Assessment of melanoma precision prevention materials incorporating MC1R genetic risk information

John Charles A Lacson, Stephanie M Forgas, Scarlet H Doyle, Lu Qian, Jocelyn Del Rio, Stella Valavanis, Rodrigo Carvajal, Guillermo Gonzalez-Calderon, Youngchul Kim, Richard G Roetzheim, Susan T Vadaparampil, Peter A Kanetsky, John Charles A Lacson, Stephanie M Forgas, Scarlet H Doyle, Lu Qian, Jocelyn Del Rio, Stella Valavanis, Rodrigo Carvajal, Guillermo Gonzalez-Calderon, Youngchul Kim, Richard G Roetzheim, Susan T Vadaparampil, Peter A Kanetsky

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.

Trial registration: ClinicalTrials.gov NCT03509467.

Keywords: Genetic testing; MC1R; Melanoma; Precision prevention; Public health genomics.

© Society of Behavioral Medicine 2022. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Figures

Fig. 1
Fig. 1
Bubble plots show the distribution of amount of intervention materials read (A, E), believability (B, F), clarity (C, G), and intention to change preventive behaviors (D, H) by standard, average- and higher-risk precision prevention groups among all study participants (A-D) and among those who correctly recalled their MC1R risk category (E-H). Median values for each group are represented as black dots, with black lines showing the interquartile range. P-values in the upper right-hand corner of each plot are global p-values from Kruskal–Wallis tests. Starred brackets indicate pairwise comparisons that were statistically significant at alpha = 0.05 after Bonferroni correction. The diameter of each circle is proportional to the number of participants who reported that score, which is reported in Supplementary Table S1.

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