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针对黑色素瘤患者家庭成员降低皮肤癌风险的个性化干预与通用干预措施对比

Tailored versus generic interventions for skin cancer risk reduction for family members of melanoma patients.

作者信息

Manne Sharon, Jacobsen Paul B, Ming Michael E, Winkel Gary, Dessureault Sophie, Lessin Stuart R

机构信息

Fox Chase Cancer Center, Philadelphia, PA, USA.

出版信息

Health Psychol. 2010 Nov;29(6):583-93. doi: 10.1037/a0021387.

Abstract

BACKGROUND

Improving strategies for risk reduction among family members of patients with melanoma may reduce their risk for melanoma.

OBJECTIVE

To evaluate the effects of two behavioral interventions designed to improve the frequency of total cutaneous skin examination by a health provider (TCE), skin self-examination (SSE), and sun protection among first degree relatives of patients with melanoma; and to evaluate whether increased intentions, increased benefits, decreased barriers, and improved sunscreen self-efficacy mediated the effects of the tailored intervention, as compared with the generic intervention on TCE, SSE, or sun protection.

METHODS

Four hundred forty-three family members (56 parents, 248 siblings, 239 children) who were nonadherent with these practices were randomly assigned to either a generic (N = 218) or a tailored intervention (N = 225) which included 3 print mailings and 1 telephone session. Participants completed measures of TCE, SSE, and sun protections at baseline, 6 months, and 1 year, and measures of intentions, benefits, barriers, and self-efficacy at baseline and 6 months.

RESULTS

Those enrolled in the tailored intervention had almost a twofold increased probability of having a TCE ( p < .0001). Treatment effects in favor of the tailored intervention were also noted for sun protection habits ( p < .02). Increases in TCE intentions mediated the tailored intervention's effects on TCE. Increases in sun protection intentions mediated effects of the tailored intervention's effect on sun protection.

CONCLUSIONS

Tailored interventions may improve risk reduction practices among family members of patients with melanoma.

摘要

背景

改进黑色素瘤患者家庭成员的风险降低策略可能会降低他们患黑色素瘤的风险。

目的

评估两种行为干预措施的效果,这两种干预措施旨在提高医疗服务提供者进行全面皮肤检查(TCE)的频率、皮肤自我检查(SSE)以及黑色素瘤患者一级亲属的防晒措施;并评估与通用干预相比,增加的意愿、增加的益处、减少的障碍以及提高的防晒霜自我效能是否介导了量身定制的干预对TCE、SSE或防晒的影响。

方法

443名未坚持这些做法的家庭成员(56名父母、248名兄弟姐妹、239名子女)被随机分配到通用干预组(N = 218)或量身定制的干预组(N = 225),干预措施包括3次印刷品邮寄和1次电话会议。参与者在基线、6个月和1年时完成TCE、SSE和防晒措施的测量,并在基线和6个月时完成意愿、益处、障碍和自我效能的测量。

结果

接受量身定制干预的参与者进行TCE的概率几乎增加了两倍(p <.0001)。在防晒习惯方面也注意到了有利于量身定制干预的治疗效果(p <.02)。TCE意愿的增加介导了量身定制干预对TCE的影响。防晒意愿的增加介导了量身定制干预对防晒的影响。

结论

量身定制的干预措施可能会改善黑色素瘤患者家庭成员的风险降低行为。

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