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National Institutes of Health: National Cancer Institute: Division of Cancer Control and Population Sciences
Grant Details

Grant Number: 5R01CA154908-02 Interpret this number
Primary Investigator: Robinson, June
Organization: Northwestern University At Chicago
Project Title: A Comparison of Interventions to Teach Melanoma Patients' Skin Self-Examination
Fiscal Year: 2012
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Abstract

DESCRIPTION (provided by applicant): Population based registries document that survival from melanoma, a growing public health problem with approximately 70,000 new melanoma cases and an estimated 8,600 deaths in 2010, is dependent on the thickness of the melanoma. By facilitating seeking medical care, skin self-examinations (SSEs) by individuals with a prior history of melanoma, who are at risk to develop subsequent melanomas, may lead to the early detection and treatment of melanoma when it is usually more effective. Thus, further research that enhances early detection is warranted and our application directly tests novel methods of training high-risk melanoma patients and their partners on how to conduct SSEs to promote early detection. Our proposed research builds upon the strengths of the R21 that: a) established that in-person training to conduct SSE with a partner significantly enhanced SSE performance 4 months after the intervention, and b) developed and pilot tested a manual take-home workbook training approach (WORKBOOK). Our pilot work on the WORKBOOK with partners suggests that patient-partner dyads (n = 21) perceived it to be readable, useful, and in the short term 4 month follow-up, empirically equivalent in promoting SSE knowledge, skills, and behaviors compared with patient-partner dyads in the in-person partner training condition (n = 19). Our proposed research builds on our NCI funded studies by conducting a formal examination with 430 subjects randomized to either the in-person or workbook training vs. an assessment only control group that receives standard of care over a 2 year longitudinal study with 4 month interval evaluations. Our proposed research directly tests novel methods of training Stage I and IIA melanoma patients, who have a 5 year survival of 80-90%, and their partners, on how to conduct SSEs. We will compare the efficacy of the in- person training vs. workbook for patients and partners vs. controls on SSE knowledge/skill acquisition and retention, and SSE performance and accuracy on a short (4 and 8 months post baseline) and long term basis (12, 16, 20, and 24 months post baseline) and examine whether partner-patient relationship-qualities moderate the relationship between the training approaches and SSEs knowledge/skill acquisition and retention, and SSE performance and accuracy. Establishing health promotion partnerships is important to those at risk to develop melanoma because SSE is difficult to successfully perform as an individual. It is expected that the workbook will promote SSE at least as well as and perhaps better than in-person training and become an easily disseminated SSE training approach that is not dependent on the time and teaching skills of the non-MD clinical office staff. PUBLIC HEALTH RELEVANCE: The almost 724,000 Americans survivors of melanoma are estimated to have 4 first degree relatives per case; thus, 2.8 million Americans are at increased risk of developing melanoma in comparison to the general public. SSE with the assistance of a partner by these individuals could improve survival. If effective, the workbook tested in this proposal could be distributed to people at risk of developing melanoma by large scale means in physician offices.

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Publications

Line Transect Estimators For Left-truncated Distributions
Authors: Alldredge J.R. , Gates C.E. .
Source: Biometrics, 1985 Mar; 41(1), p. 273-80.
PMID: 4005381
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New Approaches To Melanoma Prevention
Authors: Robinson J.K. , Baker M.K. , Hillhouse J.J. .
Source: Dermatologic Clinics, 2012 Jul; 30(3), p. 405-12.
PMID: 22800548
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Skin Self-examination Education For Early Detection Of Melanoma: A Randomized Controlled Trial Of Internet, Workbook, And In-person Interventions
Authors: Robinson J.K. , Gaber R. , Hultgren B. , Eilers S. , Blatt H. , Stapleton J. , Mallett K. , Turrisi R. , Duffecy J. , Begale M. , et al. .
Source: Journal Of Medical Internet Research, 2014; 16(1), p. e7.
PMID: 24418949
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The Influence Of Disease Perceptions On The Participation Of Melanoma Patients And Their Partners In Skin Self-examination Education
Authors: Rikki G. , Brittney H. , Jerod S. , Mallett Kimberly A. , Rob T. , Claudia H. , Karl B. , Wayne Jeffrey D. , Martini Mary C. , Robinson June K. .
Source: Journal Of Community Medicine & Health Education, 2013-11-01 00:00:00.0; 3(6), p. 242.
PMID: 24795843
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Rates Of Sunburn Among Dermatology Patients
Authors: Mallett K.A. , Ackerman S. , Turrisi R. , Robinson J.K. .
Source: Jama Dermatology, 2015 Feb; 151(2), p. 231-2.
PMID: 25354316
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Enhanced Fidelity Of An Educational Intervention On Skin Self-examination Through Surveillance And Standardization
Authors: Gaber R. , Mallett K.A. , Hultgren B. , Turrisi R. , Gilbertsen M.L. , Martini M.C. , Robinson J.K. .
Source: Journal Of Nursing Education And Practice, 2014; 4(2), p. 253-258.
PMID: 25414761
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Comparison Of Efficacy Of Differing Partner-assisted Skin Examination Interventions For Melanoma Patients: A Randomized Clinical Trial
Authors: Turrisi R. , Hultgren B. , Mallett K.A. , Martini M. , Robinson J.K. .
Source: Jama Dermatology, 2015 Sep; 151(9), p. 945-51.
PMID: 26049533
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Correspondence Between Pigmented Lesions Identified By Melanoma Patients Trained To Perform Partner-assisted Skin Self-examination And Dermatological Examination
Authors: Stapleton J.L. , Turrisi R. , Mallett K.A. , Robinson J.K. .
Source: Cancer Epidemiology, Biomarkers & Prevention : A Publication Of The American Association For Cancer Research, Cosponsored By The American Society Of Preventive Oncology, 2015 Aug; 24(8), p. 1247-53.
PMID: 26063475
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Cost-effective Melanoma Screening
Authors: Robinson J.K. , Halpern A.C. .
Source: Jama Dermatology, 2016-01-01 00:00:00.0; 152(1), p. 19-21.
PMID: 26465644
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