title: Examination of mediating variables in a partner assistance intervention designed to increase performance of skin self-examination.
abstract: OBJECTIVE
  We sought to identify mediating variables that may explain the increased effectiveness of a partner-learning skin self-examination (SSE) skills training program over a solo-learning SSE skills training program in a sample of patients at risk for melanoma.
  
  
  METHODS
  We conducted a randomized control design with pretest, immediate posttest, and 4-month follow-up measures in a clinical ambulatory care office of a hospital. In all, 130 participants were drawn from a melanoma hospital registry and randomly assigned to a solo-learning control group (n = 65) or a partner-learning group (n = 65). Participants either received the skills training individually in the solo-learning control group or in the partner-learning group in which a partner was actively involved in the training. The intervention consisted of a 10-minute educational presentation and skills training session about the ABCDE rule of early melanoma detection. The main outcome measure was SSE performance as measured by use of a body map. The mediators measured included attitudes toward SSE, self-efficacy/confidence in the ability to effectively perform SSE, comfort with having a partner help with SSE, perceived melanoma/skin cancer risk, concern about developing skin cancer/skin damage, and melanoma/skin cancer knowledge.
  
  
  RESULTS
  Attitudes toward SSE, self-efficacy, comfort with having someone help with SSE, and concern about developing sun-damaged skin were found to be significant mediators.
  
  
  CONCLUSIONS
  Study limitations include sample size, the evaluation of short-term program effects, and partner relationship variables that could influence the effectiveness of partner learning.
  
  
  CONCLUSIONS
  Involvement of a partner in the SSE skills training was more effective than solo learning because of the changes in the above-mentioned mediators. Future SSE skills training programs could benefit through using approaches that produce changes in key variables such as increasing attitudes toward SSE, increasing self-efficacy beliefs in the ability to perform SSE, and making participants feel confident in their ability to examine their skin.
authors.affiliation: Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA. wtjkr@rc.com
authors.forename: June K
authors.initials: JK
authors.lastname: Robinson
authors.forename: Rob
authors.initials: R
authors.lastname: Turrisi
authors.forename: Jerod
authors.initials: J
authors.lastname: Stapleton
mesh_terms: D005500:Follow-Up Studies; D015438:Health Behavior; D006801:Humans; D007858:Learning; D008545:Melanoma / Q000473:pathology* / Q000523:psychology; D017008:Negotiating; D020377:Self Efficacy; D016353:Self-Examination / Q000523:psychology; D012878:Skin Neoplasms / Q000473:pathology* / Q000523:psychology; D018454:Spouses / Q000523:psychology*