Social media, a useful tool for communicating about skin cancer

In a recent study published in JID InnovationsResearchers evaluated health communication messages that effectively inform the public and elicit intentions to undergo skin exams.

Background

The incidence of melanoma in the United States is increasing, with rates decreasing among younger individuals and increasing among older adults. Early diagnosis is essential to save lives and improve outcomes, as tumor thickness influences metastasis rates.

Skin self-examination is associated with early detection. Public health campaigns can help patients make more informed decisions and adopt healthier practices. Successful initiatives in Italy and South West England have increased the number of diagnoses of thin melanomas (less than 1.0 mm) and reduced detection of melanomas of medium thickness.

About the study

In the current study, researchers sought to discover health communication techniques that improve correct visual identification of moles, understanding of melanoma warning signs, dermatological self-check intentions, and positive attitudes toward examining their skin.

The researchers used social media sites such as Facebook and Instagram to reach a broad audience and evaluated public health communication messages tailored to these platforms. They collected demographic information through self-reports at the end of the survey to analyze potential disparities in knowledge or behavior.

The researchers estimated the accuracy of visual mole identification by adding correct responses to 24 photographs of moles (previously identified as benign or malignant). They tested their understanding of melanoma warning indicators by adding correct verbal descriptions of melanoma into six pairs of descriptions. They calculated attitudes toward skin self-checks by averaging responses to four questions.

In four experimental settings, participants read six control messages or those that increased knowledge, self-efficacy, or both. Awareness messages aimed to improve knowledge of melanoma warning signs and mole identification accuracy, and self-efficacy texts aimed to increase viewer confidence in skin monitoring to prevent melanoma. Self-efficacy messages included side-by-side comparisons of an identical body photo with a photo showing easily identifiable melanoma. The researchers created a melanoma-specific indicator to ensure manipulation of self-efficacy.

The researchers assigned participants to conditions based on a random arrangement of messages within each type. Each participant read six messages: six in the control condition, three in the self-efficacy condition, three in the knowledge condition, and all three in the knowledge + self-efficacy condition. On August 10 and 11, 2021, researchers gathered online survey data from qualified individuals recruited through the CloudResearch interface for Amazon MTurk.

Other requirements were to comply 99-100% with human intelligence tasks and complete at least 1,000 human intelligence tasks to ensure data quality. The researchers excluded people who performed exceptionally poorly on the visual recognition test or the warning signal awareness task.

Results

The study included 401 people with an average age of 40, of whom 46% (n = 183) were women. Reading messages aimed at improving knowledge about melanoma led participants to correctly identify a higher proportion (75% vs. 70%) of moles (mean number = 18) with greater awareness of warning signs of melanoma (mean number = 5.8) than individuals with only exposure to self-efficacy or control type messages, indicating their increased ability to distinguish melanomas from benign moles.

Exploratory investigations demonstrated that knowledge-enhancing messages reduced false positive rates, thereby reducing the number of benign moles classified as melanomas. The researchers found no significant influence of gender in any analysis.

Participants who read messages intended to increase their confidence to properly examine their skin showed an increased likelihood of expressing a stronger intention to undertake a skin assessment on a scale of 1 to 5. The team found no no interaction between self-efficacy and knowledge that would have influenced the results. Although the effects of the knowledge and self-efficacy messages were independent, the combination of the two was found to be the most beneficial since participants experienced the benefits of both types of messages without unintended consequences of mixing messages.

The study indicated that self-efficacy messages significantly influenced melanoma-related self-efficacy, with women having more confidence in skin inspections than men. They were also more likely to perform a skin check and had more favorable feelings toward skin inspections. When examining malignant moles, women accurately recognized more melanomas (mean = 10) than men, while self-efficacy messages resulted in more false positives (mean = 5.2 ) when they examined benign moles.

Based on study results, online messaging improves knowledge and self-efficacy and can improve skin self-examination accuracy and intentions. These posts, created for sites like Instagram and Facebook, can be effective tools for health communication about melanoma. Knowledge communications help detect moles and melanoma warning indicators, while self-efficacy messages encourage skin self-assessment.

However, integrating the two types of messages did not improve the effectiveness of each, indicating the need for further research. The findings could guide large-scale public health efforts, with future research incorporating a pre-test-post-test design, comprehensive medical history collection, and randomized trials.