Lois J Loescher
- Professor, Nursing
- Associate Professor, Public Health
- Director, PhD Program
My passion is the study of cancer risk reduction, prevention and control behaviors, with a focus on skin cancer. Skin cancer is the most common cancer in the US; early detection of cutaneous lesions is paramount for increasing survival and reducing morbidity. My research concepts of interest are risk perception, risk communication and risk reduction; cancer worry; self-efficacy and personal control; and technology acceptance. I have received funding for my research from the NIH, private foundations, and through collaborations with Queensland (AU) University of Technology. My research involves UA multidisciplinary teams comprised of co-investigators from the Colleges of Nursing, Public Health, Medicine, and Engineering, as well as Bio5 and Dermatology. I also am an active member of a research team in Australia. Strengths of my research include: (1) A focus on skin cancer lesion identification by healthcare providers not typically studied, such as primary care physicians, nurse practitioners, and massage therapists, as well as by high-risk patients; (2) Use of novel technology as interventions, e.g., mobile teledermoscopy (smartphone+app+dermoscopy attachment), internet-delivered video, to improve skin lesion diagnosis and increase provider and patient self-efficacy; (3) Targeting of skin cancer prevention behaviors in understudiedpopulations such as Hispanic adolescents and vulnerable skin cancer high-risk populations such as solid organ transplant recipients (SOTR); (4) Evaluating training of health sciences students, and testing novel skin cancer information delivery methods in middle and high school students. My research uses quantitative methods (survey and instrument development), qualitative methods (focus groups, qualitative description) and mixed methods. As part of my joint appointment in the College of Public Health, I have developed and evaluated skin cancer prevention hybrid training for health sciences students. As a longstanding member of the UA Cancer Center, I have several years of experience developing and evaluating public and professional outreach education programs. I have been a productive member of the Skin Cancer Institute since its inception, contributing to grant submission proposals, outreach, and dissemination.
- Post doctoral Cancer Prevention and Control
- National Institutes of Health, Bethesda, Maryland, United States
- Instrument and model development in cancer genetics nursing research. Mentors: Paula Meek, Ph.D., RN; Neil Weinstein, Ph.D.
- Ph.D. Nursing
- The University of Arizona, Tucson, Arizona, United States
- Perceived risk of inherited susceptibility to cancer©. Ann Arbor, MI: UMI, 2001. Chair: Joan Haase, Ph.D., RN
- M.S.N. Nursing
- The University of Arizona, Tucson, Arizona, United States
- Perceptions of symptom distress in the patient with cancer of the colon and rectum, Chair: Alice J. Longman, RN, Ed.D
- B.S.N. Nursing
- The University of Wisconsin, Madison, Wisconsin, United States
- The University of Arizona, Tucson, Arizona (2018 - Ongoing)
- The University of Arizona Cancer Center (2015 - 2018)
- The University of Arizona, Tucson, Arizona (2011 - Ongoing)
- The University of Arizona College of Nursing (2009 - 2018)
- The University of Arizona College of Nursing (2003 - 2009)
- The University of Arizona College of Medicine (2002 - 2003)
- The University of Arizona College of Medicine (1993 - 2002)
- The University of Arizona College of Medicine (1990 - 1993)
- The University of Arizona College of Medicine (1985 - 1990)
- Dana Farber Cancer Institute (1984 - 1985)
- The University of Arizona College of Medicine (1981 - 1984)
- Veterans Affairs Medical Center, Tucson, Arizona (1980 - 1981)
- The University of Arizona Health Sciences Center, Tucson, Arizona (1978 - 1980)
- Tucson Medical Center (1975 - 1977)
- University of Minnesota Hospitals (1974 - 1975)
- Anna M. Shannon Mentorship Award
- Western Institute of Nursing, Spring 2021
- Outstanding Graduate Faculty
- UArizona CON, Spring 2019
- Extraordinary Faculty Award
- The University of Arizona College of Nursing Alumni council, Fall 2018
- International Research Development Grant Travel Award
- The University of Arizona Office of Global Initiatives, Fall 2016
- Researcher in Residence (Sponsor Peter Soyer)
- University of QueenslandBrisbane Australia, Fall 2016
- Nominated for Suzanne Van Ort Teaching Award
- College of Nursing, Spring 2016 (Award Nominee)
- American Academy of Nursing, Fall 2012
- Oncology Nursing Society Excellence in Cancer Prevention and Early Detection Award
- Oncology Nursing Society, Spring 2012
- Suzanne Van Ort Graduate Teaching Peer Award
- The University of Arizona College of Nursing, Spring 2011
- Cancer Prevention, Control, Behavioral and Population Sciences Career Development Award (1 K07 CA106996)
- National Cancer Institute, Spring 2009
- Gold Triangle Award for the video, Skin Cancer: Learn to Spot it Early©
- American Academy of Dermatology, Spring 2009
Licensure & Certification
- RN 031852 (Arizona), Arizona State Board of Nursing (1975)
- Arizona Nurses Association (1994)
Health promotion and risk reduction theories as foundations for research; research methods including mixed methods research and writing of systematic reviews; community health
Concepts of interest: Risk perception, risk communication and risk reduction; cancer worry; self-efficacy and personal control; and technology acceptance.Main research foci: Cancer prevention and control. Specific research focus: Skin cancer prevention, particularly interventions using technology to improve skin cancer risk-reducing behaviors.Populations: skin cancer-high-risk; border-dwelling adolescents
DissertationNURS 920 (Spring 2021)
Syst/inte Review ImpleNURS 701B (Spring 2021)
Thry/Hlth Prom+Risk RdctNURS 726 (Spring 2021)
DissertationNURS 920 (Fall 2020)
Intro to Proposal WritingNURS 707 (Fall 2020)
Sci+Practice of NursingNURS 695A (Fall 2020)
Syst/int Review FoundationsNURS 701A (Fall 2020)
Population/Community Hlt NursNURS 611 (Summer I 2020)
DNP ProjectNURS 922 (Spring 2020)
Independent StudyNURS 799 (Spring 2020)
Thry/Hlth Prom+Risk RdctNURS 726 (Spring 2020)
DNP ProjectNURS 922 (Fall 2019)
Sci+Practice of NursingNURS 695A (Fall 2019)
DNP ProjectNURS 922 (Summer I 2019)
Population/Community Hlt NursNURS 611 (Summer I 2019)
DNP ProjectNURS 922 (Spring 2019)
DissertationNURS 920 (Spring 2019)
DissertationNURS 920 (Fall 2018)
Sci+Practice of NursingNURS 695A (Fall 2018)
DissertationNURS 920 (Summer I 2018)
Independent StudyNURS 699 (Summer I 2018)
Independent StudyNURS 799 (Summer I 2018)
Population/Community Hlt NursNURS 611 (Summer I 2018)
DNP ProjectNURS 922 (Spring 2018)
DissertationNURS 920 (Spring 2018)
Thry/Hlth Prom+Risk RdctNURS 726 (Spring 2018)
DNP ProjectNURS 922 (Fall 2017)
Dissemination & ImplementationNURS 738 (Fall 2017)
DissertationNURS 920 (Fall 2017)
DNP ProjectNURS 922 (Summer I 2017)
DissertationNURS 920 (Summer I 2017)
Hlth Promotion & Risk ReductNURS 540 (Summer I 2017)
Population/Community Hlt NursNURS 611 (Summer I 2017)
DNP ProjectNURS 922 (Spring 2017)
DissertationNURS 920 (Spring 2017)
Independent StudyNURS 799 (Spring 2017)
Thry/Hlth Prom+Risk RdctNURS 726 (Spring 2017)
DNP ProjectNURS 922 (Fall 2016)
DissertationNURS 920 (Fall 2016)
Evid-Based Practice ImprovemntNURS 521 (Fall 2016)
PracticumNURS 694 (Fall 2016)
DNP ProjectNURS 922 (Summer I 2016)
DissertationNURS 920 (Summer I 2016)
Population/Community Hlt NursNURS 611 (Summer I 2016)
DNP ProjectNURS 922 (Spring 2016)
DissertationNURS 920 (Spring 2016)
Independent StudyNURS 799 (Spring 2016)
PracticumNURS 694 (Spring 2016)
Thry/Hlth Prom+Risk RdctNURS 726 (Spring 2016)
- Curiel-Lewandrowski, C., Leachman, S., Stemwedel, C., Chen, S., Feis, L., Gerami, P., Green, A., Johnson, M., Loescher, L. J., Malvehy, J., Marghoob, A., Martires, K., Petrie, T., Puig, S., Swetter, S., Svedenhag, P., Tkaczyk, E., & Wisco, O. (2018). Methods of melanoma detection. In In: Riker A. (ed.) Melanoma: Comprehensive Management. New York: Springer.
- Horsham, C., Snoswell, C., Vagenas, D., Loescher, L. J., Gillespie, N., Soyer, H. P., & Janda, M. (2020). Is teledermoscopy ready to replace face to face examinations for the early detection of skin cancer? Consumer views, technology acceptance and satisfaction with care. Dermatology, 2, 170-176. doi:https://doi-org.ezproxy3.library.arizona.edu/10.1159/000506154
- Janda, M., Horsham, C., Vagenas, D., Loescher, L. J., Gillespie, N., Koh, U., Curiel-Lewendrowski, C., Hofman-Wellenhof, R., Halpern, A., Whiteman, D. C., Whitty, J. A., Smithers, B. M., & Soyer, H. P. (2020). Accuracy of mobile digital teledermoscopy for skin self-examinations in adults at high risk of skin cancer: an open-label, randomized controlled trial. 2:. Lancet Digital Health, 2, e129-137. doi:https://doi.org/10.1016/S2589-7500(20)30001-7
- Loescher, L. J., Heslin, K. M., Silva, G. E., & Muramoto, M. L. (2020). Partnering with massage therapists to communicate information on reducing the risk of skin cancer among clients: Longitudinal study. JMIR Formative Research, 4(11), e21309. doi:http://dx.doi.org/10.2196/21309
- Loescher, L. J., Love, R., & Badger, T. A. (2020). Breaking new ground? The Dual (PhD-DNP) Doctoral Degree in Nursing https://doi.org/10.1016/j.profnurs.2020.05.001. Journal of Professional Nursing. doi:https://doi.org/10.1016/j.profnurs.2020.05.001
- May, J. T., Littzen, C. O., Morrison, H. W., & Loescher, L. J. (2020). Experiences of dual PHD-DNP nursing students during doctoral education. Journal of professional nursing : official journal of the American Association of Colleges of Nursing, 36(5), 348-355.More infoNursing doctoral education now includes an option with a growing national interest: the PhD-DNP dual degree. Although programs have existed for 10 years, little is known about experiences of dual PhD-DNP degree nursing students (DDNS) during doctoral education, including their perceptions of mentorship during coursework, comprehensive exams, and dissertation readiness.
- Stratton, D. B., Shea, K. D., Knight, E. D., & Loescher, L. J. (2020). Delivering clinical skin examination education to nurse practitioners using an Internet-based, microlearning approach: Development and feasibility of a video intervention. 2020.. JMIR Dermatology, 3(1), e16714.
- Webber-Ritchey, K. J., Taylor-Piliae, R. E., & Loescher, L. J. (2020). Recruiting African American parents of school-aged children in a physical activity study: Lessons learned. Chronic illness, 1742395320928389.More infoTo describe the recruitment strategies and lessons learned when enrolling African American parents/caregivers of school-aged children (ages 6-12 years) in an online survey of physical activity. With physical activity serving as a modifiable behavioral risk factor for several chronic diseases (obesity and cardiovascular diseases), little is understood regarding the influences on African Americans' physical activity participation to develop culturally appropriate physical activity interventions. Gaining a better understanding of physical activity influences is possible through research, yet recruiting and enrolling African Americans in health research is a challenge.
- Janda, M., Horsham, C., Koh, U., Gillespie, N., Vaganes, D., Loescher, L. J., Curiel-Lewandowski, C., Hofmann-Wellenhof, R., & Soyer, H. P. (2019). Evaluating healthcare practitioners’ views on store-and-forward teledermoscopy services for the diagnosis of skin cancer. .. Digital Health, 5, 1-11. doi:http://dx.doi.org/10.1177/2055207619828225
- Koh, U., Horsham, C., Soyer, H. P., Loescher, L. J., Gillespie, N., Vagenas, D., & Janda, M. (2019). Consumer Acceptance and Expectations of a Mobile Health Application to Photograph Skin Lesions for Early Detection of Melanoma. DERMATOLOGY, 235(1), 4-10.
- Loescher, L. J., Heslin, K. M., Szalacha, L. A., Silva Torres, G. E., & Muramoto, M. L. (2019). Online Skin Cancer Prevention Training for Massage Therapists: Protocol for the MTsSHARE Study: A Research Protocol. Journal of Medical Internet Research Protocols, 8(5), 4-15. doi:doi:10.2196/13480
- Loescher, L. J., Nguyen, A., & McEwen, M. (2019). Perceived risk of developing diabetes in the general population and Asian Americans: A systematic review.. Journal of Transcultural Nursing, 1-14. doi:DOI: 10.1177/1043659619876685
- Stratton, D. B., & Loescher, L. J. (2019). Educational interventions for primary care providers to improve clinical skin examination for skin cancer. Journal of the American Association of Nurse Practitioners.More infoSkin cancer, the most commonly diagnosed cancer in the United States, is a serious health care concern. Early skin cancer detection improves prognosis; most common early detection approach is a comprehensive clinical skin examination (CSE). A CSE consists of skin cancer risk assessment, head-to-toe skin examination, and skin lesion assessment. Nurse practitioners (NPs) currently lack adequate training and confidence to conduct CSE. The goal of this systematic review was to learn more about published interventions targeting CSE training for primary care NPs and/or other primary care providers. The findings were categorized based on the established procedures for intervention development.
- Goodman, H., Pacheco, C. L., & Loescher, L. J. (2018). An Online Intervention to Enhance Nurse Practitioners’ Skin Cancer Knowledge, Attitudes, and Counseling Behaviors: A Pilot Study. Journal of the Dermatology Nurses' Association, 10(1), 20–28. doi:10.1097/JDN.0000000000000367More infoManuscript development late Spring - Fall. Accepted Fall 2017 for Jan/Feb 2018 publication.
- Loescher, L. J., Howerter, A. L., Heslin, K. M., Azzolina, C. M., & Muramoto, M. (2018). A survey of licensed massage therapists’ perceptions of skin cancer prevention and detection activities. International Journal of Therapeutic Massage and Bodywork, 11(4), 4-10.
- Snoswell, C. L., Whitty, J. A., Caffery, L. J., Loescher, L. J., Gillespie, N., & Janda, M. (2018). Direct-to-consumer mobile teledermoscopy for skin cancer screening: Preliminary results demonstrating willingness-to-pay in Australia. Journal of Telemedicine and Telecare, 24(10), 683-689. doi:doi.org/10.1177/1357633X18799582
- Webber-Ritchey, K. J., Taylor-Piliae, R. E., & Loescher, L. J. (2018). Physical Activity in Parents of Young African American Children: The Application of Social Cognitive Theory. Research and theory for nursing practice, 32(1), 63-81.More infoSocial cognitive theory (SCT) proposes that personal and environmental factors influence behavior bidirectionally. Research examining the personal and environmental factors of physical activity (PA) among African Americans (AAs) framed by SCT is scarce.
- Kindarara, D. M., McEwen, M. M., Crist, J. D., & Loescher, L. J. (2017). Health-Illness Transition Experiences With Type 2 Diabetes Self-management of Sub-Saharan African Immigrants in the United States. The Diabetes educator, 43(5), 506-518.More infoPurpose The purpose of this study was to describe Sub-Saharan African immigrants' health-illness transition experiences associated with type 2 diabetes mellitus (T2DM) self-management. Methods A qualitative description methodology was used in this study. Face-to-face semi-structured in-depth interviews lasting 60 to 90 minutes were conducted with 10 Sub-Saharan African immigrant men and women with T2DM recruited using purposive and snowball sampling. Each interview was audio-taped, transcribed, and analyzed using qualitative content analysis. Results Participants' mean age was 60.3 years (range, 44-76 years), 5 men and 5 women; most had lived in the US for more than 10 years (70%) and with T2DM for more than 5 years (60%). Four overarching domains described the health-illness transition experiences the participants had with T2DM self-management: (1) knowledge of T2DM self-management behaviors, (2) current T2DM self-management behaviors, (3) inhibitors of T2DM self-management, and (4) facilitators of T2DM self-management. Conclusions Health professionals should be equipped with an understanding of the properties and conditions of health-illness transition. This understanding is necessary to build a foundation that facilitates healthy adaptation to the T2DM transition requiring the development and mastery of new skills consistent with gaining control of T2DM. Culturally tailored interventions need to be developed to decrease inhibitors of and encourage self-management in daily T2DM care for Sub-Saharan African immigrants with T2DM.
- Kindarara, D., McEwen, M., Crist, J., & Loescher, L. J. (2017). Health-illness transition experiences with type 2 diabetes self-management of Sub-Saharan African immigrants in the United States. The Diabetes Educator. doi:10.1177/0145721717724725
- Loescher, L. J., Rawdin, S., Machain, T., Emrick, G., Pasvogel, A., Spartoon, D., Johnson, R. E., & Campas, D. (2017). Implementation of Project Students are Sun Safe (SASS) in rural high schools along the Arizona-Mexico border. Journal of Cancer Education.
- Loescher, L. J., Stratton, D., Slebodnik, M., & Goodman, H. (2018). A systematic review of nurse practitioners’ skin cancer knowledge and attitudes, skin examination, and skin cancer detection and prevention education and training. Journal of the American Association of Nurse Practitioners, 30, 43-58. doi:DOI# 10.1097/JXX.0000000000000004
- Argenbright, C. A., Taylor-Piliae, R. E., & Loescher, L. J. (2016). Bowenwork for symptom management of women breast cancer survivors with lymphedema: A pilot study. Complementary therapies in clinical practice, 25, 142-149.More infoPurpose: The objectives of this pilot study for women breast cancer survivors with lymphedema was 1) to evaluate recruitment rates, retention rates, adherence to Bowenwork (a noninvasive complementary therapy involving gentle muscle movements), home exercises, safety and comfort; 2) determine the effect of Bowenwork on quality of life (QOL), functional status, perceived pain, range of motion (ROM), arm/ankle circumference (to assess for localized and systemic changes).Methods: Participants received 4 Bowenwork sessions with home exercises. Initial and post assessments included QOL, functional status, and pain. ROM, arm/ankle circumference and pain measures were recorded before each session.Results: Twenty-one women enrolled in the study; 95% completion; adherence 100%; home exercises 95%; no adverse events. The intervention improved mental health (SF-36-MCS); breast cancer-related functional (FACT-B); increased ROM; reduced arm circumferences. P value set at
- Finch, L., Janda, M., Loescher, L. J., & Hacker, E. (2016). Can skin cancer prevention be improved through mobile technology interventions? A systematic review. Preventive medicine, 90, 121-32.More infoObjective. Print-based health promotion interventions are being phased out to bring forthmore appealing and assessable newtechnology applications. This review aimed to evaluate the current literature on the use ofmobiletext messaging and similar electronic technology interventions in the area of skin cancer prevention.Method. A search of studies guided by Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) was conducted on mobile technology interventions for improving skin cancer prevention in the electronicdatabases PubMed, MEDLINE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and PsycINFO.Results. Overall, 136 articles were screened for eligibility between 2001 (earliest relevant article found) and November 2015. Eight studies fulfilled the inclusion criteria and were reviewed according to the PRISMA guidelines.Of these, five were randomised controlled trials (RCTs), two were controlled clinical trials, and one was a cohort study. Five studies used textmessages as an intervention, two usedmobile phone applications, and another used electronic messages via email. All studies resulted in self-reported behaviour change in at least one of their outcome measures (e.g., sunscreen application, seeking shade).Conclusion. While the behaviour change outcomes are promising, the lack of change in more objective measures such as sunburn indicates a need to further improve mobile phone technology-delivered interventions in order to have a greater impact on skin cancer prevention. Future studies may consider the use of objective outcome measures (e.g., sunscreen weight), electronic diaries, or behavioural outcomes in social networks
- Horsham, C., Loescher, L. J., Whiteman, D. C., Soyer, H. P., & Janda, M. (2016). Consumer acceptance of patient-performed mobile teledermoscopy for the early detection of melanoma. The British journal of dermatology, 175(6), 1301-1310.More infoBackground Mobile teledermoscopy allows consumers to send images of skin lesions to a teledermatologist for remote diagnosis. Currently, technology acceptance of mobile teledermoscopy by people at high risk of melanoma is unknown.Objectives We aimed to determine the acceptance of mobile teledermoscopy byconsumers based on perceived usefulness, ease of use, compatibility, attitude/in- tention, subjective norms, facilitators and trust before use. Consumer satisfaction was explored after use.Methods Consumers aged 50–64 years at high risk of melanoma (fair skin or previous skin cancer) were recruited from a population-based cohort study and via media announcements in Brisbane, Australia in 2013. The participants completed a 27-item questionnaire preteledermoscopy modified from a technology acceptance model. The first 49 participants with a suitable smartphone then conducted mobile teledermoscopy in their homes for early detection of melanoma and were asked to rate their satisfaction.Results The preteledermoscopy questionnaire was completed by 228 participants. Most participants (87%) agreed that mobile teledermoscopy would improve their skin self-examination performance and 91% agreed that it would be in their best interest to use mobile teledermoscopy. However, nearly half of participants (45%) were unsure about whether they had complete trust in the telediagnosis. The partic- ipants who conducted mobile teledermoscopy (n = 49) reported that the dermato- scope was easy to use (94%) and motivated them to examine their skin more often (86%). However, 18% could not take photographs in hard-to-see areas and 35% required help to submit the photograph to the teledermatologist.Conclusions Mobile teledermoscopy consumer acceptance appears to be favourable. his new technology warrants further assessment for its utility in the early detection of melanoma or follow-up.
- Loescher, L. J., Rains, S. A., Kramer, S. S., Akers, C., & Moussa, R. (2016). A Systematic Review of Interventions to Enhance Healthy Lifestyle Behaviors in Adolescents Delivered via Mobile Phone Text Messaging. American journal of health promotion : AJHP, 1-15. doi:doi: 10.1177/0890117116675785More infoAbstractObjective: To systematically review healthy lifestyle interventions targeted to adolescents and delivered using text messaging (TM).Data Source: PubMed, Embase, CINAHL, PsycINFO, and Web of Science databases.Study Inclusion Criteria: Research articles published during 2011 to 2014; analyses focused on intervention targeting adolescents (10-19 years), with healthy lifestyle behaviors as main variables, delivered via mobile phone-based TM.Data Extraction: The authors extracted data from 27 of 281 articles using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses method.Data Synthesis: Adolescent and setting characteristics, study design and rigor, intervention effectiveness, challenges, and risk of bias.Results: Across studies, 16 (59.3%) of 27 included non-Caucasians. The gender was split for 22 (81.5%) of 27 studies. Thirteen studies were randomized controlled trials. There was heterogeneity among targeted conditions, rigor of methods, and intervention effects. Interventions for monitoring/adherence (n ¼ 8) reported more positive results than those for health behavior change (n ¼ 19). Studies that only included message delivered via TM (n ¼ 14) reported more positive effects than studies integrating multiple intervention components. Interventions delivered using TM presented minimal challenges, but selection and performance bias were observed across studies.Conclusion: Interventions delivered using TM have the potential, under certain conditions, to improve healthy lifestyle behaviors in adolescents. However, the rigor of studies varies, and established theory and validated measures have been inconsistently incorporated.
- Lucas, M. A., Pacheco, C. L., & Loescher, L. J. (2016). Nurse Practitioners Knowledge of Prevention Guidelines and Counseling Practices Related to Primary Prevention of Skin Cancer Among Adolescents in Arizona. Journal of the Dermatology Nurses' Association, 8(6), p 368–377. doi:10.1097/JDN.0000000000000257More infoAbstractSkin cancer is the most common cancer worldwide and one of the most preventable. Skin cancer incidence continues to rise among adolescents. The inconsistent practice guidelines for skin cancer prevention create challenges for counseling. The purpose of this study was to investigate skin cancer knowledge, attitudes, and primary prevention counseling practices by Arizona nurse practitioners caring for adolescents on an outpatient basis and determine congruency of counseling with evidence-based guidelines. Participants completed a quantitative, descriptive, cross-sectional study using an online survey. The main variables were knowledge of skin cancer, skin cancer prevention, attitudes regarding counseling, current practice guideline use, and recommendations. Of the 67 participants that responded to the survey, 51 were eligible, and 44 completed the survey. Participant knowledge regarding skin cancer was moderate to low, and less was known about skin cancer in adolescents. Despite positive attitudes toward skin cancer prevention, participants reported low rates of counseling in practice, similar to previous interdisciplinary research. Reported recommendations used in practice were not reflective of any one particular guideline. Future research should explore barriers to incorporating primary prevention counseling practices and aim to educate nurse practitioners on skin cancer prevention.
- Stratton, D., & Loescher, L. J. (2016). The acceptance of mobile teledermoscopy by primary care nurse practitioners in the state of Arizona. Journal of the American Association of Nurse Practitioners, 28(6), 287-93.More infoPurpose: To conduct a pilot survey to assess acceptance of mobile teledermoscopy(MTD) by primary care nurse practitioners (NPs) working in Arizona.Data sources: Sixty-two participants recruited from NP and academic listservsin Arizona completed an online survey prefaced by a MTD definition, device photographs,and a practice case, followed by 33 items measuring TeledermatologyTechnology Acceptance Model (TeleTAM) constructs.Conclusions: Participants were highly interested in using MTD to assess skinlesions. They perceived MTD utility to greatly improve diagnosis and positivelyimpact their practice. Most participants had never used MTD, but had high meanscores for MTD attitude and moderate scores for MTD perceived ease of use,perceived use, and facilitators of MTD. They had moderate scores for intentionto use MTD. The construct facilitators (organizational infrastructure) were moststrongly associated with intention to use MTD. Cronbach alphas were 0.70 orhigher for all subscales except compatibility and habit.Implications for practice: Moderate acceptance of MTD may reflect NPs’knowledge of the technology, self-confidence for using it, or MTD financial constraints.Future research will address these factors to foster use of MTD by NPs,thereby improving patients’ access to early skin lesion assessment and diagnosis.
- Webber-Ritchey, K. J., Taylor-Piliae, R. E., Insel, K. C., & Loescher, L. J. (2016). Physical Activity among African American Parents of Young Children: Roles of Personal and Environmental Factors.. International Journal of Sport Psychology, 46, 523-544. doi:doi: 10.7352/IJSP 2015.46.523More infoOBJECTIVES: To assess the factors that influence self-reported physical activity(PA).METHODS: African American (AA) parents/caregivers (n=96; M age=36years) completed an online survey to describe PA, personal (PA knowledge, exerciseself-efficacy-SE and outcome expectations-OE) and environmental factors (socialeconomic status-SES, neighborhood safety-NS, and culture).RESULTS: Moderate (30%, n=29) to high (54%, n=52) levels of PA werereported. There were significant correlations between PA and NS (rs=.25) and PAknowledge and PA (rs =-.30). Significant predictors of PA included SE (β=.21,t(84)=2.20, p=.030), NS (=.33, t(84)=3.56, p=.001), and an unexpected inverse ofPA knowledge (β=-.25, t(84)=-2.42, p=.018).CONCLUSIONS: Unlike prior studies, we found AA parents of young childrenwere physically active, knowledgeable of the PA guidelines, with moderate-highexercise SE, high SES, felt safe in their neighborhoods with a positive cultural identity.Future research examining the influence of AA parents’ PA on health indicatorsamong their children is needed next.
- Webber-Ritchey, K. J., Taylor-Piliae, R., Insel, K., & Loescher, L. J. (2016). Physical activity among African American parents of young children: Personal and environmental factors. Int J Sports Psychol.
- Webber-Ritchey, K. J., Webber-Ritchey, K. J., Taylor-Piliae, R. E., Taylor-Piliae, R. E., Insel, K. C., Insel, K. C., Loescher, L. J., & Loescher, L. J. (2016). Physical Activity among African American Parents of Young Children: Roles of Personal and Environmental Factors.. International Journal of Sport Psychology, 47(6), 523-544. doi:doi: 10.7352/IJSP 2015.46.523More infoOBJECTIVES: To assess the factors that influence self-reported physical activity(PA).METHODS: African American (AA) parents/caregivers (n=96; M age=36years) completed an online survey to describe PA, personal (PA knowledge, exerciseself-efficacy-SE and outcome expectations-OE) and environmental factors (socialeconomic status-SES, neighborhood safety-NS, and culture).RESULTS: Moderate (30%, n=29) to high (54%, n=52) levels of PA werereported. There were significant correlations between PA and NS (rs=.25) and PAknowledge and PA (rs =-.30). Significant predictors of PA included SE (β=.21,t(84)=2.20, p=.030), NS (=.33, t(84)=3.56, p=.001), and an unexpected inverse ofPA knowledge (β=-.25, t(84)=-2.42, p=.018).CONCLUSIONS: Unlike prior studies, we found AA parents of young childrenwere physically active, knowledgeable of the PA guidelines, with moderate-highexercise SE, high SES, felt safe in their neighborhoods with a positive cultural identity.Future research examining the influence of AA parents’ PA on health indicatorsamong their children is needed next.
- Davis, R., Loescher, L. J., Rogers, J., Spartonos, D., Snyder, A., Koch, S., & Harris, R. B. (2015). Evaluation of Project Students are Sun Safe (SASS): A University Student-Delivered Skin Cancer Prevention Program for Schools. Journal of cancer education : the official journal of the American Association for Cancer Education, 30(4), 736-42.More infoSkin cancer is the most common cancer in the USA and is increasing in children and young adults. Adolescents are an important target population for sun-safety interventions with ultraviolet radiation as the strongest risk factor for developing skin cancer. Schools are an ideal setting to intervene with adolescents. A novel Arizona skin cancer prevention in-class education-activity program, Project 'Students are Sun Safe' (SASS), was designed to be delivered by university students for middle school and high school students. Participant students completed the pre- and post-program tests and a satisfaction questionnaire; teachers completed reviews. The evaluation examined the program's influence on participants' sun-safety knowledge, perceptions, and behaviors; satisfaction with the program; and intent to change. After exposure to Project SASS, participants were more likely to perceive a high risk of skin cancer, report negative attitudes toward tanned skin, and answer knowledge-based questions correctly. There were minimal differences in self-reported sun-safety behaviors, though participants did report intent to change. Both participants and teachers were satisfied with the program. Project SASS appears to be an effective sun-safety program for middle school and high school students for knowledge and perceptions, and the results confirm that appropriately tailoring program components to the target population has strong potential to impact adolescent perceived susceptibility, knowledge, and behavioral intent. The strengths and weaknesses of Project SASS have many implications for public health practice, and Project SASS may hold promise to be a model for skin cancer prevention in adolescents.
- Manahan, M. N., Soyer, H. P., Loescher, L. J., Horsham, C., Vagenas, D., Whiteman, D. C., Olsen, C. M., & Janda, M. (2015). A pilot trial of mobile, patient-performed teledermoscopy. The British journal of dermatology, 172(4), 1072-80.More infoEarly detection by skin self-examination (SSE) could improve outcomes for melanoma. Mobile teledermoscopy may aid this process.
- Chadwick, X., Loescher, L. J., Janda, M., & Soyer, H. P. (2014). Mobile medical applications for melanoma risk assessment: False assurance or valuable tool?. Proceedings of the 47th Hawaii International Conference on System Science, 2675-2684. doi:10.1109/HICSS.2014.337
- Janda, M., Loescher, L. J., Banan, P., Horsham, C., & Soyer, H. P. (2014). Lesion selection by melanoma high-risk consumers during skin self-examination using mobile teledermoscopy. JAMA dermatology, 150(6), 656-8.
- Janda, M., Loescher, L. J., & Soyer, H. P. (2013). Enhanced skin self-examination: A novel approach to skin cancer monitoring and follow-up. JAMA Dermatology, 149(2), 231-236.More infoPMID: 23426490;
- Loescher, L. J. (2013). Introduction. Seminars in oncology nursing, 29(3), 157-9.
- Loescher, L. J., Hansen, C., Hepworth, J. T., Quale, L., & Sligh, J. (2013). A preliminary study of a video intervention to inform solid organ transplant recipients about skin cancer. Transplantation Proceedings, 45(9), 3187-3189.More infoPMID: 23747188;PMCID: PMC3818294;Abstract: Purpose: To obtain preliminary evidence on the effect of a skin cancer prevention video for adult solid organ transplant recipients (SOTR) and informational brochures on outcomes of skin cancer knowledge, beliefs, prevention and detection behaviors, and personal agency (self-confidence/ personal control) for behaviors. Background: SOTR have a high risk of skin cancer potentiated by life-long immunosuppressive therapy posttransplantation. Skin cancer in SOTR is aggressive and difficult to treat. Prevention and early detection are important for reducing risk and improving skin cancer outcomes, but methods to inform SOTR about their risk are understudied. Methods: A brief, evidence-based skin cancer informational video tailored to SOTR was evaluated using a quasi-experimental design that compared the outcome variables in two groups of SOTR seen in 4 transplantation clinics within 4-6 weeks posttransplantation. The video/brochure group (VBG) viewed the video once and received skin cancer information brochures. The brochure group (BG) received brochures only. Participants completed a survey on sun protection behavior (6 items; alpha = 0.75), personal agency (6 items; alpha = 0.64), beliefs (6 items; alpha = 0.60), skin cancer knowledge (6 items), and skin self-examination (SSE; 1 item) at baseline and 3 months postintervention. Data were analyzed using descriptive statistics and 2 × 2 analysis of variance. Results: Of 113 participants, 90 completed both surveys (VBG, n = 46; BG, n = 44). Both groups had a significant increase in sun protective behavior (P
- Loescher, L. J., Janda, M., Soyer, H. P., Shea, K., & Curiel-Lewandrowski, C. (2013). Advances in skin cancer early detection and diagnosis. Seminars in oncology nursing, 29(3), 170-81.More infoTo provide an overview of 1) traditional methods of skin cancer early detection, 2) current technologies for skin cancer detection, and 3) evolving practice models of early detection.
- Loescher, L., Webber, K. J., & Loescher, L. J. (2013). A systematic review of parent role modeling of healthy eating and physical activity for their young African American children. Journal for specialists in pediatric nursing : JSPN, 18(3).More infoWe systematically reviewed current literature on parent role modeling of healthy eating and physical activity as a strategy to influence healthy weight of middle school-age African American children.
- Siaki, L. A., Loescher, L. J., & Trego, L. L. (2013). Synthesis strategy: Building a culturally sensitive mid-range theory of risk perception using literary, quantitative, and qualitative methods. Journal of Advanced Nursing, 69(3), 726-737.More infoPMID: 22813232;Abstract: Aim. This article presents a discussion of development of a mid-range theory of risk perception. Background: Unhealthy behaviours contribute to the development of health inequalities worldwide. The link between perceived risk and successful health behaviour change is inconclusive, particularly in vulnerable populations. This may be attributed to inattention to culture. Data sources: The synthesis strategy of theory building guided the process using three methods: (1) a systematic review of literature published between 2000-2011 targeting perceived risk in vulnerable populations; (2) qualitative and (3) quantitative data from a study of Samoan Pacific Islanders at high risk of cardiovascular disease and diabetes. Discussion: Main concepts of this theory include risk attention, appraisal processes, cognition, and affect. Overarching these concepts is health-world view: cultural ways of knowing, beliefs, values, images, and ideas. This theory proposes the following: (1) risk attention varies based on knowledge of the health risk in the context of health-world views; (2) risk appraisals are influenced by affect, health-world views, cultural customs, and protocols that intersect with the health risk; (3) strength of cultural beliefs, values, and images (cultural identity) mediate risk attention and risk appraisal influencing the likelihood that persons will engage in health-promoting behaviours that may contradict cultural customs/protocols. Implications: Interventions guided by a culturally sensitive mid-range theory may improve behaviour-related health inequalities in vulnerable populations. Conclusions: The synthesis strategy is an intensive process for developing a culturally sensitive mid-range theory. Testing of the theory will ascertain its usefulness for reducing health inequalities in vulnerable groups. © 2012 Blackwell Publishing Ltd.
- T., J., Loescher, L. J., Soyer, H. P., & Curiel-Lewandrowski, C. (2013). Barriers to mobile teledermoscopy in primary care. Journal of the American Academy of Dermatology, 69(5), 821-824.More infoPMID: 24124819;
- Siaki, L. A., Loescher, L. J., & Ritter, L. (2012). A cultural perspective of Samoans' perceived risk of cardiovascular disease and diabetes. The Journal of cardiovascular nursing, 27(6), 468-75.More infoCardiovascular disease (CVD) and diabetes, which are leading causes of morbidity and mortality in the United States, have a high incidence among Pacific Islanders. Risk of these conditions increases in the presence of metabolic syndrome. Risk-reducing behaviors for CVD and diabetes are driven partly by perceived risk of health threats and their consequences. Perceived risk is influenced by sociocultural beliefs and is a component of some health behavior models, yet it is understudied in Pacific Islanders.
- Curiel-Lewandrowski, C., Speetzen, L. S., Cranmer, L., Warneke, J. A., & Loescher, L. J. (2011). Multiple primary cutaneous melanomas in Li-Fraumeni syndrome. Archives of dermatology, 147(2), 248-50.
- Loescher, L. J., Harris, J. M., & Curiel-Lewandrowski, C. (2011). A systematic review of advanced practice nurses' skin cancer assessment barriers, skin lesion recognition skills, and skin cancer training activities. Journal of the American Academy of Nurse Practitioners, 23(12), 667-673.More infoPMID: 22145657;Abstract: Purpose: Little is known about the skin cancer detection skills of advanced practice nurses (APNs). This systematic review of published literature seeks to describe (a) barriers to APNs' performance of skin examination, (b) APNs' ability to recognize suspicious skin lesions, and © APNs' skin cancer detection training activities. Data sources: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement guided the literature search (OVID Medline, Web of Science, and CINAHL databases) and interpretation of findings. Of the 136 articles meeting criteria for selection, 12 pertaining to the purpose were selected for further review. Conclusions: Barriers to skin examination by APNs have been infrequently and inconsistently measured. Limited time to conduct skin examination is the most consistent barrier. APNs' ability to recognize and refer suspicious and benign lesions is inconsistent, but shows improvement after training. Few skin cancer training programs are available for APNs. Implications: Larger and more rigorously designed studies are needed to better determine APNs' barriers and facilitators to skin cancer assessment and their ability to recognize and appropriately refer potentially malignant skin lesions with a high level of sensitivity and specificity. Training to increase these skills needs to be targeted to APNs and occur at a much higher volume than current efforts. ©2011 The Author(s) Journal compilation ©2011 American Academy of Nurse Practitioners.
- Loescher, L. J., Hibler, E., Hiscox, H., Hla, H., & Harris, R. B. (2011). Challenges of using the internet for behavioral research. Computers, informatics, nursing : CIN, 29(8), 445-8.More infoUsing the Internet in behavioral research remains a challenge. We developed a video intervention and conducted a pilot study that was designed to deliver and test the intervention via the Internet. One aim of this study was to evaluate the feasibility of using the Internet to both deliver the intervention and collect data from participants. This article summarizes procedures for delivering the intervention and survey via the Internet, obstacles encountered during delivery of the intervention and data collection, and lessons learned that can be applied to future research involving the Internet.
- Loescher, L., Siaki, L. A., & Loescher, L. J. (2011). Pacific Islanders' perceived risk of cardiovascular disease and diabetes. Journal of transcultural nursing : official journal of the Transcultural Nursing Society / Transcultural Nursing Society, 22(2).More infoTo explore literature on Pacific Islanders' perceived risk of cardiovascular disease (CVD) and diabetes.
- Quevedo Garcia, S. P., Greco, K. E., & Loescher, L. J. (2011). Teaching strategies to incorporate genomics education into academic nursing curricula. The Journal of nursing education, 50(11), 612-9.More infoThe translation of genomic science into health care has expanded our ability to understand the effects of genomics on human health and disease. As genomic advances continue, nurses are expected to have the knowledge and skills to translate genomic information into improved patient care. This integrative review describes strategies used to teach genomics in academic nursing programs and their facilitators and barriers to inclusion in nursing curricula. The Learning Engagement Model and the Diffusion of Innovations Theory guided the interpretation of findings. CINAHL, Medline, and Web of Science were resources for articles published during the past decade that included strategies for teaching genomics in academic nursing programs. Of 135 articles, 13 met criteria for review. Examples of effective genomics teaching strategies included clinical application through case studies, storytelling, online genomics resources, student self-assessment, guest lecturers, and a genetics focus group. Most strategies were not evaluated for effectiveness.
- Loescher, L. J., Hibler, E., Hiscox, H., Quale, L., & Harris, R. (2010). An internet-delivered video intervention for skin self-examination by patients with melanoma. Archives of Dermatology, 146(8), 922-923.More infoPMID: 20713834;
- Marble, N., Loescher, L. J., Lim, K. H., & Hiscox, H. (2010). Use of technology for educating melanoma patients. Journal of Cancer Education, 25(3), 445-450.More infoPMID: 20336399;Abstract: We evaluated the feasibility of using technology for melanoma patient education in a clinic setting. We assessed technology skill level and preferences for education. Data were collected using an adapted version of the Use of Technology Survey. Most participants owned a computer and DVD player and were skilled in the use of these devices, along with Internet and e-mail. Participants preferred the option of using in-clinic and at-home technology versus in-clinic only use. Computer and DVD applications were preferred because they were familiar and convenient. Using technology for patient education intervention is a viable option; however, patients' skill level and preferences for technology should be considered. © 2010 Springer.
- Loescher, L. J., Crist, J. D., & Siaki, L. A. (2009). Perceived intrafamily melanoma risk communication. Cancer nursing, 32(3), 203-10.More infoMelanoma is a skin cancer that can be deadly. Members of families with a strong history of melanoma have a high risk of melanoma occurrence or recurrence. Enhanced survival in these family members could be influenced by their knowledge of melanoma risk and by simple behaviors to decrease their risk or detect melanoma in its early, most curable, stage. Yet, there is minimal exploration on communication of risk or risk-modifying behaviors in melanoma at-risk families. In this study, we describe perceived intrafamily communication of melanoma risk. Using a qualitative descriptive approach, we examined in-depth interviews with 22 members of 8 families having 2 or more cases of melanoma. We identified 4 major themes: (1) awareness and understanding of risk, (2) families facilitate and hinder communication, (3) promoting melanoma prevention and detection in the family, and (4) an obligation to tell others. We discuss these findings in the context of extant knowledge of cancer risk communication in families at high risk for other cancers, impediments to cancer risk communication, remaining gaps in knowledge of this phenomenon, suggestions for hypothesis-driven research, and clinical implications that are applicable to these and other at-risk families.
- Loescher, L. J., Crist, J. D., Cranmer, L., Curiel-Lewandrowski, C., & Warneke, J. A. (2009). Melanoma high-risk families' perceived health care provider risk communication. Journal of cancer education : the official journal of the American Association for Cancer Education, 24(4), 301-7.More infoFamilies with a melanoma history are at risk of melanoma. Melanoma survival improves when people are aware of their risk and ways to modify it. We explored at-risk families' perceived risk communication from healthcare providers.
- Loescher, L. J., Lim, K. H., Leitner, O., Ray, J., D'Souza, J., & Armstrong, C. M. (2009). Cancer surveillance behaviors in women presenting for clinical BRCA genetic susceptibility testing. Oncology Nursing Forum, 36(2), E57-E67.More infoPMID: 19273395;Abstract: Purpose/Objectives: To investigate cancer surveillance behaviors of women at risk for hereditary breast and ovarian cancer (HBOC) who presented for clinical BRCA cancer susceptibility testing, specifically to describe cancer surveillance behaviors and reasons for not engaging in behaviors, compare surveillance behaviors with existing surveillance guidelines, and evaluate associations of cancer surveillance behaviors with BRCA results. Design: Cross-sectional, descriptive. Setting: Genetic risk-assessment programs in a National Cancer Institute-designated comprehensive cancer center and a community cancer center, both in the southwestern region of the United States. Sample: Purposive sample of 107 at-risk women. Methods: Self-report survey. Main Research Variables: Breast and ovarian cancer surveillance behaviors and BRCA test results. Findings: Ninety percent of participants had a personal history of breast cancer; 84% had a negative BRCA result. About 60% of participants engaged in at least the minimum recommended breast cancer surveillance behaviors, but 70% had suboptimal ovarian cancer surveillance behaviors. Lack of physician recommendation was the most frequently reported reason for not having surveillance procedures. BRCA results were not associated with the breast cancer surveillance categories and the ovarian cancer surveillance recommendations. Conclusions: Although most participants were not carriers of a mutation, the presence of other risk factors for breast and ovarian cancer dictates continued cancer surveillance. At-risk women may not be informed adequately about cancer surveillance. Implications for Nursing: Healthcare providers should be aware of changing breast and ovarian cancer surveillance recommendations and counsel their at-risk patients accordingly.
- Kieran, S., Loescher, L. J., & Lim, K. H. (2007). The role of financial factors in acceptance of clinical BRCA genetic testing. Genetic Testing, 11(1), 101-110.More infoPMID: 17394399;Abstract: Many women who are offered BRCA genetic testing by genetics professionals do not have the test, possibly for financial reasons. We explored financial factors implicated in non-uptake of BRCA testing in women who had received genetic counseling in a clinical setting. Specifically, we described financial factors (affordability, health insurance, other) involved with BRCA testing; compared nonfinancial factors (disease, sociodemographic, risk assessment) in women who did not have BRCA testing (nontesters) with women who had the test (testers); showed associations of financial and nonfinancial factors with BRCA testing; and identified predictors of non-uptake of BRCA testing. The sample of 100 women (64 nontesters and 36 testers) completed an anonymous mailed survey on financial factors; 52 of the nontesters answered questions about nonfinancial factors. Testers had significantly better affordability and insurance coverage (p < 0.001), more diagnoses of breast or ovarian cancer (p < 0.05) and higher rates of receiving post-counseling risk estimates (p < 0.05), than nontesters. Non-uptake was 5.5-fold more likely in women that could not afford full or partial payment for the test and was 15.5-fold more likely in women that did not recall receiving risk estimates post-counseling. For many women having risk factors for breast/ovarian cancer, affordability of BRCA testing and insurance coverage for the test remain problematic. Post-counseling reminders of risk estimates may contribute to uptake of testing. © Mary Ann Liebert, Inc.
- Loescher, L. J., Harris, R. B., Lim, K. H., & Yani, S. u. (2006). Thorough skin self-examination in patients with melanoma. Oncology Nursing Forum, 33(3), 633-637.More infoPMID: 16676019;Abstract: Purpose/Objectives: To examine the feasibility of using Weinstock et al.'s thorough skin self-examination (TSSE) assessment in patients with melanoma, to describe TSSE characteristics of patients with melanoma, and to explore associations of personal and disease variables with TSSE. Design: Cross-sectional, descriptive feasibility study; part of a larger study of melanoma in families. Setting: Outpatient melanoma clinics in a National Cancer Institute-designated comprehensive cancer center. Sample: Purposive sample of 70 predominantly white participants (47% women, 53% men), with a mean age of 65 years (SD = 11 years) and pathologically confirmed cutaneous melanoma (any stage). Methods: Weinstock et al.'s TSSE assessment (self-report of the number of times patients examined the surface of seven specific body areas during the prior two months) and items regarding partnered TSSE and skin examination from healthcare providers. Main Research Variables: Frequency of TSSE and healthcare provider skin examination, partnered TSSE, and reasons for not performing TSSE. Findings: Forty-one (59%) participants reported performing TSSE; by Weinstock et al.'s criteria, only 23 (33%) practiced TSSE. Use of a partner was significantly associated with TSSE (p = 0.001); patients indicated high rates of skin examination by healthcare providers. Conclusions: Patients with melanoma are at high risk for recurrent disease. TSSE contributes to early detection of melanoma. Although Weinstock et al.'s TSSE assessment is feasible for use among patients with melanoma in a clinical setting, the focus should be on examination of specific body areas, rather than global skin examination. Overall, patients with melanoma had a low frequency of TSSE; however, data regarding previous knowledge or instruction of TSSE were not collected. Involving a partner enhances the frequency of TSSE. Implications for Nursing: Patients with melanoma should be informed of the importance of conducting systematic TSSE and using a partner during examination; however, some patients may prefer skin examination by healthcare providers. Measurement of TSSE self-report merits further study.
- Loescher, L., Riordan, S. H., & Loescher, L. J. (2006). Medical students' attitudes toward genetic testing of minors. Genetic testing, 10(1).More infoThe purpose of this study was to examine attitudes of medical students at a single university toward genetic testing in minors, defining attitudes as willingness to offer testing, and reasons for offering or not offering testing. A survey was distributed to all University of Arizona medical students (n = 428) during the 2003-2004 academic year. The survey consisted of three clinical vignettes concerning genetic testing for Huntington's disease (HD), BRCA1 breast cancer predisposition mutation, and cystic fibrosis (CF) carrier status. For each vignette, students responded to whether they would provide testing for a 7-year-old, a 17-year-old, and their reasons for each age and condition. One hundred thirty-five students (31.5%) responded to the survey. Medical students were significantly more likely to test a 7-year-old for CF carrier status (57%), than they were for a BRCA1 mutation (47%), and an HD mutation (40%). Students were significantly more likely to test a 17-year-old than a 7-year-old in each clinical scenario. Students who had completed a genetics course in medical school were significantly less likely to test a 7-year-old for a BRCA1 mutation than those who had not completed a formal course. Medical students' willingness to perform genetic testing in a minor is influenced by the type of condition, the age of the minor being tested, and the amount of genetics education received in medical school.
- Loescher, L. J., & Merkle, C. J. (2005). The interface of genomic technologies and nursing. Journal of nursing scholarship : an official publication of Sigma Theta Tau International Honor Society of Nursing, 37(2), 111-9.More info(a) to summarize views of the interface of technology, genomic technology, and nursing; (b) provide an overview of current and emerging genomic technologies; (c) present clinical exemplars of uses of genomic technology in two disease conditions; and (d) list genomic-focused nursing research on genomic technologies.
- Ray, J. A., Loescher, L. J., & Brewer, M. (2005). Risk-reduction surgery decisions in high-risk women seen for genetic counseling. Journal of Genetic Counseling, 14(6), 473-484.More infoPMID: 16388328;Abstract: Women at greatest risk for hereditary breast and ovarian cancer may consider prophylactic removal of breasts or ovaries as a risk-reduction measure. This report describes uptake of risk-reduction mastectomy (RRM), risk-reduction oophorectomy (RRO), and related factors in 62 high-risk women who received genetic counseling. Seven (11%) participants underwent RRM and 13 (21%) underwent RRO. Of these women, 37% did not have BRCA testing, suggesting other factors influence decisions to undergo surgery. Women who had indicated (pre-genetic counseling) their intent not to have surgery chose not to have surgery. Information received during genetic counseling that women perceived as being most important for influencing risk-reduction surgery decisions was BRCA test result (positive or negative), followed by discussion of family cancer history. Reasons for indecision about risk-reduction surgery included genetic testing results, concerns about surgery, timing in life, and early menopause. The findings enhance our understanding of information that is helpful to women considering this surgery. © 2005 National Society of Genetic Counselors, Inc.
- Loescher, L., & Loescher, L. J. (2004). Nursing roles in cancer prevention position statements. Seminars in oncology nursing, 20(2).More infoPreventing cancer saves the labor of mending social, economic, cultural, and emotional upheaval engendered by a diagnosis of cancer. The four position statements discussed in this article provide a wealth of perspective regarding the professional organizations' views on cancer prevention and the important roles of nurses.
- Fraser, M. C., & Loescher, L. J. (2003). Oncology Nursing: Introduction. Seminars in Oncology Nursing, 19(1), 1-.
- Loescher, L. J. (2003). Cancer worry in women with hereditary risk factors for breast cancer.. Oncology nursing forum, 30(5), 767-772.More infoPMID: 12949589;Abstract: PURPOSE/OBJECTIVES: To investigate symptom-based cancer worry in women who are at hereditary risk for breast cancer, specifically levels of worry, correlations of cancer worry, perceived cancer risk, and clinical signs or symptoms of breast cancer, as well as predictors of cancer worry. DESIGN: Cross-sectional, correlational. SETTING: Primarily the United States. SAMPLE: 200 women, aged 18-80, with no personal history of cancer, who met at least one established criterion of hereditary breast cancer risk were recruited primarily from a mammography facility and cancer prevention clinics or via network sampling. METHODS: Completion of the following self-report instruments: Thoughts About Cancer Scale and measures of clinical symptoms, perceived risk, and sample characteristics. Data analysis consisted of descriptive statistics, Pearson correlations, and binary logistic regression. MAIN RESEARCH VARIABLES: Cancer worry, total clinical signs of cancer, perceived cancer risk, age, and family history. FINDINGS: Participants sometimes worried about breast cancer but had more general breast cancer worry than worry based on perceived neutral or breast cancer-specific symptoms. Total clinical signs of breast cancer correlated significantly with cancer worry. Women aged 41-50 and those with more clinical signs of breast cancer were 3.76 and 1.49 times more likely to have high worry, respectively. CONCLUSIONS: Moderate worry in high-risk women is not unusual. Total symptoms and younger age predict higher breast cancer worry, whereas perceived risk and family history do not. IMPLICATIONS FOR NURSING: Counseling of young, high-risk women should include assessments of worry and clinical signs of breast cancer.
- Loescher, L. J. (2000). The influence of technology on cancer nursing.. Seminars in oncology nursing, 16(1), 3-11.More infoPMID: 10701236;Abstract: OBJECTIVES: To summarize technologies that have been described in nursing literature (in the context of oncology) over the last 25 years, and to present projections of possible technology in the future of oncology nursing. DATA SOURCES: CINAHL (1982 to present), MEDLINE (1976 to 1984), and author identification of articles. CONCLUSIONS: Technology has greatly influenced the evolution of oncology nursing, particularly concerning treatment (chemotherapy, radiation therapy, biotherapy, marrow and blood transplantation), access devices, and genetic and information technologies. IMPLICATIONS FOR NURSING PRACTICE: Nurses must be prepared to deal with how technology affects their philosophical perspective of nursing and the challenges presented by technology.
- Loescher, L. J. (1999). Genetics and ethics: The family history component of cancer genetic risk counseling. Cancer Nursing, 22(1), 96-102.More infoPMID: 9990765;Abstract: Family history is an important risk factor for inherited cancers. Obtaining a family history is therefore a key component of cancer genetic risk counseling (CGRC). Many oncology nurses do not have training in cancer genetic risk counseling. However, every nurse is capable of obtaining a basic family history. The family history can help in identifying patterns of cancer transmission in families. Nurses can then refer families with a strong history of cancer to nurse geneticists, genetic counselors, or others qualified to make a further assessment of risk. If those resources are unavailable locally, the Internet can be of assistance. This article summarizes genetic and clinical characteristics of inherited cancers, the significance of family history, interview approaches, questions to ask about personal and family history of cancer, what a pedigree is and how to draw one, what to do with family information including risk analysis and documentation, and available resources on the Internet.
- Loescher, L., & Loescher, L. J. (1999). The family history component of cancer genetic risk counseling. Cancer nursing, 22(1).More infoFamily history is an important risk factor for inherited cancers. Obtaining a family history is therefore a key component of cancer genetic risk counseling (CGRC). Many oncology nurses do not have training in cancer genetic risk counseling. However, every nurse is capable of obtaining a basic family history. The family history can help in identifying patterns of cancer transmission in families. Nurses can then refer families with a strong history of cancer to nurse geneticists, genetic counselors, or others qualified to make a further assessment of risk. If those resources are unavailable locally, the Internet can be of assistance. This article summarizes genetic and clinical characteristics of inherited cancers, the significance of family history, interview approaches, questions to ask about personal and family history of cancer, what a pedigree is and how to draw one, what to do with family information including risk analysis and documentation, and available resources on the Internet.
- Loescher, L. J. (1998). DNA testing for cancer predisposition.. Oncology nursing forum, 25(8), 1317-1327.More infoPMID: 9766286;Abstract: PURPOSE/OBJECTIVES: To describe and review scientific and regulatory aspects of molecular genetic technology in the context of DNA testing for cancer predisposition. DATA SOURCES: Published professional articles, texts, and proceedings; commercial testing companies; computerized data bases; and the World Wide Web. DATA SYNTHESIS: This article reviews the basic molecular biology (e.g., DNA, genes, chromosomes, DNA mutations) that is the foundation for indirect and direct methods of DNA testing for cancer predisposition. Key issues in DNA testing include who should be tested, provision of testing, and regulatory concerns. Benefits and problems of testing contribute to its current controversial status. CONCLUSIONS: Understanding the mechanisms of DNA testing for cancer requires knowledge of basic molecular biology. Family history of the cancer in question is a key indicator for predisposition testing. Accessing information regarding research-based testing is challenging. DNA testing for cancer predisposition is not a perfect test, as exemplified by issues related to test regulation and sensitivity. IMPLICATIONS FOR NURSING PRACTICE: Basic knowledge of DNA testing for cancer predisposition will help nurses to (a) have a better understanding of the indications for and ramifications of testing, (b) provide information about testing to patients and the lay public, (c) counsel patients and families at high risk for inherited cancers more effectively, and (d) interpret DNA test results.
- Loescher, L. J., & Ronan, J. P. (1998). Toward a holistic view of genetic technology as a way of knowing.. Holistic nursing practice, 12(3), 1-8.More infoPMID: 9624952;Abstract: Technology changes the face of science and, ultimately, nature. How do we as nurses come to know technology? Nurses' ways of knowing, as described by Carper, help nurses better understand technology as a way of knowing; that is, using empirical, ethical, personal, and esthetic ways of knowing provides a means to incorporate technology into holistic nursing practice. Knowledge of technology also requires considering clients' and families' multiple facets of knowing. The article summarizes the nature of technology, nurses' ways of knowing in the context of genetic technology, and the rationale for understanding clients' and families' ways of knowing.
- Loescher, L. J. (1997). Cancer genetics is not all inheritance.. Oncology nursing forum, 24(3), 437-.More infoPMID: 9127352;
- Alberts, D. S., Goldman, R., Xu, M., Dorr, R. T., Quinn, J., Welch, K., Guillen-Rodriguez, J., Aickin, M., Peng, Y., Loescher, L., & Gensler, H. (1996). Disposition and metabolism of topically administered α-tocopherol acetate: A common ingredient of commercially available sunscreens and cosmetics. Nutrition and Cancer, 26(2), 193-201.More infoPMID: 8875556;Abstract: Skin cancers are a serious health problem in the United States. One common method of skin cancer primary prevention is use of sunscreens. Research has been conducted to ascertain the role of active ingredients of sunscreen products in photoprotection and possible carcinogenesis. In contrast, little is known about the 'other ingredients,' listed or unlisted, on sunscreen product labels. One such ingredient is vitamin E, usually in the form of α-tocopherol acetate. Results of recent studies of skin carcinogenesis in an ultraviolet (UV) B mouse carcinogenesis model suggest that topically applied α-tocopherol acetate does not prevent and, under some conditions, enhances skin cancer development and growth, whereas the free unesterified form of α-tocopherol significantly reduces experimental UVB carcinogenesis. We have performed a Phase II cancer prevention study to evaluate whether topically applied α-tocopherol acetate is absorbed in human skin and metabolizes to the free or other forms. In this double-blind study, 19 men and women >30 years of age who had at least three actinic keratoses on their forearms were randomly assigned to apply α-tocopherol acetate (125 mg/g) or difluoromethylornithine cream to their arms twice daily for three months. Blood samples and photographs and punch biopsies of actinic keratoses were obtained before and at the end of the study (Month 4). Plasma and skin concentrations of free α-tocopherol, α-tocopherol acetate, and γ- tocopherol were analyzed by high-performance liquid chromatography at Month 4. The results of this report focus only on data obtained from the 11 participants randomized to the α-tocopherol acetate arm of the study. Topically applied α-tocopherol acetate was substantially absorbed in skin, with no evidence of conversion within skin to its unesterified form (i.e., free α-tocopherol). There was no evidence of systemic availability or biotransformation of topically applied α-tocopherol acetate. In summary, we have determined that α-tocopherol acetate is not metabolized to the free form of α-tocopherol in plasma or skin.
- Loescher, L. J., Emerson, J., Taylor, A., Christensen, D. H., & McKinney, M. (1995). Educating preschoolers about sun safety. American Journal of Public Health, 85(7), 939-943.More infoPMID: 7604917;PMCID: PMC1615522;Abstract: Objectives. This feasibility study examined whether a sun safety curriculum designed for and administered to preschoolers affects their cognition (knowledge, comprehension, application) regarding san safety. Methods. Twelve classes of 4- to 5-year-olds were recruited from local preschools and randomly assigned to an intervention group or a control group. The intervention group received an investigator-developed sun safety curriculum; the control group did not. Children in both groups were tested at the beginning of the study about their cognition related to sun safety. They then received posttests 2 and 7 weeks following the pretest. Results. The curriculum had a significant effect on the knowledge (P = .01) and comprehension (P = .006) components of cognition. The application component of cognition was not significantly changed by the curriculum. Conclusions. A structured curriculum was found to be an efficacious means of enhancing knowledge and comprehension of sun safety in preschool children. At the preoperational developmental stage, however, children may not be able to apply such knowledge and comprehension.
- Loescher, L., & Loescher, L. J. (1995). Genetics in cancer prediction, screening, and counseling: Part I, Genetics in cancer prediction and screening. Oncology nursing forum, 22(2 Suppl).More infoTo review molecular biology and gene technology as they relate to cancer prediction and screening.
- Loescher, L., & Loescher, L. J. (1995). Genetics in cancer prediction, screening, and counseling: Part II, The nurse's role in genetic counseling. Oncology nursing forum, 22(2 Suppl).More infoTo describe an expanded role for oncology nurses in genetic counseling for cancer.
- Buller, M. K., Loescher, L. J., & Buller, D. B. (1994). 'Sunshine and skin health': A curriculum for skin cancer prevention education. Journal of Cancer Education, 9(3), 155-162.More infoPMID: 7811604;Abstract: Skin cancer rates are increasing. Instilling preventive behavior in youngsters is essential to prevent overexposure during childhood. The effectiveness of a curriculum for increasing knowledge and skills, creating supportive attitudes, and engendering a supportive environment to enhance skin cancer prevention was tested on 139 fourth-, fifth-, and sixth-graders. One class in each grade was assigned to treatment (curriculum) and another to control. The curriculum increased knowledge of the effects of exposure to sunlight, skin cancer, and prevention immediately and eight weeks later, across all grades. It also cultivated less favorable attitudes toward tanning and, among fourth-graders, reduced unfavorable attitudes toward sunscreen. Behavioral changes were less consistently evident, with students reporting less suntanning, fourth-graders more frequently using sunscreen, and fifth- and sixth-graders more frequently wearing protective clothing compared with controls. The curriculum was more effective at influencing knowledge and attitudes than changing behavior, highlighting the need for student- and parent-oriented cues to action.
- Loescher, L. J. (1994). Prostate cancer: controversies surrounding risk, screening, and management.. Oncology nursing forum, 21(9), 1503-1504.More infoPMID: 7816676;
- Loescher, L. J. (1994). To screen or not to screen?. Oncology nursing forum, 21(1), 9-.More infoPMID: 8140008;
- Loescher, L. J., Buller, M. K., Buller, D. B., Emerson, J., & Taylor, A. M. (1994). Public education projects in skin cancer. The evolution of skin cancer prevention education for children at a comprehensive cancer center. Cancer, 75(2 SUPPL.), 651-656.More infoPMID: 7804990;Abstract: Background. Skin cancer affects more Americans than any other type of cancer. Children are prime targets for prevention education, because sun overexposure in early childhood may affect the development of skin cancer later in life. Preventive behaviors adopted early in life may be less resistant to change than those acquired in adulthood. Thus, there is a need to educate children at an early age about sun overexposure. Methods. This article describes the evolution of skin cancer prevention research at the Arizona Cancer Center, a National Cancer Institute - designated comprehensive cancer center. Research focusing on children is highlighted. Results. From its roots in the Arizona Sun Awareness Project, an informal public skin cancer education program, skin cancer prevention research at the Arizona Cancer Center has produced two developmentally appropriate, age-based curricula aimed at teaching children about the benefits and dangers of the sun. The elementary school curriculum, Sunny Days, Healthy Ways, has undergone two tests of feasibility and is the intervention used in a large,randomized, experimental trial. The preschool curriculum, Be Sun Safe, has been tested in a randomized trial and was found to have a positive effect on preschoolers' knowledge and comprehension of sun safety. Conclusions. Educating children about skin cancer may be an important way of decreasing the incidence of skin cancer. Although informal skin cancer prevention education can be helpful, educational programs preferably should be research based and evaluated for effectiveness before public distribution. The Arizona Cancer Center experience can serve as a model for other programs.
- Loescher, L. J. (1993). Commentary: expanding our horizons with an alternative approach to cancer prevention and detection.. Seminars in oncology nursing, 9(3), 147-149.More infoPMID: 8210780;Abstract: In order to parallel the advances in cancer prevention science, nurses need to develop alternative approaches to viewing cancer prevention and cancer screening. An alternative cancer prevention model bases prevention and screening on the science of carcinogenesis.
- Loescher, L. J. (1993). Skin cancer prevention and detection update.. Seminars in oncology nursing, 9(3), 184-187.More infoPMID: 8210786;Abstract: The best way to remedy the skin cancer epidemic is for the population to collectively practice primary preventive behaviors. However, many advances have been made in the areas of secondary and tertiary prevention, including the search for intermediate markers to facilitate skin cancer screening of high-risk groups and the use of chemopreventive agents in individuals with a history of high-risk lesions.
- Cartmel, B., Loescher, L. J., & Villar-Werstler, P. (1992). Professional and consumer concerns about the environment, lifestyle, and cancer. Seminars in Oncology Nursing, 8(1), 20-29.More infoPMID: 1546215;Abstract: Although it cannot be said that "everything causes cancer," our environment will never be carcinogen-free. As a result, there are many substances we come in contact with daily that could be potentially harmful to our health. Even with the growing knowledge of the mechanisms of carcinogenesis, it is difficult to single out the exact cancer-causing or -promoting effects of single substances. The confusion that exists about the environment, lifestyle, and cancer can be overwhelming for everyone. Garfinkel94 94 Garfinkel L: The environment and cancer: Putting the risks into perspective. CA 40:261-263, 1990. offered the following suggestions for health care providers to use in putting this issue into better perspective for consumers: (1) no single study of cancer risk factors should be used as a basis for writing or changing public health policy; (2) animal studies should be supportive of findings in epidemiological studies; (3) any environmental factor-cancer effect relationship should be demonstrated biologically; (4) regulatory agencies such as the EPA tend to be conservative in their interpretation of study results, and may suggest caution even when the risk of developing cancer is low; (5) regulatory agencies have been known to extrapolate future effects of carcinogen exposure from current incomplete or limited information about the carcinogen in question. With the knowledge that we do have, we must strive to take personal control over life-style factors that may cause cancer.95 95 Kupchella CE: Environmental factors in cancer etiology. Semin Oncol Nurs 2:161-169, 1986. © 1992.
- Loescher, L. J. (1991). Introduction. Seminars in Oncology Nursing, 7(1), 1-.
- Loescher, L. J., & Meyskens Jr., F. L. (1991). Chemoprevention of human skin cancers. Seminars in Oncology Nursing, 7(1), 45-52.More infoPMID: 2011658;
- Loescher, L. J., & Meyskens Jr., F. L. (1990). Correction: Prevention of hemorrhagic cystitis after cyclophosphamide (I: Reply). Annals of Internal Medicine, 112(8), 634-.
- Loescher, L. J., Clark, L., Atwood, J. R., Leigh, S., & Lamb, G. (1990). The impact of the cancer experience on long-term survivors.. Oncology nursing forum, 17(2), 223-229.More infoPMID: 2315186;Abstract: Little is known about the impact of the cancer experience on long-term survivors of adult cancers. This exploratory study describes survivors' needs and identifies emic (in the subject's own words) categories and patterns among physiological, psychological, and socioeconomic changes, problems/concerns, and needs. A purposive sample of 17 adults more than two years post-cancer therapy was interviewed using the semi-structured Cancer Survivor Questionnaire (CSQ). Deductive content analysis was used to identify specific changes, problems/concerns, or needs associated with physiological, psychological, and socioeconomic categories. Inductive content analysis identified major emic themes and patterns. Findings indicate that the cancer experience permanently changes life patterns and suggest guidelines for nurses to use in helping the cancer survivor better adapt holistically to long-term survival.
- Loescher, L. J., Graham, V. E., Aickin, M., Meyskens Jr., F. L., & Surwit, E. A. (1990). Development of a contingency recruitment plan for a phase III chemoprevention trial of cervical dysplasia.. Progress in clinical and biological research, 339, 151-163.More infoPMID: 2202990;Abstract: Development of contingency recruitment plans in cancer chemoprevention research is as important as formulation of the initial plan. We found that requesting recruitment information from our initial CTCD subjects provided a framework for our contingency plan. The revised recruitment plan consisted of: 1) calling and sending letters to community gynecologists in private practice or affiliated with HMO's to explain the study and ask for referrals; 2) continued personal contact by the principal investigator with referring physicians; 3) sending thank you and follow-up letters to every physician who referred patients to the study; 4) soliciting Papanicolaou smear reports from HMO's if physicians of women with abnormal Papanicolaou smears gave permission to pathologists to release this information; 5) utilizing free media such as feature articles on the CTCD in local papers, public service announcements, and television "spots;" 6) continued use of brochures and posters printed for the initial recruitment effort; and 7) continued presentations to local professional physician and nurse groups about the study. Our contingency plan to date has provided us with 100% of our projected accrual. Thus, our recruitment methods have proved to be effective in accruing subjects for this cancer chemoprevention trial.
- Berdeaux, D. H., Meyskens Jr., F. L., Parks, B., Tong, T., Loescher, L., & Moon, T. E. (1989). Cutaneous malignant melanoma. II. The natural history and prognostic factors influencing the development of Stage II disease. Cancer, 63(7), 1430-1436.More infoPMID: 2920369;Abstract: The survival history of 259 patients with Stage I cutaneous malignant melanoma who were at risk for developing regional nodal metastases (Stage II) were studied. Eighty-seven of 377 Stage I patients (23%) developed regional nodal metastases (Stage II(B)) with 40% 5-year survival. Fifty patients had regional nodal metastases at presentation, with or without a known primary (Stages II(A) or II(C), respectively), with a 42% 5-year survival. A step-down multivariate analysis using the Cox regression model revealed four risk factors as being highly significant for predicting a more favorable survival outcome: (1) thinner Breslow thickness (P = 0.0001), (2) pathologic Stage I disease (P = 0.004), (3) no clinical ulceration (P = 0.0004), and (4) being a woman younger than 50 years of age (P = 0.029). These results are discussed in reference to other series.
- Loescher, L. J., Welch-McCaffrey, D., Leigh, S. A., Hoffman, B., & Meyskens Jr., F. L. (1989). Surviving adult cancers. Part 1: Physiologic effects. Annals of Internal Medicine, 111(5), 411-432.More infoPMID: 2669594;Abstract: Purpose: to provide an overview of the physiologic long-term and late effects of adult cancers and cancer treatments by a review of the medical and nursing literature. Data Identification: Primarily from an English-language literature search using MEDLINE (1980 to 1988) and Index Medicus (1980 to 1988). Study Selection: After a consensus review by four observers, 285 articles were selected that addressed the stated purpose. Data Extraction: Four observers assessed the literature using predetermined criteria for eliciting information about long-term and late effects. Results and Data Synthesis: Much has been written about the acute phases of cancer and cancer treatments. In comparison, relatively few data are available that define physiologic long-term and late effects of cancer treatments in adult survivors. Review of the existing data showed that these sequelae may affect virtually any body system months or years after treatment ends. In addition, few prospective studies dealing with physiologic survivorship issues have been done. Conclusions: Health care providers need to be aware of long-term or late complications that may affect the increasing number of adult cancer survivors. Attention to treatment regimens in the acute cancer phase and careful follow-up once the disease is eradicated may help to prevent or manage these complications. More prospective research should be done in this area.
- Welch-McCaffrey, D., Hoffman, B., Leigh, S. A., Loescher, L. J., & Meyskens Jr., F. L. (1989). Surviving adult cancers. Part 2: Psychosocial implications. Annals of Internal Medicine, 111(6), 517-524.More infoPMID: 2672926;Abstract: The continuation of a rehabilitation effort begun around the initial diagnosis of cancer would be instrumental in providing post-therapy evaluation and guidance needed by adult long-term survivors of cancer. Education, research, and support interventions need to be mobilized for this population of adults with a history of cancer.
- Lippman, S. M., Kassler, J. F., Al-Sarraf, M., Alberts, D. S., Itri, L. M., Mattox, D., D., D., Loescher, L., & Meyskens Jr., F. L. (1988). Treatment of advanced squamous cell carcinoma of the head and neck with isotretinoin: a phase II randomized trial. Investigational New Drugs, 6(1), 51-56.More infoPMID: 3165972;Abstract: Retinoids, the analogs of vitamin A, are active in vitro and in vivo against squamous cell carcinoma in animals and against certain epithelial precancers and cancers in humans. These data led us to design a prospective, multi-institutional, randomized phase II trial of isotretinoin in advanced head and neck squamous cell carcinoma. We randomly assigned 40 patients to receive isotretinoin or methotrexate, the best-studied and most active single agent for this disease. Overall, the study patients had extremely poor prognoses, i.e., low performance statuses and recurring disease after surgery and/or irradiation. Three objective responses (16%), including one complete response, occurred in the 19 evaluable isotretinoin-treated patients. Only one minor response (5%) occurred in the methotrexate-treated group. Toxicity occurred with both drugs, but was manageable and never life threatening in the retinoid group. These results and the established activity of retinoids in oral leukoplakia (a precursor of head and neck cancer) indicate the need for further study of this class of drugs in head and neck cancer. © 1988 Martinus Nijhoff Publishers.
- Meyskens Jr., F. L., Berdeaux, D. H., Parks, B., Tong, T., Loescher, L., & Moon, T. E. (1988). Cutaneous malignant melanoma (Arizona Cancer Center experience): I. Natural history and prognostic factors influencing survival in patients with stage I disease. Cancer, 62(6), 1207-1214.More infoPMID: 3409189;Abstract: The authors have studied the natural history of 377 patients with Stage I cutaneous malignant melanoma followed at the Arizona Cancer Center, Tucson. Two hundred eight patients, or 55%, remained free of metastatic disease after a median follow-up of 30 months. The survival at 5, 8, and 10 years was 69, 65, and 63%, respectively. Natural breakpoints in Breslow thickness for survival occurred in 0.85, 1.95, and 4.00 mm. These are not significantly different from those found by other investigators. A step-down multivariate analysis using the Cox regression model yielded four factors as highly significant in predicting survival: Breslow thickness (P < 0.001), an age/sex interaction (P = 0.0012), clinical ulceration (P = 0.0039), and a prophylactic node dissection (P = 0.019). No predictive value for a BANS or non-BANS location was detected. These results are discussed in reference to other large series which describe the natural history of cutaneous melanoma.
- Meyskens Jr., F. L., Kingsley, E. M., Glattke, T., Loescher, L., & Booth, A. (1986). A phase II study of α-difluoromethylornithine (DFMO) for the treatment of metastatic melanoma. Investigational New Drugs, 4(3), 257-262.More infoPMID: 3102397;Abstract: Difluoromethylornithine (DFMO) is an irreversible enzyme-activated inhibitor of ornithine decarboxylase, a key enzyme in polyamine synthesis. We have screened for potential anti-cancer activity of DFMO using a clonogenic assay, which suggested that melanoma might have sensitivity to this agent. Accordingly, we have performed a phase II trial of DFMO (2 g/m2 po q 8 h) in 24 patients, 21 of whom were evaluable for response. One patient achieved a complete response of a large subcutaneous mass for 11 months. Although stabilization is frequently difficult to measure, seven patients appeared to stabilize previously active disease, with a median duration of response of eight weeks. Toxicity was significant and DFMO was discontinued in five patients due to side effects - hearing loss alone in four and hearing loss associated with thrombocytopenia in the fifth patient. Hearing changes occurred in ten patients. Other side effects were mild. These data indicate that DFMO as a single agent may be an effective therapy for melanoma. A phase II trial of DFMO in previously untreated patients using a different schedule to decrease hearing loss is warranted. Additionally, several in vitro and animal models suggest that DFMO plus interferon are synergistic, and this combination might be used for a clinical trial as well. © 1986 Martinus Nijhoff Publishers.
- Loescher, L. J., & Leigh, S. (1984). Isolated regional limb hyperthermic perfusion as treatment for melanoma.. Cancer Nursing, 7(6), 461-467.More infoPMID: 6568866;
- Loescher, L. J., & Sauer, K. A. (1984). Vitamin therapy for advanced cancers.. Oncology nursing forum, 11(6), 38-45.More infoPMID: 6568711;
- Loescher, L., Kessler, J., & Jones, S. (1984). 13-Cis retinoic acid as treatment for mycosis fungoides: Clinical results of a phase II trial. Federation Proceedings, 43(4), no. 3896.
- Meyskens Jr., F. L., Loescher, L., Moon, T. E., Takasugi, B., & Salmon, S. E. (1984). Relation of in vitro colony survival to clinical response in a prospective trial of single-agent chemotherapy for metastatic melanoma. Journal of Clinical Oncology, 2(11), 1223-1228.More infoPMID: 6387058;Abstract: We have used the effect of therapeutic agents on clonogenic growth in agar to discriminate between active and inactive agents for malignant melanoma. We report a prospective study of single-agent chemotherapy for metastatic melanoma. Forty-five separate in vitro/in vivo correlative trials were conducted in 34 patients. A number of agents were used in these evaluations, including actinomycin D, Amsacrine, bisantrene, mitoxantrone, BCNU, vinblastine, vindesine, 5-fluorouracil, MGBG, etoposide, interferon, tamoxifen, and 13-cis-retinoic acid. At the 'cut-off' concentration, a colony survival 30% as 'resistance'. Clinical sensitivity was designated to include complete, partial, and mixed responses and was predicted in eight of 18 trials (44%). Clinical resistance (nonresponse) was predicted correctly in 24 of 27 cases (89%). Using Fisher's exact test the association of in vitro and in vivo results was significant (P=.05). These results offer further support for the concept that clonogenic assays may help select useful agents for clinical trials in metastatic melanoma.
- Loescher, L. J., & Love, R. (2020, January). Emerging Solutions: Breaking new ground? The Dual PhD/DNP Degrees in Nursing. Doctoral Education Conference. Naples, FL: American Association of Colleges of Nursing.
- Loescher, L. J., Littzen, C., May, J., & Morrison, H. (2020, January). In-betweenness and Isolation: Unique Experiences of PhD-DNP Dual Doctoral Degree Nursing Students in the Online Environment. Doctoral Education Conference. Naples, FL: American Association of Colleges of Nursing.
- Loescher, L. J., Love, R., & Badger, T. (2020, April). The dual doctoral degree in nursing (PhD-DNP): a 10-year report of outcomes and program changes. Western Institute of Nursing Virtual Conference. Virtual: Western Institute of Nursing.
- Loescher, L. J., Silva Torres, G. E., Muramoto, M. L., & Heslin, K. M. (2020, October). Educating massage therapists to engage in skin cancer primary prevention conversations with clients. International Cancer Education Conference.. Virtual (COVID-19): American Association of Cancer Education.
- Loescher, L. J., Silva, G., Muramoto, M., & Heslin, K. (2020, March). Decision simulation technology to assess practical application of massage therapists’ (MTs) use of a MT-client helping conversation for skin cancer risk reduction (Abstract 292). American Society of Preventive Oncology Virtual Conference. Virtual: American Society of Preventive Oncology.
- Curiel-Lewandrowski, C., Harris, R., Loescher, L. J., Wondrak, G., & Dickinson, S. (2019, March). Curiel C, Harris RB, Loescher LJ, Wondrak G & Dickinson S. The UACC Skin Cancer Institute: Who We Are, What We Are Doing, and Opportunities Ahead. . March 26, 2019.. Presentation to Dr. Robert Robbins, President, The University of Arizona. Tucson, AZ: University of Arizona Skin Cancer Institute.
- Janda, M., Horsham, C., Vagenas, D., Loescher, L. J., Gillespie, N., & Soyer, H. P. (2019, November). Gillespie N, Soyer HP. Using mobile teledermoscopy for the early detection of skin cancer by patients in the home. Society for Melanoma Research. Salt Lake City, UT. November 22, 2019. (podium). Society for Melanoma Research. Salt Lake City, UT: Society for Melanoma Research.
- Janda, M., Soyer, H. P., & Loescher, L. J. (2017, Feb/Winter). Exploring patient views of mobile health apps for detection and management of melanoma. ASBHM/APS-CHP Conference 2017. Brisbane, Australia: Australasian Society of Behavioural Health and Medicine.
- Loescher, L. J., Emrick, G., Rawdin, S., Spartonos, D., Machain, T., Pasvogel, A., & Harris, R. (2017, July/Summer). Symposium Title: Translational Research: Dissemination andImplementation of Interventions From Research to Practice: Implementation of Project Students are Sun Safe (SASS) in rural and underserved high schools. Sigma Theta Tau International 28th International Nursing Research Congress. Dublin, Ireland: Sigma Theta Tau International.
- Argenbright, C., Taylor-Piliae, R., & Loescher, L. J. (2016, Summer). A pilot study on Bowenwork for symptom management of women breast cancer survivors with lymphedema. American Holistic Nurses Association annual conference. Bonita Springs FLA: American Holistic Nurses Association.
- Rosenfeld, A. G., Taylor-Piliae, R. E., Carrington, J. M., Gephart, S. M., Insel, K. C., Loescher, L. J., & Reed, P. G. (2016, January). Defying the skeptics! Strategies and successes of an online PhD program.. AACN Doctoral Education Conference. Florida: AACN.
- Loescher, L. J., Heslin, K., Silva, G., & Muramoto, M. (2020, February). Preliminary Results of the Massage Therapists Skin Health Awareness, Referral and Education (MTsSHARE) Study to Reduce Skin Cancer Risk in Arizonans. Arizona Biomedical Research Centre annual conference. Virtual: Arizona Biomedical Research Centre.
- Loescher, L. J., McEwen, M. M., & Nguyen, A. (2020, August). Perceived risk of developing diabetes and health-promoting behaviors in Vietnamese Americans with prediabetes. American Association of Diabetes Care and Education Specialists.. Virtual (COVID-19): American Association of Diabetes Care and Education Specialists..
- Heslin, K. M., Loescher, L. J., Silva, G. E., & Muramoto, M. (2019, October). Recruiting massage therapists as research participants: challenges and lessons learned.. American Massage Therapy Association National Convention. Indianapolis, IN.
- Loescher, L. J., Heslin, K. M., Szalacha, L. A., Silva, G. E., & Muramoto, M. (2019, May). Development and Usability Testing of the MTsSHARE Online Skin Cancer Prevention Training for Massage Therapists. 4th Annual ABRC Annual Research Conference. Phoenix, AZ: Arizona Biomedical Research Centre.
- Loescher, L. J., Heslin, K. M., Szalacha, L. A., Silva, G., & Muramoto, M. (2019, March). Development and Usability Testing of the MTsSHARE Online Skin Cancer Prevention Training for Massage Therapists. (poster B124). 38th Annual Meeting and Scientific Sessions of the Society of Behavioral MedicineSociety of Behavioral Medicine.
- Rung, O., Stauber, L. S., Loescher, L. J., & Pace, T. W. (2020, Spring). Intimate partner violence in pregnant women: Reducing stress with yogic breathing. Western Institute of Nursing Annual Meetings.
- Loescher, L. J., Rawdin, S., Emrick, G. E., Machain, T., Spartonos, D., Pasvogel, A., Johnson, R., & Campas, D. (2017, April/Spring). Training students in underserved high schools along the US-Mexico border to implement Project Students are Sun Safe (SASS). Poster Number: B130. Society of Behavioral Medicine. San Diego: Society of Behavioral Medicine.
- Loescher, L. J., Yung, A., & Thomson, C. (2017, April/Spring). The Behavioral Measurement and Intervention Shared Resource (BMISR) supports researchers conducting behavioral studies. Poster Number: D036. Society of Behavioral Medicine. San Diego, CA: Society of Behavioral Medicine.
- Yung, A., Crane, T., Merchant, N., Loescher, L. J., Younger, A., Wright, S., & Thomson, C. A. (2017, March). Abstract: A novel model to support lifestyle interventions in cancer survivors: undergraduate students and multimodel software platform. Society of Behavioral Medicine. San Diego, CA: SBM.
- Argenbright, C., Loescher, L. J., & Koithan, M. (2016, October-November). Offering integrative complementary practices for symptom management of lymphedema in breast cancer survivors: reframing a complex problem using nonlinear dynamical sciences (NDS). Annual Conference of the American Public Health Association. Denver, CO: American Public Health Association.
- Loescher, L. J., Chao, J., Soyer, H. P., & Curiel-Lewandrowski, C. (2016, April). Primary care providers’ use of mobile teledermoscopy to assess and manage pigmented skin lesions. Society of Behavioral Medicine 37th Annual Meeting and Scientific Sessions. Washington DC: Society of Behavioral Medicine.
- Loescher, L. J., Rains, S., Moussa, R., & Harris, R. (2016, April). Feasibility of sending sun-safety text messages to youth. Society of Behavioral Medicine 37th Annual Meeting and Scientific Sessions. Washington DC: Society of Behavioral Medicine.
- Loescher, L. J., Spartonos, D., & Harris, R. (2016, April). Trained peer leaders evaluate ‘Project Students are Sun Safe (SASS)’ presentations for community students. Society of Behavioral Medicine 37th Annual Meeting and Scientific Sessions. Washington DC: Society of Behavioral Medicine.
- Stratton, D., Slebodnik, M., Kramer, S., & Loescher, L. J. (2016, April). Nurse practitioners’ skin cancer prevention practice: A systematic review. Western Institute of Nursing 49th Annual Conference, Innovations in Engagement through Research, Practice, and Education. Anaheim CA: Western Institute of Nursing.
- Washington, B. S., & Loescher, L. J. (2016, April). African American breast cancer survivors’ intentions to prevent weight gain. Western Institute of Nursing 49th Annual Conference, Innovations in Engagement through Research, Practice, and Education. Anaheim CA: Western Institute of Nursing.
- Webber-Ritchey, K. J., Loescher, L. J., & Taylor-Piliae, R. E. (2016, March). Predictors of Physical Activity Among African-American Parents of Young Children: Personal and Environmental Factors. American Heart Association/ American Stroke Association Cardiovascular Disease Epidemiology and Prevention/Lifestyle and Cardiometabolic Health Scientific Sessions. Phoenix, AZ.More infoAbstractCirculation 2016: 33: AP135