A Mobile Technology Intervention With Ultraviolet Radiation Dosimeters and Smartphone Apps for Skin Cancer Prevention in Young Adults: Randomized Controlled Trial

Abstract

BackgroundSkin cancer is the most prevalent and most preventable cancer in Australia. Despite Australia’s long-running public health campaigns, young Australian adults continue to report high levels of ultraviolet radiation (UVR) exposure and frequent sunburns. Young people are now increasingly turning away from traditional media, such as newspapers and TV, favoring Web-based streaming, which is challenging the health care sector to develop new ways to reach this group with targeted, personalized health promotion messages. Advances in technology have enabled delivery of time- and context-relevant health interventions.ObjectiveThe primary aim of this randomized controlled trial was to test the effect of UVR feedback from a smartphone app or a UVR dosimeter feedback device on sun protection habits, sun exposure behaviors, sunburn, and physical activity levels in young adults.MethodsYoung adults aged 18-35 years (n=124) were recruited from Queensland, Australia, between September 2015 and April 2016, via social or traditional media campaigns and outreach activities in the local community. Participants were randomized into 3 groups for a 4-week intervention: (1) no intervention control group; (2) UVR monitor group, who were asked to wear a UVR dosimeter feedback device set to their skin type; and (3) a SunSmart app group, who were asked to download and use the SunSmart phone app. Data were self-assessed through Web-based surveys at baseline and 1 week and 3 months postintervention.ResultsComplete data were available for 86.2% (107/124) of participants (control group, n=36; UVR monitor group, n=36; and SunSmart app group, n=35). Intervention uptake in the UVR monitor group was high, with 94% (34/36) of participants using the device all or some of the time when outdoors. All SunSmart app group participants downloaded the app on their smartphone. There was no significant difference in the change in the sun protection habits (SPH) index (main outcome measure) across the 3 groups. However, compared with the control group, a significantly greater proportion of the participants in the UVR monitor group reduced their time unprotected and exposed to UVR on weekends during the intervention compared with the baseline (odds ratio [OR]: 2.706, 95% CI 1.047-6.992, P=.04). This significant effect was sustained with greater reductions observed up to 3 months postintervention (OR: 3.130, 95% CI 1.196-8.190, P=.02). There were no significant differences between the groups in weekday sun exposure, sunscreen use, sunburn, suntan, or physical activity.ConclusionsUsing technology such as apps and personal UVR monitoring devices may improve some sun exposure behaviors among young adults, but as the SPH index did not increase in this study, further research is required to achieve consistent uptake of sun protection in young people.Trial RegistrationThe Australian and New Zealand Clinical Trials register ACTRN12615001296527; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=368458 (Archived by WebCite at http://www.webcitation....

Primary prevention of keratinocyte carcinoma among outdoor workers, the general population and medical professionals: a systematic review updated for 2019

“…Four studies assessed sun‐related attitudes, of which three found significant differences in the sun risk attitude and perceived sun damage susceptibility . Sixteen studies found a significant protective behavioural changes and two studies reported significant changes in the intention to change sun protection behaviour …”

“…A powerful tool could be smart phones, which through the use of text messages and Apps could be useful methods for teaching individuals sun‐related knowledge in order to change attitudes and behaviours. Messaging could be individually tailored, which could be beneficial in the sense that they are more effective for health behaviour changes compared to standard messages .…”

“…[77][78][79][80] Four studies assessed sun-related attitudes, of which three found significant differences in the sun risk attitude and perceived sun damage susceptibility. [81][82][83] Sixteen studies found a significant protective behavioural changes [20][21][22][79][80][81][83][84][85][86][87][88][89][90][91][92] and two studies reported significant changes in the intention to change sun protection behaviour. 82,93 Four of the nine studies assessing the effect on appearance of sunburns reported a significant change in sunburn incidences.…”

Solar Ultraviolet Exposure in Individuals Who Perform Outdoor Sport Activities

“…Hacker et al [57] performed a prospective study in 2018 comparing the effectiveness of a personal UVR dosimeter and a "SunSmart" mobile application in altering sun protection habits over 3 months. The app displayed the daily UVI, information on interpreting the UVI, the weather forecast, and a vitamin D tracker tool.…”

“…Since question 2 is oriented to target electronic means of UVI communication for mobile athletes, we added various restrictions in place of “Behavior” including “Mobile”, “Email”, and “App”, yielding one relevant citation [ 56 ]. Additional focused searches discovered 3 more articles [ 57 – 59 ]. For questions 3–5, we evaluated studies from January 1990 through December 2018 utilizing the following search criteria in PubMed: ((“skin cancer”/sports) OR “skin cancer” prevalence AND “sports” [MeSH]).…”