Rutgers Cancer Institute of New Jersey, 195 Little Albany Street, New Brunswick, NJ 08903, USA.
Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Ann Behav Med. 2022 Aug 2;56(8):791-803. doi: 10.1093/abm/kaab090.
Regular skin self-examination (SSE) reduces melanoma mortality but is not often conducted.
To promote SSE performance in individuals at increased risk for melanoma.
One hundred sixteen individuals at heightened risk for development of melanoma (i.e., personal/family history of melanoma, high-risk mole phenotype) who did not conduct a thorough SSE during in the prior 3 months were randomly assigned to receive either an automated internet-based intervention (mySmartCheck) or usual care (UC). One hundred sixteen participants completed surveys before random assignment and 99 completed the follow-up survey 13-weeks afterward. The primary outcome was participant self-reported examination (SSE) of all 15 parts of the body in the last 3 months. Secondary outcomes were SSE of any part of the body in the last 3 months and number of body parts examined during the last SSE.
More mySmartCheck participants examined all 15 body parts (32.6% vs. 7.1%, p = .001). More individuals in mySmartCheck reported conducting SSE on any body part than those in UC (81.4% vs. 62.5%, p = .04). Effect sizes were large (d = 1.19 all 15 body parts) to moderate (d = 0.55 for any body part). mySmartCheck participants examined more body areas than UC participants (12.7 vs. 10.3, p = 0.003) during the last SSE. Participants in mySmartCheck reported higher levels of knowledge of suspicious lesions, SSE benefits, SSE self-efficacy, and planning for SSE, and lower SSE barriers, than those assigned to UC.
mySmartCheck had a significant positive impact on SSE performance and behaviors. Additional research with a larger sample size, a longer follow-up, and more varied clinical settings is needed.
ClinicalTrials.gov registration # NCT03725449 (https://clinicaltrials.gov/ct2/show/NCT03725449).
定期进行皮肤自我检查(SSE)可降低黑色素瘤死亡率,但这种做法并不常见。
促进高风险黑色素瘤人群进行 SSE。
116 名有黑色素瘤发展风险(即个人/家族黑色素瘤病史、高危痣表型)且在过去 3 个月内未进行全面 SSE 的参与者被随机分配接受基于互联网的自动干预(mySmartCheck)或常规护理(UC)。116 名参与者在随机分配前完成了调查,99 名参与者在 13 周后完成了随访调查。主要结局是参与者自我报告在过去 3 个月内对所有 15 个身体部位进行检查。次要结局是在过去 3 个月内对任何身体部位进行 SSE 检查以及在最后一次 SSE 中检查的身体部位数量。
mySmartCheck 组参与者对所有 15 个身体部位进行检查的比例(32.6% vs. 7.1%,p =.001)更高。与 UC 组相比,mySmartCheck 组报告对任何身体部位进行 SSE 的比例更高(81.4% vs. 62.5%,p =.04)。效应大小较大(所有 15 个身体部位为 d = 1.19)到中等(任何身体部位为 d = 0.55)。在最后一次 SSE 中,mySmartCheck 组参与者检查的身体部位多于 UC 组(12.7 对 10.3,p = 0.003)。与 UC 组相比,mySmartCheck 组参与者报告对可疑病变的了解程度、SSE 益处、SSE 自我效能感和 SSE 计划更高,而 SSE 障碍更低。
mySmartCheck 对 SSE 表现和行为有显著的积极影响。需要更大样本量、更长随访时间和更多不同临床环境的进一步研究。
ClinicalTrials.gov 注册号 NCT03725449(https://clinicaltrials.gov/ct2/show/NCT03725449)。