Background
Skin cancer prevention
Early detection of melanoma
Behaviour change interventions
Study aims
Methods
Design
Study population and recruitment
Intervention description
Intervention adherence and acceptability
Variables and measures
Sunscreen use intention
Sunscreen use planning
SSE behaviour and intention
SSE planning
Talking about skin cancer
Illness perceptions
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Identity: ‘How much would getting skin cancer affect your life?’ An eleven-point continuous rating scale was used to gauge response from 0 (not at all) to 10 (it would severely affect my life);
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Control: ‘How much control do you feel you have to prevent yourself from getting skin cancer? An eleven-point continuous rating scale was used to gauge response from 0 (not at all relevant) to 10 (very relevant).
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Timeline: ‘Given your age, how relevant is it to regularly examine your skin for signs of possible skin cancer?’ An eleven-point continuous rating scale was used to gauge response from 0 (not at all relevant) to 10 (very relevant).
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Consequence: ‘How painful do you think the effects of treatments for skin cancer would be? An eleven-point continuous rating scale was used to gauge response from 0 (not at all painful) to 10 (extremely painful).
Social-demographic characteristics
Analyses
Results
Sample characteristics
Intervention adherence
Intervention acceptability
Baseline associations
Sunscreen use intention, planning and risk perceptions
Total | Male | Female | ||||||
---|---|---|---|---|---|---|---|---|
Intention | % |
n
| % |
n
| % |
n
| Sig. | |
Sunscreen Use | 1 - Definitely will not | 5.3 | (33) | 6.8 | (23) | 3.6 | (10) | 0.001** |
2 | 11.0 | (68) | 14.2 | (48) | 7.1 | (20) | ||
3 | 25.2 | (156) | 26.8 | (91) | 23.2 | (65) | ||
4 | 27.6 | (171) | 26.8 | (96) | 28.6 | (80) | ||
5 – Definitely will | 30.9 | (191) | 25.4 | (86) | 37.5 | (105) | p<0.001*** | |
SSE | 1 - Definitely will not | 13.3 | (83) | 17 | (58) | 8.8 | (25) | 0.041* |
2 | 29.5 | (184) | 29.3 | (100) | 29.7 | (84) | ||
3 | 41.8 | (261) | 38.4 | (131) | 45.9 | (130) | ||
4 | 10.7 | (67) | 10.9 | (37) | 10.6 | (67) | ||
5 – Definitely will | 4.6 | (29) | 4.4 | (15) | 4.9 | (14) | ||
Have you spoken to anyone about skin cancer in the last month? | Yes No | 9.2 90.8 | (57) (563) | 8.2 91.8 | (28) (312) | 10.4 89.6 | (29) (251) | 0.363 |
Planning behaviour | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
When | What | Where | How | Coping | |||||||
Health Behaviour | % | (n) | % | (n) | % | (n) | % | (n) | % | (n) | |
Sunscreen Use | 1 – Completely disagree | 23.3 | (145) | 28.5 | (177) | 30.5 | (190) | 34.6 | (215) | 39.8 | (247) |
2 | 15 | (93) | 19.8 | (123) | 18.8 | (117) | 20.7 | (129) | 19.8 | (123) | |
3 | 23.5 | (146) | 23.8 | (148) | 17.4 | (108) | 20.9 | (130) | 19.8 | (123) | |
4 | 24.3 | (151) | 17.2 | (107) | 16.6 | (103) | 15.0 | (93) | 11.8 | (73) | |
5 – Completely agree | 14.0 | (87) | 10.8 | (67) | 16.7 | (104) | 8.8 | (55) | 8.7 | (54) | |
Skin Self Examination | 1 – Completely disagree | 68.8 | (431) | – | – | 64.8 | (403) | 65.1 | (404) | 63.3 | (395) |
2 | 19.5 | (122) | – | – | 19.1 | (119) | 20.8 | (129) | 20.4 | (127) | |
3 | 8.6 | (54) | – | – | 10 | (62) | 10.3 | (64) | 13.1 | (82) | |
4 | 1.9 | (12) | – | – | 4.8 | (30) | 2.6 | (16) | 2.4 | (15) | |
5 – Completely agree | 1.1 | (7) | – | – | 1.3 | (8) | 1.3 | (8) | 0.8 | (5) |
Planning Behaviour (% Yes) | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|
When | What | Where | How | Coping | ||||||
Intention/behaviour | % | (n) | % | (n) | % | (n) | % | (n) | % | (n) |
Sunscreen Use Intention | ||||||||||
Yes | 86.2 | (150) | 79.8 | (190) | 75.4 | (156) | 81.1 | (120) | 82.7 | (105) |
Don’t know | 62.2 | (92) | 54.8 | (80) | 61.1 | (66) | 66.9 | (87) | 68.3 | (84) |
No | 40.5 | (121) | 39.2 | (93) | 46.1 | (141) | 45.5 | (156) | 46.9 | (173) |
Sig. | < 0.001 | < 0.001 | < 0.001 | 0.001 | 0.001 | |||||
SSE Intention | ||||||||||
Yes | 9.4 | (9) | – | – | 11.6 | (11) | 11.7 | (11) | 9.4 | (9) |
Don’t know | 3.5 | (9) | – | – | 7.0 | (18) | 4.3 | (11) | 0.8 | (2) |
No | 0.4 | (1) | – | – | 3.4 | (9) | 0.4 | (1) | 3.5 | (9) |
Sig. | < 0.001 | – | – | < 0.001 | < 0.001 | < 0.001 | ||||
SSE behaviour | ||||||||||
Yes | 10.5 | (4) | – | – | 16.2 | (6) | 22.2 | (8) | 13.2 | (5) |
Don’t know | 20.8 | (5) | – | – | 20.8 | (5) | 16.7 | (4) | 8.3 | (2) |
No | 1.8 | (10) | – | – | 4.8 | (27) | 2.1 | (12) | 2.3 | (13) |
Sig. | < 0.001 | – | – | < 0.001 | < 0.001 | 0.001 |
SSE/SSE Intention/sunscreen use intention | Sig | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
Yes1 | Don’t know | No | |||||||||
CSM Attribute | n | Mean | SD | n | Mean | SD | n | Mean | SD | ||
Skin Self Examination (SSE) | Identity: How much skin cancer would affect your life? | 38 | 7.66 | 2.122 | 561 | 8.13 | 1.888 | 24 | 8.13 | 2.071 | 0.375 |
Control: How much control you feel you have to prevent skin cancer? | 38 | 6.39 | 2.047 | 562 | 5.65 | 2.256 | 24 | 5.13 | 2.659 | 0.128 | |
Timeline: Given your age, how relevant to conduct SSE? | 38 | 6.42 | 2.332 | 557 | 5.13 | 2.241 | 24 | 4.92 | 2.749 | 0.008** | |
Consequences: How painful the effects of skin cancer would be? | 38 | 7.24 | 2.307 | 557 | 7.02 | 2.014 | 24 | 6.75 | 2.625 | 0.707 | |
SSE Intention | Identity: How much skin cancer would affect your life? | 96 | 8.56 | 1.514 | 261 | 8.12 | 1.759 | 265 | 7.93 | 2.104 | 0.078 |
Control: How much control you feel you have to prevent skin cancer? | 96 | 6.00 | 2.088 | 261 | 5.98 | 2.057 | 265 | 5.24 | 2.433 | < 0.001*** | |
Timeline: Given your age, how relevant to conduct SSE? | 96 | 6.10 | 2.174 | 258 | 5.56 | 2.027 | 263 | 4.53 | 2.373 | < 0.001*** | |
Consequences: How painful the effects of skin cancer would be? | 95 | 7.40 | 1.991 | 260 | 7.04 | 2.000 | 263 | 6.89 | 2.125 | 0.101 | |
Sunscreen Intention | Identity: How much skin cancer would affect your life? | 363 | 8.33 | 1.749 | 156 | 7.81 | 1.947 | 100 | 7.67 | 2.265 | < 0.001*** |
Control: How much control you feel you have to prevent skin cancer? | 363 | 5.80 | 2.129 | 157 | 5.60 | 2.287 | 100 | 5.36 | 2.607 | 0.190 | |
Timeline: Given your age, how relevant to conduct SSE? | 359 | 5.29 | 2.214 | 156 | 5.19 | 2.246 | 100 | 4.95 | 2.560 | 0.412 | |
Consequences: How painful the effects of skin cancer would be? | 362 | 7.26 | 1.916 | 154 | 6.79 | 2.016 | 100 | 6.53 | 2.460 | 0.002** |
Yes | Don’t know | No | Sig | ||||
---|---|---|---|---|---|---|---|
% |
n
| % | (n) | % | (n) | ||
Skin Self Examination (SSE) | 9.8 | 19 | 5.2 | 10 | 85.1 | 165 | 0.006 |
SSE Intention | 20.1 | 39 | 41.2 | 80 | 38.7 | 75 | 0.079 |
Sunscreen Intention | 61.7 | 119 | 25.9 | 50 | 12.4 | 24 | 0.187 |
SSE behaviour, intention, planning and risk perceptions
Total (n = 625) | Male (n = 342) | Female (n = 283) | Sig. | ||||
---|---|---|---|---|---|---|---|
% | (n) | % | (n) | % | (n) | ||
Yes | 6.1 | (38) | 5.6 | (19) | 6.7 | (19) | 0.42 |
No | 90.1 | (563) | 89.8 | (307) | 90.5 | (256) | |
Don’t Know | 3.8 | (24) | 4.7 | (16) | 2.8 | (8) |
Indicative intervention outcomes
Sunscreen use intention and planning
Control | Intervention | |||||||||
---|---|---|---|---|---|---|---|---|---|---|
Baseline | Follow-up | Unadjusted | Adjusted | Baseline | Follow-up | Unadjusted | Adjusted | |||
Outcome Measures | Mean (SD) | Mean (SD) | n | Sig | Sig | Mean (SD) | Mean (SD) | n | Sig | Sig |
Sunscreen Use Intention and Planning Behaviour | ||||||||||
Intention to use sunscreen | 3.61 (1.203) | 3.37 (1.341) | 79 | 0.015* | 0.388 | 3.67 (1.177) | 3.88 (1.099) | 360 | < 0.001*** | 0.186 |
Plan WHAT sunscreen intend to use | 2.47 (1.440) | 2.44 (1.366) | 79 | 0.443 | 0.773 | 2.64 (1.353) | 3.33 (1.268) | 369 | < 0.001*** | 0.261 |
Plan WHEN to use sunscreen | 2.52 (1.376) | 2.44 (1.366) | 79 | 0.533 | 0.803 | 3.01 (1.378) | 3.33 (1.268) | 369 | < 0.001*** | 0.817 |
Plan WHERE to get it | 2.43 (1.420) | 2.29 (1.360) | 79 | 0.237 | 0.965 | 2.81 (1.479) | 3.17 (1.358) | 369 | < 0.001*** | 0.779 |
Plan HOW to get it | 2.27 (1.288) | 2.10 (1.257) | 79 | 0.198 | 0.952 | 2.52 (1.365) | 2.93 (1.259) | 368 | < 0.001*** | 0.196 |
COPING Plan | 2.11 (1.368) | 2.04 (1.203) | 79 | 0.513 | 0.479 | 2.32 (1.309) | 2.91 (1.337) | 366 | < 0.001*** | 0.915 |
Skin Self Examination Intention and Planning Behaviour | ||||||||||
Intention to examine skin for possible signs of skin cancer on a regular basis | 2.71 (0.865) | 2.49 (0.932) | 79 | 0.035* | 0.456 | 2.62 (0.976) | 3.04 0.978 | 375 | < 0.001*** | 0.051 |
I have made a detailed plan regarding WHEN | 1.47 (0.875) | 1.49 (0.799) | 79 | 0.300 | 0.125 | 1.48 (0.842) | 2.21 (1.103) | 376 | < 0.001*** | 0.718 |
I have made a detailed plan regarding WHERE | 1.56 (0.920) | 1.56 (0.877) | 78 | 0.991 | 0.569 | 1.61 (0.945) | 2.62 (1.221) | 374 | < 0.001*** | 0.192 |
I have made a detailed plan regarding HOW | 1.55 (0.935) | 1.62 (0.901) | 78 | 0.744 | 0.996 | 1.55 (0.858) | 2.72 (1.213) | 374 | < 0.001*** | 0.022* |
I have made a detailed plan for COPING | 1.48 (0.830) | 1.76 (0.950) | 79 | 0.017* | 0.672 | 1.65 (0.915) | 2.37 (1.166) | 372 | < 0.001*** | 0.426 |
Skin cancer risk representations | ||||||||||
Identity: How much skin cancer would affect your life | 7.70 (2.084) | 7.71 (2.316) | 77 | 0.729 | 0.888 | 8.22 (1.806) | 8.26 (1.943) | 375 | 0.215 | 0.474 |
Control: How much control you feel you have to prevent skin cancer | 5.29 (2.251) | 5.05 (2.197) | 78 | 0.834 | 0.990 | 5.90 (2.254) | 6.62 (1.893) | 376 | < 0.001*** | 0.029* |
Timeline: Given you age, how relevant to conduct SSE | 4.81 (2.391) | 4.59 (2.265) | 78 | 0.767 | 0.104 | 5.23 (2.308) | 7.14 (2.068) | 372 | < 0.001*** | 0.873 |
Consequences: How painful the effects of skin cancer would be | 6.74 (2.002) | 6.21 (2.223) | 76 | 0.053 | 0.869 | 7.05 (2.036) | 6.96 (2.200) | 369 | 0.524 | < 0.001*** |
% (n) | % (n) | % (n) | % (n) | |||||||
Skin Self Examination in past month | ||||||||||
(% Yes) | 8.7 (8) | 12.5 (13) | 0.337(+) | 0.599(+) | 5.6 (30) | 32.6 (143) | < 0.001*** (+) | < 0.001*** (+) | ||
(% No) | 85.9 (79) | 82.7 (86) | 90.8 (486) | 65.1 (286) | ||||||
(% Don’t know) | 5.4 (5) | 4.8 (5) | 3.6 (19) | 2.3 (10) | ||||||
Talk about skin cancer in the past month | ||||||||||
(% Yes) | 8.7 (8) | 14.6 (15) | 0.866(+) | 0.888(+) | 9.2 (49) | 53.5 (234) | < 0.001***(+) | < 0.001***(+) | ||
(% No) | 91.3 (84) | 85.4 (88) | 90.8 (481) | 46.5 (203) |