Grant Number:	4R01CA158322-06 Interpret this number
Primary Investigator:	Aspinwall, Lisa
Organization:	University Of Utah
Project Title:	Impact of Melanoma Genetic Testing on Health Cognitions and Prevention Behaviors
Fiscal Year:	2016

DESCRIPTION (provided by applicant): Cancer genetic testing alerts mutation carrier members to their elevated risk before disease onset, when early detection and even prevention may be possible. Little is known about the effect of genetic test reporting on prevention behaviors, as prior studies have focused on screening. Familial melanoma presents an ideal context in which to examine the impact of genetic test reporting on prevention behaviors because avoidance of UVR, a well-established risk factor in this population, represents a quantifiable prevention measure. We hypothesize that melanoma genetic test reporting will improve patient compliance with prevention and screening recommendations above that observed with counseling alone, and that specific cognitive and individual difference characteristics will be associated with compliance and non-compliance in the familial melanoma population. More broadly, our research strategy permits elucidation of cognitive processes that determine a patient's response to genetic test reporting. Thus, it may ultimately be possible to tailor genetic test results to maximize compliance with prevention recommendations. To accomplish these goals, four specific aims will be prospectively evaluated in 300 members of high-risk melanoma families. In Aim 1 we will measure UVR exposure in unaffected mutation carriers, compared to counseling-only matched controls, using a wristwatch-type UVR dosimeter and reflectance spectroscopy device. This will allow us to disentangle the effects of counseling from those of genetic test reporting in the reduction of UVR exposure, our primary prevention outcome. Aim 2 will similarly determine if counseling and/or reporting improve the frequency and thoroughness of skin self-examinations (SSEs) and professional total body skin examination (TBSEs). Aim 3 will identify specific cognitive and emotional consequences of receiving a definitive positive genetic test result compared to counseling-only controls, and whether such changes mediate modification in prevention behaviors. Aim 4 will identify patient subgroups at risk for poor adherence and psychological distress following reporting. Taken together, these Aims will allow determination of whether genetic test reporting improves prevention and screening adherence and if so, why and for whom.




Interactive Beliefs about Genes and Behavior Predict Improved Sun Protection Following Melanoma Genetic Counseling.
Authors: Aspinwall L.G. , Drummond D.M. , Stump T.K. , Kohlmann W.K. , Leachman S.A. .
Source: Annals Of Behavioral Medicine : A Publication Of The Society Of Behavioral Medicine, 2022-02-18 00:00:00.0; , .
EPub date: 2022-02-18 00:00:00.0.
PMID: 35179177
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Priority of Risk (But Not Perceived Magnitude of Risk) Predicts Improved Sun-Protection Behavior Following Genetic Counseling for Familial Melanoma.
Authors: Taber J.M. , Aspinwall L.G. , Drummond D.M. , Stump T.K. , Kohlmann W. , Champine M. , Cassidy P. , Leachman S.A. .
Source: Annals Of Behavioral Medicine : A Publication Of The Society Of Behavioral Medicine, 2021-02-12 00:00:00.0; 55(1), p. 24-40.
PMID: 32415830
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Parent and child perspectives on family interactions related to melanoma risk and prevention after CDKN2A/p16 testing of minor children.
Authors: Wu Y.P. , Aspinwall L.G. , Parsons B. , Stump T.K. , Nottingham K. , Kohlmann W. , Champine M. , Cassidy P. , Leachman S.A. .
Source: Journal Of Community Genetics, 2020-01-18 00:00:00.0; , .
EPub date: 2020-01-18 00:00:00.0.
PMID: 31955387
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A Pilot Study of a TeleHealth Family-Focused Melanoma Preventive Intervention for Children with a Family History of Melanoma.
Authors: Wu Y.P. , Boucher K. , Hu N. , Hay J. , Kohlmann W. , Aspinwall L.G. , Bowen D.J. , Parsons B.G. , Nagelhout E.S. , Grossman D. , et al. .
Source: Psycho-oncology, 2019-09-13 00:00:00.0; , .
EPub date: 2019-09-13 00:00:00.0.
PMID: 31520429
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CDKN2A testing and genetic counseling promote reductions in objectively measured sun exposure one year later.
Authors: Stump T.K. , Aspinwall L.G. , Drummond D.M. , Taber J.M. , Kohlmann W. , Champine M. , Cassidy P.B. , Petrie T. , Liley B. , Leachman S.A. .
Source: Genetics In Medicine : Official Journal Of The American College Of Medical Genetics, 2019-08-02 00:00:00.0; , .
EPub date: 2019-08-02 00:00:00.0.
PMID: 31371819
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Parent and child perspectives on perceived barriers to child sun protection and their association with sun protection strategies among children of melanoma survivors.
Authors: Wu Y.P. , Parsons B.G. , Aspinwall L.G. , Hay J.L. , Boucher K.M. , Caputo H. , Mooney R. , Grossman D. , Leachman S.A. .
Source: Pediatric Dermatology, 2019 May; 36(3), p. 317-323.
EPub date: 2019-03-20 00:00:00.0.
PMID: 30895676
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Understanding Skin Screening Practices Among Children at Elevated Risk for Melanoma to Inform Interventions for Melanoma Prevention and Control.
Authors: Parsons B.G. , Hay J.L. , Aspinwall L.G. , Zaugg K. , Zhu A. , Mooney R.H. , Klein S.Z. , Grossman D. , Leachman S.A. , Wu Y.P. .
Source: Journal Of Cancer Education : The Official Journal Of The American Association For Cancer Education, 2019-02-15 00:00:00.0; , .
EPub date: 2019-02-15 00:00:00.0.
PMID: 30771212
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Daily Minutes of Unprotected Sun Exposure (MUSE) Inventory: Measure description and comparisons to UVR sensor and sun protection survey data.
Authors: Stump T.K. , Aspinwall L.G. , Gray E.L. , Xu S. , Maganti N. , Leachman S.A. , Alshurafa N. , Robinson J.K. .
Source: Preventive Medicine Reports, 2018 Sep; 11, p. 305-311.
EPub date: 2018-07-24 00:00:00.0.
PMID: 30116702
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Barriers and Facilitators to Melanoma Prevention and Control Behaviors Among At-Risk Children.
Authors: Wu Y.P. , Parsons B.G. , Mooney R. , Aspinwall L.G. , Cloyes K. , Hay J.L. , Kohlmann W. , Grossman D. , Leachman S.A. .
Source: Journal Of Community Health, 2018-04-06 00:00:00.0; , .
EPub date: 2018-04-06 00:00:00.0.
PMID: 29623503
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A novel educational intervention targeting melanoma risk and prevention knowledge among children with a familial risk for melanoma.
Authors: Wu Y.P. , Nagelhout E. , Aspinwall L.G. , Boucher K.M. , Parsons B.G. , Kohlmann W. , Kaphingst K.A. , Homburger S. , Perkins R.D. , Grossman D. , et al. .
Source: Patient Education And Counseling, 2018 Mar; 101(3), p. 452-459.
EPub date: 2017-10-19 00:00:00.0.
PMID: 29078964
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Genetic test reporting of CDKN2A provides informational and motivational benefits for managing melanoma risk.
Authors: Aspinwall L.G. , Stump T.K. , Taber J.M. , Drummond D.M. , Kohlmann W. , Champine M. , Leachman S.A. .
Source: Translational Behavioral Medicine, 2018-01-29 00:00:00.0; 8(1), p. 29-43.
PMID: 29385581
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Genetic Test Reporting and Counseling for Melanoma Risk in Minors May Improve Sun Protection Without Inducing Distress.
Authors: Stump T.K. , Aspinwall L.G. , Kohlmann W. , Champine M. , Hauglid J. , Wu Y.P. , Scott E. , Cassidy P. , Leachman S.A. .
Source: Journal Of Genetic Counseling, 2018-01-19 00:00:00.0; , .
EPub date: 2018-01-19 00:00:00.0.
PMID: 29349527
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Melanoma risk assessment based on relatives' age at diagnosis.
Authors: Wu Y.P. , Kohlmann W. , Curtin K. , Yu Z. , Hanson H.A. , Hashibe M. , Parsons B.G. , Wong J. , Schiffman J.D. , Grossman D. , et al. .
Source: Cancer Causes & Control : Ccc, 2017-12-14 00:00:00.0; , .
EPub date: 2017-12-14 00:00:00.0.
PMID: 29243179
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Development Of An Educational Program Integrating Concepts Of Genetic Risk And Preventive Strategies For Children With A Family History Of Melanoma
Authors: Wu Y.P. , Aspinwall L.G. , Nagelhout E. , Kohlmann W. , Kaphingst K.A. , Homburger S. , Perkins R.D. , Grossman D. , Harding G. , Cassidy P. , et al. .
Source: Journal Of Cancer Education : The Official Journal Of The American Association For Cancer Education, 2016-11-26 00:00:00.0; , .
PMID: 27889875
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A systematic review of interventions to improve adherence to melanoma preventive behaviors for individuals at elevated risk.
Authors: Wu Y.P. , Aspinwall L.G. , Conn B.M. , Stump T. , Grahmann B. , Leachman S.A. .
Source: Preventive Medicine, 2016 Jul; 88, p. 153-67.
PMID: 27090434
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Discussion of photoprotection, screening, and risk behaviors with children and grandchildren after melanoma genetic testing.
Authors: Wu Y.P. , Aspinwall L.G. , Michaelis T.C. , Stump T. , Kohlmann W.G. , Leachman S.A. .
Source: Journal Of Community Genetics, 2016 Jan; 7(1), p. 21-31.
PMID: 26099287
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Impact of melanoma genetic test reporting on perceived control over melanoma prevention.
Authors: Aspinwall L.G. , Stump T.K. , Taber J.M. , Kohlmann W. , Leaf S.L. , Leachman S.A. .
Source: Journal Of Behavioral Medicine, 2015 Oct; 38(5), p. 754-65.
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Genetic test reporting enhances understanding of risk information and acceptance of prevention recommendations compared to family history-based counseling alone.
Authors: Taber J.M. , Aspinwall L.G. , Stump T.K. , Kohlmann W. , Champine M. , Leachman S.A. .
Source: Journal Of Behavioral Medicine, 2015 Oct; 38(5), p. 740-53.
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Unaffected family members report improvements in daily routine sun protection 2 years following melanoma genetic testing.
Authors: Aspinwall L.G. , Taber J.M. , Kohlmann W. , Leaf S.L. , Leachman S.A. .
Source: Genetics In Medicine : Official Journal Of The American College Of Medical Genetics, 2014 Nov; 16(11), p. 846-53.
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Perceived risk following melanoma genetic testing: a 2-year prospective study distinguishing subjective estimates from recall.
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Source: Journal Of Genetic Counseling, 2014 Jun; 23(3), p. 421-37.
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Melanoma genetic counseling and test reporting improve screening adherence among unaffected carriers 2 years later.
Authors: Aspinwall L.G. , Taber J.M. , Leaf S.L. , Kohlmann W. , Leachman S.A. .
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