title: Providers' Experiences with a Melanoma Web-Based Course: a Discussion on Barriers and Intentions.
abstract: Primary care visits provide an opportunity for skin examinations with the potential to reduce melanoma mortality. The INFORMED (INternet curriculum FOR Melanoma Early Detection) Group developed a Web-based curriculum to improve primary care providers' (PCPs') skin cancer detection skills. This study details feedback obtained from participant focus groups, including the feasibility of implementing in other PCP practices. Practicing PCPs at Henry Ford Health System and Kaiser Permanente Northern California completed the curriculum. Feedback sessions were conducted with standardized questions focusing on four domains: (1) overall impressions of the curriculum, (2) recommendations for improvement, (3) current skin examination practices, and (4) suggestions for increasing skin screening by PCPs. Discussions at each site were audio recorded, transcribed verbatim, and de-identified. Providers (N = 54) had a positive impression of the Web-based curriculum, with suggestions to provide offline teaching aids and request assistance. Despite having improved confidence in diagnosing malignant lesions, many providers felt a lack of confidence in performing the screening and time constraints affected their current practices, as did institutional constraints. Providers intended to increase discussion with patients about skin cancer. The accessibility, effectiveness, and popularity of the curriculum indicate potential for implementation in the primary care setting. Participating providers noted that institutional barriers remain which must be addressed for successful dissemination and implementation.
authors.affiliation: Stritch School of Medicine, Loyola University Chicago, 2160 1st Avenue, Maywood, IL, 60153, USA.
authors.forename: Angela J
authors.initials: AJ
authors.lastname: Jiang
authors.affiliation: Department of Dermatology, Henry Ford Hospital, 3031 W Grand Boulevard, Suite 800, Detroit, MI, 48202, USA. meide1@hfhs.org.|Department of Public Health Sciences, Henry Ford Hospital, One Ford Place, Detroit, MI, 48202, USA. meide1@hfhs.org.
authors.forename: Melody J
authors.initials: MJ
authors.lastname: Eide
authors.affiliation: Department of Public Health Sciences, Henry Ford Hospital, One Ford Place, Detroit, MI, 48202, USA.
authors.forename: Gwen L
authors.initials: GL
authors.lastname: Alexander
authors.affiliation: Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA, 94612, USA.
authors.forename: Andrea
authors.initials: A
authors.lastname: Altschuler
authors.affiliation: Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA, 94612, USA.
authors.forename: Maryam M
authors.initials: MM
authors.lastname: Asgari
authors.affiliation: Department of Social and Behavioral Sciences, Harvard School of Public Health, 677 Huntington Ave, Kresge Building, Boston, MA, 02115, USA.
authors.forename: Alan C
authors.initials: AC
authors.lastname: Geller
authors.affiliation: Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA.|, 208 Boulder Bluff, Chapel Hill, NC, 27516, USA.
authors.forename: Suzanne W
authors.initials: SW
authors.lastname: Fletcher
authors.affiliation: Dermatology Service, Memorial Sloan-Kettering Cancer Center, 16 East 60th Street, New York, NY, 10022, USA.
authors.forename: Allan C
authors.initials: AC
authors.lastname: Halpern
authors.affiliation: Dermatoepidemiology Unit, Veterans Affairs Medical Center, 830 Chalkstone Avenue, Providence, RI, 02908, USA.|Department of Dermatology, Rhode Island Hospital, 593 Eddy Street, Providence, RI, 02903, USA.|Departments of Dermatology and Community Health, Brown University, Providence, RI, 02912, USA.
authors.forename: Martin A
authors.initials: MA
authors.lastname: Weinstock
mesh_terms: D002140:California; D003479:Curriculum; D004502:Education, Medical, Continuing; D005260:Female; D006282:Health Personnel / Q000193:education*; D006801:Humans; D033182:Intention; D020407:Internet; D008297:Male; D008403:Mass Screening / Q000379:methods; D008545:Melanoma / Q000175:diagnosis* / Q000517:prevention & control; D011320:Primary Health Care; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000517:prevention & control; D013997:Time Factors
keywords: Cancer screening and prevention; Continuing medical education; Melanoma; Primary care; Qualitative research methods