Assessing Dermatologists ’ Ability to Deliver a Novel Intervention to Improve Patients ’ Use of Sun Protection: The ABC Method of Physician-Patient Communication

Abstract

Patients are often aware of the benefits of using sun protection, but this does not necessarily translate into positive behavioral outcomes. This disconnect can be a source of frustration for many dermatologists, who often emphasize the importance of proper sun protection to their patients. Research has shown that education alone is not an effective strategy to change behavior, especially among less motivated patients. However, communication that incorporates the principles of motivational interviewing (MI), a patient-centered approach that uses empathic communication, has been successful in improving a variety of health-related behaviors.1 While MI is often effective, most physicians are not familiar with this or similar communication techniques.2 Furthermore, most dermatologists have limited time to interact with patients during an office visit, making it difficult to engage in lengthy conversations about sun protection. Research suggests that training physicians to express empathy to their patients is a promising area for further research with potential to improve patient care.3,4 A recent study found that dermatologists who were shown an example of physician-patient conversations about sun protection that used MI principles felt favorably toward the technique and thought it would be a useful communication tool.5 Based on these findings, we have developed the ABC (addressing behavior change) method as a communication tool for dermatologists to use with their patients to enhance the use of sunscreen. The ABC method is based on the principles of MI and consists of the following components: (1) assess UV risk; (2) assess sunscreen use; (3) assess the obstacles to using sunscreen; (4) facilitate removal of the obstacles to sunscreen use; (5) assess other methods of sun protection; and (6) summarize patients’ motivations and ideas for improved sunscreen use. On average, the ABC method takes 2 to 3 minutes to deliver and was designed for use during a routine office visit that includes a skin examination. The ABC method is delivered in the context of a collaborative conversation with the patient rather than as a direct instruction. The focus of the current study was to teach a sample of dermatologists the ABC method and assess their ability to deliver it with fidelity as well as their sustained use and satisfaction with using it over a 6-month period.