=Malignant melanoma is a major public health problem for which early detection is critical. Melanoma incidence and mortality have increased over the past several decades. Prognosis is critically dependent on the depth of the primary lesion at the time of initial surgical excision. Hence, monthly thorough skin examination (SSE) by the general public for the purpose of early detection, before deep invasion, is one promising approach for reducing melanoma mortality which has been promoted with increasing vigor in recent years. However, strategies for increasing the practice of SSE have not been rigorously evaluated, nor have the effects of SSE interventions on health care resource use. The investigators propose to conduct a 3-group randomized trial of interventions for increasing SSE use. The participants will be recruited from primary care physician offices. The experimental interventions tested will include written materials, cues, aids, and a videotape given at baseline and tailored feedback reports at 2 and 6 months. One of the two experimental interventions will include face-to-face counseling at baseline and a follow-up phone call 2 weeks later. The control intervention will include materials and a videotape on healthy dietary habits. Assessments will be conducted at 2, 6, and 12 months after the initial intervention. The primary outcome variable will be performance of at least one SSE during the two months prior to the assessment. The investigators will also assess the number of visits to health care providers for skin problems since the prior assessment, and the procedures performed by the provider because of those skin problems. Upon completion of this project, the investigators will have developed an intervention package suitable for dissemination, and will have evaluated its efficacy in improving performance of SSE, as well as its potential effect on health care resource use. The knowledge and experiment thus gained will aid the continuing efforts to encourage SSE and reduce melanoma mortality.
