Adina Coroiu1,2, Chelsea Moran3, Catherine Bergeron2, Martin Drapeau2,4, Beatrice Wang5, Abbas Kezouh6, Jochen Ernst7, Gerald Batist8,9,10,11,12, Annett Körner2,10,13,14,15. 1. Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA. 2. Department of Educational and Counselling Psychology, McGill University, Montréal, Quebec, Canada. 3. Department of Psychology, University of Calgary, Calgary, Canada. 4. Department of Psychiatry, McGill University, Montréal, Canada. 5. Gerald Bronfman Department of Oncology, McGill University Health Center, Montréal, Canada. 6. Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montréal, Canada. 7. Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany. Jochen.Ernst@medizin.uni-leipzig.de. 8. Department of Medicine, McGill University, Montréal, Canada. 9. Department of Oncology, Sir Mortimer B. Davis-Jewish General Hospital, Montréal, Canada. 10. Department of Oncology, McGill University, Montréal, Canada. 11. Segal Cancer Centre, Montréal, Canada. 12. Centre for Translational Research in Cancer, McGill University, Montréal, Canada. 13. Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Canada. 14. Louise Granofsky Psychosocial Oncology Program, Segal Cancer Center, Montreal, Canada. 15. Psychosocial Oncology Program, McGill University Health Centre, Montreal, Canada.
Abstract
BACKGROUND: Melanoma can be lethal if not detected early and treated. Early detection can be facilitated via skin self-examination (SSE) and as such, SSE is part of melanoma follow-up care for individuals with a prior history, who face a life-long risk of reoccurrence. The objective of the current study was to identify short- and long-term predictors of SSE among melanoma survivors to inform future prevention interventions in high-risk groups. METHOD: This is an observational study with longitudinal assessments conducted with adult melanoma patients in active follow-up care. PRIMARY OUTCOME MEASURES: Behavioral outcomes, comprehensive SSE (checking up to 5 body areas in the last 3 months) and optimal SSE (checking the entire body at least monthly in the last 3 months) were assessed at 3, 12, and 24 months post a dermatological educational session on skin cancer prevention. T tests and chi square analyses were used to examine changes in outcomes from 3 to 12 and 24 months. Linear and logistic regression models were used to examine the association between predictors and the primary outcomes. RESULTS: Comprehensive SSE did not decrease significantly from 3 (M = 2.7, SD = 1.1) to 12 (M = 2.6, SD = 1.2) and 24 months (M = 2.4, SD = 1.2) post the education session, with the stronger predictor at all timepoints being intentions to perform SSE. Optimal SSE was higher at 3 months (59%) compared to 12 (46%) and 24 months (34%), with key predictors including self-efficacy and intentions to perform SSE and male sex at 3 months post; self-efficacy and reliance on medical advice at 12 months; and (lower) education and self-efficacy at 24 months. CONCLUSIONS: The key findings of this study are that 1) survivors maintain SSE behaviour over time, but rates of SSE performed in agreement with medical recommendations are higher immediately post standard dermatological education (i.e. usual care) and decrease somewhat over a 24-month period; and 2) the strongest psycho-social predictors of SSE are intentions and self-efficacy to perform the behavior, which are highly modifiable, for example via motivational interviewing and goal setting health interventions.
BACKGROUND:Melanoma can be lethal if not detected early and treated. Early detection can be facilitated via skin self-examination (SSE) and as such, SSE is part of melanoma follow-up care for individuals with a prior history, who face a life-long risk of reoccurrence. The objective of the current study was to identify short- and long-term predictors of SSE among melanoma survivors to inform future prevention interventions in high-risk groups. METHOD: This is an observational study with longitudinal assessments conducted with adult melanomapatients in active follow-up care. PRIMARY OUTCOME MEASURES: Behavioral outcomes, comprehensive SSE (checking up to 5 body areas in the last 3 months) and optimal SSE (checking the entire body at least monthly in the last 3 months) were assessed at 3, 12, and 24 months post a dermatological educational session on skin cancer prevention. T tests and chi square analyses were used to examine changes in outcomes from 3 to 12 and 24 months. Linear and logistic regression models were used to examine the association between predictors and the primary outcomes. RESULTS: Comprehensive SSE did not decrease significantly from 3 (M = 2.7, SD = 1.1) to 12 (M = 2.6, SD = 1.2) and 24 months (M = 2.4, SD = 1.2) post the education session, with the stronger predictor at all timepoints being intentions to perform SSE. Optimal SSE was higher at 3 months (59%) compared to 12 (46%) and 24 months (34%), with key predictors including self-efficacy and intentions to perform SSE and male sex at 3 months post; self-efficacy and reliance on medical advice at 12 months; and (lower) education and self-efficacy at 24 months. CONCLUSIONS: The key findings of this study are that 1) survivors maintain SSE behaviour over time, but rates of SSE performed in agreement with medical recommendations are higher immediately post standard dermatological education (i.e. usual care) and decrease somewhat over a 24-month period; and 2) the strongest psycho-social predictors of SSE are intentions and self-efficacy to perform the behavior, which are highly modifiable, for example via motivational interviewing and goal setting health interventions.
Entities:
Keywords:
Melanoma early detection; Melanoma patients; Observational study; Skin self-examination
Authors: June K Robinson; Samer Wahood; Sophia Ly; Jessie Kirk; Jamie Yoon; James Sterritt; Elizabeth Gray; Mary Kwasny Journal: Prev Med Rep Date: 2021-08-26