Figure 1 is an analytic framework that depicts the events that the primary care population experiences while undergoing counseling for the prevention of skin cancer. The framework includes five headings: Behavioral Counseling Intervention, Behavioral Outcomes, Intermediate Outcomes, Skin Cancer Outcomes, and Adverse Effects. The patient population undergoing behavioral counseling is all patients seen in primary care practices: children, adolescents, young adults, and older adults. The intervention is counseling in sun-protective behaviors. The behavioral outcomes include decreased sun exposure, avoidance of indoor tanning, and increased use of sunscreen. The intermediate outcomes include fewer number of sunburns, nevi (moles), and actinic keratoses. The final health outcomes include decreased incidence of skin cancer and decreased morbidity and mortality caused by melanoma, squamous cell carcinoma, or basal cell carcinoma. Potential harms of counseling for sun-protective behaviors include paradoxical increased sun exposure, reduced physical activity, dysphoric mood, and vitamin D deficiency.

Figure 1Analytic Framework and Key Questions

From: 2, Methods

Cover of Behavioral Counseling to Prevent Skin Cancer
Behavioral Counseling to Prevent Skin Cancer: Systematic Evidence Review to Update the 2003 U.S. Preventive Services Task Force Recommendation [Internet].
Evidence Syntheses, No. 82.
Lin JS, Eder M, Weinmann S, et al.

NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.