Implications for practice

The major implication for health promotion practice and research for solar protection interventions resulting from this summary is the need for long-term community-based RCTs using multistrategic primary and secondary interventions across targeted populations within communities. Such trials should use partnership or health alliance models including partners from health, education and workplace settings or use existing partnerships where these are already operational. These trials should include training and education in general practice as well as early detection and diagnosis outcomes. Interventions targeted at high-risk groups could be a discrete element of the trial, and in particular, identification of high-risk patients.

To date there has been a problematic gap between the reporting of initial research studies and the use of the data from these studies to plan and implement long-term randomised trials. Researchers and policy planners have not capitalised on the results from successful early pilot or short-term sun-protection interventions to develop such long-term trials. It is necessary to include behaviour change outcome measures for each specific element of the trial as well as at least one other outcome measure (for example

Can postgraduate medical training improve accurate diagnosis?

knowledge) for primary prevention interventions. Further research is needed to establish the link between knowledge and behaviour in the process of long-term behaviour change. For secondary prevention, such trials should include behaviour change outcome measures for populations as well as for clinical practice where appropriate. As global warming continues there is an urgent need for more individuals to make long-term behaviour (maintained) changes. Primary-care practitioners need to be convinced that they have a role in both the primary and secondary prevention of skin cancers, and in identifying high-risk individuals. Such improvements and the research required to substantiate them will require considerable funding.

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