title: A systematic review of interventions to improve adherence to melanoma preventive behaviors for individuals at elevated risk.
abstract: To examine the effectiveness of behavioral interventions for melanoma prevention targeted to individuals at elevated risk due to personal and/or family history.
  
  
  
  Through literature searches in 5 search databases (through July 2014), 20 articles describing 14 unique interventions focused on melanoma prevention among individuals at elevated risk for the disease were identified. Interventions targeting only patients undergoing active treatment for melanoma were excluded.
  
  
  
  The average study quality was moderate. The majority of interventions (6 out of 9, 66% of studies) led to improvements in one or more photoprotective behaviors, particularly for improvements in use of protective clothing (3 out of 5, 60% of studies), and frequency and/or thoroughness of skin self-examinations (9 out of 12, 75%). Fewer interventions (5 out of 14, 36%) targeted uptake of total body skin examinations (60% led to improvements). Also, fewer interventions targeted all three preventive behaviors (5 out of 14, 36%).
  
  
  
  Findings suggest that future interventions should aim to improve adherence across multiple preventive behaviors, over a longer time period (past 8months post-intervention), and target high-risk children. Studies should include adequate sample sizes to investigate moderators and mediators of intervention effectiveness. Interventions may be strengthened by new techniques, such as incorporating family members (e.g., to improve thoroughness of skin self-examinations) and eHealth technology.
authors.affiliation: Division of Public Health, Department of Family and Preventive Medicine, University of Utah, USA; Huntsman Cancer Institute, USA. Electronic address: yelena.wu@utah.edu.
authors.forename: Yelena P
authors.initials: YP
authors.lastname: Wu
authors.affiliation: Huntsman Cancer Institute, USA; Department of Psychology, University of Utah, USA.
authors.forename: Lisa G
authors.initials: LG
authors.lastname: Aspinwall
authors.affiliation: Department of Pediatrics, Division of Adolescent and Young Adult Medicine, Children's Hospital Los Angeles, USA.
authors.forename: Bridgid M
authors.initials: BM
authors.lastname: Conn
authors.affiliation: Department of Psychology, University of Utah, USA.
authors.forename: Tammy
authors.initials: T
authors.lastname: Stump
authors.affiliation: Division of Public Health, Department of Family and Preventive Medicine, University of Utah, USA.
authors.forename: Bridget
authors.initials: B
authors.lastname: Grahmann
authors.affiliation: Huntsman Cancer Institute, USA; Department of Dermatology, Oregon Health & Science University, USA.
authors.forename: Sancy A
authors.initials: SA
authors.lastname: Leachman
mesh_terms: D015438:Health Behavior; D006801:Humans; D008545:Melanoma / Q000517:prevention & control*; D011481:Protective Clothing / Q000706:statistics & numerical data*; D012307:Risk Factors; D016353:Self-Examination / Q000379:methods*
keywords: High-risk; Intervention; Melanoma; Prevention; Review