An interventional study of Skin Cancer Self-Detection Educational Program with gain-framing and Skin Cancer Self-Detection Educational Program with loss-framing in Skin Cancer, Skin Cancer Prevention and Benign Skin Growth, sponsored by National University Hospital, Singapore. Recruiting at 1 site in Singapore. Open to participants aged 16 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2026-09-24.
Sponsored by National University Hospital, Singapore · Not applicable, Interventional, and Other
Skin cancer is a significant public health concern, even in an Asian society like Singapore where it ranks among the top 10 cancers. This RCT tests the effectiveness of a skin cancer educational intervention to improve skin cancer outcomes among skin-of-color individuals, including the effects of gain versus loss framing.
Reducing skin cancer related morbidity and mortality involves two broad domains; (1) Identification and early detection of skin cancers and (2) Awareness and behavioral change to reduce modifiable risk factors like UV exposure. Regular self-examination and public education have been shown in RCTs to improve knowledge and identification of skin cancers. However most of these existing studies and the tools they utilise rely on Western-centric photographs and messaging, such as the 'ABCDE rule' for superficial spreading and nodular melanoma. These neglect skin cancers far more common in skin of colour population such as acral lentiginous melanomas, pigmented basal cell and squamous cell carcinomas.
In addition to improving detection, effective behavioural change strategies are needed to encourage protective practices such as regular sunscreen use. Message framing has gained interest as a behavioral change technique: gain-framed messages emphasize the benefits of adopting a behavior, while loss-framed messages highlight the negative consequences of not doing so. Although message framing is widely used in health communication, evidence of its effectiveness in promoting skin cancer-related behaviors is unclear.
Effectiveness of our proposed intervention can help to increase adoption of sun protective behaviours, improve detection rates of skin cancer and allow earlier medical intervention, hence reducing morbidity and mortality of skin cancer.
604 studies on the registry are indexed under Skin Neoplasms; 126 are open to participants now.
This study's planned enrollment of 280 is above the median of 55 across 408 interventional studies indexed under Skin Neoplasms.
Browse Skin Neoplasms studies →National University Hospital, Singapore is the lead sponsor of 454 studies on the registry; 99 are open to participants now.
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Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.
Exclusion Criteria:
- Individuals who have cognitive impairment or decline to participate. There will be no exclusion criteria based on a previous history of skin cancer.
Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.
You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.
Informed consent
Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.
You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Participants will fill up a baseline competency examination and questionnaire, and another at the 4 month mark. Access to the intervention for control group participants will only be provided after the 4-month questionnaire is completed.
Behavioral: Wait-list Control
Participants will fill up a baseline competency examination and questionnaire. Afterwards, they will have access to a website with gain-framed messages emphasising benefits of adopting a behaviour. Thereafter, another competency questionnaire will be administered following completion of material.
Behavioral: Skin Cancer Self-Detection Educational Program with gain-framing
Participants will fill up a baseline competency examination and questionnaire. Afterwards, they will have access to a website with loss-framed messages highlighting consequences of failing to adopt a behaviour. Thereafter, another competency questionnaire will be administered following completion of material.
Behavioral: Skin Cancer Self-Detection Educational Program with loss-framing
This educational website will feature gain-framing messages, emphasizing the benefits of adopting a behavior, utilising positive language and analogies. The interventional domains are (1) Education on skin cancer risk factors and epidemiology, (2) UV Protection Advice, (3) Skin Self-Examination Techniques and (4) Differentiating benign vs malignant skin conditions.
This educational website will feature loss-framing messages, highlight the consequences of failing to adopt a behavior, utilising negative language and analogies. The interventional domains are (1) Education on skin cancer risk factors and epidemiology, (2) UV Protection Advice, (3) Skin Self-Examination Techniques and (4) Differentiating benign vs malignant skin conditions.
Participants in the control group will gain access to the intervention websites after the 4-month questionnaire is completed.
Change in competency scores
Scores measured as percentage of correct questions answered. Range from 0% to 100% with higher score indicating higher ability to differentiate benign from malignant skin lesions. Change in scores will be calculated and compared between 1. Both intervention arms with the control group at 4 months, and 2. Between gain framed and loss framed intervention arms at 4 months
Time frame: Baseline, immediately post-intervention (for intervention arms), 4 months post-intervention
Knowledge of skin cancer, sun protection and skin self-examination
20 Multiple Choice Questions created based on intervention website. Score range from 0 to 20, with a higher score indicate higher knowledge in risks of skin cancer, appropriate sunscreen use and features of cancerous lesions.
Time frame: Baseline, immediately post-intervention (for intervention arms), 4 months post-intervention
Attitudes toward carrying out sun protection behaviours
6 questions graded on a 7-point Likert scale, with higher scores indicating better attitudes toward sun protection behaviours
Time frame: Baseline, immediately post-intervention (for intervention arms), 4 months post-intervention
Subjective norms, which refer to participants' perception of whether significant individuals in their lives would support sun protection behaviours
7 questions graded on a 7-point Likert scale, with higher scores indicating a greater influence of others' perception on their sun protection behaviours
Time frame: Baseline, immediately post-intervention (for intervention arms), 4 months post-intervention
Behavioural outcomes (sun protection behaviour and skin self-examination)
Sun Exposure and Protection Index. 9 questions graded on a 5-point Likert scale assessing sun habits and sun protection behaviour. Lower scores indicate more optimal sun protection behaviours, with an additional adapted question. 11 additional questions regarding participants' sunscreen usage (e.g. type of sunscreen, frequency of reapplication), and skin-self examination, with a lower score indicating more optimal sun protection behaviours.
Time frame: Baseline, immediately post-intervention (for intervention arms), 4 months post-intervention
Intentions of participants toward carrying out skin cancer risk prevention strategies
Sun Exposure and Protection Index (6 questions with an additional adapted question). Each given response score (0-4) are summed, with scores ranging from 0-24, with higher score indicating a low propensity to increase sun protection. 2 additional questions regarding participants' intentions of conducting a skin-self examination. 7 point Likert Scale (1-7), with higher score indicating higher intentions of conducting a skin-self examination.
Time frame: Baseline, immediately post-intervention (for intervention arms), 4 months post-intervention
Plan to share: Yes — IPD shared includes de-identified demographics and measures.
Supporting information: Study protocol, Informed consent form, Analytic code
Time frame: IPD and supporting information will be available from the time of publication and for four years thereafter.
Access criteria: Deidentified individual participant data supporting the findings of this study will be available from the corresponding author upon reasonable request. Access will be granted on a case-by-case basis following review and approval of a data access proposal and completion of a data sharing agreement.
No publications or documents are linked to this record.
Started Jun 2026 (actual). Primary completion is estimated for Jun 2027, 12 months after the start.
Of 94 non-industry interventional studies with no phase under Skin Neoplasms, half reached primary completion within 23 months of starting (the median), counting those still running; a quarter within 9 and three quarters within 49. This study's planned 12 months is below that.
Counting every sponsor, half of 116 studies reached it within 27 months; a quarter within 10 and three quarters within 66.
How these figures are worked out, and which studies are left out of them.
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