Relationship and partner moderator variables increase self-efficacy of performing skin self-examination

Abstract

Objective-We sought to identify relationship and partner-related moderating variables that influence the effectiveness of both a couples and a solo learning intervention designed to increase skin self-examination behavior in a sample of patients at risk for developing melanoma.Methods-Patients received a brief intervention designed to teach skin self-examination skills and were randomly assigned into either a solo learning condition where the intervention was administered to the patient alone (n = 65) or a couple learning condition where the intervention was administered to the patient and patient's spouse or cohabiting partner (n = 65). The main outcome measure was skin self-examination self-efficacy, which is the strongest mediator of skin self-examination. The relationship moderator variables measured were quality of relationship, partner motivation, and ability to assist in implementation of the intervention.Results-When quality of the marital/partner relationship was high, the beneficial effects provided by the partner being included in the skin self-examination skills training were the highest and patients exhibited higher self-efficacy. Similar effects were observed for those with partners who were motivated to implement the intervention, and for those with partners high in ability to provide support.Limitations-Study limitations include the need to evaluate whether the effects can be sustained long term and the exclusion of patients with melanoma without partners.Conclusions-The amount of beneficial effects gained by the patient from the skin selfexamination intervention was influenced by marital/partner relationships. Clinicians may need to consider these relationship and partner characteristics when communicating to patients about skin cancer screening.With an estimated 60,000 new cases of invasive melanoma and 8100 deaths in 2007, the incidence of melanoma, the deadliest form of skin cancer, has increased more rapidly than any other cancer in the past 10 years. 1 Early detection techniques, such as skin self-examination (SSE) and the use of the ABCDE rule of melanoma identification, 2 have been identified as effective prevention tools to reduce the mortality of melanoma. 3 However, few studies exist that report on the efficacy of efforts designed to increase SSE. [4][5][6][7][8][9][10][11][12][13] early detection in successful treatment of melanoma, this lack of empirical SSE studies suggests that more work is needed to understand these behaviors.SSE is unlike other self-screening cancer techniques, such as breast or testicular selfexamination, because complete SSE often requires assistance from others (eg, significant others, friends, family members) to examine areas of the skin that are not easily seen. Given this reliance on helpers for effective SSE performance, there is a need to study the role of the helper in the adaptation and maintenance of SSE behaviors. In an attempt to elucidate the role of the partner, Robinson et al 14 recently examined the efficacy of a SSE skill training inter...

Skin self-examinations and visual identification of atypical nevi: Comparing individual and crowdsourcing approaches

“…Interventions aimed at improving patient self-efficacy for SSE found that people in relationships with motivated partners who perceived being in a high-quality relationship, showed greatest improvements in self-efficacy [10]. Improving self-efficacy is important for increasing quality of skin self-examination, but improving people’s ability to identify atypical nevi specifically is a different challenge.…”

“…Collective effort can be effective even when a single person has low reliability at a task, as the pattern of the group overcomes the limitations of each individual. In the case of skin cancer prevention and skin self-examination, motivation has been suggested as a key moderator in improving relevant outcomes [10], and crowdsourcing approaches to decision making take advantage of collective motivation, as participation is voluntary, to engage in classification tasks.…”

An online skin cancer risk-reduction intervention for young adults: Mechanisms of effects.

“…Similarly, though prior research has most commonly focused on college women, the current study did not find moderator effects by age, education level, difficulty living on income, or health literacy. Prior studies of moderation in skin cancer prevention interventions have focused primarily on relationship variables in dyadic interventions including patients and partners or children and parents (Hultgren, Turrisi, Mallett, Ackerman, & Robinson, 2016; Robinson, Stapleton, & Turrisi, 2008; Turrisi, Hillhouse, Robinson, Stapleton, & Adams, 2006). However, one study found that an appearance-focused workbook reduced indoor tanning specifically among low-knowledge female college indoor tanners (Stapleton, Turrisi, Hillhouse, Robinson, & Abar, 2010).…”

Development and psychometric testing of the ‘Motivation and Self‐Efficacy in Early Detection of Skin Lesions’ index

“…Martin et al 2007, Robinson et al 2008, Mesters et al 2009, Mujumdar et al 2009, Glanz et al 2010, Coups et al 2011, Kasparian et al 2012, Körner et al 2013 Figure 2 Summary of the barriers and levers to skin self-examination identified from the literature.…”