A CDKN2A/p16 mutation confers 28%-67% lifetime melanoma risk, a risk that may be moderated by ultraviolet radiation exposure. The aim of this study was to test whether melanoma genetic counseling and test disclosure conferred unique informational, motivational, or emotional benefits compared to family history-based counseling. Participants included were 114 unaffected members of melanoma-prone families, ages 16-69, 51.8% men, 65.8% with minor children or grandchildren. Carriers (n = 28) and noncarriers (n = 41) from families with a CDKN2A mutation were compared to no-test controls (n = 45) from melanoma-prone families without an identifiable CDKN2A mutation. All participants received equivalent counseling about melanoma risk and management; only CDKN2A participants received genetic test results. Using newly developed inventories, participants rated perceived costs and benefits for managing their own and their children's or grandchildren's melanoma risk 1 month and 1 year after counseling. Propensity scores controlled for baseline family differences. Compared to no-test controls, participants who received test results (carriers and noncarriers) reported feeling significantly more informed and prepared to manage their risk, and carriers reported greater motivation to reduce sun exposure. All groups reported low negative emotions about melanoma risk. Parents reported high levels of preparedness to manage children's risk regardless of group. Carrier parents reported greater (but moderate) worry about their children's risk than no-test control parents. Women, older, and more educated respondents reported greater informational and motivational benefits regardless of group. Genetic test results were perceived as more informative and motivating for personal sun protection efforts than equivalent counseling based on family history alone.

Background Happiness and health behavior are positively related, but most existing research does not distinguish between conceptually and empirically distinct components of subjective well‐being—satisfaction with life, positive affect, and negative affect. Method We assessed the associations of each component of subjective well‐being and health behavior, such as exercising and not smoking, in a broad, representative sample of nearly 2.5 million respondents from the USA in the Gallup Daily Poll. Results We found that both life satisfaction and positive affect, but not negative affect, are unique predictors of health behavior, even after controlling for a wide range of variables, including demographics, chronic illness, daily stress and pain, and other relevant factors. Positive affect was linearly related to health behavior, while life satisfaction showed an association only for individuals relatively satisfied with their lives (but not for those dissatisfied with their lives). These associations were not moderated by various factors, occurring across gender and age, personal resources like time and money, and environmental affordances such as access to fresh food and safe places to exercise. Conclusions The relationship between well‐being and health behavior is robust and generalisable in a large cross‐section of the US population.

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This study investigated whether genetic counseling and test reporting for the highlypenetrant CDKN2A melanoma predisposition gene promoted decreases in sun exposure. Method: A prospective, non-equivalent control group design compared unaffected participants (N=128, M age =35.24, 52% men) from: 1) families known to carry a CDKN2A mutation, who received counseling about management recommendations and a positive or negative genetic test result, and 2) "no-test control" families known not to carry a CDKN2A mutation, who received equivalent counseling based on their comparable family history. Changes in daily UVR exposure (joules/m 2), skin pigmentation (Melanin Index), and sunburns between baseline and one year following counseling were compared among carriers (n=32), noncarriers (n=46), and no-test control participants (n=50). Results: Both carriers and no-test control participants exhibited a decrease one year later in daily UVR dose (Bs=−.52, −.33, ps<.01). Only carriers exhibited a significant decrease in skin pigmentation at the wrist one year later (B=−.11, p< .001), and both carriers and no-test control participants reported fewer sunburns than noncarriers (ps<.05). Facial pigmentation did not change for any group. Noncarriers did not change on any measure of UVR exposure. Conclusions: These findings support the clinical utility of disclosing CDKN2A test results and providing risk-management education to high-risk individuals. Users may view, print, copy, and download text and data-mine the content in such documents, for the purposes of academic research, subject always to the full Conditions of use:

Background Understanding multiple components of risk perceptions is important because perceived risk predicts engagement in prevention behaviors. Purpose To examine how multiple components of risk perceptions (perceived magnitude of and worry about risk, prioritization of the management of one’s risk) changed following genetic counseling with or without test reporting, and to examine which of these components prospectively predicted improvements in sun-protection behavior 1 year later. Methods A prospective, nonrandomized study design was used. Participants were 114 unaffected members of melanoma-prone families who (i) underwent genetic testing for a CDKN2A/p16 mutation (n = 69) or (ii) were at comparably elevated risk based on family history and underwent genetic counseling but not testing (no-test controls, n = 45). Participants reported risk perception components and sun-protection behavior at baseline, immediately following counseling, and 1 month and 1 year after counseling. Results Factor analysis indicated three risk components. Carriers reported increased perceived magnitude and priority of risk, but not cancer worry. No-test controls showed no changes in any risk perception. Among noncarriers, priority of risk remained high at all assessments, whereas magnitude of risk and cancer worry decreased. Of the three risk components, greater priority of risk uniquely predicted improved self-reported sun protection 1 year post-counseling. Conclusions Priority of risk (i) seems to be a component of risk perceptions distinguishable from magnitude of risk and cancer worry, (ii) may be an important predictor of daily prevention behavior, and (iii) remained elevated 1 year following genetic counseling only for participants who received a positive melanoma genetic test result.