monitoring (59%) and record keeping (39%). Challenges reported were the increased time to support the additional workload (45%), technical issues (33%) and cost of equipment (27%). Practitioners were unsure (36%) or did not advocate teledermoscopy for direct-to-consumer use (41%). Only 23% supported the use of direct-to-consumer teledermoscopy., Conclusion: While most practitioners are receptive to mobile teledermoscopy, there was less support for patient-initiated use, whereby the patient controls the imaging process. As technology improves rapidly it is important to evaluate practitioners' acceptance and satisfaction of evolving telehealth services, moving forward with models of practice where healthcare practitioners and other healthcare providers will feel comfortable engaging in telehealth services.

Patients often detect melanoma themselves; therefore, regular skin self-examinations (SSEs) play an important role in the early detection and prompt treatment of melanoma. Mobile teledermoscopy is a technology that may facilitate consumer SSEs and rapid communication with a dermatologist. This paper describes the planned randomised controlled trial of an intervention to determine whether mobile technologies can help improve the precision of SSE in consumers. A randomised controlled trial will be conducted to evaluate mobile teledermoscopy-enhanced SSE versus naked-eye SSE. Participants in each group will conduct three home whole-body SSEs at baseline, 1 and 2 months, then present for a clinical skin examination (CSE) by a doctor after the 2-month SSE. Specifically, participants will identify skin lesions that meet the AC (asymmetry and colour) rule for detecting a suspicious skin spot. The primary outcomes are sensitivity and specificity of the skin lesions selected by the participants as needing attention by a doctor, compared to the clinical diagnosis by the dermatologist that will serve as the reference standard for this analysis. For the mobile teledermoscopy-enhanced SSE group, researchers will assess the number, location and type of lesions (1) sent by the participant via mobile teledermoscopy, (2) found at CSE or (3) missed by the participant. For the naked-eye SSE group, researchers will assess the number, location and type of lesions (1) recorded on their body chart by the participant, (2) found at CSE or (3) missed by the participant. Secondary outcomes are based on participants' self-reported data via online questionnaires., (© 2018 S. Karger AG, Basel.)

Background: Mobile teledermoscopy may facilitate skin self-examinations (SSEs) and further improve monitoring and detection of melanoma., Objective: To assess consumer acceptability and expectations of a mobile health app used to: (i) instruct SSE and (ii) conduct consumer-performed mobile teledermoscopy., Methods: People aged 18 years and above were invited to participate in either (i) an online survey or (ii) focus group in Brisbane, Australia. Participants were asked about their SSE practices, mobile teledermoscopy acceptance, and app design and functionality. The online survey responses and focus group discussions were coded by two researchers who conducted thematic analysis., Results: Four focus groups were held with a total of 28 participants; 88 participants completed the online survey. The mean ages of participants in the focus group and online survey were 46 and 38 years, respectively. There were more males in the focus groups (61%, 17/28) compared to the online survey (19%, 17/88). Regular SSEs were conducted by 56 (64%) of the online survey participants. Barriers to SSE were forgetfulness (44%), low self-perceived risk of melanoma (25%) and low confidence in conducting SSEs (25%). The large majority of online survey participants (95%) would consider sending photos of their skin lesions to a medical practitioner via an app. Focus group participants reported that they would accept using mobile teledermoscopy; however, they would prefer to use it to monitor lesions between face-to-face consultations., Conclusions: Overall, participants had positive views on using mobile teledermoscopy to send images of skin lesions to a dermatologist or other medical practitioner., (© 2018 S. Karger AG, Basel.)

Introduction Internationally, teledermoscopy has been found to have clinical and economic efficacy. This study aims to identify the attributes of a mobile teledermoscopy service that consumers prefer. This preliminary study was set within a broader randomised control trial (RCT) investigating the effectiveness of direct to consumer mobile teledermoscopy. Methods We undertook a discrete choice experiment (DCE). The DCE comprised 24 choice sets, divided into in two blocks of 12. For each choice set, respondents were asked to make discrete choices between two opt-out choices and two skin cancer screening service options described by seven attributes. A mixed logit model was used to estimate preferences for skin cancer screening services. Consumer preferences weights were used to calculate marginal willingness-to-pay (WTP) for skin cancer screening services. Results The DCE was completed by 113 consumer respondents. Consumers' preference for dermatologist involvement in their diagnosis, increased accuracy, and reduced excisions were all statistically significant in driving choice between service models. Consumers preferred having a professional involved in their skin cancer screening, rather than performing a self-examination. Consumers were only WTP $1.18 to change from a GP visit to mobile teledermoscopy (diagnosis using a phone camera). However, they were WTP $43 to have their results reviewed by a dermatologist rather than a GP, and $117 to increase the chance of detecting a melanoma if it was present from 65-75% to 95%. Conclusion Skin cancer screening services which are delivered by health professionals, rather than skin self-examination, are preferred by consumers. Consumers were willing to pay for their preferred skin cancer screening method, especially if a dermatologist was involved.

Background: Skin cancer is the most common cancer in the US. Training massage therapists (MTs) in skin cancer prevention and detection creates opportunity for reducing skin cancer burden. Little is known about MTs' perceptions of skin cancer prevention and detection, their discussions of these topics with clients, or their referral recommendations for suspicious skin lesions., Purpose: We surveyed MTs' perceptions of their role in engaging in conversations about skin cancer prevention, viewing the skin for suspicious lesions, and referring clients with such lesions to health care providers., Setting Participants Research Design: We administered an online survey from 2015-2017 of licensed MTs practicing in the US and at least age 21 years (n = 102); quantitative and qualitative data were analyzed in 2017., Main Outcome Measures: The main variables assessed were MTs perceptions of (a) appropriateness for asking clients about skin cancer history, skin cancer prevention, suspicious lesion referral and follow-up; and (b) comfort with recognizing and discussing suspicious lesions, recommending a client see a doctor for suspicious lesion, and discussing skin cancer prevention., Results: Quantitative data revealed that most MTs were amenable to discussing skin cancer prevention during appointments; few were engaging in these conversations. MTs were more comfortable discussing suspicious lesions and recommending that a client see a doctor than they were sharing knowledge about skin cancer and sun safety. Categories based on qualitative content analysis were: sharing information for the client's benefit, and concerns about remaining within scope of practice., Conclusions: MTs have boundaries for skin cancer risk-reduction content to include in a client discussion and remain in their scope of practice. These findings will help support a future educational intervention for MTs to learn about and incorporate skin cancer risk-reduction messages and activities into their practice., Competing Interests: CONFLICT OF INTEREST NOTIFICATION The authors declare there are no conflicts of interest. The Skin Cancer Institute did not have any role in the study design; collection, analysis, and interpretation of data; writing the report; or the decision to submit the report for publication.

Objective: To systematically review healthy lifestyle interventions targeted to adolescents and delivered using text messaging (TM)., Data Source: PubMed, Embase, CINAHL, PsycINFO, and Web of Science databases. Study Inclusion Criteria: Research articles published during 2011 to 2014; analyses focused on intervention targeting adolescents (10-19 years), with healthy lifestyle behaviors as main variables, delivered via mobile phone-based TM., Data Extraction: The authors extracted data from 27 of 281 articles using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses method., Data Synthesis: Adolescent and setting characteristics, study design and rigor, intervention effectiveness, challenges, and risk of bias., Results: Across studies, 16 (59.3%) of 27 included non-Caucasians. The gender was split for 22 (81.5%) of 27 studies. Thirteen studies were randomized controlled trials. There was heterogeneity among targeted conditions, rigor of methods, and intervention effects. Interventions for monitoring/adherence (n = 8) reported more positive results than those for health behavior change (n = 19). Studies that only included message delivered via TM (n = 14) reported more positive effects than studies integrating multiple intervention components. Interventions delivered using TM presented minimal challenges, but selection and performance bias were observed across studies., Conclusion: Interventions delivered using TM have the potential, under certain conditions, to improve healthy lifestyle behaviors in adolescents. However, the rigor of studies varies, and established theory and validated measures have been inconsistently incorporated.

Background: Social cognitive theory (SCT) proposes that personal and environmental factors influence behavior bidirectionally. Research examining the personal and environmental factors of physical activity (PA) among African Americans (AAs) framed by SCT is scarce., Purpose: The purpose of this article is to enhance knowledge of SCT as a foundation for health promotion and PA research, in general, and among AAs. Findings from a previous study provide exemplars for key factors and relationships in SCT., Implications for Research and Practice: The SCT serves as a good framework for researchers studying health promotion and PA in generalamong AA parents.

Background and Purpose: Skin cancer is the most common malignancy in the United States; early detection reduces the public health burden. This systematic review updates the state of advanced practice nurses' skin cancer knowledge and attitudes, performance of and barriers to clinical skin examination (CSE), recognition of skin lesions, and related training activities., Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement guided a search of eight literature databases that yielded 12 studies from 2010 to 2016. The United States Preventive Services Task Force's Levels of Certainty guided evidence assessment., Conclusions: The studies mainly targeted or included nurse practitioners. Collectively, participants had variable, suboptimal skin cancer knowledge, even after an intervention. A slight majority performed CSE during annual visits but agreed that CSE was important and within their scope of practice. Major CSE barriers were lack of time, training, and confidence. Participants who received training were more proficient in identifying suspicious versus benign lesions. Few skin cancer detection training opportunities for nurses exist., Implications: The level of certainty of the evidence for skin cancer detection by advanced practice nurses and their impact on the skin cancer problem remain low. These nurses would benefit from accessible and efficacious CSE and lesion training.

Purpose The purpose of this study was to describe Sub-Saharan African immigrants' health-illness transition experiences associated with type 2 diabetes mellitus (T2DM) self-management. Methods A qualitative description methodology was used in this study. Face-to-face semi-structured in-depth interviews lasting 60 to 90 minutes were conducted with 10 Sub-Saharan African immigrant men and women with T2DM recruited using purposive and snowball sampling. Each interview was audio-taped, transcribed, and analyzed using qualitative content analysis. Results Participants' mean age was 60.3 years (range, 44-76 years), 5 men and 5 women; most had lived in the US for more than 10 years (70%) and with T2DM for more than 5 years (60%). Four overarching domains described the health-illness transition experiences the participants had with T2DM self-management: (1) knowledge of T2DM self-management behaviors, (2) current T2DM self-management behaviors, (3) inhibitors of T2DM self-management, and (4) facilitators of T2DM self-management. Conclusions Health professionals should be equipped with an understanding of the properties and conditions of health-illness transition. This understanding is necessary to build a foundation that facilitates healthy adaptation to the T2DM transition requiring the development and mastery of new skills consistent with gaining control of T2DM. Culturally tailored interventions need to be developed to decrease inhibitors of and encourage self-management in daily T2DM care for Sub-Saharan African immigrants with T2DM.

Background: Mobile teledermoscopy allows consumers to send images of skin lesions to a teledermatologist for remote diagnosis. Currently, technology acceptance of mobile teledermoscopy by people at high risk of melanoma is unknown., Objectives: We aimed to determine the acceptance of mobile teledermoscopy by consumers based on perceived usefulness, ease of use, compatibility, attitude/intention, subjective norms, facilitators and trust before use. Consumer satisfaction was explored after use., Methods: Consumers aged 50-64 years at high risk of melanoma (fair skin or previous skin cancer) were recruited from a population-based cohort study and via media announcements in Brisbane, Australia in 2013. The participants completed a 27-item questionnaire preteledermoscopy modified from a technology acceptance model. The first 49 participants with a suitable smartphone then conducted mobile teledermoscopy in their homes for early detection of melanoma and were asked to rate their satisfaction., Results: The preteledermoscopy questionnaire was completed by 228 participants. Most participants (87%) agreed that mobile teledermoscopy would improve their skin self-examination performance and 91% agreed that it would be in their best interest to use mobile teledermoscopy. However, nearly half of participants (45%) were unsure about whether they had complete trust in the telediagnosis. The participants who conducted mobile teledermoscopy (n = 49) reported that the dermatoscope was easy to use (94%) and motivated them to examine their skin more often (86%). However, 18% could not take photographs in hard-to-see areas and 35% required help to submit the photograph to the teledermatologist., Conclusions: Mobile teledermoscopy consumer acceptance appears to be favourable. This new technology warrants further assessment for its utility in the early detection of melanoma or follow-up., (© 2016 British Association of Dermatologists.)

Purpose: The objectives of this pilot study for women breast cancer survivors with lymphedema was 1) to evaluate recruitment rates, retention rates, adherence to Bowenwork (a noninvasive complementary therapy involving gentle muscle movements), home exercises, safety and comfort; 2) determine the effect of Bowenwork on quality of life (QOL), functional status, perceived pain, range of motion (ROM), arm/ankle circumference (to assess for localized and systemic changes)., Methods: Participants received 4 Bowenwork sessions with home exercises. Initial and post assessments included QOL, functional status, and pain. ROM, arm/ankle circumference and pain measures were recorded before each session., Results: Twenty-one women enrolled in the study; 95% completion; adherence 100%; home exercises 95%; no adverse events. The intervention improved mental health (SF-36-MCS); breast cancer-related functional (FACT-B); increased ROM; reduced arm circumferences. P value set at <0.05., Conclusions: The Bowenwork intervention was safe and acceptable for women breast cancer survivors with lymphedema., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Objective: Print-based health promotion interventions are being phased out to bring forth more appealing and assessable new technology applications. This review aimed to evaluate the current literature on the use of mobile text messaging and similar electronic technology interventions in the area of skin cancer prevention., Method: A search of studies guided by Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) was conducted on mobile technology interventions for improving skin cancer prevention in the electronic databases PubMed, MEDLINE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and PsycINFO., Results: Overall, 136 articles were screened for eligibility between 2001 (earliest relevant article found) and November 2015. Eight studies fulfilled the inclusion criteria and were reviewed according to the PRISMA guidelines. Of these, five were randomised controlled trials (RCTs), two were controlled clinical trials, and one was a cohort study. Five studies used text messages as an intervention, two used mobile phone applications, and another used electronic messages via email. All studies resulted in self-reported behaviour change in at least one of their outcome measures (e.g., sunscreen application, seeking shade)., Conclusion: While the behaviour change outcomes are promising, the lack of change in more objective measures such as sunburn indicates a need to further improve mobile phone technology-delivered interventions in order to have a greater impact on skin cancer prevention. Future studies may consider the use of objective outcome measures (e.g., sunscreen weight), electronic diaries, or behavioural outcomes in social networks., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Purpose: To conduct a pilot survey to assess acceptance of mobile teledermoscopy (MTD) by primary care nurse practitioners (NPs) working in Arizona., Data Sources: Sixty-two participants recruited from NP and academic listservs in Arizona completed an online survey prefaced by a MTD definition, device photographs, and a practice case, followed by 33 items measuring Teledermatology Technology Acceptance Model (TeleTAM) constructs., Conclusions: Participants were highly interested in using MTD to assess skin lesions. They perceived MTD utility to greatly improve diagnosis and positively impact their practice. Most participants had never used MTD, but had high mean scores for MTD attitude and moderate scores for MTD perceived ease of use, perceived use, and facilitators of MTD. They had moderate scores for intention to use MTD. The construct facilitators (organizational infrastructure) were most strongly associated with intention to use MTD. Cronbach alphas were 0.70 or higher for all subscales except compatibility and habit., Implications for Practice: Moderate acceptance of MTD may reflect NPs' knowledge of the technology, self-confidence for using it, or MTD financial constraints. Future research will address these factors to foster use of MTD by NPs, thereby improving patients' access to early skin lesion assessment and diagnosis., (©2015 American Association of Nurse Practitioners.)

Skin cancer is the most common cancer in the USA and is increasing in children and young adults. Adolescents are an important target population for sun-safety interventions with ultraviolet radiation as the strongest risk factor for developing skin cancer. Schools are an ideal setting to intervene with adolescents. A novel Arizona skin cancer prevention in-class education-activity program, Project 'Students are Sun Safe' (SASS), was designed to be delivered by university students for middle school and high school students. Participant students completed the pre- and post-program tests and a satisfaction questionnaire; teachers completed reviews. The evaluation examined the program's influence on participants' sun-safety knowledge, perceptions, and behaviors; satisfaction with the program; and intent to change. After exposure to Project SASS, participants were more likely to perceive a high risk of skin cancer, report negative attitudes toward tanned skin, and answer knowledge-based questions correctly. There were minimal differences in self-reported sun-safety behaviors, though participants did report intent to change. Both participants and teachers were satisfied with the program. Project SASS appears to be an effective sun-safety program for middle school and high school students for knowledge and perceptions, and the results confirm that appropriately tailoring program components to the target population has strong potential to impact adolescent perceived susceptibility, knowledge, and behavioral intent. The strengths and weaknesses of Project SASS have many implications for public health practice, and Project SASS may hold promise to be a model for skin cancer prevention in adolescents.

Background: Early detection by skin self-examination (SSE) could improve outcomes for melanoma. Mobile teledermoscopy may aid this process., Objectives: To establish the clinical accuracy of SSE plus mobile teledermoscopy vs. clinical skin examination (CSE) and to test whether providing people with detailed SSE instructions improves accuracy., Methods: Men and women aged 50-64 years (n = 58) performed SSE plus mobile teledermoscopy in their homes between May and November 2013 and were given technical instructions plus detailed SSE instructions (intervention) or technical instructions only (control). Within 3 months, they underwent a CSE. Outcome measures included (i) body sites examined, lesions photographed, and missed; (ii) sensitivity of SSE plus mobile teledermoscopy vs. in-person CSE using either patients or lesions as denominator; and (iii) concordance of telediagnosis with CSE., Results: Overall 49 of 58 randomized participants completed the study, and submitted 309 lesions to the teledermatologist. Intervention-group participants were more likely to submit lesions from their legs compared with controls (P = 0·03), with no other differences. Eleven participants (22%) did not photograph 14 pigmented lesions that the dermatologist considered worthwhile photographing or monitoring. The sensitivity of SSE plus mobile teledermoscopy was 82% using the patient as denominator and 42% using the lesion as denominator. There was substantial agreement between telediagnosis and CSE (κ = 0·90), accounting for differential diagnoses., Conclusions: SSE plus mobile teledermoscopy is promising for surveillance of particular lesions even without detailed SSE instructions. However, in the format tested in this study, consumers may overlook lesions and send many nonpigmented lesions. This investigation demonstrates that high-quality dermoscopic images can be taken by patients at home with high accuracy., (© 2014 British Association of Dermatologists.)

Purpose: To obtain preliminary evidence on the effect of a skin cancer prevention video for adult solid organ transplant recipients (SOTR) and informational brochures on outcomes of skin cancer knowledge, beliefs, prevention and detection behaviors, and personal agency (self-confidence/personal control) for behaviors., Background: SOTR have a high risk of skin cancer potentiated by life-long immunosuppressive therapy posttransplantation. Skin cancer in SOTR is aggressive and difficult to treat. Prevention and early detection are important for reducing risk and improving skin cancer outcomes, but methods to inform SOTR about their risk are understudied., Methods: A brief, evidence-based skin cancer informational video tailored to SOTR was evaluated using a quasi-experimental design that compared the outcome variables in two groups of SOTR seen in 4 transplantation clinics within 4-6 weeks posttransplantation. The video/brochure group (VBG) viewed the video once and received skin cancer information brochures. The brochure group (BG) received brochures only. Participants completed a survey on sun protection behavior (6 items; alpha = 0.75), personal agency (6 items; alpha = 0.64), beliefs (6 items; alpha = 0.60), skin cancer knowledge (6 items), and skin self-examination (SSE; 1 item) at baseline and 3 months postintervention. Data were analyzed using descriptive statistics and 2 × 2 analysis of variance., Results: Of 113 participants, 90 completed both surveys (VBG, n = 46; BG, n = 44). Both groups had a significant increase in sun protective behavior (P < .001), skin cancer knowledge (P < .001), beliefs (P = .003), and personal agency (P = .003). There was no effect of either intervention on SSE., Conclusion: Both interventions effectively informed SOTR about skin cancer and sun protection, promoted favorable beliefs, and improved personal agency, but were not differentially effective, suggesting that the addition of the video may not be necessary or that the video may need to be viewed more than once. More in-depth SSE teaching strategies may be necessary., (Copyright © 2013 Elsevier Inc. All rights reserved.)

Objectives: To provide an overview of 1) traditional methods of skin cancer early detection, 2) current technologies for skin cancer detection, and 3) evolving practice models of early detection., Data Sources: Peer-reviewed databased articles and reviews, scholarly texts, and Web-based resources., Conclusion: Early detection of skin cancer through established methods or newer technologies is critical for reducing both skin cancer mortality and the overall skin cancer burden., Implications for Nursing Practice: A basic knowledge of recommended skin examination guidelines and risk factors for skin cancer, traditional methods to further examine lesions that are suspicious for skin cancer and evolving detection technologies can guide patient education and skin inspection decisions., (Copyright © 2013 Elsevier Inc. All rights reserved.)

Purpose: We systematically reviewed current literature on parent role modeling of healthy eating and physical activity as a strategy to influence healthy weight of middle school-age African American children., Conclusions: The evidence for parent role modeling is low to average. Most studies did not target African American participants or middle school-age children., Practice Implications: Nurses can begin to remedy deficient knowledge of parent role modeling by assessing parent attitudes, beliefs, and healthy behaviors, as well as the children's. Existing dietary and physical activity guidelines are not specific to African Americans but can be a starting point for educating parents., (© 2013, Wiley Periodicals, Inc.)

Aim: This article presents a discussion of development of a mid-range theory of risk perception., Background: Unhealthy behaviours contribute to the development of health inequalities worldwide. The link between perceived risk and successful health behaviour change is inconclusive, particularly in vulnerable populations. This may be attributed to inattention to culture., Data Sources: The synthesis strategy of theory building guided the process using three methods: (1) a systematic review of literature published between 2000-2011 targeting perceived risk in vulnerable populations; (2) qualitative and (3) quantitative data from a study of Samoan Pacific Islanders at high risk of cardiovascular disease and diabetes., Discussion: Main concepts of this theory include risk attention, appraisal processes, cognition, and affect. Overarching these concepts is health-world view: cultural ways of knowing, beliefs, values, images, and ideas. This theory proposes the following: (1) risk attention varies based on knowledge of the health risk in the context of health-world views; (2) risk appraisals are influenced by affect, health-world views, cultural customs, and protocols that intersect with the health risk; (3) strength of cultural beliefs, values, and images (cultural identity) mediate risk attention and risk appraisal influencing the likelihood that persons will engage in health-promoting behaviours that may contradict cultural customs/protocols., Implications: Interventions guided by a culturally sensitive mid-range theory may improve behaviour-related health inequalities in vulnerable populations., Conclusions: The synthesis strategy is an intensive process for developing a culturally sensitive mid-range theory. Testing of the theory will ascertain its usefulness for reducing health inequalities in vulnerable groups., (© 2012 Blackwell Publishing Ltd.)

Background: Cardiovascular disease (CVD) and diabetes, which are leading causes of morbidity and mortality in the United States, have a high incidence among Pacific Islanders. Risk of these conditions increases in the presence of metabolic syndrome. Risk-reducing behaviors for CVD and diabetes are driven partly by perceived risk of health threats and their consequences. Perceived risk is influenced by sociocultural beliefs and is a component of some health behavior models, yet it is understudied in Pacific Islanders., Objective: This mixed-methods study explored the perceived risk of CVD and diabetes in at-risk Samoan Pacific Islanders., Subjects and Methods: We used culturally sensitive strategies to recruit and enroll 43 adult Samoans from a community setting in Hawaii. Participants were obese with at least 1 other component of metabolic syndrome. Their objective risk was determined by the National Cholesterol Education Program Adult Treatment Program III risk categories. Participants provided demographic and health history information and answered 2 quantitative perceived risk questions. They also participated in 1 of 7 focus groups--the source of perceived risk qualitative data. Quantitative and qualitative data were analyzed using descriptive statistics and content analysis, respectively. The mixed-methods analysis targeted points of data convergence and complementarity for the 2 methods., Results: More than 80% of participants who were at moderately high (10%-20%) objective risk for CVD and diabetes had high (>20%) perceived risk of these conditions. There was high concordance of perceived risk for CVD and diabetes (P < .05). Qualitative data revealed bidirectional codes that influenced and were influenced by perceived risk within the participants' cultural perspective: current and planned health behavior, physical health, and family history of CVD or diabetes., Conclusion: Using mixed methods facilitated better understanding of cultural perspectives of perceived risk of CVD and diabetes. These results provide a foundation for developing culturally appropriate interventions targeting CVD and diabetes risk reduction in Samoans.

Purpose: Little is known about the skin cancer detection skills of advanced practice nurses (APNs). This systematic review of published literature seeks to describe (a) barriers to APNs' performance of skin examination, (b) APNs' ability to recognize suspicious skin lesions, and (c) APNs' skin cancer detection training activities., Data Sources: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement guided the literature search (OVID Medline, Web of Science, and CINAHL databases) and interpretation of findings. Of the 136 articles meeting criteria for selection, 12 pertaining to the purpose were selected for further review., Conclusions: Barriers to skin examination by APNs have been infrequently and inconsistently measured. Limited time to conduct skin examination is the most consistent barrier. APNs' ability to recognize and refer suspicious and benign lesions is inconsistent, but shows improvement after training. Few skin cancer training programs are available for APNs., Implications: Larger and more rigorously designed studies are needed to better determine APNs' barriers and facilitators to skin cancer assessment and their ability to recognize and appropriately refer potentially malignant skin lesions with a high level of sensitivity and specificity. Training to increase these skills needs to be targeted to APNs and occur at a much higher volume than current efforts., (©2011 The Author(s) Journal compilation ©2011 American Academy of Nurse Practitioners.)

The translation of genomic science into health care has expanded our ability to understand the effects of genomics on human health and disease. As genomic advances continue, nurses are expected to have the knowledge and skills to translate genomic information into improved patient care. This integrative review describes strategies used to teach genomics in academic nursing programs and their facilitators and barriers to inclusion in nursing curricula. The Learning Engagement Model and the Diffusion of Innovations Theory guided the interpretation of findings. CINAHL, Medline, and Web of Science were resources for articles published during the past decade that included strategies for teaching genomics in academic nursing programs. Of 135 articles, 13 met criteria for review. Examples of effective genomics teaching strategies included clinical application through case studies, storytelling, online genomics resources, student self-assessment, guest lecturers, and a genetics focus group. Most strategies were not evaluated for effectiveness., (Copyright 2011, SLACK Incorporated.)

Using the Internet in behavioral research remains a challenge. We developed a video intervention and conducted a pilot study that was designed to deliver and test the intervention via the Internet. One aim of this study was to evaluate the feasibility of using the Internet to both deliver the intervention and collect data from participants. This article summarizes procedures for delivering the intervention and survey via the Internet, obstacles encountered during delivery of the intervention and data collection, and lessons learned that can be applied to future research involving the Internet.