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Improvement in Patient Performance of Skin Self-examinations After Intervention With Interactive Education and Telecommunication Reminders:  A Randomized Controlled Study

Savina Aneja, MD; Angela K. Brimhall, DO, MS; Douglas R. Kast, DO; Sanjay Aneja, BS; Diana Carlson, DO; Kevin D. Cooper, MD; Jeremy S. Bordeaux, MD, MPH
Arch Dermatol. 2012;148(11):1266-1272. doi:10.1001/archdermatol.2012.2480.
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Objective  To determine if interactive computerized patient education, skin self-examination (SSE) tutorials, and telecommunication reminders could be combined to increase patient performance of SSEs, increase confidence in ability to identify melanoma, and influence individual melanoma risk perception.

Design  A total of 132 adult participants from our dermatology clinics were enrolled in an interventional study and randomized to a control group or an intervention group. Survey data were collected from all participants on the day of enrollment and 3 months after enrollment.

Setting  University Hospitals Case Medical Center outpatient dermatology clinics.

Participants  English speakers older than 18 years.

Interventions  The intervention group (1) participated in a computer-assisted learning tutorial, (2) took part in a hands-on SSE tutorial, (3) received monthly telecommunication reminders to perform SSEs for 12 weeks, and (4) received a brochure on melanoma detection. The control group received only the brochure on melanoma detection.

Main Outcome Measures  Self-report of performance of SSEs. Melanoma risk perception and confidence in ability to identify melanoma were secondary considerations. Logistic regressions, controlling for race, age, sex, education, and family history of melanoma, were used to assess the effectiveness of the intervention.

Results  At the 3-month follow-up, those in the intervention group were more likely to perform SSEs (odds ratio [OR], 2.36; P ≤ .05). In addition, those who participated in the intervention were more likely to report being confident in their ability to identify melanoma during an SSE (OR, 2.72; P ≤ .05).

Conclusion  Computer-assisted patient education used in conjunction with a hands-on SSE tutorial and telecommunication reminders can increase patient performance of SSEs and confidence in the ability to identify melanoma.

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Figures

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Grahic Jump Location

Figure 1. Flowchart illustrating progression of participants through the trial.

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Grahic Jump Location

Figure 2. Reported performance of self-skin examinations (SSEs) by participants in the control and intervention groups at the baseline and the 3-month follow-up. δ Indicates change.

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Grahic Jump Location

Figure 3. Risk assessment for melanoma as perceived by participants in the intervention group compared with the risk calculated by the Skinsafe software program.

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