In the United States in 2015, approximately 73,870 invasive melanoma cases will be diagnosed and of those, 9,940 will die from the disease. Treatment at later stages of the disease is associated with metastasis to internal organs and ultimately, death. These data underscore the critical significance of early detection of melanoma. Our ongoing R01 randomized controlled trial (RCT) demonstrated preliminary evidence for a melanoma survivor and skin check partner-assisted skin self-examination (SSE) training program resulting in regular and accurate SSEs relative to patients and partners receiving treatment as usual care. However, four critical questions remain unanswered: 1) Whether these patients will retain the knowledge/skills in real-world conditions following the conclusion of the RCT; 2) Whether they will continue to engage in reliable SSE behaviors with their skin check partners; 3) Whether they will retain the high level of accuracy of the SSEs with their skin check partners; and 4) Do they differ from patients who receive training while under the customary care of their own dermatologists? The proposed continuation builds on our NCI funded studies of Stage I to IIA melanoma patients by examining the influence of SSE training on early detection behaviors in real- world conditions. Our existing treatment condition patients' (TRT1) SSE early detection behaviors will be compared to three groups: 1) Participants who receive the tablet- intervention accessed via the web while under the customary care of their own dermatologists; (TRT2); 2) active-controls - control participants from the RCT who were repeatedly surveyed and seen by study-physicians every 4 mo. over the past two years who are also returning to the care of their own dermatologists (C1); and 3) assessment- only controls - control participants to be recruited for the proposed study (C2). The current proposal will contribute critical information to the scientific literature on the impact of early detection of melanomas using SSEs and will be the first to test the sustainability and long-term impact of an efficacious SSE intervention for early detection targeting melanoma survivors in real-world settings. Specifically, the aims of the study will examine: 1) the long-term efficacy of SSE training on knowledge, performance, and accuracy under real-world conditions; and 2) whether patient-partner relationship qualities and age moderate the relationship between the conditions (treatment/controls) and SSE outcomes (retention of SSE knowledge, performance, and accuracy).
In the United States in 2015, approximately 73,870 invasive melanoma cases will be diagnosed and of those, 9,940 will die from the disease. Treatment at later stages of the disease is associated with metastasis to internal organs and ultimately death; therefore, the early detection of melanoma is critical. Our previous work has demonstrated evidence for a melanoma survivor and partner skin self-examination (SSE) training program and the current proposal will contribute critical information to the scientific literature on the impac of early detection of melanomas using SSEs and will be the first to test the SSE intervention in real-world settings.
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