An Online Intervention to Improve Family Nurse Practitioner Student Knowledge, Attitudes and Intent to Provide Counseling on Skin Cancer Primary Prevention

Abstract

Background: Skin cancer is the most common form of cancer in the United States and is a public health concern. There are over 5 million new cases of non-melanoma skin cancer and over 96,000 new cases of melanoma annually in the United States. Skin cancer is highly preventable, although nurse practitioners do not regularly provide primary prevention counseling. Nurse practitioners have a key role in educating and encouraging patients to practice skin cancer prevention methods, however, primary prevention is not part of the family nurse practitioner education. Purpose/Aims: The purpose of this DNP quality improvement project was to develop an online multi-component skin cancer prevention intervention in an online DNP course for primary care nurse practitioner students obtaining their DNP degree. Improvement in primary prevention knowledge, confidence with counseling about skin cancer, and intention to counsel, were the main outcomes of this quality improvement project. Secondary to the above was to determine the feasibility of the training intervention as determined by rates of completion, participant satisfaction, and survey response rates. Methods: A single subject pre-test/post-test design guided this project. Participants completed an online pretest assessing skin cancer knowledge, attitudes, self-efficacy, and intent to counsel. Following the pretest, participants were given access to intervention hosted on the Desire2Learn (D2L) online learning platform. The intervention included information about skin cancer and published guidelines about skin cancer prevention counseling. Changes in knowledge, attitudes, self-efficacy, intent to counsel and satisfaction with the intervention were assessed through the posttest. Results: A total of 21 eligible family nurse practitioner students completed both the pretest and posttest surveys. There was an increase (p=.059) in knowledge of skin cancer from 75.24% on the pretest to 98.10% on the posttest. Knowledge of professional and government organization recommendations significantly improved (p=0.003) from 20.63% on the pretest to 71.41% on the posttest. Skin cancer attitudes were fair to positive on the pretest and improved (p=.000) on the posttest. On the pretest, participants had fair self-efficacy on providing counseling, which positively increased on the posttest (p=0.043). Intent to counsel also significantly improved from pretest to posttest (p=0.000). These attitudes favorably increased (p=.009) on the posttest. Participants’ attitudes regarding the intervention were generally favorable. Conclusions: The online multi-component intervention offered to family nurse practitioner students is highly effective for improving their knowledge and attitudes regarding skin cancer, and their self-efficacy and intent to provide skin cancer prevention counseling. The intervention is feasible to administer and is acceptable to family nurse practitioner students at the University of Arizona College of Nursing. Keywords: skin cancer, primary prevention, Social Cognitive Theory, intent to counsel, family nurse practitioner students, online education intervention