Abstract
Objective. To investigate, in primary health care, differentiated levels of prevention directed at skin cancer, and how the propensity of the patients to change sun habits/sun protection behaviour and attitudes towards sunbathing were affected, three years after intervention. Additionally, the impact of the performance of a phototest as a complementary tool for prevention was evaluated. Design. Randomized controlled study. Setting and subjects. During three weeks in February, all patients ≥ 18 years of age registering at a primary health care centre in southern Sweden were asked to fill in a questionnaire mapping sun exposure habits, attitudes towards sunbathing, and readiness to increase sun protection according to the Transtheoretical Model of Behaviour Change (TTM) (n = 316). They were randomized into three intervention groups, for which sun protection advice was given, in Group 1 by means of a letter, and in Groups 2 and 3 orally during a personal GP consultation. Group 3 also underwent a phototest to demonstrate individual skin UV sensitivity. Main outcome measures. Change of sun habits/sun protection behaviour and attitudes, measured by five-point Likert scale scores and readiness to increase sun protection according to the TTM, three years after intervention, by a repeated questionnaire. Results. In the letter group, almost no improvement in sun protection occurred. In the two doctor's consultation groups, significantly increased sun protection was demonstrated for several items, but the difference compared with the letter group was significant only for sunscreen use. The performance of a phototest did not appear to reinforce the impact of intervention. Conclusion. Sun protection advice, mediated personally by the GP during a doctor's consultation, can lead to improvement in sun protection over a prolonged time period.
Highlights
The aim of the present paper was to investigate, in a primary health care setting, differentiated levels of prevention directed at skin cancer, and how the propensity of the patients to change sun habits/sun protection behaviour and attitudes towards sunbathing was affected, three years after intervention
Of 652 patients registering at the primary health care station during the inclusion period, 330 subjects filled in the questionnaire
The present paper describes an attempt to evaluate the effectiveness of a preventive intervention against skin cancer, over an extended time period
Summary
The study constitutes a three-year follow-up of the half-year study performed earlier, which was initiated in 2005 and published in 2008 [5]. The study was performed at Kärna Primary Health Care Centre, situated in a suburb of Linköping, southern Sweden, a population consisting of suburban and rural/outer metropolitan inhabitants with mixed socioeconomic status, totalling about 13 500 individuals. Regardless of the purpose of their visits (including visits to doctors, nurses, physiotherapists etc., or for laboratory tests), all patients Ն18 years of age registering at the health care centre during three weeks in February (inclusion criteria) were asked to fill in a questionnaire concerning sun exposure habits. The questionnaire was administered in the reception area at registration, together with written information concerning the study, and the participants gave written consent to voluntary participation. Estimated sample size was based on sizes and outcomes of previous studies using equivalent measures [7,8,17]
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