Behavioral intervention to increase skin examination following melanoma: Development and evaluation

Marie Johnston, Judith Masthoff, Fiona Walter, Kaz Rahman, Julia Allan, Nigel Burrows, Charlotte Proby, Amanda Lee, Amer Durrani, Ivan Depasquale, William Brant, Aileen Neilson, Fiona Meredith, Shaun Treweek, Susan Hall, Alison McDonald, Peter Murchie

Research output: Contribution to journalAbstractpeer-review


Background: Following melanoma surgery, risk of recurrence is high. Patients are encouraged to perform regular total skin self examination (TSSE) but performance is sub-optimal. The ASICA intervention [Achieving-Self-directed-Integrated-Cancer-Aftercare] was developed on the basis of literature review, patient interviews, theory [Information-Motivation-Behavioural skills model and Control Theory], selection of behavior change techniques and extensive simulation with patients. ASICA involves text message prompts, information and TSSE demonstration by tablet, monitoring of TSSE, photographing any skin changes and sending to the nurse via tablet, feedback and follow-up.
Aims: 1) To assess acceptability and feasibility of ASICA 2) to evaluate
ASICA in a randomized controlled trial.
Methods: Interviews with 21 people previously treated for cutaneous melanoma and pilot-testing with 20 people treated for melanoma. 240 people with primary cutaneous melanoma were randomized to ASICA or treatment as usual. Participants were followed up by postal questionnaire at 2, 6 and 12 months following randomization on the following measures: TSSE practice, intentions, self-efficacy and planning; Melanoma Worry Scale; the Hospital Anxiety and Depression Scale (HADs); the EuroQoL EQ-5D-5L.
Results: 1) Interviewees were positive about the use of technology to remind and instruct on TSSE, conducting it in their homes and getting feedback quickly. Pilot participants were strongly positive; intention and self-efficacy increased, 15 adhered well to the intervention, 4 intermittently and one withdrew. 2) Trial results will be reported
Conclusions: The ASICA intervention was acceptable to most patients and feasible following small technical adjustments. Results of the randomized controlled trial will inform future use of ASICA.
Original languageEnglish
Pages (from-to)S126-S126
Number of pages1
JournalInternational Journal of Behavioral Medicine
Issue numberSUPPL 1
Publication statusPublished - Jun 2021


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