Table 1 Core intervention components of the three arms

PAE

• 14 text messages

• 1 text: welcoming participants to the study

• PAM components:

• 12 texts: reminders to conduct thorough skin self-examinations (TSSE), prompts to see a health care provider (HCP) for suspect lesions, messages highlighting key areas on targeting mediators and suggesting relevant website content (for example, demo of TSSE, risk factors for skin cancer)

Playing an active role in early detection

• 1 text: reminding participants about the 18-month survey

Self-efficacy re TSSE and asking HCP for skin exam

• Study website

• Information about skin cancer risk among survivors, and the key role that skin self-examinations and early detection (ED) play

Knowledge/awareness

Taking action

• Risk perception: re cancer status

• Information about how to conduct a self-examination and clinical images illustrating what to look for

• Information about how to ask a HCP for a skin exam:

• Barrier reduction

Printable checklist

Guide to discussion

• Information about preventive behaviors

• Interactive skin exam quizzes

• Tips for making ED a priority

• Lay summaries of research on the efficacy of skin exams

• Videos and links to additional resources about skin cancer

PAE + MD (Additional components/Mediators addressed)

• Physician activation packet

• Introduction letter describing intervention and encouraging MDs to do a full-body skin examination at the patient’s next visit

• Self-efficacy to perform a skin examination on the patient

• Guide to conducting a full skin cancer examination

• Information about survivors’ increased risk of skin cancer

• Access to the provider section of the ASK website, which houses additional resources including clinical images illustrating what to look for

• Study website

• Information about skin cancer risk among survivors, and the key roles that skin exams and early detection (ED) play

• Barrier reduction related to HCP provision of skin examination (for example, how to do exam; how to identify suspicious lesions)

• Video demonstration of how to conduct a thorough clinical skin examination

• Summaries of research on the efficacy of skin exams

• Videos and links to additional resources regarding skin cancer

• Access to all participant website materials

PAE + MD + TD

• Telederm

• Participant given dermatoscope attachment

• Barrier reduction decrease wait times for dermatology review of lesions

• Website provides information about typical and atypical lesions

• As part of regular TSSE, participant takes photographs of suspect lesions and sends to study dermatologist

• Teledermoscopy report sent within 1 week, includes instructions to health care provider about needed follow-up or treatment