Developing evidence and theory-informed digital videos employing a user-centred participatory approach, to support the early detection of skin cancer (EDSC) via self-examination of the skin (SSE), focused on at-risk (older men) and under-served populations (‘people of colour’)

Background More people are getting skin cancer and dying from it; climate change may drive this further. People are likely to live longer with better prognosis if cancer is diagnosed early.

However, many are unaware of the need to check their skin regularly and are unsure what to do/how to spot risk signs and when to present to primary care.

While there are existing digital resources to support skin self-examination (SSE), few are theoretically underpinned, take a structured approach to SSE or are tailored to at-risk or underserved groups, such as older men and people of colour. Aims i.

Develop an inter-disciplinary team, encompassing expertise in dermatology, behavioural science, participatory design approaches, health communications/media and lived experience. ii.

Iteratively co-design three evidence- and theory-informed video resources targeting three groups (people of colour, older men and adults of mixed gender and ethnicity) Methods Following Medical Research Council guidance, the intervention development process will be theoretically underpinned and consider contextual factors.

Adopting an agile participatory design approach, we will hold three co-design workshops per target group to harness their lived experiences.

Analysis of the workshop transcripts will involve the Framework method, using the Theoretical Domains Framework as our theoretical underpinning. Workshop 1 – What will we do?

The focus will be on establishing trust and a shared understanding, discuss what is most important for improving early detection of skin cancer, explore barriers and facilitators to regular SSE (using a validated questionnaire to prompt discussions) and produce guiding principles for the videos.

Workshop 2 – ‘What we are doing’ We will explore content, structure, function of the videos (reflecting on strengths/ weaknesses of existing resources) and select pragmatic behavioural change strategies for inclusion in the logic models underpinning each video.

Workshop 3 – ‘What we have done’ Thematic maps/insights from workshops 1 and 2 will be used to create initial prototype videos.

Screening the videos will elicit insights on acceptability in relation to narrative and visual elements, style and tone. We will explore possible implementation pathways/ways to increase reach. The three prototype videos plus logic models will be finalised following workshop 3.

How the results of the research will be used • Provide links to videos on relevant charity/NHS websites. • Promote uptake of videos through community engagement. • Engage public stakeholders and health care professionals to distribute videos to service users via their networks. • Publications to raise awareness and further research.