Background: Melanoma is the fastest growing tumor of the skin, which disproportionately affects younger\r\nand middle-aged adults. As melanomas are visible, recognizable, and highly curable while in early stages, early\r\ndiagnosis is one of the most effective measures to decrease melanoma-related mortality. Skin self-examination\r\nresults in earlier detection and removal of the melanoma. Due to the elevated risk of survivors for developing\r\nsubsequent melanomas, monthly self-exams are strongly recommended as part of follow-up care. Yet, only a\r\nminority of high-risk individuals practices systematic and regular self-exams. This can be improved through patient\r\neducation. However, dermatological education is effective only in about 50% of the cases and little is known about\r\nthose who do not respond. In the current literature, psychosocial variables like distress, coping with cancer, as well\r\nas partner and physician support are widely neglected in relation to the practice of skin self-examination, despite\r\nthe fact that they have been shown to be essential for other health behaviors and for adherence to medical advice.\r\nMoreover, the current body of knowledge is compromised by the inconsistent conceptualization of SSE. The main\r\nobjective of the current project is to examine psychosocial predictors of skin self-examination using on a rigorous\r\nand clinically sound methodology.\r\nMethods/Design: The longitudinal, mixed-method study examines key psychosocial variables related to the\r\nacquisition and to the long-term maintenance of skin self-examination in 200 patients with melanoma. Practice of\r\nself-exam behaviors is assessed at 3 and 12 months after receiving an educational intervention designed based on\r\nbest-practice standards. Examined predictors of skin self-exam behaviors include biological sex, perceived self-exam\r\nefficacy, distress, partner and physician support, and coping strategies. Qualitative analyses of semi-structured\r\ninterviews will complement and enlighten the quantitative findings.\r\nDiscussion: The identification of short and long-term predictors of skin self-examination and an increased\r\nunderstanding of barriers will allow health care professionals to better address patient difficulties in adhering to this\r\nlife-saving health behavior. Furthermore, the findings will enable the development and evaluation of evidencebased,\r\ncomprehensive intervention strategies. Ultimately, these findings could impact a wide range of outreach\r\nprograms and secondary prevention initiatives for other populations with increased melanoma risk.
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