An Educational Intervention for Skin Cancer Prevention With Hospital Staff: Pilot Project for System Change

An Educational Intervention for Skin Cancer Prevention with Hospital Staff: A Pilot Project for System Change Amy F. Bruce, MSN, RN, NE-BC PURPOSE: The purpose of this project was to design, implement, and evaluate an educational intervention provided to health care professionals using the Sun Smart U Curriculum created by the Skin Cancer Foundation (2017). METHODS: Using a pretest-posttest design with a convenience sample (N=40), this intervention targeted the health professionals and staff from a residential/acute care facility caring for pre-adolescent, adolescent, and adult populations. Aims of this project included: (1) the staff’s baseline level of knowledge regarding sun protective behaviors using the Sun Smart U Curriculum, (2) the staff’s level of knowledge regarding sun protective behaviors post educational intervention using the Sun Smart U Curriculum, (3) the staff’s intent to change behavior; and, (4) the feasibility of implementing behavior change within the organization. RESULTS: Parametric summary statistics were used to report pretest-posttest survey data. The Continuing Professional Development-Reaction (CPD-R) tool (Légaré et al., 2017) was used to measure intent to change sun protective behaviors. The CPD-R is reported as a valid and reliable tool (Cronbach’s coefficients for constructs varied from 0.77 to 0.85) for assessing the impact of CPD activities on the behavioral intentions of healthcare providers. Results from this project indicate a significant increase in test scores from pretest to posttest knowledge (95% CI, Cohen’s d=0.463, p=0.006). The majority of participants would encourage the children to use sunscreen at the facility (100%), and 98% indicated the organization would support the behavior change; however, 35% indicated likeliness to personally use sunscreen and/or sun prevention methods at the facility. Participants with a higher level of education were significantly more likely to engage in sun protective behaviors (x2 =35.50, df=20, p=0.018). CONCLUSIONS: In summary, this study addressed two important necessities in skin cancer prevention: the need for a staff intervention to improve knowledge regarding sun safe behaviors, and an educational intervention targeting health care professionals’ intent to change behaviors. IMPLICATIONS: A pre-determined curriculum was used to compare hospital staff’s baseline level of knowledge to posttest results regarding sun protective behaviors after an educational intervention. Although staff indicated a significantly higher level of knowledge post intervention, future dissemination of research would recommend a 3 to 6-month follow-up evaluating actual changes in behavior. Those individuals with a higher level of education indicated a likeliness to engage in sun protective behavior. This may imply a further need for targeting those individuals with lower education and socioeconomic status to encourage skin screening and sun protective behavior changes resulting in lower morbidity and mortality of melanoma skin cancer. Health care professionals would benefit from specific sun protective education to improve both personal health and patient care practices. EDUCATIONAL INTERVENTION WITH HOSPITAL STAFF iii Acknowledgements The concept of graduate education was never an option for me. I had always known I would push myself to the very limits of existence from an early age, even to my own detriment. Being an only child propelled this inner desire to compete with no one, barring myself. Hence, I view the completed work before me not only as an accomplishment of scholarship and professional viability, but as a completed goal once thought unattainable. I was not considered a child of privilege, and therefore was not afforded the luxuries or opportunities most children have – my road was self-paved against the grain of a tranquil childhood. A very special thank you to my committee members for their unrelenting support, guidance, and enthusiasm during the phases of this project. To Dr. Theresa Cowan, committee chairperson, who guided me through every phase of the process with encouragement and confidence. Also, with heartfelt recognition and gratitude, I thank Dr. Cynthia Armstrong Persily for her wisdom, leadership, and networking abilities connecting me with those individuals who continue to help propel my career forward. Thank you to Georgia Daniel, my content expert, who contributed the evidence-based practice knowledge to elevate the importance of my work. Lastly, Dr. Kari Sand-Jecklin, a scholar whose energy and vision for this project kept me persevering to completion. I would like to recognize other good friends and colleagues that I have called upon for assistance during the development of this project. Dr. Pamela L. Alderman and Dr. Evelyn Klocke who served as my mentors during the final phases of completion, and Dr. Aida Jimenez, who spent countless hours assisting me with the statistical significance and interpretation of my data I have a great respect for your abilities. Thank you, Melinda Stoecklin, for your emotional support from beginning to end, and those most important parts in between. EDUCATIONAL INTERVENTION WITH HOSPITAL STAFF iv This journey has not come without its own trials and tribulations. There are those individuals that have sacrificed much more than I during my professional evolution. My husband Ivan exhibits the strength, support, and love I needed to continue this goal against all odds – you are my rock. My 3 most precious, Olivia, Roman, and IJ, have inspired me to become not only a better mother, but a successful female role-model serving as the foundation for their future growth and development. For my 5 step-children, Joshua, Lindsey, Ellen, Caroline, and Alex, who helped me learn to expand my horizons and love larger. Lastly, for my mother who helped instill the determination of self-reliance, and my grandmother for all the much-needed prayers. That being said, this entire work is dedicated to my late grandfather, Newell Lee Haynes, who will never see me walk across the stage for my terminal degree but is watching me from Heaven – I love you and thank you for being my ‘Dad’. I told you I would do it, and I have never broken a promise. 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