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

摘要

ObjectivesMelanoma 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.MethodsA 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.ResultsFirst 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.ConclusionsA 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 implicationsThis program can be provided to melanoma families to improve their sun protection and screening behaviors, at the point of diagnosis.