Development and Preliminary Psychometric Evaluation of a Melanoma Risk, Knowledge and Protective Behavior...

Background/Objectives: Effective melanoma prevention depends on reliable instruments capable of assessing individual risk factors, knowledge, attitudes, risk perception, and preventive behaviors. However, no culturally adapted questionnaire has been available for Serbian melanoma patients. This study aimed to develop and evaluate the psychometric properties of a Serbian questionnaire designed to assess melanoma-related risk factors, knowledge, concern, attitudes, and sun-protective behavior in a clinical population. Methods: A cross-sectional study was conducted among 333 melanoma patients treated at the Oncology Institute of Vojvodina, Serbia. The questionnaire was developed using the conceptual framework of a previously published instrument as a methodological reference and was modified and expanded for the Serbian clinical setting. Internal consistency was evaluated using Cronbach's alpha. Differences between participant groups were analyzed using independent-samples t-tests and one-way ANOVA. Correlations between questionnaire domains were assessed using Spearman's correlation coefficients, while predictors of sun-protective behavior were identified using multivariable linear regression. Results: The developed questionnaire demonstrated satisfactory internal consistency, with Cronbach's alpha coefficients ranging from 0.711 to 0.874. Participants demonstrated high levels of melanoma-related knowledge and attitudes, melanoma-related concern, and reported sun-protective behavior, whereas perceived personal melanoma risk was comparatively lower. Female participants reported significantly greater melanoma-related concern and more frequent sun-protective behavior than males (p < 0.05). Significant positive correlations were observed among all questionnaire domains, with the strongest associations identified between melanoma-related concern and sun-protective behavior and between knowledge and sun-protective behavior (both p < 0.001). Multivariable analysis demonstrated that melanoma-related concern and knowledge independently predicted adequate sun-protective behavior, explaining 61.2% of its variance. Conclusions: The developed Serbian questionnaire demonstrated satisfactory psychometric performance and represents a practical instrument for assessing melanoma-related knowledge, perceptions, and preventive behaviors in clinical settings. The findings emphasize the importance of combining knowledge with behavioral motivation and support the implementation of targeted educational interventions to improve melanoma prevention among high-risk individuals.