Population based registries document that survival from melanoma, a growing public health problem with approximately 70,000 new melanoma cases and an estimated 8,600 deaths in 2010, is dependent on the thickness of the melanoma. By facilitating seeking medical care, skin self-examinations (SSEs) by individuals with a prior history of melanoma, who are at risk to develop subsequent melanomas, may lead to the early detection and treatment of melanoma when it is usually more effective. Thus, further research that enhances early detection is warranted and our application directly tests novel methods of training high-risk melanoma patients and their partners on how to conduct SSEs to promote early detection. Our proposed research builds upon the strengths of the R21 that: a) established that in-person training to conduct SSE with a partner significantly enhanced SSE performance 4 months after the intervention, and b) developed and pilot tested a manual take-home workbook training approach (WORKBOOK). Our pilot work on the WORKBOOK with partners suggests that patient-partner dyads (n = 21) perceived it to be readable, useful, and in the short term 4 month follow-up, empirically equivalent in promoting SSE knowledge, skills, and behaviors compared with patient-partner dyads in the in-person partner training condition (n = 19). Our proposed research builds on our NCI funded studies by conducting a formal examination with 430 subjects randomized to either the in-person or workbook training vs. an assessment only control group that receives standard of care over a 2 year longitudinal study with 4 month interval evaluations. Our proposed research directly tests novel methods of training Stage I and IIA melanoma patients, who have a 5 year survival of 80-90%, and their partners, on how to conduct SSEs. We will compare the efficacy of the in- person training vs. workbook for patients and partners vs. controls on SSE knowledge/skill acquisition and retention, and SSE performance and accuracy on a short (4 and 8 months post baseline) and long term basis (12, 16, 20, and 24 months post baseline) and examine whether partner-patient relationship-qualities moderate the relationship between the training approaches and SSEs knowledge/skill acquisition and retention, and SSE performance and accuracy. Establishing health promotion partnerships is important to those at risk to develop melanoma because SSE is difficult to successfully perform as an individual. It is expected that the workbook will promote SSE at least as well as and perhaps better than in-person training and become an easily disseminated SSE training approach that is not dependent on the time and teaching skills of the non-MD clinical office staff.

Public Health Relevance

The almost 724,000 Americans survivors of melanoma are estimated to have 4 first degree relatives per case;thus, 2.8 million Americans are at increased risk of developing melanoma in comparison to the general public. SSE with the assistance of a partner by these individuals could improve survival. If effective, the workbook tested in this proposal could be distributed to people at risk of developing melanoma by large scale means in physician offices.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Research Project (R01)
Project #
5R01CA154908-04
Application #
8633007
Study Section
Community Influences on Health Behavior (CIHB)
Program Officer
Perna, Frank
Project Start
2011-05-13
Project End
2016-03-31
Budget Start
2014-04-01
Budget End
2015-03-31
Support Year
4
Fiscal Year
2014
Total Cost
$514,641
Indirect Cost
$106,574
Name
Northwestern University Chicago
Department
Dermatology
Type
Schools of Medicine
DUNS #
005436803
City
Chicago
State
IL
Country
United States
Zip Code
60611
Robinson, June K; Nodal, Mercedes; Chavez, Leonid et al. (2017) Enhancing the Relevance of Skin Self-examination for Latinos. JAMA Dermatol 153:717-718
Rzepecki, A K; Jain, N; Ali, Y et al. (2017) Promoting early detection of melanoma during the mammography experience. Int J Womens Dermatol 3:195-200
Robinson, June K; Penedo, Frank J; Hay, Jennifer L et al. (2017) Recognizing Latinos' range of skin pigment and phototypes to enhance skin cancer prevention. Pigment Cell Melanoma Res 30:488-492
Robinson, June K; Hultgren, Brittney; Mallett, Kimberly et al. (2017) Self-confidence and Embarrassment About Partner-Assisted Skin Self-examination for Melanoma. JAMA Dermatol 153:342-344
Robinson, June K; Halpern, Allan C (2016) Cost-effective Melanoma Screening. JAMA Dermatol 152:19-21
Robinson, June K; Wayne, Jeffrey D; Martini, Mary C et al. (2016) Early Detection of New Melanomas by Patients With Melanoma and Their Partners Using a Structured Skin Self-examination Skills Training Intervention: A Randomized Clinical Trial. JAMA Dermatol 152:979-85
Hultgren, Brittney A; Turrisi, Rob; Mallett, Kimberly A et al. (2016) Influence of Quality of Relationship Between Patient With Melanoma and Partner on Partner-Assisted Skin Examination Education: A Randomized Clinical Trial. JAMA Dermatol 152:184-90
Mallett, Kimberly A; Ackerman, Sarah; Turrisi, Rob et al. (2015) Rates of sunburn among dermatology patients. JAMA Dermatol 151:231-2
Turrisi, Rob; Hultgren, Brittney; Mallett, Kimberly A et al. (2015) Comparison of Efficacy of Differing Partner-Assisted Skin Examination Interventions for Melanoma Patients: A Randomized Clinical Trial. JAMA Dermatol 151:945-51
Stapleton, Jerod L; Turrisi, Rob; Mallett, Kimberly A et al. (2015) Correspondence between pigmented lesions identified by melanoma patients trained to perform partner-assisted skin self-examination and dermatological examination. Cancer Epidemiol Biomarkers Prev 24:1247-53

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