Background: A personal melanoma genomic risk intervention was trialled in the Melanoma Genomics Managing Your Risk Study, which demonstrated some improvements in melanoma prevention and early detection behaviours.
Purpose: We aimed to evaluate some hypothesised mediators on behaviour change outcomes.
Methods: Australians of European-ancestry without melanoma and aged 18-69 years were recruited via the Medicare database and randomised (n=1025). Questionnaires were administered at baseline, 1-month post-intervention (T1), and 12-months post-baseline (T2), measuring self-reported prevention and early detection behaviours and hypothesized mediators of behaviour change. The mediation analysis was conducted using the Barron and Kenny approach. Analysis was conducted in STATA/SEv14.2 with module PARAMED. Analyses were adjusted for traditional melanoma risk factors, state of residence, and age.
Results: Questionnaires were completed by 994 (97%) participants at T1 and 973 (95%) at T2. Perceived effectiveness of sun protection behaviours in reducing melanoma risk mediated the effect of receiving genomic risk information on sun protection habits (T1; mediated variable effect: 0.02, bootstrapped 95% confidence interval (CI): 0.00-0.04, p=0.03). Perceived risk of melanoma mediated the effect of receiving genomic risk information on reducing sunburn incidence (T2; 0.88, 95% CI: 0.80-0.94, p=0.001) and increasing sun protection habits (T1; 0.02, 95% CI: 0.01-0.05, p=0.01).
Conclusions: These findings identify mediators of sun-related behaviour change that could be used in targeted prevention, defining clinical trial eligibilities and early detection strategies to reduce melanoma risk in the Australian community.