Background: In the Melanoma Genomics Managing Your Risk Study, access to personal genomic risk information led to improvements in some melanoma prevention and early detection behaviors.
Objectives: We aimed to examine the hypothesized psychosocial mediators of the effects observed in the trial.
Methods: Australians of European ancestry without melanoma (aged 18–69 years) were recruited via the Medicare database and randomized to receive personal genomic risk information or usual care (N=1,025). Questionnaires were administered at baseline, 1-month post-intervention, and 12-months post-baseline to assess self-reported prevention and early detection behaviors and psychosocial measures. To identify potential mediators, we evaluated the intervention’s effect on psychosocial measures, the associations between psychosocial measures and behavioral outcomes, and estimated the natural indirect effects (NIEs).
Results: Among participants with high traditional melanoma risk, perceived importance [NIE mean difference in Likert scale 0.02; bootstrapped 95% confidence interval (CI): 0.00, 0.04] and perceived effectiveness (0.01; 0.00, 0.03) of sun protection strategies partly mediated the intervention’s effect on increased sun protection behaviors 1-month post-intervention. Among women, perceived capability to engage in skin examinations (NIE odds ratio 1.08; bootstrapped 95% CI 1.00, 1.29) and perceived control over detecting a future melanoma (1.13; 1.03, 1.32) partly mediated the intervention’s effect on increased whole-body skin examinations 1-month post-intervention.
Conclusions: The impact of precision prevention and early detection interventions may be enhanced by addressing identified psychosocial mediators through personal melanoma risk communication strategies in targeted populations.