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      An application of a series of theory-based educational intervention based on the health belief model on skin cancer prevention behaviors in female high school students

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          Abstract

          Background

          Cancer is a leading cause of death globally and the second cause of death in developed countries. Having a rising incidence, skin cancer is the most prevalent cancer in Iran. Long-term UV radiations, particularly during childhood and adolescence, is a major cause of skin cancers. The Theory of Planned Behavior as the most precise indicator of behavior, contains motivational factors affecting behavior. This theory has been successful in predicting factors related to chronic diseases, especially cancer. As this model was successful in assessing sun-protective behaviors in previous studies, this study was designed to figure out how a theory-based educational intervention can affect the skin cancer prevention practices of Iranian female high school students.

          Methods

          This experimental investigation was carried out 2019–2020 using multistage cluster sampling method on 400 female high school students in Fasa, Fars, Iran. A questionnaire consisting of demographic data and a questionnaire including the components of the Theory of Planned Behavior was used to assess skin cancer preventative behaviors of both the trial and control groups of the study. An educational program based on the Theory of Planned Behavior was held for the experimental group for eight weeks regarding skin cancer preventive behaviors. The two groups completed questionnaires three months following the intervention for a second time.

          Results

          The study's findings revealed that prior to the intervention, there was no considerable distinction between the two study groups with regard to knowledge, attitude, subjective norms, perceived behavioral control, behavioral intentions, and skin cancer prevention behaviors; yet, three months later, the experimental group demonstrated increases in each of the mentioned variables with a significant difference. In contrast, the control group showed no discernible difference.

          Conclusions

          The findings of this investigation highlighted the success of the Theory of Planned Behavior for designing educational interventions aimed at encouraging skin cancer prevention in a population of female high school students.

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          Most cited references41

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          The theory of planned behavior

          Icek Ajzen (1991)
          Organizational Behavior and Human Decision Processes, 50(2), 179-211
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            Dermatologist-level classification of skin cancer with deep neural networks

            Skin cancer, the most common human malignancy, is primarily diagnosed visually, beginning with an initial clinical screening and followed potentially by dermoscopic analysis, a biopsy and histopathological examination. Automated classification of skin lesions using images is a challenging task owing to the fine-grained variability in the appearance of skin lesions. Deep convolutional neural networks (CNNs) show potential for general and highly variable tasks across many fine-grained object categories. Here we demonstrate classification of skin lesions using a single CNN, trained end-to-end from images directly, using only pixels and disease labels as inputs. We train a CNN using a dataset of 129,450 clinical images—two orders of magnitude larger than previous datasets—consisting of 2,032 different diseases. We test its performance against 21 board-certified dermatologists on biopsy-proven clinical images with two critical binary classification use cases: keratinocyte carcinomas versus benign seborrheic keratoses; and malignant melanomas versus benign nevi. The first case represents the identification of the most common cancers, the second represents the identification of the deadliest skin cancer. The CNN achieves performance on par with all tested experts across both tasks, demonstrating an artificial intelligence capable of classifying skin cancer with a level of competence comparable to dermatologists. Outfitted with deep neural networks, mobile devices can potentially extend the reach of dermatologists outside of the clinic. It is projected that 6.3 billion smartphone subscriptions will exist by the year 2021 (ref. 13) and can therefore potentially provide low-cost universal access to vital diagnostic care.
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              The ever‐increasing importance of cancer as a leading cause of premature death worldwide

              The relative importance of cardiovascular disease (CVD) and cancer as leading causes of premature death are examined in this communication. CVD and cancer are now the leading causes in 127 countries, with CVD leading in 70 countries (including Brazil and India) and cancer leading in 57 countries (including China). Such observations can be seen as part of a late phase of an epidemiologic transition, taking place in the second half of the 20th century and the first half of the present one, in which the dominance of infectious diseases is progressively superseded by noncommunicable diseases. According to present ranks and recent trends, cancer may surpass CVD as the leading cause of premature death in most countries over the course of this century. Clearly, governments must factor in these transitions in developing cancer policies for the local disease profile.
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                Author and article information

                Contributors
                Journal
                Heliyon
                Heliyon
                Heliyon
                Elsevier
                2405-8440
                18 June 2023
                June 2023
                18 June 2023
                : 9
                : 6
                : e17209
                Affiliations
                [a ]Faculty of Medicine, Fasa University of Medical Sciences, Fasa, Iran
                [b ]Department of Public Health, School of Health, Fasa University of Medical Sciences, Fasa, Iran
                [c ]Department of Dermatology, School of Medicine, Fasa University of Medical Sciences, Fasa, Iran
                [d ]Nutrition Research Center, Department of Public Health, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
                Author notes
                []Corresponding author. Department of Public Health, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran. Khani_1512@ 123456yahoo.com
                Article
                S2405-8440(23)04417-1 e17209
                10.1016/j.heliyon.2023.e17209
                10333432
                92726980-1497-4e06-9f71-a44df672a024
                © 2023 The Authors

                This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

                History
                : 7 October 2022
                : 29 May 2023
                : 9 June 2023
                Categories
                Research Article

                students,intention,behavior,prevention and control,skin neoplasms,knowledge,attitude

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