Assessment of melanoma precision prevention materials incorporating MC1R genetic risk information

• Published in: Translational behavioral medicine 2022-05, Vol.12 (5), p.683-687
• Main Authors: Lacson, John Charles A, Forgas, Stephanie M, Doyle, Scarlet H, Qian, Lu, Del Rio, Jocelyn, Valavanis, Stella, Carvajal, Rodrigo, Gonzalez-Calderon, Guillermo, Kim, Youngchul, Roetzheim, Richard G, Vadaparampil, Susan T, Kanetsky, Peter A
• Format: Article
• Language: English
• Subjects: Behavioral health care; Cancer; Evaluation; Genetic aspects; Health behavior; Health pamphlets; Influence; Melanoma; Methods; Patient education; Prevention
• ISSN: 1869-6716; 1613-9860
• DOI: 10.1093/tbm/ibac034

Abstract Few studies have examined cognitive responses to mailed precision prevention materials. MC1R is a robust, well-described melanoma susceptibility marker. The purpose was to assess cognitive responses to generic or precision prevention materials incorporating MC1R genetic risk. Non-Hispanic White participants (n = 1134) enrolled in a randomized controlled trial received either precision prevention materials incorporating MC1R genetic risk (higher/average) or generic prevention (standard) materials. Six months after baseline, 808 (71.3%) participants reported on the amount of prevention materials read (5-point scale); believability and clarity of materials; intention to change preventive behaviors (7-point Likert scale); and recall of their MC1R genetic risk. Comparisons were conducted using Kruskal–Wallis and chi-squared tests. Overall, participants read most to all (Mdn = 4, IQR = 2) of the prevention materials, reported high believability (Mdn = 7, IQR = 1) and clarity (Mdn = 7, IQR = 1), and moderate intention to change preventive behaviors (Mdn = 5, IQR = 2). Higher-risk participants reported slightly less clarity (Mdn = 6, IQR = 2) than either average-risk (Mdn = 6, IQR = 1, p = 2.50 × 10−3) or standard participants (Mdn = 7, IQR = 1, p = 2.30 × 10−5); and slightly less believability (Mdn = 6, IQR = 1) than standard participants (Mdn = 7, IQR = 1, p = .005). Higher-risk participants were 2.21 times as likely (95% CI = 1.43–3.43) to misremember or forget their risk compared to average-risk participants; misremembering was observed only among higher-risk participants (14%). Mailed precision prevention information were mostly read, highly believable and clear, and resulted in moderate levels of intention to change sun protection behaviors, bolstering the feasibility of population-level precision prevention. Defensive reactions may explain lower clarity, believability, and higher incorrect risk recall among higher-risk participants. Lay Summary Precision prevention uses an individual’s genetics, environment, and/or lifestyle to promote prevention behaviors. However, if materials incorporating precision prevention information are not easily accessible, individuals may misinterpret or distrust findings. Few studies have examined participant-reported believability and clarity of mailed precision prevention materials, how much they read, and whether they intend to change preventive behaviors. We assessed genetic risk for melanoma by determining DNA var