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Gepubliceerd in: Journal of Behavioral Medicine 5/2015

31-03-2015

Impact of melanoma genetic test reporting on perceived control over melanoma prevention

Auteurs: Lisa G. Aspinwall, Tammy K. Stump, Jennifer M. Taber, Wendy Kohlmann, Samantha L. Leaf, Sancy A. Leachman

Gepubliceerd in: Journal of Behavioral Medicine | Uitgave 5/2015

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Abstract

To determine whether receiving melanoma genetic test results undermines perceived control over melanoma prevention, control-related beliefs were examined among 60 adults from melanoma-prone families receiving CDKN2A/p16 test results (27 unaffected noncarriers, 15 unaffected carriers, 18 affected carriers; response rate at 2 years = 64.9 % of eligible respondents). Multilevel modeling of perceived control ratings over a 2-year period revealed significant variation in individual trajectories: most participants showed increases (45 %) or no change (38.3 %), while 16.7 % showed decreases. At the group level, noncarriers reported sustained increases through the 2-year follow-up (ps < .05); unaffected carriers reported significant short-term increases (ps < .05); and affected carriers reported no change. Participants in all groups continued to rate photoprotection as highly effective in reducing melanoma risk and reported decreased beliefs that carrying the p16 mutation would inevitably lead to the development of melanoma. Qualitative responses immediately following counseling and test reporting corroborated these findings, as 93 % indicated it was possible to either prevent (64.9 %) or decrease the likelihood (28.1 %) of future melanomas. Thus, genetic test reporting does not generally undermine perceived control over melanoma prevention, though variability in response to positive results warrants future study.
Voetnoten
1
Because 95 % of participants came from two large extended families or kindreds, we examined whether responses depended on family membership. Because immediate family groups were not mutually exclusive (i.e., a participant could be a brother in one group, but a father in another group), we did not include family unit as a level of nesting. Instead, we accounted for dependencies among members of the same extended family by adding kindred as a level-2 variable in the model testing change in perceived control at 1 month. Of note, the interactions between kindred and participant group were not significant predictors of the intercept, slope for time, or the quadratic effect. Likewise, in a separate model, we found that average changes in perceived control reported by one’s siblings did not predict one’s own changes and did not interact with participant group. As these analyses did not suggest that outcomes depended on family unit, we did not retain either kindred or sibling group as factors in the model.
 
2
We considered using latent change score models to evaluate the relationships among difference scores over time (for example, changes in perceived control and changes in protective clothing use). However, these models assume linear relationships and equal time intervals across the assessments, assumptions that are not met by our study design (with assessments at post-counseling, 1, 6, 12, and 24 months) and findings (the curvilinear pattern of increases in perceived control over these time points).
 
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Metagegevens
Titel
Impact of melanoma genetic test reporting on perceived control over melanoma prevention
Auteurs
Lisa G. Aspinwall
Tammy K. Stump
Jennifer M. Taber
Wendy Kohlmann
Samantha L. Leaf
Sancy A. Leachman
Publicatiedatum
31-03-2015
Uitgeverij
Springer US
Gepubliceerd in
Journal of Behavioral Medicine / Uitgave 5/2015
Print ISSN: 0160-7715
Elektronisch ISSN: 1573-3521
DOI
https://doi.org/10.1007/s10865-015-9631-8