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Public confidence in skin cancer self-examination as a target for education

Examples of knowledge, self-efficacy, and control messages from the social media study. Photo by: OHSU, Lewis & Clark College, University of Oregon and The Ohio State University

Findings from two recent studies suggest that an individual’s lack of confidence in their ability to self-examine for skin cancer may be the most significant barrier to engaging in self-examination.

A press release from Lewis and Clark College and Oregon Health & Science University (Portland, Ore.) explains the studies were conducted as part of an effort to identify effective interventions to increase skin self-examinations and decrease melanoma deaths.

First, a population-based survey of 15,000 Oregon, Washington, and Utah households produced 2,326 responses. The authors of the study, published in Pigment Cell & Melanoma Research, point to increasing melanoma knowledge combined with strengthening skin-check confidence as having great potential to improve early detection and save lives.

“The study we did with Oregon and two other states showed that, generally, people knew that they should check their own skin, but they did not feel confident that they would be able to do so successfully,” said Brian Detweiler-Bedell, PhD, professor of psychology and director of the Bates Center for Entrepreneurship and Leadership at Lewis & Clark, in the release. “So, there was a gap there.”

“We knew we needed to focus particularly on how to help people become more confident in their ability to check their own skin,” said Jerusha Detweiler-Bedell, PhD, professor of psychology and director of L&C’s Center for Community and Global Health.

The Detweiler-Bedels lead the behavioural science aspect of the research. The lead physician-scientist on the project is Sancy Leachman, MD, PhD, John D. Gray Endowed Chair for Melanoma Research and Professor of Dermatology at Oregon Health & Science University’s School of Medicine.

“With melanoma, your eyes really can be your best tool. A mole or spot on your skin that is changing in appearance—size, shape, colour—is a key indicator for melanoma,” said Dr. Leachman. “And the data is clear: When melanoma is caught early, in stage 1 or 2, the five-year relative survival rate is extremely high—almost 100 per cent. When it’s caught late, in stage 4, the five-year relative survival is only 35 per cent! That’s why it’s so important that people are empowered to check their skin regularly, and we get the word out about the tools that can help.”

Among respondents, skin self-exam performance was most strongly associated with higher melanoma knowledge and more self-efficacy, or confidence in one’s ability to complete an action effectively.

Dr. Leachman and the Detweiler-Bedells collaborated with faculty at the Center for Science Communications Research at the University of Oregon to develop and test several social media advertisements to increase melanoma knowledge and skin-check confidence. The results were recently published in the journal JID Innovations.

“If you look at the results, the true active ingredient is confidence,” said Dr. Brian Detweiler-Bedell.

“We were able to demonstrate that the combination of knowledge and confidence is important, but in particular, it is the confidence that really matters,” said Dr. Jerusha Detweiler-Bedell. “Of course, you need to know what unhealthy or potentially suspicious moles look like. But you might ignore or just not even try to check your own skin if you don't first believe in yourself.”


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