Evaluating a game-based randomized experiment to increase melanoma identification among adults living in the U.S

Nick Carcioppolo; Soyoon Kim; Margaret Sanchez; Bingjing Mao; Ekaterina Malova; Ashley Ryan; Di Lun; Clay Ewing; Shasa Hu

doi:10.1016/j.socscimed.2022.115281

Evaluating a game-based randomized experiment to increase melanoma identification among adults living in the U.S

Soc Sci Med. 2022 Oct:310:115281. doi: 10.1016/j.socscimed.2022.115281. Epub 2022 Aug 18.

Authors

Nick Carcioppolo¹, Soyoon Kim², Margaret Sanchez³, Bingjing Mao⁴, Ekaterina Malova⁵, Ashley Ryan⁶, Di Lun⁷, Clay Ewing⁸, Shasa Hu⁹

Affiliations

¹ Department of Communication Studies, University of Miami, USA; Sylvester Comprehensive Cancer Center, University of Miami, USA. Electronic address: n.carcioppolo@miami.edu.
² Department of Communication Studies, University of Miami, USA; Sylvester Comprehensive Cancer Center, University of Miami, USA.
³ Sylvester Comprehensive Cancer Center, University of Miami, USA.
⁴ TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma, USA.
⁵ Simon Business School, University of Rochester, New York, USA.
⁶ United States Marine Corps, Headquarters, USA.
⁷ Department of Communication Studies, University of Miami, USA.
⁸ Department of Interactive Media, University of Miami, USA.
⁹ Sylvester Comprehensive Cancer Center, University of Miami, USA; Department of Dermatology, University of Miami Miller School of Medicine, USA.

PMID: 36001916
DOI: 10.1016/j.socscimed.2022.115281

Abstract

Background: Although cutaneous melanoma diagnoses are rising, morbidity and mortality can be reduced through early detection. This investigation seeks to improve melanoma identification accuracy, attitudes, and intentions among a lay population by comparing the effectiveness of different melanoma identification training strategies and the effect of real-time decisional feedback on a melanoma identification task. We developed an innovative, game-based approach and hypothesize differences among frequently used melanoma identification training modalities (i.e, the Asymmetry/Border/Color/Diameter [ABCD] rule, the Ugly Duckling Rule [UDS], and a modality that combines them both, ABCDF (where the F stands for 'funny looking"), and investigate differences in types of immediate feedback on a melanoma identification task.

Methods: We conducted a national online randomized experiment to test a 4 (melanoma training strategies: ABCD, UDS, ABCD-F, control) × 3 (feedback: Dermatological, Dermatological + Motivational, control) factorial design on melanoma identification, skin cancer beliefs (perceived susceptibility, severity, response efficacy, self-efficacy), attitudes, and prevention intentions.

Results: ABCD training (p < .001) and UDS training (p = .05) resulted in significantly higher melanoma identification than the control. All training types resulted in significantly higher self-efficacy than the control (p = .02). Both Dermatological (p = .02) and Dermatological + Motivational feedback (p = .01) elicited significantly lower melanoma identification than the control condition, although this effect may be due to differences observed among participants who received UDS training. There was a significant main effect of feedback on self-efficacy (p = .002), where both Dermatological and Dermatological + Motivational feedback elicited higher levels of self-efficacy than the control.

Conclusions: Our results suggest that game-based ABCD and UDS training strategies could increase melanoma identification accuracy. Real-time feedback reduced accuracy, but was associated with increased self-efficacy related to melanoma detection outcomes.

Keywords: Melanoma prevention; Randomized control trial; Serious games; Tailored feedback.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Early Detection of Cancer
Humans
Intention
Melanoma* / diagnosis
Self Efficacy
Skin Neoplasms* / diagnosis