Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.
SWOG Statistics and Data Management Center, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
Transl Behav Med. 2022 May 26;12(5):683-687. doi: 10.1093/tbm/ibac034.
Few studies have examined cognitive responses to mailed precision prevention materials. MC1R is a robust, well-described melanoma susceptibility marker. The purpose was to assess cognitive responses to generic or precision prevention materials incorporating MC1R genetic risk. Non-Hispanic White participants (n = 1134) enrolled in a randomized controlled trial received either precision prevention materials incorporating MC1R genetic risk (higher/average) or generic prevention (standard) materials. Six months after baseline, 808 (71.3%) participants reported on the amount of prevention materials read (5-point scale); believability and clarity of materials; intention to change preventive behaviors (7-point Likert scale); and recall of their MC1R genetic risk. Comparisons were conducted using Kruskal-Wallis and chi-squared tests. Overall, participants read most to all (Mdn = 4, IQR = 2) of the prevention materials, reported high believability (Mdn = 7, IQR = 1) and clarity (Mdn = 7, IQR = 1), and moderate intention to change preventive behaviors (Mdn = 5, IQR = 2). Higher-risk participants reported slightly less clarity (Mdn = 6, IQR = 2) than either average-risk (Mdn = 6, IQR = 1, p = 2.50 × 10-3) or standard participants (Mdn = 7, IQR = 1, p = 2.30 × 10-5); and slightly less believability (Mdn = 6, IQR = 1) than standard participants (Mdn = 7, IQR = 1, p = .005). Higher-risk participants were 2.21 times as likely (95% CI = 1.43-3.43) to misremember or forget their risk compared to average-risk participants; misremembering was observed only among higher-risk participants (14%). Mailed precision prevention information were mostly read, highly believable and clear, and resulted in moderate levels of intention to change sun protection behaviors, bolstering the feasibility of population-level precision prevention. Defensive reactions may explain lower clarity, believability, and higher incorrect risk recall among higher-risk participants.
很少有研究检查过对邮寄的精准预防材料的认知反应。MC1R 是一个强大的、描述良好的黑色素瘤易感性标志物。本研究的目的是评估对包含 MC1R 遗传风险的通用或精准预防材料的认知反应。非西班牙裔白人参与者(n=1134)被纳入一项随机对照试验,他们收到了包含 MC1R 遗传风险(高/平均)或通用预防(标准)材料的精准预防材料。在基线后 6 个月,808 名(71.3%)参与者报告了阅读预防材料的数量(5 分制);材料的可信度和清晰度;改变预防行为的意图(7 分李克特量表);以及对其 MC1R 遗传风险的回忆。使用 Kruskal-Wallis 和卡方检验进行比较。总体而言,参与者阅读了大部分(Mdn=4,IQR=2)的预防材料,报告了高可信度(Mdn=7,IQR=1)和清晰度(Mdn=7,IQR=1),并适度改变预防行为的意图(Mdn=5,IQR=2)。高风险参与者报告的清晰度略低(Mdn=6,IQR=2),低于平均风险(Mdn=6,IQR=1,p=2.50×10-3)或标准参与者(Mdn=7,IQR=1,p=2.30×10-5);并且可信度略低(Mdn=6,IQR=1),低于标准参与者(Mdn=7,IQR=1,p=0.005)。与平均风险参与者相比,高风险参与者记错或忘记风险的可能性高 2.21 倍(95%CI=1.43-3.43);仅在高风险参与者中观察到记错(14%)。邮寄的精准预防信息大多被阅读,高度可信且清晰,并导致适度改变防晒行为的意图,支持了人群精准预防的可行性。防御反应可能解释了高风险参与者中较低的清晰度、可信度和较高的错误风险回忆。