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 intervention was 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.

Conflict of interest statement

Conflict of Interest Disclosures: None reported.

Figures

Figure 1.. Patients Enrolled in the Control and Intervention Groups

Figure 2.. Standardized Addressing Behavior Change (ABC) Intervention Training Script