Abstract：
OBJECTIVE: Outdoor workers are at increased risk for skin cancer and melanoma. This qualitative study aimed to explore outdoor workers\' perspectives and experiences of primary (i.e. sun protection) and secondary prevention, i.e. skin self-examination (SSE) of skin cancer.
METHODS: Purposive, snowball, and theoretical sampling was used to recruit outdoor workers in Kentucky and Indiana. Semi-structured interviews via telephone or videoconference of approximately 45 min were conducted with interviewer probes and questions about perceptions of cancer risk, prevention, and screening techniques conducted, perceived barriers and facilitators, and preferences for health dissemination venues. The recordings were transcribed verbatim and de-identified. Analysis involved constructivist grounded theory coding strategies. Using peer debriefing and consensus building around themes, the researcher established a codebook for all interviews to utilize within Dedoose software for systematizing and organizing data.
RESULTS: Eighteen interviews were conducted. Interviewees (N = 18) ranged in age from 35 to 78 yr, with 3 females. Outdoor industries included agriculture, maintenance, and grounds maintenance. Themes derived from the data showed the underlying factors and perceptions that influence outdoor workers to conduct primary and secondary cancer prevention activities. The level of alarm attributed to disease and the level of trust in information contribute to intentions to conduct activities. The intentions and trust toward healthcare institutions and providers drive the primary or secondary prevention behaviors. Cultural and contextual factors included masculinity and self-sufficiency, familial and occupational priorities, and community ties.
CONCLUSIONS: These data provide a basis for developing future communications and interventions to decrease skin cancer incidence in outdoor workers. They indicate that secondary prevention and building self-efficacy in conducting SSE should be emphasized in tandem or over primary skin cancer prevention methods in this population. Trusted local healthcare providers should primarily provide prevention information, and materials should utilize testimonials from the local community to best influence this population. Communications and training interventions are needed in this population to induce a proactive level of alarm about cancer and result in the performance of SSE.
METHODS: Purposive, snowball, and theoretical sampling was used to recruit outdoor workers in Kentucky and Indiana. Semi-structured interviews via telephone or videoconference of approximately 45 min were conducted with interviewer probes and questions about perceptions of cancer risk, prevention, and screening techniques conducted, perceived barriers and facilitators, and preferences for health dissemination venues. The recordings were transcribed verbatim and de-identified. Analysis involved constructivist grounded theory coding strategies. Using peer debriefing and consensus building around themes, the researcher established a codebook for all interviews to utilize within Dedoose software for systematizing and organizing data.
RESULTS: Eighteen interviews were conducted. Interviewees (N = 18) ranged in age from 35 to 78 yr, with 3 females. Outdoor industries included agriculture, maintenance, and grounds maintenance. Themes derived from the data showed the underlying factors and perceptions that influence outdoor workers to conduct primary and secondary cancer prevention activities. The level of alarm attributed to disease and the level of trust in information contribute to intentions to conduct activities. The intentions and trust toward healthcare institutions and providers drive the primary or secondary prevention behaviors. Cultural and contextual factors included masculinity and self-sufficiency, familial and occupational priorities, and community ties.
CONCLUSIONS: These data provide a basis for developing future communications and interventions to decrease skin cancer incidence in outdoor workers. They indicate that secondary prevention and building self-efficacy in conducting SSE should be emphasized in tandem or over primary skin cancer prevention methods in this population. Trusted local healthcare providers should primarily provide prevention information, and materials should utilize testimonials from the local community to best influence this population. Communications and training interventions are needed in this population to induce a proactive level of alarm about cancer and result in the performance of SSE.
摘要：
目标：户外工作者患皮肤癌和黑色素瘤的风险增加。这项定性研究旨在探索户外工作者对初级（即防晒）和二级预防的看法和经验，即皮肤癌的皮肤自检(SSE)。
方法：目的，滚雪球,理论抽样被用来招募肯塔基州和印第安纳州的户外工人。通过大约45分钟的电话或视频会议进行半结构化访谈，面试官对癌症风险的看法进行了调查和提问。预防,和进行的筛选技术，感知到的障碍和促进者，以及对健康传播场所的偏好。录音被逐字转录和去识别。分析涉及建构主义扎根理论编码策略。利用同行汇报和围绕主题建立共识，研究人员为所有访谈建立了一个码本，以便在Dedoose软件中使用该码本来系统化和组织数据。
结果：进行了18次访谈。受访者(N=18)年龄从35岁到78岁，三个女人。户外产业包括农业，维护,和地面维护。从数据中得出的主题显示了影响户外工作者进行原发性和继发性癌症预防活动的潜在因素和观念。归因于疾病的警报级别和对信息的信任级别有助于进行活动的意图。对医疗机构和提供者的意图和信任推动了一级或二级预防行为。文化和背景因素包括男子气概和自给自足，家庭和职业优先事项，和社区联系。
结论：这些数据为制定未来的沟通和干预措施以降低户外工作者皮肤癌发病率提供了基础。它们表明，在该人群中，应在串联或超过原发性皮肤癌预防方法中强调进行SSE的二级预防和建立自我效能。受信任的本地医疗保健提供者应主要提供预防信息，材料应该利用当地社区的推荐来最好地影响这个人群。在该人群中需要通信和培训干预措施，以引起对癌症的主动警报，并导致SSE的表现。
方法：目的，滚雪球,理论抽样被用来招募肯塔基州和印第安纳州的户外工人。通过大约45分钟的电话或视频会议进行半结构化访谈，面试官对癌症风险的看法进行了调查和提问。预防,和进行的筛选技术，感知到的障碍和促进者，以及对健康传播场所的偏好。录音被逐字转录和去识别。分析涉及建构主义扎根理论编码策略。利用同行汇报和围绕主题建立共识，研究人员为所有访谈建立了一个码本，以便在Dedoose软件中使用该码本来系统化和组织数据。
结果：进行了18次访谈。受访者(N=18)年龄从35岁到78岁，三个女人。户外产业包括农业，维护,和地面维护。从数据中得出的主题显示了影响户外工作者进行原发性和继发性癌症预防活动的潜在因素和观念。归因于疾病的警报级别和对信息的信任级别有助于进行活动的意图。对医疗机构和提供者的意图和信任推动了一级或二级预防行为。文化和背景因素包括男子气概和自给自足，家庭和职业优先事项，和社区联系。
结论：这些数据为制定未来的沟通和干预措施以降低户外工作者皮肤癌发病率提供了基础。它们表明，在该人群中，应在串联或超过原发性皮肤癌预防方法中强调进行SSE的二级预防和建立自我效能。受信任的本地医疗保健提供者应主要提供预防信息，材料应该利用当地社区的推荐来最好地影响这个人群。在该人群中需要通信和培训干预措施，以引起对癌症的主动警报，并导致SSE的表现。
