Save Your Skin

HPEB 300: Section 001

Team Skin Cancer:
Carleigh Capone, Jordan Bramlett, Ladd Platt, Mackenzie Leinbach, Zainab Alfarhan


Table of Contents

1. Program Rationale……………………………………………………………………………………… Page 3

1.1 Health problem and the relevance of issue
1.2 Target population
1.3 Importance of issue
1.4 Marketing Strategy
2. Needs Assessment………………………………………………………………………………………. Page 8
2.1 Sun protection
2.2 Indoor Tanning
2.3 Environmental risk factors
2.4 Genetics
2.5 Prioritization Matrix
3. Mission Statement, Goals, and Objectives……………………………………………………… Page 13
3.1 Mission statement
3.2 Program goals
3.3 SMART objectives
4. Implementation of Intervention……………………………………………………………………. Page 16
4.1 Theoretical foundation of the program
4.2 Intervention strategies
4.3 Program “kick-off” event
4.4 Program materials
4.5 Logic Model
5. Program Resources……………………………………………………………………………………. Page 20
5.1 Intervention Design
5.2 Getting started
5.3 Program staff and management
5.4 Time frame
6. Program Marketing…………………………………………………………………………………… Page 22
6.1 Program participants
6.2 Program tools and incentives
6.3 Example of promotional material
7. Budget…………………………………………………………………………………………………….. Page 24
8. Program Evaluation…………………………………………………………………………………… Page 28
9. References……………………………………………………………………………………………….. Page 33
10. Appendix……………………………………………………………………………………………….. Page 37
10.1 Participant survey of session
10.2 Sample flyer

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Meet Our Team

Hi, my name is Carleigh Capone
and I’m from Foxboro,
Massachusetts. I’m a Public
Health major and business
minor.
Hey y’all! My name is Mackenzie Leinbach and I’m
from Charleston, South Carolina. I’m a Public Health
major who is graduating this spring!

Hey! My name is Jordan Hi, my name is Ladd Platt Hey! My name is

Bramlett and I’m from
Darlington, South Carolina.
I’m also a Public Health
major!
and I’m from Columbia, SC. I
am a pre-med student getting
a B.S. in Public Health and a
performance certificate in
piano.
Zainab Alfarhan and I’m
from Saudi Arabia. I’m
majoring in Public Health
and minoring in
psychology.

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Program Rationale
Health problem and the relevance of issue

According to the Mayo Clinic (2019), skin cancer is defined as “the

abnormal growth of skin cells” (para. 1). This type of cancer can grow
on any area of your skin, mainly areas that are exposed to sunlight.
There are three main types of skin cancer which are known as basal cell
carcinoma, squamous cell carcinoma, and melanomas which increase
with severity, respectively. Basal cell carcinomas are formed from the
basal cells found in the deepest layers of the skin and they almost never
spread, or metastasize, to other areas of the body (Skin Cancer
Foundation, 2019). Squamous cell carcinomas arise from the
outermost, squamous layer, of the skin and usually occur after long-
term sun UV light exposure. Melanoma develops when DNA goes
unrepaired, causing tumors, and arise from the melanocyte cells in the
basal layer of the skin. “Melanoma is responsible for the most deaths of
all skin cancers, with nearly 9,000 people dying from it each year”
(para. 2). Along with this, treating melanoma can be extremely costly. It
is estimated that around $3.3 billion can be credited to melanoma,
annually (U.S. Department of Health and Human Services [DHHS],
2014). DHHS (2014) also reports “melanoma is the third most common
cancer in adolescents and young adults” (para. 16). There are many risk
factors that contribute to skin cancer. Such factors include genetics,
skin type, race, and exposure to UV radiation (DHHS, 2014). The health
problem our group will be focusing on is illnesses and/or death caused
by skin cancer. This is continuing to become a larger issue because
incidence rates are increasing, and the cost is substantially high.
Therefore, preventative measures must be taken in order to reduce the
risk and prevalence of skin cancer.

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Target Population

According to the Centers for Disease Control and Prevention (CDC,

2018a), “Skin cancer is the most common form of cancer in the United
States” (para. 1). Anyone is susceptible to getting skin cancer, but
certain groups of individuals are more likely to get it. The CDC (2018b)
narrowed it down to individuals who have “a lighter natural skin color,
skin that burns, freckles, reddens easily, or becomes painful in the sun,
blue or green eyes, blonde or red hair, certain types and large number
of moles, a family history of skin cancer, a personal history of skin
cancer” (para.1) along with individuals who spend too much time in
ultraviolet light and tanning beds. It was also found that “The National
Cancer Institute recently reported from the Surveillance, Epidemiology,
and End Results (SEER) database that in males aged 15 to 39 years the
age-adjusted annual incidence of melanoma increased from 4.7 cases
per 100,000 persons in 1973 to 7.7 cases per 100,000 persons in 2004.
In females of similar age, the age-adjusted annual incidence increased
from 5.5 cases per 100,000 persons in 1973 to 13.9 cases per 100,000
persons in 2004” (Reed et al., 2012). Because there is an increased risk
of skin cancer among women who have a lighter skin color, a family
history of skin cancer, use tanning beds, and are 18-24 years old, the
main target group affected by this health problem are those 18-24 year
old women with light skin, a family history of skin cancer, and who use
tanning beds.

Importance of Issue

Skin cancer is not only an issue to the infected individual himself/

herself, but also to their family members including their spouse,
children, parents and close friends. They have to understand the
changes that will happen in that person’s ability to go outside in a

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sunny day, do outdoor activities or wear swimming clothes, during or

after treatment period. In addition, individuals who have experienced
having skin cancer might change most of their old habits in order to
complete treatment plans and decrease the possibility to have cancer
cells growing back again. According to Fraser (n.d.) who is a weather
forecaster, after surgery had been done to remove a skin cancer under
her eye, she was not able to go outside for two weeks. Also, she was
not able to wear makeup, but because she had been working with the
company for long time, they allowed her to wear a sunglass to avoid
hurting her injury with cosmetics (Fraser, n.d, para. 8). That story
indicates skin cancer might influence someone's job or position,
especially where an individual is required to look professional or go
under sun lights. Furthermore, individuals might ignore signs of having
skin cancer due to the cost of removing tumors from the skin.
According to skin cancer foundation (n.d.), Ashley had discovered small
lesion on her body and had been removed by dermatologist. However,
Ashley unfortunately ignored the signs that she had lesion growing back
due to the fact that she doesn't has health insurance. That lesion cost
her more money and her life after the cancer spread through the lymph
nodes to the rest of her body. According to the National Center for
Biotechnology Information (n.d.), “In addition to causing illness and
death, skin cancer is costly to the nation. Skin cancer treatment is
estimated to cost about $8.1 billion in the United States each year.”
(para. 12). That simply illustrates the damages caused by skin cancer for
individuals and nations. Therefore, it is extremely important that we do
something about this and work to reduce the prevalence of skin cancer.

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Marketing Strategy

The purpose of promotion is to inform, persuade, reinforce, and

differentiate. Some of the promotional tools we will be using include:
advertising, direct marketing, public relations, and digital
communication. In terms of advertising, we will make flyers and
pamphlets to post in areas across town where most 18-24-year-old
women spend time such as coffee shops and public pools. We estimate
that the total cost of printing these flyers and pamphlets will be $650.
We will also make a brief presentation at University of South Carolina
School of Medicine in Greenville, SC to inform them of the
consequences of skin cancer and invite them to participate in our
program on primary prevention. Another marketing campaign we want
to utilize is the local news station. When the weatherman talks about
the upcoming hot and sunny days with high UV rays, he can mention
our program and encourage viewers to participate. This will cost
roughly $8,000 for the weekly air time. The last source of marketing
that we want to use is social media. This a great source for getting the
public's attention, especially those who are 18-24 years old, so we can
share statistics pertaining to skin cancer and encourage them to take
part in our program on how to best protect yourself from skin cancer.
The total cost for having one ad per day on Instagram during the
months of the intervention will cost about $850. In order to motivate
participants to participate in our program we will be using various
incentives such as free samples and free food. At our presentation we
will be giving out free sunscreen samples to each person. We estimate
a total of $840 for an estimated attendance of 2,400 people. Another
incentive we will implement is having refreshments like food and

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beverages from Chick Fil A. We have budgeted a total of $2500 to

spend on this food. Lastly, we will have a social media campaign where
we will enter participants in a drawing to win a $50 amazon gift card if
they repost our program information and tag their friends. We will
draw a total of 25 winners which will cost around $1,250.

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Needs Assessment
According to our research the following behaviors and factors are big
contributors to the risk of getting skin cancer:

Sun protection

• Young women believe it is not necessary to wear sunscreen or

proper sun protection clothing like hats etc.

• “Much of the cancer-causing damage of UVR can be prevented by

wearing protective clothing or chemical sunscreens. The cost of
this behavior is the reduction or elimination of the potential to
make vitamin D in the skin, but these effects depend on the
specific properties of clothing and the way chemical sunscreens
are used” (Jablonski, 2012, p. 80).

• “Primary prevention programs for skin cancer that are focused on

lowering UV exposure appear to be having a positive effect in
lowering skin cancer incidence” (Rigel, 2008, p. 131).

Indoor tanning

• Young women enjoy being tan, it may make them feel more
confident and pretty especially in the dead of winter leading them
to use an alternative source of sunlight: tanning beds

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• “The use of such tanning devices has been associated with a

significantly increased risk of melanoma” (Olsen & Green, 2012, p.
7).

• It was found that “exposure to artificial ultraviolet radiation is a

cause of the three main skin cancers” (Olsen & Green, 2012, p. 7).
“Young people in particular should be made aware that the use of
sunbeds for short term cosmetic tanning carries the long term
price of an increased risk of skin cancer” (Olsen & Green, 2012, p.
7).

Environmental Risk Factors

• UV radiation due to sun exposure

o “People who live in regions with strongly seasonal patterns

of sunshine are less likely to be “sun smart” (Jablonski, 2012,
p. 83).

o “The “vacation effect” - the tendency for people to ignore

sun-exposure guidelines while on vacation in the summer or
in a sunny place- has a big effect on the amount of UVR a
person receives and the likelihood of developing a sun-
related disease” (Jablonski, 2012, p. 84).

§ Young women think because they are on vacation for a

brief period of time that they need to increase the

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chances of them getting a tan/ holding on to that tan

for as long as possible
Genetics

• Genes consist of a young women’s genetic makeup and genetics

refer to the genes and characteristics passed down from parents
to children and they traits of an individual cannot be changed.

• “Though people with dark skin and people with light skin have the
same number of melanocytes, the way the melanin is distributed
and produced is quite different. Darker skin contains more
melanin, which protects against ultraviolet radiation and damage
to DNA. For this reason, it is rare to see skin cancer in African
Americans” (Norman, 2014, p. 18).

• A population-based case study found that, “the risk of BCC was

increased in subjects with light skin color and those who freckled
in childhood” (Gallagher et al., 1995, p. 157).

• Location of residence and ability to afford protection from sun

• Socioeconomic status

Prioritization Matrix

A prioritization matrix is provided below to show the importance and

changeability of each behavior and factor discussed above.

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-Not Using Sunscreen -Using Tanning Oil

-Using Tanning Beds

-Avoiding Sun Exposure -Genetics

-Self Exams for Lesions -Location of Residence SES

Out of the behaviors/factors above, the most important and

changeable are using tanning beds and not wearing sunscreen. Out of
these two we chose to focus on the behavior of not wearing sunscreen.
Many Caucasian women ages 18-24 are exposed to ample amounts of
sunlight without the use of sunscreen. One reason for this behavior
could be that a lot of women that are this age believe they shouldn’t be
worried about getting skin cancer which leads them to believing they
don’t need to wear sunscreen. In fact, many of them like to use tanning
oils to enhance the effects of sunlight. Another factor could that they
are simply uneducated on how skin cancer develops and therefore do
not worry about it. Another possibility is that some women are allergic
to sunscreen and don’t know alternatives like sun protective clothing.
Finally, one of the most important factors is having peer support about
using sunscreen. If women are surrounding themselves with other
women who use sunscreen then they are more likely to continue to use
sunscreen and vice versa (reference?). Below is a table summarizing the
information just discussed.

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Factor Type Factor Explanation of

relationship with
behavior

Predisposing Attitudes, knowledge - “I don’t need

sunscreen.”
- Wanting to use tanning
oil instead of sunscreen.
-Uneducated on skin
cancer and how it
develops and infection
rate given exposure.

Enabling Access, genetics -Allergic to sunscreen

-Can’t afford sunscreen
or protective clothes

Reinforcing Incentives, social -Peer-support to use

support sunscreen. -Not getting
skin cancer.

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Mission, Goals, Objectives

Mission Statement: To educate and inform the general population of
caucasian women in Greenville County on primary prevention strategies
of skin cancer to prevent health issues and have an overall improvement
of the health of these individuals.

Goals:

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Objectives:

Objectives

· By April 1st, 2019, program planners will have found an 18-24 aged
Caucasian woman with skin cancer who is willing to participate in the
program committee.
Process
· By April 1st, 2019, program planners will have contacted and gained
the support of the director of South Carolina Cancer Action Center.

· After completion of the program, 85% of the program participants

will be able to explain how skin cancer develops and the negative
effects of skin cancer.
Impact
· After showing a sunscreen benefits documentary, 80% of the
(learning)
program participants will learn about the importance of wearing
sunscreen before exposure to sunlight.

· After completion of program, 65% of the participants will report

having used sunscreen at the recommended amounts during days in
Impact which they are exposed to high concentration of UV rays during the
(Behavioral) month of July.

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· By 2022, the rate of tests that come back positive for skin cancer in
Caucasian women aged 18-24 will be reduced by 15% in Greenville
Outcome County.

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Implementation of Intervention
Theoretical Foundation of the Program

The theory that our group plans to implement in our intervention

is called the Extended Parallel Process Model (EPPM). The reason that
we chose to use this theory is because it provides good evidence to
support our intervention method. Our group is going to use primary
prevention to decrease the incidence of skin cancer in Caucasian
women aged 18-24 in Greenville County, SC. We believe that one of the
best means of primary prevention of skin cancer is using sunscreen, and
that the main reason that our target population does not wear
sunscreen lies in the presupposition that our target population does not
see skin cancer as an immediate threat to their health. We plan on
addressing this issue by using fear appeals, such as education sessions
which would highlight some explicit skin cancer images. This plan fits
nicely with the EPPM because, “The Extended Parallel Process Model
(EPPM) provides important insights as to why feedback from imaging
photographs might be useful as an intervention tool. In essence,
biometric feedback can be framed as fear appeals, in the form of
images highlighting damaged skin. EPPM posits that such fear appeals,
when provided together with messages emphasizing self-efficacy to
take action, should increase protective behavior” (Emmons et al., 2010,
p. 2). In essence, we believe that because the EPPM, “helps to
understand the impact of “fear appeals”, which are most effective
when they include both a threat component emphasizing severity and
susceptibility, and messages about recommended actions that

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emphasize both response efficacy (e.g. sunscreen will reduce the risk of
further sun damage and cancer) and self-efficacy (e.g. this is something
you can easily do)” (Emmons et al., 2010, p. 6), and we want to use fear
appeals, response efficacy, and self-efficacy messages in our prevention
methods, then the EPPM will be an effective theory to adapt to our
intervention to make it successful.

Intervention Strategies

In order to get started, we first need to gain the proper funding in

order to start up the program. We will then need to secure proper
space and equipment to train our facilitators and to hold our
intervention meetings. We then need to hire facilitators and train them
before we can begin the pilot test of our intervention. After we change
the program according to how the pilot test goes then we can officially
start the program. There are no limitations regarding who is able to
participate in this intervention. This intervention can help anyone who
goes outside and spends any amount of time in the sun without
protection. It encompasses a large variety of individuals. For more
specific targeting we could zone in on individuals whose jobs require
them to spend time working in the sun. Especially those who may not
know how dangerous UV rays can be without proper protection. We
have set a goal to have around 150 participants per intervention day
which, because we are holding 16 intervention days, comes out to
2,400 total participants by the end of the program.

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Program “Kick-off” Event

The main kickoff event will be held on the quad of The University
of South Carolina School of Medicine in Greenville. Here we will be
trying to get individuals of the target population to sign up for our info
sessions. We will be handing out flyers with the dates of the sessions
and flyers expressing the opportunity to obtain free sunscreen and free
Chick Fil A by attending the sessions.

Program Materials

● Equipment and Supplies

○ Table and chairs (provided)
○ Projector (provided)
○ Speaker (provided)
○ Printer
○ Laptop computers
○ Cellphones
○ Incentives (sunscreen samples, gift cards)
○ Refreshments
○ Office materials (paper, pencils, stapler, staples)
● Curriculum and other instrumental resources
○ Attend a session at The University of South Carolina School
of Medicine in Greenville on Skin Cancer on how skin cancer
develops and the negative effects on skin cancer.
○ Individuals will take the evaluation survey after the session
and will become more knowledgeable about how important
sunscreen and sun protection is.

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Logic Model

The table below represents a logic model of inputs, outputs, and

outcomes for the program.

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Program Resources
Intervention Design:

This program will include 16, 1-hour long informational sessions. These
sessions will occur over the course of four months with 1 informational
session every Saturday. These sessions will be run by trained education
specialist and will inform individuals of the importance of using
sunscreen.

Getting Started:

In order to begin this process, the program planners will need to hire
and train education specialist to teach the informational sessions. The
University of South Carolina School of Medicine in Greenville will need
to be contacted in order to secure a location and space to hold the
intervention informational sessions.

Program Staff and Management:

Management of People- Ladd Platt and Carleigh Capone. Program

Educators will manage the health educators and all of the individuals
that come into the informational sessions making sure they are
comfortable and understand the material presented to them. These
people will also recruit individuals to attend the informational sessions.

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Management of Technology- Zainab Alfarhan. Educators and program

planners will use the projector screens, speakers, and laptops to teach
the informational sessions

Management of Finances- Mackenzie Leinbach and Jordan Bramlett.

Program planners will stick to the budget closely

Time Frame: Gantt Chart

____ = planned time frame

2020 Jan Feb. Mar April June July Aug. Sept. Oct. Nov

Secure proper space and __ __ __

equipment to train facilitators

Hire and adequately train __

program facilitators

Pilot test the program ___

Make revisions based upon ___

results from pilot test

Promote the new and revised __ __ __ ___

program

Implement the program within __ __ __ ___

the desired community

Evaluate the results ___ __

Write final report __

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Program Marketing
Program Participants

We have set a goal to have around 150 participants per

intervention day which, because we are holding 16 intervention days,
comes out to 2,400 total participants by the end of the program.

Promotional Tools and Incentives

The purpose of promotion is to inform, persuade, reinforce, and

differentiate. Some of the promotional tools we will be using include:
advertising, direct marketing, public relations, and digital
communication. In terms of advertising, we will make flyers and
pamphlets to post in areas across town where most 18-24-year-old
women spend time such as coffee shops and public pools. We estimate
that the total cost of printing these flyers and pamphlets will be $650.
We will also make brief presentations at University of South Carolina
School of Medicine in Greenville, SC to inform them of the
consequences of skin cancer and invite them to participate in our
program on primary prevention. Another marketing campaign we want
to utilize is the local news station. When the weatherman talks about
the upcoming hot and sunny days with high UV rays he can mention our
program and encourage viewers to participate. This will cost roughly
$8,000 for the weekly air time. The last source of marketing that we
want to use is social media. This a great source for getting the public's
attention, especially those who are 18-24 years old, so we can share

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statistics pertaining to skin cancer and encourage them to take part in

our program on how to best protect yourself from skin cancer. The
total cost for having one ad per day on Instagram during the months of
the intervention will cost about $850. In order to motivate participants
to participate in our program we will be using various incentives such as
free samples and free food. At our presentation we will be giving out
free sunscreen samples to each person. We estimate a total of $840 for
an estimated attendance of 2,400 people. Another incentive we will
implement is having refreshments like food and beverages from Chick
Fil A. We have budgeted a total of $2500 to spend on this food. Lastly,
we will have a social media campaign where we will enter participants
in a drawing to win a $50 amazon gift card if they repost our program
information and tag their friends. We will draw a total of 25 winners
which will cost around $1,250.

Example of Promotional Materials

The image below will be used on Instagram and other social media
platforms to promote safe sun exposure.

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Budget
Budget Categories

Grants

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The USCGSOM will offer in kind to us some features.

$144,790.00
Total project cost (100%)

Amount provided by The Skin Cancer $36,197.50

Foundation (25%)

Amount requested from The Winningham $108,592.50

Foundation (75%)

Personnel
$115,000

Educators Full-time Health Education 80,000

Specialist x 2

Technical Assistant Technical Assistant staff member x 35,000

1

Marketing
$8,850

Social Media Ad 1 ad per day x 120 850

Time

TV Air Time 1 ad per day x 16 8,000

Space
$7,200

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Program Sessions 3 classrooms x 16 sessions at 7,200

USCSOMG

Equipment
$8,990

Printer HP printer/copier/scanner 650

Laptop Computers Macbook Computers Compatible 2,000

with Smartphones x 2

Projector Projector x 1 In-kind

Speaker Speaker x 1 In-kind

Cell phones Smartphones x 5 4,500

Sunscreen Sunscreen samples x 2,400 840

Supplies
$4,750

Refreshments Food/beverages x 1 session at USC 2,500

School of Medicine - Greenville

Office materials Paper, pens, staplers, staples 1,000

Incentives $50 Amazon Gift-cards x 25 1,250

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TOTAL
$144,790

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Program Evaluation
The following is a list of examples of objectives from the objectives
section and below each one is a plan for how we are going to evaluate
it.

1. By April 1st, 2019, program planners will have found an 18-24

aged Caucasian woman with skin cancer who is willing to
participate in the program committee.
Who: program planners
What: acquired Caucasian woman to be on committee
When: By April 1st, 2019
How much/To what extent: one

This process evaluation will be accomplished by having the

Caucasian woman sign a program document ensuring that she has
agreed to be present on the program committee for the duration of the
program.

2. By April 1st, 2019, program planners will have contacted and

gained the support of the director of South Carolina Cancer Action
Center.
Who: program planners
What: contacted and gained support of director of SCCAC
When: By April 1st, 2019
How much/To what extent: talked with director and confirmed support
of program.

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This process evaluation will be accomplished by having the SCCAC

sign a document that indicates he has given his support to our program.

Learning:

1. After completion of the program, 85% of the program
participants will be able to explain how skin cancer develops and
the negative effects of skin cancer.
Who: Program participants
What: explain how skin cancer develops and the negative effects of skin
cancer
When: by the end of the program
How much/ to what extent: 85%

2. After completion of program, 85% of participants will be able to

cite primary prevention methods of skin cancer.
Who: Program participants
What: will be able to explain correct primary prevention methods of skin
cancer
When: after completion of program
How much: 85%

Both of these learning evaluations will be accomplished by using

qualitative measures. We will create a questionnaire that the
participants will take which will inform us of the participant’s
knowledge on skin cancer prior to the program. Then, after completion
of the program, the participants will take a second questionnaire which
will ask them a series of questions about their new knowledge on skin
cancer. We can then compare the two questionnaires to determine
how effective the program was and make changes accordingly.

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Behavioral:

After completion of program, 65% of the participants will report having

used sunscreen at the recommended amounts during days in which they
are exposed to high concentration of UV rays during the month of July.
Who: Program participants
What: Report having used sunscreen at the recommended amounts
while exposed to UV rays
When: After completion of program
What Extent: During the entire month of July.

This behavioral evaluation will be accomplished by using
quantitative measures. We will get the participants contact
information, such as email and phone number, and let them indicate
whether email, text, or phone call would be best to send them further
information. In the month following the end of the program we will
contact the participants through the medium that they denoted and
ask them a series of questions to see how often they wore sunscreen
when exposed to high concentration of UV rays.

Outcome:

By 2022, the incidence rates of skin cancer in South Carolina 18-24 will
be reduced by 3% in South Carolina.
Who: Caucasian women aged 18-24
What: decrease incidence rates of skin cancer in South Carolina
When: by 2022
What extent: 3%

This outcome evaluation will be accomplished by using

quantitative data. We will gather data from DHEC on the incidence of

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skin cancer in South Carolina in 2019 and see if it has decreased when
compared to past years incidence rates.

Summary of Evaluation

The quality of our program will be assessed using mainly

qualitative measures. For example, we plan on holding a total of 48
sessions by the end of September. To assess whether or not these
sessions were held, we will interview each education specialist at the
end of each intervention day. If, by the end of September, all 48
sessions were held then this would be considered a success. We will
use this interview technique, in addition to weekly staff meetings, to
make sure that everything is going according to our logic model. This
continual evaluation will ensure that we will be able to make changes
as needed and catch any red flags that may appear during the
implementation process.
The effectiveness of the program will be assessed by using a mix
of qualitative and quantitative measures. The aim of our program is to
increase awareness of the dangers of skin cancer and increase
knowledge about the best ways to prevent skin cancer. From that, we
hope to decrease the incidence of skin cancer in South Carolina. The
primary prevention method we will focus on will be wearing adequate
amounts of sunscreen when exposed to UV rays. We will measure the
quality of this program by having the participants take a survey both
prior to and after the session. The survey before the session will ask
about the estimated use of sunscreen per individual, their current
knowledge about skin cancer, and their current knowledge about
prevention techniques. The survey following the session will ask their
new knowledge about skin cancer and their new knowledge about
primary prevention techniques. The new estimated use of sunscreen
per individual will be measured in the months following the information
session by interviewing the participants by their preferred method of

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contact, i.e. phone, email, etc. The incidence of skin cancer will be
measured by gathering incidence data from DHEC and comparing it to
previous years. The quality of the program will be measured by the
percentage of participants who have increased knowledge about skin
cancer and prevention techniques, an increased use of sunscreen, and a
decrease in the incidence of skin cancer in South Carolina. An increase
in knowledge and behaviors in the majority of participants, and a
decrease in incidence of skin cancer in South Carolina would be
considered a success. In contrast, low numbers or no increase in these
impact measures (knowledge and behaviors) and an increase the
outcome measure (incidence) would indicate a need for changing the
program strategy.

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References

American Academy of Dermatology. (n.d.) Skin Cancer. Retrieved from https://www.aad.org

/media/stats/conditions/skin-cancer

Centers for Disease Control and Prevention. (2018a). Skin cancer facts & statistics. Retrieved from

https://www.cdc.gov/cancer/skin/statistics/

Centers for Disease Control and Prevention. (2018b). What are the risk factors for skin

cancer? Retrieved from https://www.cdc.gov/cancer/skin/basic_info/risk_factors.htm

Emmons, K. M., Geller, A. C., Puleo, E., Savadatti, S. S., Hu, S. W., Gorham, S. (2010). The impact of

dermatologist examination and biometric feedback delivered at the beach on skin cancer

prevention. Journal of the American Academy of Dermatology, 64(2), 282–289.

doi:10.1016/j.jaad.2010.01.040

Fraser, J. (n.d.). Skin Cancer Foundation. How skin cancer changed my life. Retrieved from

https://www.skincancer.org/true-stories/how-skin-cancer-changed-my-life

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Gallagher, R. P., Hill, G. B., Bajdik, C. D., Fincham, S., Coldman, A. J., McLean, D. I., & Threlfall, W. J.

(1995). Sunlight exposure, pigmentary factors, and risk of nonmelanocytic skin cancer: I. Basal

cell carcinoma. Archives of dermatology, 131(2), 157-163.

http://dx.doi.org/10.1001/archderm.1995.01690140041006

Jablonski, N. G. (2012). Skin color and health. In N.G. Jablonski, Living in color: The biological and social

meaning of skin color (pp. 72-90). Retrieved from http://www.jstor.org/stable. 10.1525

/j.ctt1pn64b.11

Mayo Clinic. (n.d.-a). Basal cell carcinoma. Retrieved from https://www.mayoclinic.org /diseases-

conditions/basal-cell-carcinoma/symptoms-causes/syc-20354187

Mayo Clinic. (n.d.-b). Squamous cell carcinoma. Retrieved from https://www.mayoclinic.org /diseases-

conditions/squamous-cell-carcinoma/symptoms-causes/syc-20352480

Mayo Clinic. (2019). Skin cancer. Retrieved from https://www.mayoclinic.org/diseases-

conditions/skin-cancer/symptoms-causes/syc-20377605

National Cancer Institute. (n.d.). State cancer profiles. Retrieved from https://statecancerprofiles

.cancer.gov/incidencerates/index.php?stateFIPS=45&cancer=053&race=00&sex=0&age=001&t

ype=incd&sortVariableName=rate&sortOrder=default#results

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Reed, K. B., Brewer, J. D., Lohse, C. M., Bringe, K. E., Pruitt, C. N., & Gibson, L. E. (2012). Increasing

incidence of melanoma among young adults: An epidemiological study in Olmsted County,

Minnesota. Mayo Clinic Proceedings, 87(4), 328-34.

Norman, R. (2014). Care and protection of the skin. In R. Norman, The blue man and other stories of the

skin (pp. 17-28). Retrieved from http://www.jstor.org/stable/10.1525/j.ctt5hjhz6.7

Olsen, C., & Green, A. (2012). More evidence of harms of sunbed use, particularly for young people:

Indoor tanning increases risk of the three most common skin cancers. British Medical Journal,

345(7877), 7. doi: 10.1136/bmj.e6101

Rigel, D. S. (2008). Cutaneous ultraviolet exposure and its relationship to the development of skin

cancer. Journal of the American Academy of Dermatology, 58(5 Suppl 2), S129-S132.

https://doi.org/10.1016/j.jaad.2007.04.034

Skin Cancer Foundation. (n.d.). Ashley’s journey. Retrieved from https://www.skincancer.org /true-

stories/ashley

Skin Cancer Foundation. (2019a). Basal cell carcinoma. Retrieved from https://www.skincance-

r.org/skin-cancer-information/basal-cell-carcinoma

Skin Cancer Foundation. (2019b). Melanoma. Retrieved from https://www.skincancer.org/skin-

cancer-information/melanoma

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Skin Cancer Foundation. (2019c). Squamous cell carcinoma. Retrieved from https://www.skin-

Cancer.org/skin-cancer-information/squamous-cell-carcinoma

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https://www.ncbi.nlm.nih.gov/books /NBK247164/#skincancer.s14

SAVE YOUR SKIN 36



Appendix

Participant Survey of Session

Name: __________________________ Date _______________________________

Email: __________________________ Phone Number: ______________________

Age: ___________________________ Preferred method of contact: ____________

Please rate the following information on a scale of 1 to 5, with 5 being “strongly agree” and 1 being “strongly
disagree”.

Indicate how knowledgeable you were about skin cancer prior to the session.

1 2 3 4 5

Indicate how knowledgeable you were about prevention techniques for skin cancer
prior to the session.

1 2 3 4 5

Indicate how regularly you use sunscreen when exposed to UV rays for extended
periods of time.

1 2 3 4 5

Indicate how aware you were of the prevalence of skin cancer prior to the session.

1 2 3 4 5

SAVE YOUR SKIN 37



Indicate how aware you are of the prevalence of skin cancer following the session.

1 2 3 4 5

Indicate how knowledgeable you are about skin cancer following the session.

1 2 3 4 5

Indicate how knowledgeable you are about prevention techniques following the
session.

1 2 3 4 5

Indicate the overall effectiveness of this session in providing knowledge of skin cancer
and prevention techniques.

1 2 3 4 5

Indicate your predicted new use of sunscreen following the session.

1 2 3 4 5

Indicate how easy you the information presented in this session was to understand.

1 2 3 4 5

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What part of the session did you feel was most important and beneficial?

What part of this session did you believe to be least useful or unnecessary?

What changes would you recommend to make for future sessions?

Sample of Follow Up Survey Questions for Participants in Months Following Session:

1. How often would you say that you used sunscreen in prior to this year?
2. How often would you say that you used sunscreen this summer?
3. Would you be willing to participate in more sessions in the future?
4. How much of that do you believe was due to the session?
5. Is there anything else you would like to say that is related to you experience with the session?

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Sample Flyer

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