An online skin cancer risk-reduction intervention for young adults: Mechanisms of effects.

Abstract

Objective The study’s purpose was to investigate moderator, implementation, and mediator variables related to the efficacy of UV4.me, an internet intervention that decreased ultraviolet radiation (UV) exposure and increased skin protection behaviors among young adults. Methods Nine-hundred sixty-five 18-25 year olds at risk for skin cancer were recruited nationally online. Participants were randomized to an experimental website (UV4.me), a control website, or assessment only. Participant characteristics (moderators), engagement with and perceptions of interventions (implementation measures), and exposure and protection attitudinal variables (mediators) were assessed. Linear regression and mediation analyses were conducted. Results Intervention effects on skin protection were greater for participants with a family history of skin cancer (p = 0.01). Intervention effects on UV exposure were greater among recent indoor tanners (p = 0.04). Improvements in skin protection (but not UV exposure) were associated with perceiving the interventions as satisfying or helpful (ps< .01). The experimental group had better outcomes if they completed more modules (ps< .01) or set more behavioral goals (ps< .01). Knowledge and exposure decisional balance mediated intervention effects for UV exposure (ps < 0.05), and protection decisional balance, self-efficacy, and intentions mediated intervention effects for protection (ps < 0.05). Conclusions The experimental intervention was more efficacious for certain high risk groups. The more individuals liked and engaged with the interventions (e.g., by setting goals), the better their outcomes. Mediation results inform theory about change mechanisms and differed by behavioral outcome.

Appearance‐based interventions to reduce UV exposure: A systematic review

“…Fourteen studies (Chait et al . ; Cooper, Goldenberg, & Arndt, ; Cornelis et al ., ; Heckman, Handorf, Darlow, Ritterband, & Manne, ; Hevey et al ., ; Hillhouse et al ., , ; Jackson & Aiken, ; Mahler, Beckerley, et al ., ; Mahler, Kulik, et al ., ; Owen et al ., ; Stapleton et al ., , ; Williams et al., ) examined the effectiveness of interventions not classed as either of the above on a combination of all of the outcome variables, as well as sun protection intentions, UV exposure, and UV exposure intentions separately. For the effects of these interventions on the above outcome variables, the combined effect size was small, r + = .191; k = 14, N = 3,895, 95% CI = 0.117–0.265, p < .001.…”

Sun protection education for adolescents: a feasibility study of a wait-list controlled trial of an intervention involving a presentation, action planning, and SMS messages and using objective measurement of sun exposure

“…Self-reported intervention adherence varied for each of the three intervention components. Adherence to the presentation (92%) and the booklet (68%) is higher in comparison to a study that reported that less than half of online skin cancer risk-reduction modules were completed by young people (18-25 years) [54]. The study found that the intervention was more effective in young people who completed more of the modules, thus highlighting the importance of adherence [55].…”

Sun protection education for adolescents: A feasibility study of a wait-list controlled trial of an intervention involving a presentation, action planning, and SMS messages and using objective measurement of sun exposure

“…Self-reported intervention adherence varied for each of the three intervention components. Adherence to the presentation (92%) and the booklet (68%) is higher in comparison to a study that reported that less than half of online skin cancer risk-reduction modules were completed by young people (18-25 years) [55]. The study found that the intervention was more effective in young people who completed more of the modules, thus highlighting the importance of adherence [56].…”