Graduation Year

2003

Document Type

Dissertation

Degree

Ph.D.

Degree Granting Department

Psychology

Major Professor

Paul B. Jacobsen, Ph.D.

Committee Member

Thomas Brandon, Ph.D.

Committee Member

Karen Brandon, Ph.D.

Committee Member

Douglas Rohrer, Ph.D.

Committee Member

Susan Thomas Vadaparampil, M.P.H., Ph.D.

Keywords

skin cancer screening, skin self-examination, skin neoplasms, health behaviors, at-risk populations

Abstract

Current ACS guidelines recommend routine screening for cancer (ACS, 2002). Motivation to adhere to guidelines may be different for individuals with and without a family history of melanoma (Jonna, et al., 1998). Prior research examining the relationship between family history and skin cancer detection behaviors (Berwick et al., 1996; Friedman et al., 1993; Oliveria et al., 1999) have failed to utilize a theoretical framework to derive hypotheses. The purpose of the present study was to examine the utility of Protection Motivation Theory (PMT) in explaining intentions to engage in skin cancer screening (SCS) and skin self-examination (SSE). In addition, the present study explored whether PMT variables explained the relationship between having a family history of melanoma and SCS/SSE intentions. The research design was cross-sectional with 101 participants in the positive family history group and 80 participants in the negative family history group. Using a standardized, self-report measure, participants were assessed on demographic characteristics, melanoma risk factors, PMT variables, family history, and SCS/SSE behaviors and intentions. Statistical analyses included descriptive statistics, chi square for categorical variables, t-tests for continuous variables, correlational analyses, and multiple regression analyses. The majority of participants (N = 181) were Caucasian (97%) and female (59%). As expected, findings indicated that greater perceived vulnerability, self-efficacy, and response efficacy were associated with greater SCS intentions (p greater or less than .0001). Additionally, greater self-efficacy and response efficacy were associated with greater SSE intention (p greater or less than .01). Additionally, positive family history individuals reported greater perceived vulnerability, greater self-efficacy, and less perceived severity than negative family history individuals (p greater or less than .01). Individuals with a family history of melanoma also had greater SCS intentions and were more likely to have a healthcare provider who recommended SCS. Finally, perceived vulnerability and self-efficacy partially mediated the relationship between group status and SCS intentions. The present study confirms and extends prior research on psychological factors associated with SCS/SSE intentions and on individuals with a family history of melanoma. Clinical implications and future directions are discussed.

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