title: Effects of tailored risk communications for skin cancer prevention and detection: the PennSCAPE randomized trial.
abstract: BACKGROUND
  Prevention and early detection measures for melanoma, such as sun avoidance and skin examinations, are important, but are practiced inconsistently. In this replication of the Project SCAPE trial, we sought to determine whether tailored print materials were more effective at improving adherence than generic print materials for patients at increased risk of skin cancer.
  
  
  METHODS
  Participants were randomized to receive personalized mailed communications about their skin cancer risk and recommended sun protection, or generic mailings. Participants were Caucasian adults, at moderate or high risk for skin cancer, recruited in outpatient primary care. The main outcomes were overall sun protection behaviors and specific protective behaviors including use of sunscreen, shirt, hat, sunglasses, shade, and sun avoidance; recent sunburns; and skin self-examination and provider skin examination.
  
  
  RESULTS
  One hundred ninety-two (93.2%) subjects completed the study. Six outcome variables showed significant intervention condition effects in mixed effects models: overall sun protection behavior (P = 0.025); sunscreen use (P = 0.026); use of sunglasses (P = 0.011); sunburns in the past three months (P = 0.033); recency of last skin self-exam (P = 0.017); and frequency of skin exams by health care provider (P = 0.016).
  
  
  CONCLUSIONS
  Relative to generic communications, tailored risk communications resulted in improved adherence to six skin cancer protective behaviors, including a composite sun protection behavior measure, sunburns, and health care provider skin examinations.
  
  
  CONCLUSIONS
  Tailored interventions can be more effective in improving patient prevention behaviors than nontailored, generic information for patients at moderate to high risk of skin cancer.
authors.affiliation: Perelman School of Medicine and School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania. kglanz@upenn.edu.
authors.forename: Karen
authors.initials: K
authors.lastname: Glanz
authors.affiliation: Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Volpicelli
authors.affiliation: Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Christopher
authors.initials: C
authors.lastname: Jepson
authors.affiliation: Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Michael E
authors.initials: ME
authors.lastname: Ming
authors.affiliation: Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Lynn M
authors.initials: LM
authors.lastname: Schuchter
authors.affiliation: Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Katrina
authors.initials: K
authors.lastname: Armstrong
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D055088:Early Detection of Cancer / Q000379:methods*; D005260:Female; D015438:Health Behavior; D058015:Health Communication / Q000379:methods*; D006801:Humans; D008297:Male; D008545:Melanoma / Q000175:diagnosis* / Q000517:prevention & control*; D008875:Middle Aged; D012307:Risk Factors; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000517:prevention & control*; D055815:Young Adult