UArizona Nursing Researchers Develop Web-Based Skin Cancer Prevention Training for Massage Therapists

Nov. 19, 2020

In response to the threat of skin cancer – the most common form of cancer in the United States – University of Arizona College of Nursing researcher Lois J Loescher, PhD, RN, FAAN, and her team are looking at the feasibility of partnering with massage therapists (MTs) to help reduce their clients’ skin cancer risk.

Dr. Loescher’s team recently concluded a study funded by the Arizona Biomedical Research Centre, “Massage Therapists Skin Health Awareness, Referral and Education (MTsSHARE) to Reduce Skin Cancer Risk in Arizonans,” the results of which have been published in the Journal of Medical Internet Research (JMIR). Manuscripts detailing follow-ups to the study are also currently under review by two other academic publications.

“Skin cancer is the most common cancer in the US and costs about $8.1 billion annually to manage,” said Dr. Loescher. “Massage therapists trained to properly communicate skin cancer risk reduction information to their clients ultimately could contribute to decreased skin cancer incidence and management costs.”


“Skin cancer is the most common cancer in the US and costs about $8.1 billion annually to manage. Massage therapists trained to properly communicate skin cancer risk reduction information to their clients ultimately could contribute to decreased skin cancer incidence and management costs,”  ~ Lois J Loescher, PhD, RN, FAAN


Because of their eyes-on-the-skin observation and client-centered communication, MTs are uniquely positioned to promote skin cancer risk reduction. During a typical full body massage, MTs have a full view of each anatomical area of a client’s body, allowing the opportunity to visualize skin cancer risk factors such as sunburn, tanning lines, high mole counts, or suspicious lesions. Additionally, clients typically see their MTs more often and for longer durations than their primary care provider and are more likely to discuss health promotion offering greater opportunities for communication and encouragement of effective skin cancer risk reduction behaviors.

Some MTs receive education about skin cancer while completing licensing and certification training; however, there is no national standard for the extent of inclusion in massage therapy curricula. To help fill this gap, Dr. Loescher and her team developed an e-training intervention with two purposes: to inform MTs about skin cancer risk reduction and to train MTs how to have positive client-focused conversations about skin cancer risk reduction without compromising their scope of practice.

Lois J Loescher , PhD, RN, FAAN

Dr. Loescher’s team utilized the DecisionSim™ online platform in the e-training intervention. The team developed five virtual cases (simulations), each highlighting different components of a conversation within the context of a massage client visit. Each case contained between four and seven decision points for the participant to apply knowledge. The five cases were seamlessly integrated into the learning management system (LMS) to directly follow the e-training modules, allowing staff to monitor participant status and case completion.

To test the efficacy of the e-training, Dr. Loescher and her team recruited 80 MTs practicing in the state of Arizona. Participants demonstrated high rates of success with the training, which significantly improved their skin cancer knowledge and attitudes and comfort with delivering risk reduction information with their clients. A majority of MTs found the simulations useful and worth including in the training of future MTs. Dr. Loescher and her team concluded that adding decision simulation technology to e-training modules was useful not only to assess participant knowledge and skills, but also to assess e-training content and delivery for improvement. This innovative, practical application of simulation technology may be useful in a wide variety of health promotion and disease prevention contexts across disciplines and populations of study.

As for the future, Dr. Loescher’s team is planning on further testing of the e-training in a larger sample of massage therapists in sunbelt states in the US.