title: Skin cancer prevention practices among malignant melanoma survivors: a systematic review.
abstract: OBJECTIVE
  This systematic review was conducted to evaluate and summarize the existing literature on prevalence of ultraviolet radiation (UVR) exposure, sun protection, and screening behaviors among individuals diagnosed with malignant melanoma (MM).
  
  
  METHODS
  The search was performed in PubMed, CINAHL, PsycINFO, ScienceDirect, EMBASE, and ERIC from inception of each database through July 2014. Studies were included if (1) individuals diagnosed with MM were the primary sample, (2) measured UVR exposure, primary and secondary preventive behaviors, (3) original research communication that constitutes an entire set of empirical data, (4) observational design, and (5) English peer-reviewed. Studies were excluded if (1) all of the inclusion criteria were not met and (2) duplicates, conference abstracts, editorials, news, letters to the editor, comments, reviews, feature articles, white papers, and guidelines.
  
  
  RESULTS
  The search resulted in 255 articles that were screened for relevance; however, only 15 articles met all of the inclusion criteria. Most of the studies were cross-sectional (n = 10), used self-administered surveys (n = 8), and were conducted in North America (n = 10). The sample sizes ranged considerably, but were mostly Caucasian (n = 6) and included a higher proportion of women (n = 8). Evidence demonstrated that individuals with MM still engaged in sunbathing, indoor tanning, and reported sunburns. Moreover, survivors reported inadequate levels of both sun protection and skin self-examinations.
  
  
  CONCLUSIONS
  The findings highlight the need for intensifying intervention strategies to reduce the risk of new primary MMs in this group. Future research should increase in rigor and include more diverse populations and regions.
authors.affiliation: Department of Health, Exercise Science and Recreation Management, The University of Mississippi, 215 Turner Center, PO Box 1848, University, MS, 38677, USA. vknahar@go.olemiss.edu.|Department of Dermatology, University of Mississippi Medical Center, 2500 N., State St., Jackson, MS, 39216, USA. vknahar@go.olemiss.edu.
authors.forename: Vinayak K
authors.initials: VK
authors.lastname: Nahar
authors.affiliation: Department of Health, Exercise Science and Recreation Management, The University of Mississippi, 215 Turner Center, PO Box 1848, University, MS, 38677, USA.
authors.forename: M
authors.initials: M
authors.lastname: Allison Ford
authors.affiliation: Department of Dermatology, University of Mississippi Medical Center, 2500 N., State St., Jackson, MS, 39216, USA.|Department of Pathology, University of Mississippi Medical Center, 2500 N., State St., Jackson, MS, 39216, USA.|Department of Dermatology, University of Rochester School of Medicine and Dentistry, Rochester, NY, 14642, USA.
authors.forename: Robert T
authors.initials: RT
authors.lastname: Brodell
authors.affiliation: Department of Social Work, University of Mississippi, 208 Longstreet Hall, PO Box 1848, Oxford, MS, 38677, USA.
authors.forename: Javier F
authors.initials: JF
authors.lastname: Boyas
authors.affiliation: Department of Dermatology, University of Mississippi Medical Center, 2500 N., State St., Jackson, MS, 39216, USA.
authors.forename: Stephanie K
authors.initials: SK
authors.lastname: Jacks
authors.affiliation: Department of Health Policy and Management, Richard M. Fairbanks School of Public Health, Indiana University, IUPUI, 714 N. Senate Ave, Suite 250, Indianapolis, IN, 46202, USA.
authors.forename: Rizwana
authors.initials: R
authors.lastname: Biviji-Sharma
authors.affiliation: Department of Health, Exercise Science and Recreation Management, The University of Mississippi, 215 Turner Center, PO Box 1848, University, MS, 38677, USA.
authors.forename: Mary A
authors.initials: MA
authors.lastname: Haskins
authors.affiliation: Department of Health, Exercise Science and Recreation Management, The University of Mississippi, 215 Turner Center, PO Box 1848, University, MS, 38677, USA.
authors.forename: Martha A
authors.initials: MA
authors.lastname: Bass
mesh_terms: D005260:Female; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008545:Melanoma / Q000473:pathology*; D012878:Skin Neoplasms / Q000517:prevention & control*; D013472:Sunlight; D017741:Survivors
keywords: MM survivors; Skin self-examinations; Sun protection behaviors; UVR exposure