Skin cancer prevention education for kidney transplant recipients: a systematic evaluation of Internet sites.
BACKGROUND
Repeated patient education about skin cancer prevention is important to self-care after transplant.


OBJECTIVE
Examine educational materials for kidney transplant recipients available on the Internet that address sun protection and skin self-examination for early detection of squamous cell carcinoma.


METHODS
Systematic review of Web sites for kidney transplant recipients endorsed by transplant physicians and dermatologists.


METHODS
An expert panel of 8 dermatologists providing care for kidney transplant recipients and 1 research medical anthropologist.


METHODS
Reading grade level, inclusion of people with skin of color, sufficient content to support effective sun protection, and description of 4 sun-protection strategies and skin self-examination. Results-Of the 40 sites identified, 11 contained information about sun protection or increased risk of any type of cancer. The Web sites had a ninth-grade median reading level (range, seventh grade to college senior). Interrater reliability for the 25-item assessment tool was assessed by Fleiss' kappa (kappa = 0.87). Skin cancer risk was presented as relevant to those with fair skin. Sites recommended regular use of sunscreen with sun-protection factor of 15 or greater (n=3) to reduce the risk of skin cancer (n=4). Few sites recommended using protective clothing (n=5), seeking shade (n=4), and avoiding deliberate tanning with indoor or outdoor light (n=1). Five sites recommended skin self-examination.


CONCLUSIONS
Because many patients seek self-management information from the Internet, Web sites must provide more thorough educational information about skin cancer prevention and health promotion at a lower reading grade level.
Northwestern University Feinberg School of Medicine, Chicago, Ilinois, USA. june-robinson@northwestern.edu
June K
JK
Robinson
Murad
M
Alam
Neda
N
Ashourian
Misbah
M
Khan
Roopal
R
Kundu
Anne E
AE
Laumann
Bethanee J
BJ
Schlosser
Simon
S
Yoo
Elisa J
EJ
Gordon
D032882:Comprehension; D055088:Early Detection of Cancer; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects; D020407:Internet / Q000458:organization & administration*; D016030:Kidney Transplantation / Q000009:adverse effects / Q000276:immunology; D018307:Neoplasms, Squamous Cell / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control; D010353:Patient Education as Topic / Q000458:organization & administration*; D018570:Risk Assessment; D012648:Self Care; D016353:Self-Examination; D012878:Skin Neoplasms / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D012880:Skin Pigmentation; D013473:Sunscreening Agents / Q000627:therapeutic use
D013473:Sunscreening Agents