Report on Skin Cancer Prevention Strategies in Rural NSW, Australia

This report outlines a health promotion initiative focused on skin cancer prevention in rural communities of northern coastal New South Wales, Australia. It addresses the high incidence of skin cancer in these areas, driven by factors like UV exposure and limited access to protective measures. The initiative, titled 'Ban the Tan: Be Sun Smart!', aims to reduce skin cancer cases through strategies like community education, promoting sun-safe behaviors, and advocating for environmental changes. The report includes a needs assessment, defined goals and objectives, and an action plan detailing the implementation of strategies such as health education sessions using video-assisted teaching, free sunscreen distribution, and community engagement activities. The plan emphasizes short-term objectives like educating the community about the dangers of sun exposure and promoting the use of sun protection measures. The effectiveness of the initiative will be evaluated through questionnaires and impact assessments.

Running head: Skin care prevention 1
Skin care prevention
Report
Student name:
12/18/2018

Skin care prevention 2
Contents
Title of the Initiative: Ban the tan: Be Sun Smart!.............................................................2
Needs assessment:..........................................................................................................2
Goals:..............................................................................................................................4
Objectives & Strategies:.....................................................................................................4
Long-term objectives:.....................................................................................................4
Strategies for long-term objectives:................................................................................4
Short-term objectives:.....................................................................................................5
Strategies for short-term goal:........................................................................................5
Appendix 1: Health teaching plan......................................................................................8
Appendix 2: Questionnaire...............................................................................................14

Skin care prevention 3
Introduction:
In Australia, second foremost reason of the death is Skin cancer that is
transmitted through the evolution of anomalous tissue in the body (Cancer
Council of Australia, 2018). It is categorized into three different types of cancer
that is Squamous cell carcinoma, basal cell carcinoma and the most dangerous one
is melanoma cancer.
Squamous cell carcinoma is the type of cancer where the skin appears as scaly
ulceral spot that is tender and it might bleed. The other type of cancer is basal cell
carcinoma. This type of cancer is ulcerated from the skin at the center of the spot
with pinkish colour appearance, which usually does not heal.
Melanoma stands in one of the most dangerous cell that causes damage to the
DNA (by ultraviolet rays or genetically inheriting it from parents) (Australian
Institute of Health and Welfare, 2016). The government applied strategies to
prevent skin cancer at local and community levels to control it but this strategy did
not work well.
This report focuses on the health campaign initiative that is “skin cancer
prevention” in rural communities of northern coast of North South Wales. In this
report, further described in details about the basic strategies, aims and purposes
with a structural development, application and assessment phase, supporting with
the facts. The action plan is for the execution of the strategies using suitable
teaching plan and using funds for community training program alongside the
assessment strategy (impact evaluation and questionnaire) which can be used to
assess the benefit of the skin cancer prevention program (in appendices).This
initiative imitates the “New South Wales Skin Prevention Strategy ” agenda.
Title of the Initiative: Ban the tan: Be Sun Smart!

Skin care prevention 4
Needs assessment:
Framing a health policy is an essential task for instance it directs the policy
producers to the real health issue experiences through which the community
exclude the advantages and disadvantages of the opportunities to improve health
(McMurray & Clendon, 2015a). The need of this assessment is to present the
epidemiological model. In addition, this assessment also conducts Bradshaw’s
experimental model, which include s the sensed requirements, articulated
requirements and reasonable requirements to the public (Naidoo & Wills,
2009a).Every year, estimation is held and in that 434,000 people are starting to
age below 40 years and most of them are diagnosed with skin cancer. Skin cancer
is a harmful disease and the estimated mortality rate is 645 out of 100,000 people
and according to the specialists the death rate will be increased in the year 2020
by two percentage (Cancer Council of Australia, 2018). A case in 2014, of
Melanoma cancer in rural regions of New South Wales had the predictable ratio of
1 in 16 people has a risk of death or diagnosing cancer as the insightful guide of
ultraviolet rays are higher at sea coastlines (National Rural Health Alliance
[NRHA], 2014).
The mortality rate amongst the rural youths as well as in elder persons is higher
with five hundred four per 100,000 persons, specially the agriculturalists with
sixty percentage (NRHA, 2014). According to Perez et al. (2015) case study,
which organized a research on the attitude of persons in the rural regions of North
South Wales towards a sun tan promotion and the result of the campaign was that
the people of that region believed in sun tanning methods as it is considered as
healthy practice and avoids cancer. According to AIHW (2016) report, it states
that the frequency of occurring skin cancer to the people in rural areas is twice

Skin care prevention 5
than in urban areas. This happens due to lack of favorable conditions in the rural
region, the knowledge of self-protective skills from UV rays and lack of health
services access. Due to all these reasons, the community faces the weakness and
this can be only changed by participation of the community by interrogating the
investors (leader of the community and health specialist) straightforwardly as
prime foundation of interaction (Naidoo & Wills, 2009a).

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Goals:
Goals are defined as a path that drives towards the desired change which
determined through the community needs assessment (Talbot & Verrinder, 2018). In
Australia, 90% of the people have melanoma due to contact to the UV rays and it can
be minimized by the use of sun blockers or by covering the body with full clothes to
avoid harmful rays. The main victims of skin cancer are the people working in the
rural areas such as farmers and construction workers (Cancer Council of Australia,
2018). People residing in rural northern-coastal regions of New South Wales are
mostly targeted for skin cancer to children, juveniles working in exposed
environment and adults between the age group of 40-60 years. Hence, the foremost
motive of this initiative of skin cancer campaign is to decrease the number of cases
of skin cancer in the rural northern-coastal regions of New South Wales by
reinforcement of individual services and information, creating a safe atmosphere and
decreasing the contact to UV rays.
Objectives & Strategies:
Objectives are defined as the overall statements which provide the short idea
about the things needed to be done to achieve the ultimate goals (Talbot & Verrinder,
2018). According to Scriven & Ewles (2010), an ideal form of objective is
considered as being specific, goals which are easily achievable, relevant to the issues
(realistic goals) and it should be time bound. While, the strategies are included to
summarize the objectives for achievement of the goals through a collaborative
approaches from the various sectors for example government, community, and health
professionals (Talbot & Verrinder, 2018).
The reflective strategies are the Ottawa Charter (OC) agenda for health campaign
(WHO, 2018). The OC plans targets on reinforcement of health strategies, helpful
surroundings for health promotion, reevaluate the health services, strengthening the
personal skills and developing the participation of the community (WHO, 2018).

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Long-term objectives:
 The government should build roofs for the people of rural coastal regions of New
South Wales by the year 2020.
 The government should apply skin safety strategy for rural communities and in
the rural coastal regions of North South Wales by the year 2020.
Strategies for long-term objectives:
1. The government should plant more trees for the involvement of community
leaders and people as a part of communal activities in the nearby areas like schools,
farms and local residencies.
2. The government should mandate the sun protective glasses and windows.
Short-term objectives:
 The government should educate the people of the community on the dangerous
impact of sun’s contact to skin.
 The government should reinforce the individual services on the rural people by
using the sun shielding obstacles commendably.
Strategies for short-term goal:
3. Health education will be provided through the medium of video supported by
teaching on the dangerous effects of sun in contact with skin.
4. The government should educate the people usage of sunscreen by demonstrating
it.
5. The government should inspire the usage of complete covered clothes, sunspecs,
sunhats and ultraviolet ray concentration tracing applications in phones to decrease
the probabilities of ultraviolet contact.

Skin care prevention 8
6. The government should distribute free sunscreens and hats to poor socioeconomic
background people.
This report is based on the strategies of “ecological model” of health campaign that
focuses on changes in the natural conditions and socioeconomic conditions of an
individual to promote healthy behavior (Pender, Murdaugh and Parsons, 2015).
Action plan:
Action plan is also referred as blue print of when, how, who, where and what
requirements are needed to fulfill or execute the project or plan this is also known as
“implementation plan” (McMurray & Clendon, 2015b). To take charge of the action
plan few things are essential such as work force, budget, time and materials which
will be required to accomplish the plan or the project (Scriven & Ewles, 2010).
Policy planning should be the reflection of WHO’s and OC’s health care and
health promotion principles (Nahar, 2013). According to Pender, Murdaugh &
Parsons (2015), to make planning task easier it is necessary to set the priorities in
steps such as short-term objectives is the top priority. In this report, the short term
objectives are the main priorities as those goals can be achieved in a short duration
that is required to control the impact of the issue (skin cancer). Hence, the strategy
numbers three, four, five, and six are needed to be implemented first as they are the
short term strategies and can be done easily.
The main aim of this is health education (McMurray & Clendon, 2015b). Health
education program will be given on kinds of skin cancer such as strategies of
prevention and risk factors. Professionals, to educate the local community, will
conduct the health educating session and transportation will be provided to attain this
session (Sharma & Romas, 2012). Health education will be provided on different
types of prevention strategies to prevent from skin cancer or to detect the problems
related to skin cancer.
The professionals will teach through video assisted teaching session (VAT) and

Skin care prevention 9
the target population is the rural public and from the age group of the youth to the
elders. The teaching sessions is going to held in the secondary schools for students,
parents, older adults, workers of construction sites and farmers. The health teaching
session will be conducted by a group of trained community health workers that
consists of four to five members in the community. These members will reach to the
local community authority in the rural suburb at the public schools and conduct the
sessions.
Also, to conduct the session local community bus will be provided to commute
the people to the public schools from their respective homes to ensure that maximum
number of people attain the health promotion session. A well-defined target
audience, an accurate and significant content of teaching plan and involvement of the
audience are the key components for a successful teaching session (Sharma &
Romas, 2012).
Teaching plan is going to focus on the different types of skin cancers, and the
detection for the related risk factors and the preventive methods. A VAT session will
be provided that will run for twenty minutes which will encompass the explanation
on types, causes and preventive methods or strategies for skin cancer followed by a
poster demonstration that will run for fifteen minutes. This will discuss on the
prevention strategies and demonstration of sunscreen application and use of
ultraviolet ray intensity tracking applications on the mobile phone and this session
will run for approximately twenty minutes.
Refer to appendix one for the teaching plan. The video will be in the form of
presentation style and will be content in English language. The link of the video and
the posters for the demonstration can be retrieved from appendix three given below
at the end of the report.
According to Sharma & Romas (2012), the medium used for health education
should be interactive, brief; the content should be understandable by the target

Skin care prevention 10
population and specific. After the completion of the teaching session, the audience
will be contacted by the members of teaching sessions after one month to fill
questionnaires to evaluate the outcome of the session given to them. Later, there will
be free distribution of sunscreen and hats which will be held after the teaching
session for those who attended the session will get a complementary gift from the
teaching session members.
In addition, the project also needs budgeting or funding as it is crucial for carrying
out any health promotion activity or initiative. Funding proposal can be provided
with a short summary of the action plan with transparent objectives and strategies so
that the funding body (local, state or federal government) can estimate and cross
verify the required amount needed (Pender, Murdaugh & Parsons, 2015). For proper
implementation of strategy one and two, effective funding is required as it targets to
build the supportive environment for the public. Moreover, strategies one and two
can be achieved by inter sectoral collaboration with the community, government,
health sectors and other main stakeholders.
Tree plantation is one of the activities to be done as a part of the community to be
carried out in the places such as schools and local regions of suburbs because this can
provide shades and increasing of shades means decrease in the exposure to the sun.
To plant more trees community leaders and volunteers will help in this activity. But
on the other hand, the implementation of sun protection policy is only possible when
the government will enforce a strict law of abolishment of the usage of solarium and
glass windows at buildings where people work daily. Government should apply high
penalties for these kinds of glass windows in the buildings.
Strategies one and two require effective capital as it aim to build helpful
environment whereas; the application of skin safety policy is only conceivable if
government abolishes the use of solarium and glass windows. Therefore, action plan
is a communicative process including the contribution of community, government,

Skin care prevention 11
and health professionals.
Evaluation:
Evaluation means the process of determining whether the objectives and the
strategies is going to meet the actual aim or has already met the actual aim or not. It
is a simultaneous process which starts with the planning phase of the project and then
continuing with the action phase and then implementation of itself (Talbot &
Verrinder, 2018).
According to Talbot & Verrinder (2018), the three primary types of evaluation
process are process, impact and outcome evaluation. Process evaluation targets on
the evaluation of the policies or else involvements of the education program (Naidoo
& Wills, 2009b). In this evaluation, the stakeholders such as leaders of the
community or any federal government, funding authorities and health professionals
or practitioners are involved to review the process or the strategies of the organized
program to check if the program needs to be redesigned (Scriven & Ewles, 2010).
The process evaluation takes places through the group interview method (open ended
questions). This will be held with the community leaders and health professionals to
evaluate the effectiveness of the program.
The impact includes accessing investors and health practitioners to review the
process (Scriven & Ewles, 2010). This evaluation is done through group interview to
check the effectiveness of the program. Through the medium of interview and
surveys, the effectiveness of the teaching plan is checked and this is impact
evaluation (Pender, Murdaugh & Parsons, 2015). The impact evaluation strategy is
used to access the knowledge of the community participants thorough the
questionnaires. This questionnaire will be in the form of pre-test that will be
conducted after the teaching session (appendix two).
The outcome evaluation is a complicated process that takes place slowly as it
concentrates on behavioral changes of individuals as an outcome, of the education

Skin care prevention 12
program involvements (McMurray & Clendon, 2015b). Hence, evaluation is
important to remind the progression or deviation of goals.
From this report, we get to know that the outcome is positive in the rural north-costal
region of North South Wales. The people from this rural community have started to
apply the sun protective applications on the skin and the result of the program is
progressing. Thus, it is very essential to apply the policy in the rural regions as well
as in urban society.
References:
Australian Institute of Health and Welfare. (2016). Skin cancer in Australia (Report
no: 96). Canberra: AIHW. Retrieved from:
https://www.aihw.gov.au/getmedia/0368fb8b-10ef-4631-aa14-cb6d55043e4b/
18197.pdf.aspx?inline=true
Cancer Council of Australia. (2018). Facts andFigures. Retrieved from:
https://www.cancer.org.au/about-cancer/what-is-cancer/facts-and-figures.html
Cancer Institute NSW. (2017). NSW skin cancer prevention strategy(Report no: 30).
Sydney: Cancer Institute NSW. Retrieved from:
https://www.cancer.nsw.gov.au/nsw-skin-cancer-strategy
McMurray, A. ,&Clendon, J. (2015a). Assessing the community. In McMurray, A.,
&Clendon, J. (5th edition), Community health and wellness: Primary health care in
practice (pp 40-62). Chatswood, NSW: ElsevierAustralia.
McMurray, A. ,&Clendon, J. (2015b). Planning and promoting community health:
principles and practice. In McMurray, A., &Clendon, J. (5th edition), Community
health and wellness: Primary health care in practice (pp 61-91). Chatswood, NSW:
ElsevierAustralia.
Nahar, V. K. (2013). Skin cancer prevention among school children: a brief review.
Central European Journal of Public Health, 21(4), 227–232.
National Rural Health Alliance. (2014). Skin cancer in Australia: Awareness, early

Skin care prevention 13
diagnosis and management. Retrieved from:
http://ruralhealth.org.au/sites/default/files/publications/fact-sheet-08-cancer-rural-
australia.pdf
Naidoo, J., & Wills, J. (2009a). Assessing health needs. In Naidoo, J., & Wills, J. (3rd
edition), Foundation for health promotion (pp 253-267). Edinburg, New York:
BailliereTindallpublication.
Naidoo, J., & Wills, J. (2009b). Planning health promotion interventions. In Naidoo,
J., & Wills, J. (3rd edition), Foundation for health promotion (pp 269-286). Edinburg,
New York: BailliereTindall publication.
Pender, N.J., Murdaugh, C.L., & Parsons, M.A. (2015).Evaluating health promotion
program. In Pender, N.J., Murdaugh, C.L., & Parsons, M.A. (7th edition), Health
promotion in nursing practice (pp 298-317). New Jersey: Pearson Education.
Perez, D., Kite, J., Dunlop, S. M., Cust, A. E., Goumas, C., Cotter, T., Bauman, A.
(2015).Exposure to the “Dark Side of Tanning” skin cancer prevention mass media
campaign and its association with tanning attitudes in New South Wales,
Australia.Health Education Research, 30(2), 336–346.
doi: https://doi.org/her/cyv002
Scriven, A., &Ewles, L. (2010).Promoting health: a practical guide (6th
edition).Edinburgh, New York: BailliereTindall publication.
Sharma, M., &Romas, John Albert.(2012). Theoretical foundations of health
education and health promotion (2nd Ed.).Sudbury, MA: Jones & Bartlett Learning.
World Health Organization.(2018). The Ottawa Charter for health promotion.
Retrieved from:https://www.who.int/healthpromotion/conferences/previous/ottawa/
en
Appendix 1: Health teaching plan
Object Content Teachi Resour Evalua

Skin care prevention 14
ives ng
metho
ds
ces tion
Gener
al
objecti
ve:
After
the
teachin
g
session
, the
partici
pants
will
face
much
better
insight
concer
ning
about
skin
cancer
and its
prevent
In this session,
the teachers will
provide with skin
prevention
strategies.
Profess
ionals
will
teach
throug
h the
mediu
m of
video.
Transpo
rtation
will be
provide
d to
attain
the
session.
Questio
nnaire

Skin care prevention 15
ion
strategi
es.
Specifi
c
objecti
ve:
The
conclu
sion of
the
teachin
g
session
will
provid
e the
partici
pants
to be
able to:
Explai
n the
types
of skin
cancer.
Three types:
 Squamous
cell carcinoma
 Basal cell
carcinoma
 Melanoma
Group
questio
n and
discuss
ion
Video
presenta
tion
Questio
nnaire

Skin care prevention 16
Identifi
cation
marks
for the
type of
skin
cancer.
 Squamous
cell carcinoma:
the skin appears
as scaly ulcer
spot that is the
skin may be
tender and may
bleed.
 Basal cell
carcinoma: this
is appeared with
a pinkish spot,
which does not
heals and this is
the ulcerated
skin present in
the center of the
spot.
 Melanoma
(most
dangerous):
Follow the
ABCDE
acronym to
detect it:
A- Asymmetrical
B- Border
Discus
sion
and
explan
ation
Video
presenta
tion
Questio
nnaire

Skin care prevention 17
irregular
C- Colors
multiple
D- Diameter
greater than
6mm
E- Evolving and
changing
Recog
nition
of risk
factors
for
develo
ping
skin
cancer.
Reasons for
developing skin
cancer are
determined on
the basis of:
 Exposing skin
to sun
 Genetically
history
of skin cancer in
the family.
 Skin type is
another risk
factor (white
colored skin is
more prone to
develop it)
 Record of
Interac
tive
teachin
g and
learnin
g
Video
presenta
tion
Questio
nnaire

Skin care prevention 18
skin cancer and
sunburns to be
noted and take
care of.
 Tanning bed
can be used to
avoid risk
factors.
 Several moles
on the body.
 Immunosuppr
essant drugs.
Discus
s the
prevent
ion
strategi
es for
skin
cancer.
 Avoid sun
exposure during
peak hour time
of the day that is
10-4 pm.
 Avoid the
usage of sunbath
and tanning beds.
 Avoid
outdoor activities
during afternoon
 Prefer using
shade as much as
possible
 Prefer
Questi
oning
and
detail
explan
ation
Video
presenta
tion on
with
detail
explanat
ion and
demonst
ration
on
sunscre
en
applicat
ion and
poster
Questio
nnaire

Skin care prevention 19
wearing sun
protective
clothing (hat, sun
glasses, full
sleeve clothes,
cover the legs)
 Apply
sufficient amount
(+30 SPF) of
sunscreen to
avoid suntan
 Regular skin
checkups every
year from a
preferable
dermatologist for
early detection
and prevention
of skin cancer.
on
preventi
on
strategie
s.
References:
Mayo Clinic. (2014. December 29). Skin cancer prevention and detection.Mayo
Clinic.[Video file]. Retrieved from: https://www.youtube.com/watch?
v=QlIeNxyQkfs
Australian Institute of Health and Welfare. (2016). Skin cancer in Australia
(Report no: 96). Canberra: AIHW. Retrieved from:
https://www.aihw.gov.au/getmedia/0368fb8b-10ef-4631-aa14-cb6d55043e4b/
18197.pdf.aspx?inline=true

Skin care prevention 20
Cancer Council of Australia.(2017). Skin cancer. Retrieved from:
https://www.cancer.org.au/about-cancer/types-of-cancer/skin-cancer.html
Appendix 2: Questionnaire
Name:
Age & Sex:
Choose the appropriate option from the given three choices and put a  mark in front
of the option:
1. Skin cancer is classified into how many categories?
A. Two
B. Three
C. Four
2. What is the appearance of the skin if a person has Squamous cell carcinoma?
A. Pale yellow
B. Pinkish
C. Bluish
3. What is the acronym for melanoma?
A. AEDCB
B. AEFGHI
C. ABCDE
4. Which skin type person is at higher risk of developing skin cancer?

Skin care prevention 21
A. White
B. Black
C. Both
5. Overconsumption of which drugs lead to skin cancer?
A. Vitamin supplements
B. Immunosuppressant
C. Analgesics
6. What is the peak hour for highest ultraviolet ray exposure?
A. 11-4 pm
B. 1-6 pm
C. 10-4 pm
7. What is the minimum SPF factor required in the sunscreen to protect from sun
exposure?
A. 20
B. 30
C.50
8. How frequent one should consult with the dermatologist for the skin checkups as a
part of early detection of skin cancer?
A. Once in a month
B. Once in a year
C. Once in a week
Appendix: 3 Health teaching resources
Link for the video: Reference for the video:
Mayo Clinic. (2014, December 29). Skin cancer prevention and detection.Mayo
Clinic.[Video file]. Retrieved from: https://www.youtube.com/watch?
v=QlIeNxyQkfs
Link for the poster: skin-cancer-prevention-infographic.jpg

Skin care prevention 22
Reference for the poster or image:
Falara.(2018). Skin cancer prevention. Retrieved from:
https://www.shutterstock.com/image-vector/skincancer-prevention-infographic-
269377031