Abstract
Introduction: Melanoma patients are at high risk of recurrence or additional primary lesions. Although early detection may prolong melanoma survival, few patients report engaging in early detection behaviors. Little is known about the types of interventions, including video, that affect skin cancer risk reduction behavior in this population. We found no studies of Internet‐delivered video to facilitate skin cancer early detection behavior change. The purpose of this study was to: (1) develop and test a video intervention for skin cancer early detection; specifically to measure changes in self‐reported melanoma awareness, melanoma attitudes and beliefs, and thorough skin self‐examination (TSSE); (2) assess the feasibility of delivering and testing the intervention via the Internet.
Methods: Using concepts from social cognitive theory as a foundation, a team of researchers and media specialists developed a 13 minute evidence‐based video, which addresses the seriousness of skin cancer, includes testimonials from patients and demonstrates TSSE. A technology specialist adapted an existing survey for the Internet to measure the main variables and created a study Website. To measure knowledge, participants answered ten items about warning signs of melanoma; possible scores ranged from 0 to 10. Skin cancer attitudes and beliefs (seriousness, self‐efficacy, perceived risk) were measured by two 6‐item scales that had acceptable internal consistency estimates (Cronbach' alpha = 0.70; 0.79). The TSSE measure was Weinstock' method to query how often during the previous two months participants examined seven specific parts of the body. We recruited adult patients with melanoma from a skin cancer specialty clinic. Shortly after enrollment, participants received an encrypted email with unique login information to access the pre‐intervention survey. After completing the survey, participants could access the link to view the video. Three months later, they completed an identical post‐intervention survey on the Internet. Data were stored in the Microsoft SQL server.
Results: 41 of 85 participants (mean age 61 years, 58% men, 42% women) completed both surveys. The video intervention significantly improved melanoma awareness (p=0.002) and self‐reported TSSE performance (p=0.007), but did not change attitudes or beliefs. Contributing to attrition (failure to complete the second survey) were several issues related to use of the Internet; e.g. opening the video and surveys, nonfunctional email addresses. Characteristics of participants who completed the first survey and did not complete the second survey were similar, the only difference was that significantly more noncompleters had higher education levels.
Conclusion: Internet delivery of a video intervention is effective for short‐term improvement of skin cancer knowledge and TSSE. Attitudes and beliefs about skin cancer remain stable. Using the Internet to deliver and test an intervention presents some challenges that merit careful consideration for future research.
Citation Information: Cancer Prev Res 2010;3(1 Suppl):B34.
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