Evaluation of a brief dermatologist-delivered intervention vs usual care on sun protection behavior

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Abstract

IMPORTANCE Despite receiving dermatologic care, many patients with or without a history of skin cancer either do not use sun protection or fail to use it in an effective manner. OBJECTIVE To examine the association of a brief dermatologist-delivered intervention vs usual care with patient satisfaction and sun protection behavior. DESIGN, SETTING, AND PARTICIPANTS A longitudinal controlled cohort study among adults receiving dermatology care was conducted from April 25 to November 6, 2017, at 2 dermatologic clinic sites within a Northeastern health care system to compare outcomes associated with the intervention with that of usual care on 1- and 3-month patient outcomes. The sample consisted primarily of non-Hispanic white patients aged 21 to 65 years. Participants were assigned to the intervention group (n = 77) or the control group (n = 82) based on the site location of their dermatologists. INTERVENTIONS The intervention (<3 minutes) was delivered by dermatologists during a skin examination or the suturing phase of skin cancer surgery. The intervention consisted of 6 components targeting sun risk and protective behaviors. MAIN OUTCOMES AND MEASURES First, patient's satisfaction with the dermatologist's communication was assessed. Second, the association of the intervention with changing sun protection behavior of the patient was examined. RESULTS Patients in the intervention group (46 women and 31 men; mean [SD] age, 52.4 [9.6] years) rated dermatologist-patient communication more positive compared with patients in the control group (59 women and 23 men; mean [SD] age, 51.4 [11.3 years]). Eighteen percent (14 of 77) of patients in the intervention group reported 1 or more sunburns 1 month after the intervention compared with 35%(29 of 82) of patients in the control group (P = .01). No differences in report of sunburns were seen at the 3-month follow-up. Patients in the intervention group reported increased use of sunscreen across 3 months (face: intervention, increased 12%and controls, decreased 4%; P = .001; body: intervention, increased 12%and controls, decreased 1%; P = .02; reapplication: intervention, increased 15%and controls, remained stable; P = .002). CONCLUSIONS AND RELEVANCE The interventionwas delivered by dermatologists after minimal standardized training and resulted in a higher level of satisfaction with dermatologist-patient communication and improved sun protection behavior among patients across several months.

Original languageEnglish (US)
Pages (from-to)1010-1016
Number of pages7
JournalJAMA Dermatology
Volume154
Issue number9
DOIs
StatePublished - Sep 1 2018

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Solar System
Sunburn
Communication
Skin Neoplasms
Patient Satisfaction
Control Groups
Dermatologists
Dermatologic Surgical Procedures
Sunscreening Agents
Risk-Taking
Dermatology
Patient Care
Cohort Studies
Delivery of Health Care
Skin

All Science Journal Classification (ASJC) codes

  • Dermatology

Cite this

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title = "Evaluation of a brief dermatologist-delivered intervention vs usual care on sun protection behavior",
abstract = "IMPORTANCE Despite receiving dermatologic care, many patients with or without a history of skin cancer either do not use sun protection or fail to use it in an effective manner. OBJECTIVE To examine the association of a brief dermatologist-delivered intervention vs usual care with patient satisfaction and sun protection behavior. DESIGN, SETTING, AND PARTICIPANTS A longitudinal controlled cohort study among adults receiving dermatology care was conducted from April 25 to November 6, 2017, at 2 dermatologic clinic sites within a Northeastern health care system to compare outcomes associated with the intervention with that of usual care on 1- and 3-month patient outcomes. The sample consisted primarily of non-Hispanic white patients aged 21 to 65 years. Participants were assigned to the intervention group (n = 77) or the control group (n = 82) based on the site location of their dermatologists. INTERVENTIONS The intervention (<3 minutes) was delivered by dermatologists during a skin examination or the suturing phase of skin cancer surgery. The intervention consisted of 6 components targeting sun risk and protective behaviors. MAIN OUTCOMES AND MEASURES First, patient's satisfaction with the dermatologist's communication was assessed. Second, the association of the intervention with changing sun protection behavior of the patient was examined. RESULTS Patients in the intervention group (46 women and 31 men; mean [SD] age, 52.4 [9.6] years) rated dermatologist-patient communication more positive compared with patients in the control group (59 women and 23 men; mean [SD] age, 51.4 [11.3 years]). Eighteen percent (14 of 77) of patients in the intervention group reported 1 or more sunburns 1 month after the intervention compared with 35{\%}(29 of 82) of patients in the control group (P = .01). No differences in report of sunburns were seen at the 3-month follow-up. Patients in the intervention group reported increased use of sunscreen across 3 months (face: intervention, increased 12{\%}and controls, decreased 4{\%}; P = .001; body: intervention, increased 12{\%}and controls, decreased 1{\%}; P = .02; reapplication: intervention, increased 15{\%}and controls, remained stable; P = .002). CONCLUSIONS AND RELEVANCE The interventionwas delivered by dermatologists after minimal standardized training and resulted in a higher level of satisfaction with dermatologist-patient communication and improved sun protection behavior among patients across several months.",
author = "Mallett, {Kimberly Anne} and Turrisi, {Robert J.} and Elizabeth Billingsley and Bradley Trager and Ackerman, {Sarah Danielle} and Racheal Reavy and Robinson, {June K.}",
year = "2018",
month = "9",
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doi = "10.1001/jamadermatol.2018.2331",
language = "English (US)",
volume = "154",
pages = "1010--1016",
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T1 - Evaluation of a brief dermatologist-delivered intervention vs usual care on sun protection behavior

AU - Mallett, Kimberly Anne

AU - Turrisi, Robert J.

AU - Billingsley, Elizabeth

AU - Trager, Bradley

AU - Ackerman, Sarah Danielle

AU - Reavy, Racheal

AU - Robinson, June K.

PY - 2018/9/1

Y1 - 2018/9/1

N2 - IMPORTANCE Despite receiving dermatologic care, many patients with or without a history of skin cancer either do not use sun protection or fail to use it in an effective manner. OBJECTIVE To examine the association of a brief dermatologist-delivered intervention vs usual care with patient satisfaction and sun protection behavior. DESIGN, SETTING, AND PARTICIPANTS A longitudinal controlled cohort study among adults receiving dermatology care was conducted from April 25 to November 6, 2017, at 2 dermatologic clinic sites within a Northeastern health care system to compare outcomes associated with the intervention with that of usual care on 1- and 3-month patient outcomes. The sample consisted primarily of non-Hispanic white patients aged 21 to 65 years. Participants were assigned to the intervention group (n = 77) or the control group (n = 82) based on the site location of their dermatologists. INTERVENTIONS The intervention (<3 minutes) was delivered by dermatologists during a skin examination or the suturing phase of skin cancer surgery. The intervention consisted of 6 components targeting sun risk and protective behaviors. MAIN OUTCOMES AND MEASURES First, patient's satisfaction with the dermatologist's communication was assessed. Second, the association of the intervention with changing sun protection behavior of the patient was examined. RESULTS Patients in the intervention group (46 women and 31 men; mean [SD] age, 52.4 [9.6] years) rated dermatologist-patient communication more positive compared with patients in the control group (59 women and 23 men; mean [SD] age, 51.4 [11.3 years]). Eighteen percent (14 of 77) of patients in the intervention group reported 1 or more sunburns 1 month after the intervention compared with 35%(29 of 82) of patients in the control group (P = .01). No differences in report of sunburns were seen at the 3-month follow-up. Patients in the intervention group reported increased use of sunscreen across 3 months (face: intervention, increased 12%and controls, decreased 4%; P = .001; body: intervention, increased 12%and controls, decreased 1%; P = .02; reapplication: intervention, increased 15%and controls, remained stable; P = .002). CONCLUSIONS AND RELEVANCE The interventionwas delivered by dermatologists after minimal standardized training and resulted in a higher level of satisfaction with dermatologist-patient communication and improved sun protection behavior among patients across several months.

AB - IMPORTANCE Despite receiving dermatologic care, many patients with or without a history of skin cancer either do not use sun protection or fail to use it in an effective manner. OBJECTIVE To examine the association of a brief dermatologist-delivered intervention vs usual care with patient satisfaction and sun protection behavior. DESIGN, SETTING, AND PARTICIPANTS A longitudinal controlled cohort study among adults receiving dermatology care was conducted from April 25 to November 6, 2017, at 2 dermatologic clinic sites within a Northeastern health care system to compare outcomes associated with the intervention with that of usual care on 1- and 3-month patient outcomes. The sample consisted primarily of non-Hispanic white patients aged 21 to 65 years. Participants were assigned to the intervention group (n = 77) or the control group (n = 82) based on the site location of their dermatologists. INTERVENTIONS The intervention (<3 minutes) was delivered by dermatologists during a skin examination or the suturing phase of skin cancer surgery. The intervention consisted of 6 components targeting sun risk and protective behaviors. MAIN OUTCOMES AND MEASURES First, patient's satisfaction with the dermatologist's communication was assessed. Second, the association of the intervention with changing sun protection behavior of the patient was examined. RESULTS Patients in the intervention group (46 women and 31 men; mean [SD] age, 52.4 [9.6] years) rated dermatologist-patient communication more positive compared with patients in the control group (59 women and 23 men; mean [SD] age, 51.4 [11.3 years]). Eighteen percent (14 of 77) of patients in the intervention group reported 1 or more sunburns 1 month after the intervention compared with 35%(29 of 82) of patients in the control group (P = .01). No differences in report of sunburns were seen at the 3-month follow-up. Patients in the intervention group reported increased use of sunscreen across 3 months (face: intervention, increased 12%and controls, decreased 4%; P = .001; body: intervention, increased 12%and controls, decreased 1%; P = .02; reapplication: intervention, increased 15%and controls, remained stable; P = .002). CONCLUSIONS AND RELEVANCE The interventionwas delivered by dermatologists after minimal standardized training and resulted in a higher level of satisfaction with dermatologist-patient communication and improved sun protection behavior among patients across several months.

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