Mediation of improvements in sun protective and skin self-examination behaviours: Results from the healthy text study

Baker, Jannah, Finch, Linda, Soyer, H. Peter, Marshall, Alison L., Baade, Peter, Youl, Philippa, & Janda, Monika (2016) Mediation of improvements in sun protective and skin self-examination behaviours: Results from the healthy text study. Psycho-Oncology, 25(1), pp. 28-35.

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Melanoma is on the rise, especially in Caucasian populations exposed to high ultraviolet radiation such as in Australia. This paper examined the psychological components facilitating change in skin cancer prevention or early detection behaviours following a text message intervention.


The Queensland-based participants were 18 to 42 years old, from the Healthy Text study (N = 546). Overall, 512 (94%) participants completed the 12-month follow-up questionnaires. Following the social cognitive model, potential mediators of skin self-examination (SSE) and sun protection behaviour change were examined using stepwise logistic regression models.


At 12-month follow-up, odds of performing an SSE in the past 12 months were mediated by baseline confidence in finding time to check skin (an outcome expectation), with a change in odds ratio of 11.9% in the SSE group versus the control group when including the mediator. Odds of greater than average sun protective habits index at 12-month follow-up were mediated by (a) an attempt to get a suntan at baseline (an outcome expectation) and (b) baseline sun protective habits index, with a change in odds ratio of 10.0% and 11.8%, respectively in the SSE group versus the control group.


Few of the suspected mediation pathways were confirmed with the exception of outcome expectations and past behaviours. Future intervention programmes could use alternative theoretical models to elucidate how improvements in health behaviours can optimally be facilitated.

Impact and interest:

2 citations in Scopus
2 citations in Web of Science®
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ID Code: 92531
Item Type: Journal Article
Refereed: Yes
Keywords: cancer; oncology; skin cancer; early detection; text messaging
DOI: 10.1002/pon.4007
ISSN: 1099-1611
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Current > Schools > School of Public Health & Social Work
Copyright Owner: Copyright 2015 John Wiley & Sons, Ltd.
Copyright Statement: This is the peer reviewed version of the following article: Baker, J., Finch, L., Soyer, H. P., Marshall, A. L., Baade, P., Youl, P., and Janda, M. (2016) Mediation of improvements in sun protective and skin self-examination behaviours: results from the healthy text study. Psycho-Oncology, 25: 28–35, which has been published in final form at This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.
Deposited On: 31 Jan 2016 22:36
Last Modified: 07 Feb 2017 06:08

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