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Randomized trial of a web-based survivor intervention on melanoma prevention behaviors of first-degree relatives

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Abstract

Objectives

Melanoma can be prevented through reducing sun exposure and detected early by increasing examination of skin for lesions. First-degree relatives of melanoma cases have higher risk than the general population and, therefore, could be targets of behavioral interventions through families. We tested the effects of a family-based web delivered intervention to melanoma families on the melanoma risk reduction behaviors of first-degree relatives of melanoma cases.

Methods

A total of 313 families that included one first-degree relative were recruited to join this randomized trial. All intervention families received access to the Suntalk website developed to promote family communication and behavioral risk reduction among families of melanoma survivors.

Results

First degree relatives in the intervention arm significantly increased their yearly performance of both skin self examination and thorough provider examination from baseline to 12-month follow-up while the control FDRs decreased their yearly performance of both of those behaviors (p’s = 0.006 and 0.005, respectively). Several sun protection behaviors increased significantly in FDRs in the intervention arm but not the control arm, including wearing a covering on the head (p = 0.005), staying in available shade (p = 0.008), and avoiding sun exposure during peak hours (p = 0.010). Some of these changes were mediated by perceptions of risk and other process variables.

Conclusions

A web-based intervention can reduce risk of melanoma through changes in relevant behaviors among first-degree relatives of melanoma survivors. Future research should identify methods for making this type of intervention accessible to more families and for broadening the reach to other types of cancer families.

Practice implications

This program can be provided to melanoma families to improve their sun protection and screening behaviors, at the point of diagnosis.

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References

  1. National Cancer Institute (2015) SEER Stat Fact Sheets: Melanoma of the skin. http://seer.cancer.gov/statfacts/html/melan.html

  2. Vuong K, Armstrong BK, Weiderpass E, Lund E, Adami HO, Veierod MB, Barrett JH, Davies JR, Bishop DT, Whiteman DC, Olsen CM, Hopper JL, Mann GJ, Cust AE, McGeechan K and the Australian Melanoma Family Study Investigators (2016) Development and external validation of a melanoma risk prediction model based on self-assessed risk factors. JAMA Dermatol 152:889

    Article  PubMed  Google Scholar 

  3. National Cancer Institute (2015) UV exposure and sun protective practices. http://progressreport.cancer.gov/prevention/sun_protection

  4. Bowen DJ, Jabson JM, Haddock N, Hay J, Edwards K (2011) Skin care behaviors among melanoma survivors. Psycho-oncology 21:1285

    Article  PubMed  Google Scholar 

  5. Pitceathly C, Maguire P (2003) The psychological impact of cancer on patients’ partners and other key relatives. Eur J Cancer. https://doi.org/10.1016/S0959-8049(03)00309-5

    Article  PubMed  Google Scholar 

  6. Novilla MLB, Barnes MD, Natalie G, Williams PN, Rogers J (2006) Public health perspectives on the family: an ecological approach to promoting health in the family and community. Fam Community Health 29(1):28–42

    Article  PubMed  Google Scholar 

  7. Hay J, Shuk E, Brady MS, Berwick M, Ostroff J, Halpern A (2008) Family communication after melanoma diagnosis. Arch Dermatol. https://doi.org/10.1001/archderm.144.4.553

    Article  PubMed  PubMed Central  Google Scholar 

  8. Oliveria SA, Heneghan MK, Halpern AC, Hay JL, Geller AC (2012) Communication about family members’ risk of melanoma: self-reported practices of dermatologists in the United States. Arch Dermatol 148(5):621–627

    Article  PubMed  Google Scholar 

  9. Bowen DJ, Hay JL, Mayer J, Kuniyuki A, Meischke H, Harris J, Asgari M, Shoveller J, Press N, Burke W (2012) Predictors of recruited melanoma families into a behavioral intervention project. Contemp Clin Trials 33(1):85–92

    Article  PubMed  Google Scholar 

  10. Harris JN, Kuniyuki A, Hay J, Asgari M, Press N, Bowen DJ (2010) Using a family systems approach to investigate cancer risk communication within melanoma families. Psycho-oncology 19(10):1102–1111

    Article  PubMed  PubMed Central  Google Scholar 

  11. Torres SM, Ramos M, Leverence R, Bowen D, Berwick M, Hay J (2014) A pilot study of skin cancer risk reduction behaviors, cancer communications, and skin cancer beliefs in Hispanics in a Southwestern primary care practice. Calif J Health Promot 12(1):95–100

    Article  Google Scholar 

  12. Bowen DJ, Burke W, Hay J, Meischke H, Harris J (2015) Effects of web-based intervention on risk reduction behaviors in melanoma survivors. J Cancer Surviv 9(2):279–286

    Article  PubMed  Google Scholar 

  13. Schulz KF, Altman DG, Moher D, for the CONSORT Group (2010) CONSORT 2010 Statement: updated guidelines for reporting parallel group randomized trials. Ann Int Med 152:726

    Article  PubMed  Google Scholar 

  14. Anton-Culver H et al (2003) The cancer genetics network: recruitment results and pilot studies. Community Genet 6(3):171–177

    PubMed  Google Scholar 

  15. http://www.yourdiseaserisk.wustl.edu/. Accessed 30 Sept 2017

  16. Oh SS, Mayer JA, Lewis EC, Slymen DJ, Sallis JF, Elder JP et al (2004) Validating outdoor workers’ self-report of sun protection. Prev Med 39(4):798–803

    Article  Google Scholar 

  17. Weinstock M, Risica P, Martin R, Rakowski W, Dube C, Berwick M, Goldstein M, Acharyya S, Lasater T (2007) Melanoma early detection with thorough skin self-examination the ‘check it out’ randomized trial. Am J Prev Med 32:517

    Article  PubMed  PubMed Central  Google Scholar 

  18. Lerman C, Daly M, Masny A, Balshem A (1994) Attitudes about genetic testing for breast-ovarian cancer susceptibility. J Clin Oncol 12(4):843–850

    Article  CAS  PubMed  Google Scholar 

  19. Baron RM, Kenny D (1986) The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. J Pers Soc Psychol 51(6):1173–1182

    Article  CAS  Google Scholar 

  20. Moos RH, Moos BS (1986) The family environment scale: The manual. Consulting Psychologists Press, Palo Alto

    Google Scholar 

  21. Geller AC, Halpern AC (2013) The ever-evolving landscape for detection of early melanoma: challenges and promises. J Invest Dermatol 133(3):583–585

    Article  CAS  PubMed  Google Scholar 

  22. Bowen DJ, Albrecht T, Hay J, Eggly S, Harris-Wei J, Meischke H, Burke W (2018) Communication among melanoma family members. Fam Community 16(4):597–603

    Google Scholar 

  23. Geller AC, Emmons KE, Brooks DR, Powers C, Zhang Z, Koh HK, Heeren T, Sober AJ, Li F, Gilchrest BA (2006) A randomized trial to improve early detection and prevention practices among siblings of melanoma patients. Cancer. https://doi.org/10.1002/cncr.22050

    Article  PubMed  Google Scholar 

  24. Manne S, Jacobsen PB, Ming ME, Winkel W, Dessureault S, Lessin SR (2010) Tailored versus generic interventions for skin cancer risk reduction for family members of melanoma patients. Off J Div Health Psychol Am Psychol Assoc Health Psychol 29:583

    Google Scholar 

  25. Gritz ER, Tripp MK, Peterson SK, Prokhorov AV, Shete SS, Urbauer DL, Fellman BM, Lee J, Gershenwald JE (2013) Randomized controlled trial of a sun protection intervention for children of melanoma survivors. Cancer Epidemiol Biomark Prev 22:1813

    Article  Google Scholar 

  26. Bowen D, Powers D (2010) Effects of a mail and telephone intervention on breast health behaviors. Health Educ Behav 37(4):479–489

    Article  PubMed  Google Scholar 

  27. Hay J, Meischke H, Bowen D, Mayer J, Shoveller J, Press N,.Burke W (2007) Anticipating dissemination of cancer genomics in public health: a theoretical approach to psychosocial and behavioral challenges. Ann Behav Med 34(3):275–286

    Article  PubMed  Google Scholar 

  28. Kovalyshyn I (2011) The impact of physician screening on melanoma detection. Arch Dermatol 147:1269

    Article  PubMed  Google Scholar 

  29. Leventhal H (1987) Behavioral theories and the problem of compliance. Patient Educ Couns 10(2):117–138

    Article  Google Scholar 

  30. Leventhal H (in press) Dual process theory of predicting behaviors. In: Diefenbach MA, Miller SM, Bowen D (eds) Handbook of health decision science. Springer, New York

  31. Manne S, Lessin S (2006) Prevalence and correlates of sun protection and skin self-examination practices among cutaneous malignant melanoma survivors. J Behav Med 29:419–434

    Article  PubMed  Google Scholar 

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Funding

This study was funded by the National Cancer Institute (CA107430).

Author information

Authors and Affiliations

  1. Bioethics and Humanities, University of Washington, Seattle, WA, 98195, USA

    Deborah J. Bowen & Wylie Burke

  2. Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Jennifer Hay

  3. Health Services, University of Washington, Seattle, WA, 98195, USA

    Hendrika Meischke

  4. Graduate School of Public Health, San Diego State University, San Diego, CA, 92182, USA

    Joni A. Mayer

  5. University of California, San Francisco, San Francisco, CA, USA

    Julie Harris-Wai

Authors
  1. Deborah J. Bowen
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  2. Jennifer Hay
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  3. Hendrika Meischke
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  4. Joni A. Mayer
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  5. Julie Harris-Wai
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  6. Wylie Burke
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Corresponding author

Correspondence to Deborah J. Bowen.

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Conflict of interest

All authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

was obtained from all individual participants included in the study.

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Bowen, D.J., Hay, J., Meischke, H. et al. Randomized trial of a web-based survivor intervention on melanoma prevention behaviors of first-degree relatives. Cancer Causes Control 30, 225–233 (2019). https://doi.org/10.1007/s10552-018-1096-y

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  • DOI: https://doi.org/10.1007/s10552-018-1096-y

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