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Burke C, Reidy K, Ryan P, Jennings AA. GPs' attitudes towards and experiences of using the Dermabuddy health app for the management of patients with dermatological conditions: a descriptive cross-sectional study. BJGP Open 2024:BJGPO.2024.0038. [PMID: 38580390 DOI: 10.3399/bjgpo.2024.0038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 03/07/2024] [Accepted: 03/25/2024] [Indexed: 04/07/2024] Open
Abstract
BACKGROUND Dermatological presentations are common in primary care. The digital health space is growing in investment, revenue, and in usership numbers. Doctors utilise mobile health apps for referencing, communicating, and for clinical decision making. Dermabuddy is a secure mobile health app by which information and expertise around skin problems can be shared among a group of medical professionals with the aim of finding the best treatment and management plan. AIM To assess the utility of the Dermabuddy health app for GPs and associated trainees in the Republic of Ireland. DESIGN & SETTING This is a descriptive cross-sectional study, which involved a survey link distributed by email to GPs with Irish Medical Council membership. METHOD GPs were surveyed on their experiences of using the dermatology mobile application, Dermabuddy. RESULTS In total, 203 members took this questionnaire (13.5% response rate). Ninety-six per cent who responded to the statement, 'The app was easy to use', agreed it was 'easy' or 'very easy'. Eighty-seven per cent of those who responded to the statement, 'I would use this app again', agreed they 'definitely would'. Fifty-eight per cent of those who responded to the statement, 'The app is useful for my healthcare practice', gave it a five-star rating. The content of 36 comments included advice for improvement and positive feedback. CONCLUSION The Dermabuddy app was well received by participants in this study. Across all sections of the questionnaire looking at aspects of the app, including ease of use, interface and satisfaction, and usefulness, there was a positive response. Mobile health apps, such as Dermabuddy, may provide alternative solutions to meet the rising challenge of managing patients with dermatological conditions in primary care.
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Affiliation(s)
- Caroline Burke
- Department of General Practice, University College Cork, Cork, Republic of Ireland
| | - Karen Reidy
- Department of Dermatology, University Hospital Galway, Galway, Republic of Ireland
| | - Paul Ryan
- Department of General Practice, University College Cork, Cork, Republic of Ireland
| | - Aisling A Jennings
- Department of General Practice, University College Cork, Cork, Republic of Ireland
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Rivera-Romero O, Gabarron E, Ropero J, Denecke K. Designing personalised mHealth solutions: An overview. J Biomed Inform 2023; 146:104500. [PMID: 37722446 DOI: 10.1016/j.jbi.2023.104500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 09/14/2023] [Accepted: 09/16/2023] [Indexed: 09/20/2023]
Abstract
INTRODUCTION Mobile health, or mHealth, is based on mobile information and communication technologies and provides solutions for empowering individuals to participate in healthcare. Personalisation techniques have been used to increase user engagement and adherence to interventions delivered as mHealth solutions. This study aims to explore the current state of personalisation in mHealth, including its current trends and implementation. MATERIALS AND METHODS We conducted a review following PRISMA guidelines. Four databases (PubMed, ACM Digital Library, IEEE Xplore, and APA PsycInfo) were searched for studies on mHealth solutions that integrate personalisation. The retrieved papers were assessed for eligibility and useful information regarding integrated personalisation techniques. RESULTS Out of the 1,139 retrieved studies, 62 were included in the narrative synthesis. Research interest in the personalisation of mHealth solutions has increased since 2020. mHealth solutions were mainly applied to endocrine, nutritional, and metabolic diseases; mental, behavioural, or neurodevelopmental diseases; or the promotion of healthy lifestyle behaviours. Its main purposes are to support disease self-management and promote healthy lifestyle behaviours. Mobile applications are the most prevalent technological solution. Although several design models, such as user-centred and patient-centred designs, were used, no specific frameworks or models for personalisation were followed. These solutions rely on behaviour change theories, use gamification or motivational messages, and personalise the content rather than functionality. A broad range of data is used for personalisation purposes. There is a lack of studies assessing the efficacy of these solutions; therefore, further evidence is needed. DISCUSSION Personalisation in mHealth has not been well researched. Although several techniques have been integrated, the effects of using a combination of personalisation techniques remain unclear. Although personalisation is considered a persuasive strategy, many mHealth solutions do not employ it. CONCLUSIONS Open research questions concern guidelines for successful personalisation techniques in mHealth, design frameworks, and comprehensive studies on the effects and interactions among multiple personalisation techniques.
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Affiliation(s)
- Octavio Rivera-Romero
- Electronic Technology Department, Universidad de Sevilla, Spain; Instituto de Investigación en Informática de la Universidad de Sevilla, Spain.
| | - Elia Gabarron
- Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway; Department of Education, ICT and Learning, Østfold University College, Halden, Norway
| | - Jorge Ropero
- Electronic Technology Department, Universidad de Sevilla, Spain
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Okati-Aliabad H, Hosseini ES, Sharifabad MAM, Mohammadi M, Ardakani ME, Talebrouhi AH. Photoaging and theory-based intervention to improve sun protection behaviors in students in Zahedan: study protocol for a randomized controlled trial. Trials 2023; 24:430. [PMID: 37365669 DOI: 10.1186/s13063-023-07270-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 03/22/2023] [Indexed: 06/28/2023] Open
Abstract
BACKGROUND Excessive exposure to solar ultraviolet (UV) radiation can cause skin cancer. Implementing new technologies and computational algorithms can potentially change the outlook for cancer prevention and facilitate early detection of melanoma, thereby reducing mortality. Mobile technology as a potential provider of health services in delivering health information and conducting interventions, especially in skin fields, where a significant part of diagnosis is based on visual examination, can be important. Evidence showed that constructs of protection motivation theory (PMT) were good predictors of practicing sun protection behaviors in students. This study will investigate whether mobile applications improve safe and healthy behaviors and affect students' reduced UV exposure. METHOD/DESIGN This randomized controlled trial will be conducted on 320 students on 06/04/2022 in Zahedan. We created mobile applications (Sunshine and Skin Health and WhatsApp apps). Sunshine and Skin Health app allows users to see their changed faces in three stages of adolescence, middle age, and old age based on sun protection behavior. The WhatsApp app has 27 health messages based on PMT theory, eight educational files, and a skin cancer clip that will be sent through WhatsApp during a week. Randomization will be performed using a 1:1 (control: intervention) ratio. The primary endpoint is the group difference in sun-protective behaviors and PMT constructs immediately after the intervention. The secondary endpoint is the group difference in sun-protective behaviors and PMT constructs at a 3-month follow-up. The data will be analyzed in SPSS.22, and the significance level will be considered at 0.05. DISCUSSION The present study examines the effectiveness of mobile applications in improving sun-protective behaviors. If this intervention enhances sun protection behaviors, it can prevent students' skin damage. TRIAL REGISTRATION Iranian Registry of Clinical Trials IRCT20200924048825N1. Prospectively registered on 8 February 2021.
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Affiliation(s)
- Hassan Okati-Aliabad
- Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Esmat Sadat Hosseini
- PhD candidate of Health Education and Health Promotion,, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
| | | | - Mahdi Mohammadi
- Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
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Mortezaei S, Rabiei R, Asadi F, Emami H. Development and usability evaluation of a mHealth application for albinism self-management. BMC Med Inform Decis Mak 2023; 23:106. [PMID: 37312174 DOI: 10.1186/s12911-023-02202-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 05/26/2023] [Indexed: 06/15/2023] Open
Abstract
BACKGROUND Reduced or absence of melanin poses physical, social, and psychological challenges to individuals with albinism. Mobile health (mHealth) applications have the potential to improve the accessibility of information and services while reducing time and costs. This study aimed to develop and evaluate a mHealth application for self-management of albinism. METHODS This applied study was conducted in two stages (development and evaluation) in 2022. Initially, the functional requirements were determined, and the conceptual model of the application was then developed using Microsoft Visio 2021. In the second phase, the application was evaluated using the Mobile Application Usability Questionnaire (MAUQ) involving patients with albinism to reflect their views on the usability of the application. RESULTS The key capabilities of the application included: reminders, alerts, educational content, useful links, storage and exchange of images of skin lesions, specialist finder, and notifications for albinism-relevant events. Twenty-one users with albinism participated in the usability testing of the application. The users were predominantly satisfied with the application (5.53 ± 1.10; Max: 7.00). CONCLUSIONS The findings of this study suggest that the developed mobile application could assist individuals with albinism to effectively manage their condition by considering the users' requirements and services that the application should deliver.
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Affiliation(s)
- Saman Mortezaei
- Department of Health Information Technology and Management, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Reza Rabiei
- Department of Health Information Technology and Management, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Farkhondeh Asadi
- Department of Health Information Technology and Management, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hassan Emami
- Department of Health Information Technology and Management, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Geller AC, Coroiu A, Keske RR, Haneuse S, Davine JA, Emmons KM, Daniel CL, Gibson TM, McDonald AJ, Robison LL, Mertens AC, Elkin EB, Marghoob A, Armstrong GT. Advancing Survivors Knowledge (ASK Study) of Skin Cancer Surveillance After Childhood Cancer: A Randomized Controlled Trial in the Childhood Cancer Survivor Study. J Clin Oncol 2023; 41:2269-2280. [PMID: 36623247 PMCID: PMC10448942 DOI: 10.1200/jco.22.00408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 10/31/2022] [Accepted: 11/18/2022] [Indexed: 01/11/2023] Open
Abstract
PURPOSE To improve skin cancer screening among survivors of childhood cancer treated with radiotherapy where skin cancers make up 58% of all subsequent neoplasms. Less than 30% of survivors currently complete recommended skin cancer screening. PATIENTS AND METHODS This randomized controlled comparative effectiveness trial evaluated patient and provider activation (PAE + MD) and patient and provider activation with teledermoscopy (PAE + MD + TD) compared with patient activation alone (PAE), which included print materials, text messaging, and a website on skin cancer risk factors and screening behaviors. Seven hundred twenty-eight participants from the Childhood Cancer Survivor Study (median age at baseline 44 years), age > 18 years, treated with radiotherapy as children, and without previous history of skin cancer were randomly assigned (1:1:1). Primary outcomes included receiving a physician skin examination at 12 months and conducting a skin self-examination at 18 months after intervention. RESULTS Rates of physician skin examinations increased significantly from baseline to 12 months in all three intervention groups: PAE, 24%-39%, relative risk [RR], 1.65, 95% CI, 1.32 to 2.08; PAE + MD, 24% to 39%, RR, 1.56, 95% CI, 1.25 to 1.97; PAE + MD + TD, 24% to 46%, RR, 1.89, 95% CI, 1.51 to 2.37. The increase in rates did not differ between groups (P = .49). Similarly, rates of skin self-examinations increased significantly from baseline to 18 months in all three groups: PAE, 29% to 50%, RR, 1.75, 95% CI, 1.42 to 2.16; PAE + MD, 31% to 58%, RR, 1.85, 95% CI, 1.52 to 2.26; PAE + MD + TD, 29% to 58%, RR, 1.95, 95% CI, 1.59 to 2.40, but the increase in rates did not differ between groups (P = .43). CONCLUSION Although skin cancer screening rates increased more than 1.5-fold in each of the intervention groups, there were no differences between groups. Any of these interventions, if implemented, could improve skin cancer prevention behaviors among childhood cancer survivors.
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Affiliation(s)
- Alan C. Geller
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Adina Coroiu
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Robyn R. Keske
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Sebastien Haneuse
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Jessica A. Davine
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Karen M. Emmons
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Casey L. Daniel
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Todd M. Gibson
- Division of Cancer Epidemiology and Genetics, National Institutes of Health, Bethesda, MD
| | - Aaron J. McDonald
- Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN
| | - Leslie L. Robison
- Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN
| | - Ann C. Mertens
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA
| | - Elena B. Elkin
- Department of Health Policy and Management, Columbia University Mailman School of Public Health, New York, NY
| | - Ashfaq Marghoob
- Department of Dermatology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Gregory T. Armstrong
- Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN
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Bulzacchelli MT, Bellantoni JM, McCue L, Dzugan J. The Receptivity to Safety-Related Mobile Apps Among Commercial Fishing Captains: Descriptive Exploratory Study. JMIR Form Res 2022; 6:e33638. [PMID: 36346649 PMCID: PMC9682447 DOI: 10.2196/33638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 03/18/2022] [Accepted: 08/18/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Mobile apps addressing a variety of workplace safety issues have proliferated over the last decade as mobile technology has advanced and smartphone ownership has increased. Workplace safety interventions are often designed for a specific work site. However, some of the most dangerous jobs are ones in which workers frequently change field locations, such as commercial fishing. Mobile apps may be particularly suitable for delivering safety interventions to these workers. OBJECTIVE We sought to gauge the potential for using mobile apps to deliver safety interventions to commercial fishing workers. The purpose of this paper is to describe how fishermen use their mobile devices during fishing operations and identify any mobile apps they already use for safety. METHODS Participants comprised commercial fishing captains who already owned an iOS or Android smartphone or tablet. They completed a questionnaire that asked about their current mobile device use and their use of safety-related mobile apps, in addition to questions about their fishing operations. We performed descriptive analyses of the data. RESULTS A total of 61 participants completed the questionnaire. The most common types of mobile devices participants reported owning were iPhones (n=36, 59%) and Android phones (n=24, 39%). Most participants (n=53, 87%) reported using their mobile device for both work and personal purposes, including while out at sea (n=52, 85%). Over half of the participants reported that they had either safety-related apps (n=17, 28%) or apps that help them with their work (n=35, 57%). The types of apps most frequently mentioned were apps for weather, wind, tides, and navigation. CONCLUSIONS The results of this study indicate that some commercial fishing captains who own a mobile device are receptive to using safety-related apps for work. Apps that help avoid hazards by monitoring environmental conditions and apps optimized for use on smartphones may be most likely to be adopted and used. Overall, these results suggest that mobile apps are a promising avenue for improving safety among workers in commercial fishing and similar occupations.
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Affiliation(s)
- Maria T Bulzacchelli
- Krieger School of Arts and Sciences, Johns Hopkins University, Baltimore, MD, United States
| | - Jenna M Bellantoni
- Krieger School of Arts and Sciences, Johns Hopkins University, Baltimore, MD, United States
| | - Leigh McCue
- Department of Mechanical Engineering, George Mason University, Fairfax, VA, United States
| | - Jerry Dzugan
- Alaska Marine Safety Education Association, Sitka, AK, United States
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Conahan LJ, Robertson S. Sun-Protective Behaviors in Patients with Melasma. J Nurse Pract 2022. [DOI: 10.1016/j.nurpra.2022.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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8
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Effectiveness of a tailored web app on sun protection intentions and its implications for skin cancer prevention: A randomized controlled trial. PLOS DIGITAL HEALTH 2022; 1:e0000032. [PMID: 36812525 PMCID: PMC9931317 DOI: 10.1371/journal.pdig.0000032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 03/30/2022] [Indexed: 11/20/2022]
Abstract
Skin cancers related to sunexposure are rising globally, yet largely preventable. Digital solutions enable individually tailored prevention and may play a crucial role in reducing disease burden. We developed SUNsitive, a theory-guided web app to facilitate sun protection and skin cancer prevention. The app collected relevant information through a questionnaire and provided tailored feedback on personal risk, adequate sun protection, skin cancer prevention, and overall skin health. SUNsitive's effect on sun protection intentions and a set of secondary outcomes was evaluated with a two-arm randomized controlled trial (n = 244). At 2 weeks post-intervention, we did not find any statistical evidence for the intervention's effect on the primary outcome or any of the secondary outcomes. However, both groups reported improved intentions to sun protect compared to their baseline values. Furthermore, our process outcomes suggest that approaching sun protection and skin cancer prevention with a digital tailored "questionnaire-feedback" format is feasible, well-perceived, and well accepted. Trial registration: Protocol registration: ISRCTN registry (ISRCTN10581468).
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9
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Niu Z, Bhurosy T, Heckman CJ. Digital interventions for promoting sun protection and skin self-examination behaviors: A systematic review. Prev Med Rep 2022; 26:101709. [PMID: 35529530 PMCID: PMC9073560 DOI: 10.1016/j.pmedr.2022.101709] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 01/05/2022] [Accepted: 01/22/2022] [Indexed: 01/22/2023] Open
Abstract
A considerable number of digital interventions for skin cancer prevention have been evaluated. Most skin cancer digital interventions focus on sun protection-related outcomes. Most interventions use web-based digital technology (websites, webpages, mobile apps) rather than videos, emails or text messages alone as the delivery platform. Multi-component digital interventions are effective in promoting sun protection and skin self-examination. Almost all studies found digital interventions to be equally or more effective compared to non-digital interventions.
The skin cancer incidence rate has been rising, and digital health interventions can promote skin cancer prevention and detection behaviors. A systematic review was conducted to investigate the outcomes of digital interventions that promote sun protection and skin self-examination (SSE). This review examined studies that utilized randomized controlled designs or quasi-experiments, included outcomes related to sun safety or SSE, employed at least one digital platform, and were published in English from January 2000 to October 2020. A total of 62 studies were included in the review. Digital modalities included web-based (e.g., websites) alone (n = 29), mobile-based (e.g., mobile apps) alone (n = 12), game-based (n = 1), emails or text messages alone (n = 8), videos alone (n = 6), social media (n = 3), both text messages and mobile apps (n = 2), or both text messages and video (n = 1). Most studies (n = 44) only evaluated sun protection-related outcomes, seven studies assessed SSE outcomes only, nine studies examined both, and two assessed other related outcomes. Digital interventions are effective compared to non-intervention control conditions in promoting sun safety or SSE. Almost all studies found digital interventions to be equally or more effective compared to non-digital interventions. This review suggests that although the digital interventions varied, they showed promising effects on improving sun protection or SSE outcomes. Future research should include more sophisticated phase-based and rigorous longitudinal research designs, additional investigation of social media and other newer technologies, as well as more detailed reporting of methods and results.
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Affiliation(s)
- Zhaomeng Niu
- Section of Behavioral Sciences, Division of Medical Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, United States
- Corresponding author.
| | - Trishnee Bhurosy
- Department of Population Health, Hofstra University, Hempstead, NY, United States
| | - Carolyn J. Heckman
- Section of Behavioral Sciences, Division of Medical Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, United States
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Nguyen R, Clare IM, Gamage N, Alvares GA, Black LJ, Hart PH, Lucas RM, Strickland M, Jaimangal M, White J, Gorman S. Developing an Online Tool to Promote Safe Sun Behaviors With Young Teenagers as Co-researchers. Front Digit Health 2021; 3:626606. [PMID: 34713099 PMCID: PMC8521794 DOI: 10.3389/fdgth.2021.626606] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 02/08/2021] [Indexed: 11/13/2022] Open
Abstract
Despite education about the risks of excessive sun exposure, teenagers in Australia are sun-seeking, with sunburn common in summer. Conversely, some regular (time-limited) exposure to sunlight (that avoids sunburn) is necessary for vitamin D and healthy bones and other molecules important for immune and metabolic health. New interventions are thus required to better support teenagers to make healthy and balanced decisions about their sun behaviors. This paper describes the development of a prototype online tool—a smartphone app—that aimed to foster safe sun practices in teenagers. We recruited young adolescents (aged 12–13 years, n = 24) as “co-researchers” to provide ongoing input into the nature and design of the online tool. This age group was selected, as it is a critical time when young people transition from primary education, where “SunSmart” behaviors are entrenched in Australian schools, to high school, where risky behaviors emerge. Through a series of interviews and workshops, we codesigned an Apple iOS smartphone app with the co-researchers, leading health promotion professionals, researchers, and app designers. The developed app, Sun Safe, contains educational content relevant to teenagers about safe sun behaviors, complemented by other features requested by co-researchers and stakeholders to help engage young people, including gamified quizzes to test their sun health knowledge, real-time weather data on the UV Index and temperature, a sunscreen application timer, and reminders to check the UV Index. The developed prototype app was rated well by co-researchers, suggesting it is suitable for further feasibility and efficacy testing as an intervention tool to improve knowledge and promote safe sun behaviors by young adolescents.
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Affiliation(s)
- Rebecca Nguyen
- Telethon Kids Institute, University of Western Australia, Perth, WA, Australia
| | - Isabelle M Clare
- Telethon Kids Institute, University of Western Australia, Perth, WA, Australia
| | - Nisali Gamage
- Telethon Kids Institute, University of Western Australia, Perth, WA, Australia
| | - Gail A Alvares
- Telethon Kids Institute, University of Western Australia, Perth, WA, Australia
| | - Lucinda J Black
- School of Public Health, Curtin University, Bentley, WA, Australia
| | - Prue H Hart
- Telethon Kids Institute, University of Western Australia, Perth, WA, Australia
| | - Robyn M Lucas
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, ACT, Australia.,Centre for Ophthalmology and Visual Science, University of Western Australia, Perth, WA, Australia
| | | | | | - James White
- Reach Health Promotion Innovations, Perth, WA, Australia
| | - Shelley Gorman
- Telethon Kids Institute, University of Western Australia, Perth, WA, Australia
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Allen N, Damian DL. Interventions to Increase Sunscreen Use in Adults: A Review of the Literature. HEALTH EDUCATION & BEHAVIOR 2021; 49:415-423. [PMID: 34636262 DOI: 10.1177/10901981211046534] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Skin cancers are the most common malignancy in Australia. Regular sunscreen use can reduce the incidence of cutaneous squamous cell carcinomas and actinic keratoses and has been associated with reducing the incidence of basal cell carcinomas and melanomas. However, sunscreen effectiveness is limited by the failure of the population to use it routinely. Interventions that promote the daily application of sunscreen may reduce the morbidity, mortality, and economic burden associated with skin malignancies. We reviewed the literature that examines the effectiveness of interventions to increase routine sunscreen use and found that no one strategy has been shown to be clearly effective in adults and that relatively few studies have aimed to increase routine use in groups at extreme skin cancer risk. Future research should consider how interventions can be best designed and how sunscreen use is measured so that cost-effective, feasible strategies that result in improved sunscreen use in adults can be established.
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Affiliation(s)
- Nicholas Allen
- Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.,University of Sydney, Sydney, New South Wales, Australia
| | - Diona L Damian
- Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.,University of Sydney, Sydney, New South Wales, Australia.,Melanoma Institute Australia, Sydney, New South Wales, Australia
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12
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Thomas Craig KJ, Morgan LC, Chen CH, Michie S, Fusco N, Snowdon JL, Scheufele E, Gagliardi T, Sill S. Systematic review of context-aware digital behavior change interventions to improve health. Transl Behav Med 2021; 11:1037-1048. [PMID: 33085767 PMCID: PMC8158169 DOI: 10.1093/tbm/ibaa099] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Health risk behaviors are leading contributors to morbidity, premature mortality associated with chronic diseases, and escalating health costs. However, traditional interventions to change health behaviors often have modest effects, and limited applicability and scale. To better support health improvement goals across the care continuum, new approaches incorporating various smart technologies are being utilized to create more individualized digital behavior change interventions (DBCIs). The purpose of this study is to identify context-aware DBCIs that provide individualized interventions to improve health. A systematic review of published literature (2013-2020) was conducted from multiple databases and manual searches. All included DBCIs were context-aware, automated digital health technologies, whereby user input, activity, or location influenced the intervention. Included studies addressed explicit health behaviors and reported data of behavior change outcomes. Data extracted from studies included study design, type of intervention, including its functions and technologies used, behavior change techniques, and target health behavior and outcomes data. Thirty-three articles were included, comprising mobile health (mHealth) applications, Internet of Things wearables/sensors, and internet-based web applications. The most frequently adopted behavior change techniques were in the groupings of feedback and monitoring, shaping knowledge, associations, and goals and planning. Technologies used to apply these in a context-aware, automated fashion included analytic and artificial intelligence (e.g., machine learning and symbolic reasoning) methods requiring various degrees of access to data. Studies demonstrated improvements in physical activity, dietary behaviors, medication adherence, and sun protection practices. Context-aware DBCIs effectively supported behavior change to improve users' health behaviors.
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Affiliation(s)
| | - Laura C Morgan
- Oncology, Imaging, and Life Sciences, IBM Watson Health, Cambridge, MA, USA
| | - Ching-Hua Chen
- Computational Health Behavior and Decision Sciences, IBM Research, Yorktown Heights, NY, USA
| | - Susan Michie
- Centre for Behavior Change, University College London, London, UK
| | - Nicole Fusco
- Oncology, Imaging, and Life Sciences, IBM Watson Health, Cambridge, MA, USA
| | - Jane L Snowdon
- Center for AI, Research, and Evaluation, IBM Watson Health, Cambridge, MA, USA
| | - Elisabeth Scheufele
- Center for AI, Research, and Evaluation, IBM Watson Health, Cambridge, MA, USA
| | - Thomas Gagliardi
- Center for AI, Research, and Evaluation, IBM Watson Health, Cambridge, MA, USA
| | - Stewart Sill
- Oncology, Imaging, and Life Sciences, IBM Watson Health, Cambridge, MA, USA
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Robinson JK, Patel S, Heo SY, Gray E, Lim J, Kwon K, Christiansen Z, Model J, Trueb J, Banks A, Kwasny M, Rogers JA. Real-Time UV Measurement With a Sun Protection System for Warning Young Adults About Sunburn: Prospective Cohort Study. JMIR Mhealth Uhealth 2021; 9:e25895. [PMID: 33955844 PMCID: PMC8138709 DOI: 10.2196/25895] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 01/22/2021] [Accepted: 04/05/2021] [Indexed: 01/06/2023] Open
Abstract
Background Melanoma is attributable to predisposing phenotypical factors, such as skin that easily sunburns and unprotected exposure to carcinogenic UV radiation. Reducing the proportion of young adults who get sunburned may reduce the incidence of melanoma, a deadly form of skin cancer. Advances in technology have enabled the delivery of real-time UV light exposure and content-relevant health interventions. Objective This study aims to examine the feasibility of young adults performing the following tasks daily: wearing a UV dosimeter, receiving text messages and real-time UV-B doses on their smartphone, and responding to daily web-based surveys about sunburn and sun protection. Methods Young adults aged 18-39 years (n=42) were recruited in the United States in June 2020 via social media. Participants received the UV Guard sun protection system, which consisted of a UV dosimeter and a smartphone app. During 3 consecutive periods, intervention intensity increased as follows: real-time UV-B dose; UV-B dose and daily behavioral facilitation text messages; and UV-B dose, goal setting, and daily text messages to support self-efficacy and self-regulation. Data were self-reported through daily web-based surveys for 28 days, and UV-B doses were transmitted to cloud-based storage. Results Patients’ median age was 22 years (IQR 20, 29), and all patients had sun-sensitive skin. Sunburns were experienced during the study by fewer subjects (n=18) than those in the preceding 28 days (n=30). In July and August, the face was the most commonly sunburned area among 13 body locations; 52% (22/42) of sunburns occurred before the study and 45% (19/42) occurred during the study. The mean daily UV-B dose decreased during the 3 periods; however, this was not statistically significant. Young adults were most often exercising outdoors from 2 to 6 PM, walking from 10 AM to 6 PM, and relaxing from noon to 2 PM. Sunburn was most often experienced during exercise (odds ratio [OR] 5.65, 95% CI 1.60-6.10) and relaxation (OR 3.69, 95% CI 1.03-4.67) relative to those that did not exercise or relax in each category. The self-reported exit survey indicated that participants felt that they spent less time outdoors this summer compared to the last summer because of the COVID-19 pandemic and work. In addition, 38% (16/42) of the participants changed their use of sun protection based on their app-reported UV exposure, and 48% (20/42) shifted the time they went outside to periods with less-intense UV exposure. A total of 79% (33/42) of the participants were willing to continue using the UV Guard system outside of a research setting. Conclusions In this proof-of-concept research, young adults demonstrated that they used the UV Guard system; however, optimization was needed. Although some sun protection behaviors changed, sunburn was not prevented in all participants, especially during outdoor exercise. Trial Registration ClinicalTrials.gov NCT03344796; http://clinicaltrials.gov/ct2/show/NCT03344796
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Affiliation(s)
- June K Robinson
- Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Shiv Patel
- Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Seung Yun Heo
- Department of Biomedical Engineering, Center for Bio-Integrated Electronics, Simpson Querrey Institute for BioNanotechnology, Northwestern University, Evanston, IL, United States
| | - Elizabeth Gray
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Jaeman Lim
- Wearifi Inc, Evanston, IL, United States
| | - Kyeongha Kwon
- Department of Biomedical Engineering, Center for Bio-Integrated Electronics, Simpson Querrey Institute for BioNanotechnology, Northwestern University, Evanston, IL, United States.,School of Electrical Engineering, Korea Advanced Institute of Science and Technology, Daejeon, Republic of Korea
| | | | | | - Jacob Trueb
- Department of Biomedical Engineering, Center for Bio-Integrated Electronics, Simpson Querrey Institute for BioNanotechnology, Northwestern University, Evanston, IL, United States
| | - Anthony Banks
- Department of Biomedical Engineering, Center for Bio-Integrated Electronics, Simpson Querrey Institute for BioNanotechnology, Northwestern University, Evanston, IL, United States
| | - Mary Kwasny
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - John A Rogers
- Department of Biomedical Engineering, Center for Bio-Integrated Electronics, Simpson Querrey Institute for BioNanotechnology, Northwestern University, Evanston, IL, United States
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Siegler AJ, Knox J, Bauermeister JA, Golinkoff J, Hightow-Weidman L, Scott H. Mobile app development in health research: pitfalls and solutions. Mhealth 2021; 7:32. [PMID: 33898601 PMCID: PMC8063010 DOI: 10.21037/mhealth-19-263] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Accepted: 06/05/2020] [Indexed: 11/06/2022] Open
Abstract
Mobile app health research presents myriad opportunities to improve health, and simultaneously introduces a new set of challenges that are non-intuitive and extend beyond typical training received by researchers. Informed by our experiences with app development for health research, we discuss some of the most salient pitfalls when working with emerging technology as well as potential strategies to avoid or resolve these challenges. To address challenges at the project level, we suggest strategies that researchers can use to future-proof their research, such as using theory and involving those with app development expertise as part of a research team. At the structural level, we include a new model to characterize the relationship between technology- and research-timelines, and provide ideas regarding how to best address this challenge. Given that screen-based time now predominates our lived experiences, it is important that health researchers have the capacity and structural support to develop interventions that utilize these technologies, assess them rigorously, and ensure their timely and equitable dissemination.
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Affiliation(s)
- Aaron J. Siegler
- Department of Behavioral Sciences and Health Education, Emory University, Atlanta, GA, USA
| | - Justin Knox
- Department of Epidemiology, Columbia University, New York, NY, USA
| | - José A. Bauermeister
- Department of Family & Community Health, University of Pennsylvania, Philadelphia, PA, USA
| | - Jesse Golinkoff
- Department of Family & Community Health, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Hyman Scott
- Bridge HIV, San Francisco Department of Public Health, San Francisco, CA, USA
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Abstract
Smartphones and applications related to the same are ubiquitous now. As dermatologists, we have a wide array of smartphone apps at our disposal which we can use to improve our practice in all aspects—clinical, academic, research, and administrative. This article provides an overview of available apps, tips on using apps—both general and specific for dermatology, as well as discusses the scientific validity of some of these apps and the future of smartphone apps in the context of dermatology.
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Sümen A, Öncel S. The effect of 'I am Protecting my Child from the Sun' programme on parental sun protection behaviours: Randomized controlled trial. J Adv Nurs 2020; 77:387-400. [PMID: 33089943 DOI: 10.1111/jan.14614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 09/09/2020] [Accepted: 10/02/2020] [Indexed: 11/29/2022]
Abstract
AIMS This study aims to examine the effect of the 'I am Protecting my Child from the Sun' program based on the social cognitive theory, on parental use of sun protection products and sun avoidance behaviours. DESIGN Cluster randomized controlled trial. METHODS The study was conducted with three groups using a pre-test, post-test, and follow-up design. The study included 185 parents, of which 63 were in the education group, 62 were in the education + SMS group, and 60 were in the control group. The parents in the intervention group were engaged in the 'I am Protecting my Child from the Sun' program for a period of 6 weeks, while the education + SMS group, in addition to the program, also received. Primary outcomes include sunscreen use and sun avoidance behaviour and secondary outcomes were self-protection and protection of their children's behaviour. A repeated-measures ANOVA and marginal homogeneity were the main statistical tests. RESULTS The interventions made as part of the 'I am Protecting my Child from the Sun' program increased the following behavioural components of parents in the education group and the education + SMS group, compared with the control group: sun protection product use behaviours, sun avoidance behaviours, and behaviours related to protecting themselves and their children from the sun. There was an even higher increase in these behavioural components for those parents who also received short reminder text messages. CONCLUSION The 'I am Protecting my Child from the Sun' program and the receiving of short reminder messages had positive effects on the parents' behaviours related to protecting themselves and their children from the sun. IMPACT The 'I am Protecting my Child from the Sun' developed parents' sunscreen use self-efficacy, norms/attitudes about sunscreen use and sunscreen use expectancy behaviour, and reduced their impediments to sunscreen use behaviour. In addition, the program developed parents' sun avoidance self-efficacy, norms/attitudes about sun avoidance and sun avoidance expectancy behaviours, and reduced tanning expectancy behaviour. Receiving SMS messages following the training was effective in parental behaviours for use of sunscreen, sun avoidance, and protecting themselves and their children from the sun. Registration number: Study is registered at ClinicalTrials.gov NCT04251598.
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Affiliation(s)
- Adem Sümen
- Kumluca Faculty of Health Sciences, Department of Public Health Nursing, Akdeniz University, Antalya, Turkey
| | - Selma Öncel
- Faculty of Nursing, Department of Public Health Nursing, Akdeniz University, Antalya, Turkey
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Horsham C, Antrobus J, Olsen CM, Ford H, Abernethy D, Hacker E. Testing Wearable UV Sensors to Improve Sun Protection in Young Adults at an Outdoor Festival: Field Study. JMIR Mhealth Uhealth 2020; 8:e21243. [PMID: 32936083 PMCID: PMC7531871 DOI: 10.2196/21243] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 07/21/2020] [Accepted: 07/23/2020] [Indexed: 12/13/2022] Open
Abstract
Background Australia and New Zealand have the highest skin cancer incidence rates worldwide, and sun exposure is the main risk factor for developing skin cancer. Sun exposure during childhood and adolescence is a critical factor in developing skin cancer later in life. Objective This study aims to test the effectiveness of wearable UV sensors to increase sun protection habits (SPH) and prevent sunburn in adolescents. Methods During the weeklong school leavers outdoor festival (November 2019) at the Gold Coast, Australia, registered attendees aged 15-19 years were recruited into the field study. Participants were provided with a wearable UV sensor and free sunscreen. The primary outcome was sun exposure practices using the SPH index. Secondary outcomes were self-reported sunburns, sunscreen use, and satisfaction with the wearable UV sensor. Results A total of 663 participants were enrolled in the study, and complete data were available for 188 participants (188/663, 28.4% response rate). Participants provided with a wearable UV sensor significantly improved their use of sunglasses (P=.004) and sunscreen use both on the face (P<.001) and on other parts of the body (P=.005). However, the use of long-sleeve shirts (P<.001) and the use of a hat (P<.001) decreased. During the study period, 31.4% (59/188) of the participants reported receiving one or more sunburns. Satisfaction with the wearable UV sensor was high, with 73.4% (138/188) of participants reporting the UV sensor was helpful to remind them to use sun protection. Conclusions Devices that target health behaviors when outdoors, such as wearable UV sensors, may improve use of sunscreen and sunglasses in adolescents.
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Affiliation(s)
- Caitlin Horsham
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| | - Jodie Antrobus
- Preventive Health Branch, Queensland Health, Queensland Government, Brisbane, Australia
| | - Catherine M Olsen
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Helen Ford
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| | - David Abernethy
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| | - Elke Hacker
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
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Snyder A, Valdebran M, Terrero D, Amber KT, Kelly KM. Solar Ultraviolet Exposure in Individuals Who Perform Outdoor Sport Activities. SPORTS MEDICINE - OPEN 2020; 6:42. [PMID: 32880767 PMCID: PMC7471243 DOI: 10.1186/s40798-020-00272-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 08/13/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Skin cancer is the most common cancer in the USA. Therefore, it is important to review the contribution of ultraviolet radiation (UVR) exposure to skin cancer in individuals with the highest risk. Documenting the relationship between outdoor sports solar ultraviolet exposure and their risk of skin cancer along with appropriate risk mitigation strategies can help inform clinicians of practical information for counseling sun protective behaviors in this population. METHODS We conducted a review of the current evidence using PubMed to answer the following research questions: (1) How is ultraviolet radiation measured? (2) What is the modern utility of the ultraviolet index in modifying recreational sun protection behaviors? (3) What is the risk of developing skin cancer for outdoor sport participants? (4) What is the prevalence of skin cancer in sport participants? and (5) Is the number of nevi and solar lentigines elevated in outdoor sport participants? RESULTS Based on the literature, individuals who practice outdoor sport-related activities receive high ultraviolet radiation exposure, have a high risk for skin cancer, have a high prevalence for pigmented lesions, and may benefit from electronic sun protection educational interventions. CONCLUSIONS Individuals who practice outdoor sports experience substantially higher ultraviolet radiation exposure, routinely exceed the recommended exposure limits, and are at a higher risk of developing skin cancer. Therefore, those who are frequently engaged in outdoor leisure activities should be coached about efficient sun protective practices and relevant mobile technologies that may facilitate adherence.
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Affiliation(s)
- Alan Snyder
- College of Graduate Studies, Medical University of South Carolina, Charleston, SC, USA.
| | - Manuel Valdebran
- Division of Pediatric Dermatology, Department of Dermatology, Medical University of South Carolina, Charleston, SC, USA
| | - David Terrero
- College of Pharmacy and Pharmaceutical Sciences, University of Toledo, Toledo, OH, USA
| | - Kyle T Amber
- Department of Dermatology, University of Illinois at Chicago, Chicago, IL, USA
| | - Kristen M Kelly
- Department of Dermatology, University of California, Irvine, Irvine, CA, USA
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19
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Chambergo-Michilot D, Tellez WA, Becerra-Chauca N, Zafra-Tanaka JH, Taype-Rondan A. Text message reminders for improving sun protection habits: A systematic review. PLoS One 2020; 15:e0233220. [PMID: 32428021 PMCID: PMC7236986 DOI: 10.1371/journal.pone.0233220] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 04/30/2020] [Indexed: 12/11/2022] Open
Abstract
Background Excessive exposure to ultraviolet radiation increases the risk of skin cancer and other conditions. SMS text reminders may be a useful tool to improve sun protection habits due to its massive reach, low cost, and accessibility. Objective To perform a systematic review of randomized controlled trials (RCTs) that evaluated the effects of SMS text reminders in promoting sun protection habits. Methods We performed a systematic search in PubMed, Central Cochrane Library, and Scopus; following the PRISMA recommendations to perform systematic reviews. We included RCTs published up to December 2018, which evaluated the benefits and harms of SMS text reminders to improve sun protection habits. Random-effects meta-analyses were performed whenever possible. The certainty of the evidence was assessed for RCTs estimates using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. The study protocol was registered in PROSPERO (CRD42018091661). Results Five RCTs were included in this review. When pooled, the studies found no effect of SMS text reminders in “sunburn anytime during follow-up” (two studies, risk ratio: 0.93; 95% confidence interval: 0.83–1.05). Contradictory results were obtained for sunscreen use (three RCTs) and sun protection habits (two RCTs), however, they could not be meta-analyzed because outcomes were measured differently across studies. The certainty of the evidence was very low for these three outcomes according to GRADE methodology. Conclusions RCTs that assessed effects of SMS text reminders did not find a significant benefit on objective outcomes, such as having a sunburn, sunscreen use and composite score of sun protection habits. Since certainty of the evidence was very low, future high-quality studies are needed to reach a conclusion regarding the balance of desirable and undesirable outcomes. Protocol registration number PROSPERO (CRD42018091661).
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Affiliation(s)
| | | | - Naysha Becerra-Chauca
- Instituto de Evaluación de Tecnologías en Salud e Investigación—IETSI, EsSalud, Lima, Perú
| | | | - Alvaro Taype-Rondan
- Universidad San Ignacio de Loyola, Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Lima, Peru
- * E-mail:
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20
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Robinson JK, Durst DA, Gray E, Kwasny M. Protection-adjusted UV dose estimated for body areas: Daily self-reported sun protection modification of wearable UV sensor dose. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2020; 36:357-364. [PMID: 32189399 DOI: 10.1111/phpp.12557] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Revised: 02/16/2020] [Accepted: 03/13/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND During the last 20 years, 50% of adults with sun-sensitive skin have sunburned annually. Reducing the proportion of people who sunburn requires understanding the circumstances and outdoor activities during which at-risk people sunburn. METHODS A 7-day observational study of melanoma survivors (n = 20) and young adult first-degree relatives of melanoma survivors (FDRs) (n = 20) captured daily UV exposure, sun protection, and sunburns during spring and summer in the Midwest of the United States (latitude 41.8°N). Participants wore UV and physical activity sensors and completed a daily self-reported survey of sun protection, sunburn, and physical activities. The estimated protection-adjusted UV dose was calculated for each body area by integrating self-reported sun protection with UV sensor dose. RESULTS In 254 days, at least one body area in 9 of 20 (45%) melanoma survivors and 11 of 20 (55%) FDRs was sunburned (erythema at 24 hours). Sunburns were associated with spring and walking for transportation or leisure, especially walking the dog. Melanoma survivors used sunscreen daily on the face; however, forearms and lower legs were not protected during walking. Young adults did not use sun protection on the face, forearms or lower legs during walking for transportation and use was ineffective during sports. CONCLUSION The sun protection patterns of daily living identified in this study may promote recognition of erythema as sunburn and inform the development of tailored sun protection mobile applications promoting self-monitoring with wearable UV sensors.
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Affiliation(s)
- June K Robinson
- Department of Dermatology, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - Dalya A Durst
- Department of Dermatology, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - Elizabeth Gray
- Department of Preventive Medicine, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - Mary Kwasny
- Department of Preventive Medicine, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
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21
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Turner J, Igoe D, Parisi AV, McGonigle AJ, Amar A, Wainwright L. A review on the ability of smartphones to detect ultraviolet (UV) radiation and their potential to be used in UV research and for public education purposes. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 706:135873. [PMID: 31862595 DOI: 10.1016/j.scitotenv.2019.135873] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 11/29/2019] [Accepted: 11/29/2019] [Indexed: 06/10/2023]
Abstract
The effects of ultraviolet (UV) radiation on life on Earth have continuously been the subject of research. Over-exposure to UV radiation is harmful, but small amounts of exposure are required for good health. It is, therefore, crucial for humans to optimise their own UV exposure and not exceed UV levels that are sufficient for essential biological functions. Exceeding those levels may increase risk of developing health problems including skin cancer and cataracts. Smartphones have been previously investigated for their ability to detect UV radiation with or without additional devices that monitor personal UV exposure, in order to maintain safe exposure times by individuals. This review presents a comprehensive overview of the current state of smartphones' use in UV radiation monitoring and prediction. There are four main methods for UV radiation detection or prediction involving the use smartphones, depending on the requirements of the user: devoted software applications developed for smartphones to predict UV Index (UVI), wearable and non-wearable devices that can be used with smartphones to provide real-time UVI, and the use of smartphone image sensors to detect UV radiation. The latter method has been a growing area of research over the last decade. Built-in smartphone image sensors have been investigated for UV radiation detection and the quantification of related atmospheric factors (including aerosols, ozone, clouds and volcanic plumes). The overall practicalities, limitations and challenges are reviewed, specifically in regard to public education. The ubiquitous nature of smartphones can provide an interactive tool when considering public education on the effects and individual monitoring of UV radiation exposure, although social and geographic areas with low socio-economic factors could challenge the usefulness of smartphones. Overall, the review shows that smartphones provide multiple opportunities in different forms to educate users on personal health with respect to UV radiation.
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Affiliation(s)
- Joanna Turner
- Faculty of Health, Engineering and Sciences, University of Southern Queensland, Toowoomba, Australia.
| | - Damien Igoe
- Faculty of Health, Engineering and Sciences, University of Southern Queensland, Toowoomba, Australia
| | - Alfio V Parisi
- Faculty of Health, Engineering and Sciences, University of Southern Queensland, Toowoomba, Australia
| | - Andrew J McGonigle
- Faculty of Health, Engineering and Sciences, University of Southern Queensland, Toowoomba, Australia; Department of Geography, University of Sheffield, Sheffield S10 2TN, UK; School of Geosciences, The University of Sydney, Sydney, NSW 2006, Australia
| | - Abdurazaq Amar
- Faculty of Health, Engineering and Sciences, University of Southern Queensland, Toowoomba, Australia
| | - Lisa Wainwright
- Faculty of Health, Engineering and Sciences, University of Southern Queensland, Toowoomba, Australia
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Dantas LO, Weber S, Osani MC, Bannuru RR, McAlindon TE, Kasturi S. Mobile health technologies for the management of systemic lupus erythematosus: a systematic review. Lupus 2020; 29:144-156. [PMID: 31924145 DOI: 10.1177/0961203319897139] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVE We aimed to perform a standardized review of available mobile health (mHealth) applications (apps) for systemic lupus erythematosus (SLE) and to conduct a systematic review of the literature on mHealth technologies in SLE. METHODS Google Play and AppStore in the United States of America were queried and the quality of eligible mHealth apps was assessed using the Mobile App Rating Scale (MARS). Web of Science, EMBASE, Medline, and Cochrane databases were systematically searched from inception through June 2019. RESULTS Of 324 mHealth apps found, 20 were eligible for inclusion; 10 focused on education, 7 offered tools to track patient-reported symptoms, 5 included interactive online communities, and 1 enabled emoji sharing. The reviewed apps scored poorly on the MARS quality scale with a mean score 2.3 (0.6) out of 5. Of 1147 studies identified in the literature review, 21 were eligible for inclusion; 11 studies (52.4%) focused on the development and use of mHealth for providing patient information, while only 2 (9.5%) were randomized trials of mHealth interventions. CONCLUSIONS Although there is growing interest in the development of mHealth technologies to support SLE patients, currently available tools are of poor quality and limited functionality, and the literature examining this area is sparse.
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Affiliation(s)
- L O Dantas
- Division of Rheumatology, Allergy and Immunology, Tufts Medical Center, Boston, Massachusetts, USA
- Physical Therapy Department, Federal University of São Carlos, São Carlos, Brazil
| | - S Weber
- Division of Rheumatology, Allergy and Immunology, Tufts Medical Center, Boston, Massachusetts, USA
| | - M C Osani
- Center for Treatment Comparison and Integrative Analysis, Division of Rheumatology, Allergy and Immunology, Tufts Medical Center, Boston, Massachusetts, USA
| | - R R Bannuru
- Center for Treatment Comparison and Integrative Analysis, Division of Rheumatology, Allergy and Immunology, Tufts Medical Center, Boston, Massachusetts, USA
| | - T E McAlindon
- Division of Rheumatology, Allergy and Immunology, Tufts Medical Center, Boston, Massachusetts, USA
| | - S Kasturi
- Division of Rheumatology, Allergy and Immunology, Tufts Medical Center, Boston, Massachusetts, USA
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Stump TK, Spring B, Marchese SH, Alshurafa N, Robinson JK. Toward a precision behavioral medicine approach to addressing high-risk sun exposure: a qualitative analysis. JAMIA Open 2019; 2:547-553. [PMID: 32025652 PMCID: PMC6994011 DOI: 10.1093/jamiaopen/ooz034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 07/11/2019] [Accepted: 08/01/2019] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES Precision behavioral medicine techniques integrating wearable ultraviolet radiation (UVR) sensors may help individuals avoid sun exposure that places them at-risk for skin cancer. As a preliminary step in our patient-centered process of developing a just-in-time adaptive intervention, this study evaluated reactions and preferences to UVR sensors among melanoma survivors. MATERIALS AND METHODS Early stage adult melanoma survivors were recruited for a focus group (n = 11) or 10-day observational study, which included daily wearing a UVR sensor and sun exposure surveys (n = 39). Both the focus group moderator guide and observational study exit interviews included questions on UVR sensing as a potential intervention strategy. These responses were transcribed and coded using an inductive strategy. RESULTS Most observational study participants (84.6%) said they would find information provided by UVR sensors to be useful to help them learn about how specific conditions (eg, clouds, location) impact sun exposure and provide in-the-moment alerts. Focus group participants expressed enthusiasm for UVR information and identified preferred qualities of a UVR sensor, such as small size and integration with other devices. Participants in both studies indicated concern that UVR feedback may be difficult to interpret and some expressed that a UVR sensor may not be convenient or desirable to wear in daily life. DISCUSSION Melanoma survivors believe that personalized UVR exposure information could improve their sun protection and want this information delivered in a method that is meaningful and actionable. CONCLUSION UVR sensing is a promising component of a precision behavioral medicine strategy to reduce skin cancer risk.
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Affiliation(s)
- Tammy K Stump
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Bonnie Spring
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Sara Hoffman Marchese
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Nabil Alshurafa
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - June K Robinson
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, Illinois, USA
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Mobile applications in oncology: A systematic review of health science databases. Int J Med Inform 2019; 133:104001. [PMID: 31706229 DOI: 10.1016/j.ijmedinf.2019.104001] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 06/21/2019] [Accepted: 10/01/2019] [Indexed: 02/07/2023]
Abstract
INTRODUCTION In recent years there has been an exponential growth in the number of mobile applications (apps) relating to the early diagnosis of cancer and prevention of side effects during cancer treatment. For health care professionals and users, it can thus be difficult to determine the most appropriate app for given needs and assess the level of scientific evidence supporting their use. Therefore, this review aims to examine the research studies that deal with this issue and determine the characteristics of the apps involved. METHODOLOGY This study involved a systematic review of the scientific literature on randomized clinical trials that use apps to improve cancer management among patients, using the Pubmed (Medline), Latin America and the Caribbean in Health Sciences (LILACS), and Cochrane databases. The search was limited to articles written in English and Spanish published in the last 10 years. A search of the App Store for iOS devices and Google Play for Android devices was performed to find the apps identified in the included research articles. RESULTS In total, 54 articles were found to analyze the development of an application in the field of oncology. These articles were most frequently related to the use of apps for the early detection of cancer (n = 28), particularly melanoma (n = 9). In total, 21 studies reflected the application used. The apps featured in nine articles were located using the App Store and Google Play (n = 9), of which five were created to manage cancer-related issues. The rest of the apps were designed for use in the general population (n = 4). CONCLUSIONS There is an increasing number of research articles that study the use of apps in the field of oncology; however, these mobile applications tend to disappear from app stores after the studies are completed.
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Bertucci F, Le Corroller-Soriano AG, Monneur A, Fluzin S, Viens P, Maraninchi D, Goncalves A. [E-health and "Cancer outside the hospital walls", Big Data and artificial intelligence]. Bull Cancer 2019; 107:102-112. [PMID: 31543271 DOI: 10.1016/j.bulcan.2019.07.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 06/15/2019] [Accepted: 07/04/2019] [Indexed: 12/25/2022]
Abstract
To heal otherwise in oncology has become an imperative of Public Health and an economic imperative in France. Patients can therefore receive live most of their care outside of hospital with more ambulatory care. This ambulatory shift will benefit from the digital revolution and the development of digital health or e-health. Cancer research will also benefit with Big Data and artificial intelligence, which gather and analyze a huge amount of data. In this synthesis, we describe the different e-health tools and their potential impacts in oncology, at the levels of education and information of patients and caregivers, prevention, screening and diagnosis, treatment, follow-up, and research. A few randomized studies have already demonstrated clinical benefits. Large Big Data projects such as ConSoRe and Health Data Hub have been launched in France. We also discuss the issues and limitations of "cancer outside the hospital walls and e-health" from the point of view of patients, health care professionals, health facilities and government. This new organization will have to provide remote support "outside the walls" with care and follow-up of quality, continuous and prolonged in total safety and equity. Ongoing and future randomized clinical trials will need to definitively demonstrate areas of interest, advantages and drawbacks not only for patients, but also for caregivers, health facilities and governments.
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Affiliation(s)
- François Bertucci
- Institut Paoli-Calmettes, département d'oncologie médicale, 13009 Marseille, France; Aix-Marseille université, Centre de recherche en cancérologie de Marseille, Inserm U1068-CNRS U7258, 13009 Marseille, France.
| | - Anne-Gaëlle Le Corroller-Soriano
- Aix-Marseille université, SESSTIM, Sciences économiques & sociales de la santé & traitement de l'information médicale, Inserm UMR912, 13009 Marseille, France
| | - Audrey Monneur
- Institut Paoli-Calmettes, département d'oncologie médicale, 13009 Marseille, France
| | - Sylvain Fluzin
- Institut Paoli-Calmettes, direction du système d'information et de l'organisation, 13009 Marseille, France
| | - Patrice Viens
- Institut Paoli-Calmettes, département d'oncologie médicale, 13009 Marseille, France; Aix-Marseille université, Centre de recherche en cancérologie de Marseille, Inserm U1068-CNRS U7258, 13009 Marseille, France
| | - Dominique Maraninchi
- Institut Paoli-Calmettes, département d'oncologie médicale, 13009 Marseille, France; Aix-Marseille université, Centre de recherche en cancérologie de Marseille, Inserm U1068-CNRS U7258, 13009 Marseille, France
| | - Anthony Goncalves
- Institut Paoli-Calmettes, département d'oncologie médicale, 13009 Marseille, France; Aix-Marseille université, Centre de recherche en cancérologie de Marseille, Inserm U1068-CNRS U7258, 13009 Marseille, France
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Nicholson A, Murphy M, Walker H, Tinker R, Dobbinson S. Not part of my routine: a qualitative study of use and understanding of UV forecast information and the SunSmart app. BMC Public Health 2019; 19:1127. [PMID: 31420026 PMCID: PMC6698026 DOI: 10.1186/s12889-019-7421-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2019] [Accepted: 07/31/2019] [Indexed: 11/21/2022] Open
Abstract
Background The Ultraviolet (UV) Index provides a reliable means of monitoring the strength of UV radiation at the Earth’s surface, which can be used to indicate the potential for skin damage. This qualitative study aims to examine public understanding of the UV Index among Australians who routinely use UV forecast information as well as those who do not. Methods Recent use of the SunSmart app (a popular mobile and tablet app that provides UV forecast information) served as a proxy for use of UV forecast information. Six focus groups were conducted with ‘new users’, who trialled the SunSmart app for the first time in the two weeks preceding the group discussion. In addition, 15 in-depth interviews were conducted with ‘existing users’, who routinely used the SunSmart app. Thematic discourse analysis was undertaken to compare views and experiences. Results Misperceptions about UV radiation were common. Participants learnt new information about UV radiation, the UV Index, and the times of the day that sun protection is recommended. Among adults who were using UV forecast information for the first time, this learning rarely translated to new behaviours; for these participants, the UV Index forecast information and recommendations were inconsistent with their own observation of the weather and subsequent judgement about their propensity to burn. Thus new users considered the UV forecast information to be overly cautious. In contrast, existing users recognised their inability to judge the UV Index level; for these participants, UV forecast information provided by the SunSmart app was incorporated into their daily routines and used to inform their sun protection behaviours. Conclusions/implications No matter how broadly UV forecast information is promoted, it is unlikely to improve sun protection behaviours across the Victorian population due to the low level of basic understanding of UV radiation. Public education strategies that correct the commonly held misperception that temperature and/or sunshine can reliably predict the potential for UV damage are required. Improved public awareness about UV radiation and how the UV Index can be used to prevent skin cancer may help Australians to develop more effective sun protection habits.
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Affiliation(s)
- Anna Nicholson
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, 615 St Kilda Road, Melbourne, Victoria, 3004, Australia.
| | - Michael Murphy
- MMResearch, 9 School Lane, Ferny Creek, Victoria, 3786, Australia
| | - Heather Walker
- SunSmart Victoria, Cancer Council Victoria, 615 St Kilda Road, Melbourne, Victoria, 3004, Australia
| | - Rick Tinker
- Australian Radiation Protection and Nuclear Safety Agency, 619 Lower Plenty Road, Yallambie, Victoria, 3085, Australia
| | - Suzanne Dobbinson
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, 615 St Kilda Road, Melbourne, Victoria, 3004, Australia
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Abstract
PURPOSE OF REVIEW Patients seen at pediatric rheumatology are at increased risk of immediate and long-term consequences from sun exposure. The objective of this review is to build awareness of the need of sun protection in pediatric rheumatology patients. RECENT FINDINGS Sun exposure can lead to disease exacerbations in many rheumatic diseases. There is well documented literature linking the chronic use of immunosuppressants with long-term risk of skin cancer. Although there is a lack of literature in pediatric rheumatology addressing the need of sun protection in this patient population, the young age of patients, the nature of their disease and the treatments they receive, make them a high-risk population for the effects of the sun. SUMMARY Sun protection recommendations are outlined in the following manuscript, backed up by the rationale and biology of why it is important for pediatric rheumatology patients to be protected from the sun. The information reviewed in this article should be part of the education that all pediatric rheumatology patients should receive as part of their care.
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Hacker E, Horsham C, Ford H, Hartel G, Olsen CM, Pandeya N, Janda M. UV detection stickers can assist people to reapply sunscreen. Prev Med 2019; 124:67-74. [PMID: 31077722 DOI: 10.1016/j.ypmed.2019.05.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 04/30/2019] [Accepted: 05/07/2019] [Indexed: 12/13/2022]
Abstract
Sunscreen when applied at the recommended concentration (2 mg/cm2) has been shown to block the harmful molecular effects of ultraviolet radiation (UVR) in vivo. In real world conditions, however, sunscreen is often not applied/reapplied sufficiently to yield protection. This field study tested the effectiveness of UV detection stickers to prevent sunburn and improve reapplication of sunscreen. During the Ashes Cricket Test match event (November 2017) in Brisbane, Australia interested spectators were recruited into the control group on DAY-1 and during subsequent days (DAY-2, DAY-3, DAY-4) new participants were recruited into the UV-Sticker group. Participants in both groups were provided with free sunscreen and participants in the UV-Sticker group were additionally provided with a UV detection sticker. Primary outcomes were self-reported sunburns and reapplication of sunscreen. Secondary endpoints included satisfaction with the UV detection stickers. 813 participants enrolled in the study, and complete data is available for 428 participants (52.6% response rate, n = 369 UV detection sticker, n = 59 control). Participants provided with a UV detection sticker were more likely to re-apply sunscreen than controls (80% vs 68%, p = 0.04); but do not reduce sunburn rates. UV detection stickers may improve sunscreen re-application in a high UV-environment. Trial registration: Australian and New Zealand clinical trials register (ACTRN12617001572358).
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Affiliation(s)
- Elke Hacker
- Institute of Health and Biomedical Innovation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia; Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia.
| | - Caitlin Horsham
- Institute of Health and Biomedical Innovation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| | - Helen Ford
- Institute of Health and Biomedical Innovation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| | - Gunter Hartel
- Statistics Unit, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Catherine M Olsen
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Nirmala Pandeya
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Monika Janda
- Institute of Health and Biomedical Innovation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia; Centre of Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
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Heckman CJ, Liang K, Riley M. Awareness, understanding, use, and impact of the UV index: A systematic review of over two decades of international research. Prev Med 2019; 123:71-83. [PMID: 30844501 PMCID: PMC6534479 DOI: 10.1016/j.ypmed.2019.03.004] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 02/28/2019] [Accepted: 03/02/2019] [Indexed: 11/28/2022]
Abstract
The ultraviolet radiation index (UVI) was adopted internationally to raise awareness about and encourage the public to protect their skin from skin cancer. The current paper is a systematic review of over 20 years of research investigating awareness, comprehension, use, and impact of the UVI. Thirty-one studies were included from the USA, Canada, Europe, Australia, New Zealand, and elsewhere. Awareness of the UVI varies by country, with samples from some countries demonstrating high awareness. However, comprehension and use of the UVI to inform sun safety behaviors are typically much lower. In fact, greater UVI awareness has sometimes been associated with riskier UV-related behaviors such as intentional tanning. Fewer studies have evaluated interventions, and their results have been mixed. In summary, more research is needed to determine how to help the public understand and use the UVI for effective skin protection. This review offers suggestions for future use of and research with the UVI.
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Affiliation(s)
- Carolyn J Heckman
- Rutgers Cancer Institute of New Jersey, 195 Little Albany Street, New Brunswick, NJ, 08903, USA.
| | - Katherine Liang
- Temple University, 3500 N Broad St, Philadelphia, PA 19140, USA
| | - Mary Riley
- Rutgers Cancer Institute of New Jersey, 195 Little Albany Street, New Brunswick, NJ, 08903, USA
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Ziehfreund S, Schuster B, Zink A. Primary prevention of keratinocyte carcinoma among outdoor workers, the general population and medical professionals: a systematic review updated for 2019. J Eur Acad Dermatol Venereol 2019; 33:1477-1495. [PMID: 30801774 DOI: 10.1111/jdv.15525] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 01/29/2019] [Indexed: 02/07/2023]
Abstract
Worldwide 2-3 million cases of keratinocyte carcinoma (KC) are diagnosed annually. Sun-related knowledge is essential for adequate protection against solar ultraviolet radiation (UVR), the main risk factor for KC. The goal was (i) to provide an updated overview of primary prevention against KC including skin cancer-related knowledge, attitudes and sun protection behaviour (SPB) of outdoor workers, the general population and medical professionals as well as (ii) to evaluate the effectiveness and acceptability of sun protection programmes. We conducted a systematic review of articles indexed for MEDLINE on PubMed using selected MeSH terms and keywords related to the studied topic as well as an extensive hand search of publications between 1 January 2012 and 31 December 2018. We identified 51 relevant cross-sectional studies and 22 interventional studies. Sun-related knowledge and attitude showed substantial differences with some alarming results, including people who had not even heard about skin cancer before. Reported SPB varied enormously between the included studies, with none of the studies providing an overall sufficient SPB in their examined sun protection measures. However, sun protection programmes using new technologies seem to have great potential to increase sun-related knowledge and SPB. In countries worldwide, particularly in those where KC is not yet a public health issue, UVR protection should be promoted by healthcare institutions and authorities, politicians, cancer foundations and dermatologists to increase awareness as well as SPB and to decrease the worldwide burden of KC.
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Affiliation(s)
- S Ziehfreund
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - B Schuster
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - A Zink
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
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Psihogios AM, Li Y, Butler E, Hamilton J, Daniel LC, Barakat LP, Bonafide CP, Schwartz LA. Text Message Responsivity in a 2-Way Short Message Service Pilot Intervention With Adolescent and Young Adult Survivors of Cancer. JMIR Mhealth Uhealth 2019; 7:e12547. [PMID: 30998225 PMCID: PMC6495290 DOI: 10.2196/12547] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 01/15/2019] [Accepted: 02/05/2019] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE Within a 2-way text messaging study in AYAs who recently completed treatment for cancer, we sought to evaluate text message responsivity across different types of text messages. METHODS AYAs who recently completed treatment for cancer (n=26; mean age=16 years; 62% female, 16/26 participants) received 2-way text messages about survivorship health topics over a 16-week period. Using participants' text message log data, we coded responsivity to text messages and evaluated trends in responsivity to unprompted text messages and prompted text messages of varying content (eg, medication reminders, appointment reminders, and texts about personal experiences as a cancer survivor). RESULTS Across prompted and unprompted text messages, responsivity rapidly decreased (P ≤.001 and =.01, respectively) and plateaued by the third week of the intervention. However, participants were more responsive to prompted text messages (mean responsivity=46% by week 16) than unprompted messages (mean responsivity=10% by week 16). They also demonstrated stable responsivity to certain prompted content: medication reminders, appointment reminders, goal motivation, goal progress, and patient experience texts. CONCLUSIONS Our methodology of evaluating text message responsivity revealed important patterns of engagement in a 2-way text message intervention for AYA cancer survivors.
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Affiliation(s)
| | - Yimei Li
- The Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, United States
| | - Eliana Butler
- The Children's Hospital of Philadelphia, Philadelphia, PA, United States
| | | | - Lauren C Daniel
- Rutgers University Camden, The Children's Hospital of Philadelphia, Camden, NJ, United States
| | - Lamia P Barakat
- The Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, United States
| | - Christopher P Bonafide
- The Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, United States
| | - Lisa A Schwartz
- The Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, United States
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Kim C, Prabhu AV, Hansberry DR, Agarwal N, Heron DE, Beriwal S. Digital Era of Mobile Communications and Smartphones: A Novel Analysis of Patient Comprehension of Cancer-Related Information Available Through Mobile Applications. Cancer Invest 2019; 37:127-133. [DOI: 10.1080/07357907.2019.1572760] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Christopher Kim
- Department of Anesthesiology, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Arpan V. Prabhu
- Department of Radiation Oncology, UAMS Winthrop P. Rockefeller Cancer Institute, Little Rock, Arkansas, USA
- Department of Radiation Oncology, University of Pittsburgh School of Medicine and UPMC Hillman Cancer Institute, Pittsburgh, Pennsylvania, USA
| | - David R. Hansberry
- Department of Radiology, Thomas Jefferson University Hospitals, Philadelphia, Pennsylvania, USA
| | - Nitin Agarwal
- Department of Neurosurgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Dwight E. Heron
- Department of Radiation Oncology, University of Pittsburgh School of Medicine and UPMC Hillman Cancer Institute, Pittsburgh, Pennsylvania, USA
| | - Sushil Beriwal
- Department of Radiation Oncology, University of Pittsburgh School of Medicine and UPMC Hillman Cancer Institute, Pittsburgh, Pennsylvania, USA
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Outpatient Cancer Care Delivery in the Context of E-Oncology: A French Perspective on "Cancer outside the Hospital Walls". Cancers (Basel) 2019; 11:cancers11020219. [PMID: 30769858 PMCID: PMC6406853 DOI: 10.3390/cancers11020219] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 01/06/2019] [Accepted: 02/10/2019] [Indexed: 01/21/2023] Open
Abstract
In oncology, the treatment of patients outside of hospitals has become imperative due to an increasing number of patients who are older and live longer, along with issues such as medical desertification, oncologist hyperspecialization, and difficulties in financing mounting health expenditures. Treatments have become less "invasive", with greater precision and efficiency. Patients can therefore receive most of their care outside of hospitals. The development of e-health can address these new imperatives. In this letter, we describe the different e-health tools and their potential clinical impacts in oncology, as already reported at every level of care, including education, prevention, diagnosis, treatment, and monitoring. A few randomized studies have yet demonstrated the clinical benefit. We also comment on issues and limits of "cancer outside the hospital walls" from the point of view of patients, health care professionals, health facilities, and public authorities. Care providers in hospitals and communities will have to adapt to these changes within well-coordinated networks in order to better meet patient expectations regarding increasing education and personalizing management. Ultimately, controlled studies should aim to definitively demonstrate areas of interest, benefits, and incentives, for not only patients, but also caregivers (formal and informal) and health care providers, health care facilities, and the nation.
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Hacker E, Horsham C, Vagenas D, Jones L, Lowe J, Janda M. A Mobile Technology Intervention With Ultraviolet Radiation Dosimeters and Smartphone Apps for Skin Cancer Prevention in Young Adults: Randomized Controlled Trial. JMIR Mhealth Uhealth 2018; 6:e199. [PMID: 30487115 PMCID: PMC6291679 DOI: 10.2196/mhealth.9854] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 08/02/2018] [Accepted: 08/14/2018] [Indexed: 12/21/2022] Open
Abstract
Background Skin 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. Objective The 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. Methods Young 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. Results Complete 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. Conclusions Using 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 Registration The 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.org/731somROx)
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Affiliation(s)
- Elke Hacker
- Institute of Health and Biomedical Innovation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| | - Caitlin Horsham
- Institute of Health and Biomedical Innovation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| | - Dimitrios Vagenas
- Institute of Health and Biomedical Innovation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| | - Lee Jones
- Institute of Health and Biomedical Innovation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| | - John Lowe
- School of Health and Sport Sciences, Faculty of Science, Health, Education and Engineering, University of the Sunshine Coast, Maroochydore, Australia
| | - Monika Janda
- Institute of Health and Biomedical Innovation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia.,Centre of Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia
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Corneli P, Zalaudek I, Magaton Rizzi G, di Meo N. Improving the early diagnosis of early nodular melanoma: can we do better? Expert Rev Anticancer Ther 2018; 18:1007-1012. [DOI: 10.1080/14737140.2018.1507822] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Paola Corneli
- Dermatology Clinic, Maggiore Hospital, University of Trieste, Trieste, Italy
| | - Iris Zalaudek
- Dermatology Clinic, Maggiore Hospital, University of Trieste, Trieste, Italy
| | | | - Nicola di Meo
- Dermatology Clinic, Maggiore Hospital, University of Trieste, Trieste, Italy
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Choi J, Cho Y, Woo H. mHealth Approaches in Managing Skin Cancer: Systematic Review of Evidence-Based Research Using Integrative Mapping. JMIR Mhealth Uhealth 2018; 6:e164. [PMID: 30072362 PMCID: PMC6096168 DOI: 10.2196/mhealth.8554] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 12/26/2017] [Accepted: 06/21/2018] [Indexed: 12/26/2022] Open
Abstract
Background mHealth, which encompasses mobile health technologies and interventions, is rapidly evolving in various medical specialties, and its impact is evident in oncology. In particular, mHealth has established itself as a prominent part of dermatology for cancer screening. Intensified research to seek its use and effectiveness in each phase of the skin cancer continuum is needed in this fast-growing field of teledermatology. Objective The purpose of this review was to describe current trends in research addressing the integration of mHealth and its contributions across the skin cancer continuum. Methods A systematic review framework was applied to the search using three electronic databases: PubMed, Web of Science, and Embase. We extensively reviewed appropriate studies regarding skin cancer and mobile technology published between 2007 and 2017. Studies of the role and impact of mobile technology in the prevention and management of skin cancer were included. We selected 18 studies adhering to the inclusion and exclusion criteria for analysis. Results Of the 18 studies, 5 (28%) evaluated prevention interventions, 6 (33%) assessed diagnostic accuracy, and 7 (39%) pertained to feasibility in the context of mHealth approaches for skin cancer care. These studies portray the potential of mobile teledermatology in the prevention and management of skin cancer. However, not all phases of skin cancer involve mHealth, and not all have been addressed by research. Conclusions This review extends our knowledge not only on the contributions of mHealth technologies, but also on their integration in different phases of skin cancer care. To optimize the effectiveness of mHealth in dermatology, larger numbers of robust, evidence-based studies on teledermatology implementations, distributed evenly across the care continuum, should be conducted so that research can be expanded to systematic reviews.
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Affiliation(s)
- Jihye Choi
- Graduate School of Public Health, Department of Public Health Science, Seoul National University, Seoul, Republic Of Korea
| | - Youngtae Cho
- Graduate School of Public Health, Department of Public Health Science, Seoul National University, Seoul, Republic Of Korea
| | - Hyekyung Woo
- Graduate School of Public Health, Department of Public Health Science, Seoul National University, Seoul, Republic Of Korea
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Sharma AK, Pandey S, Sharma KH, Nerthigan Y, Khan MS, Hang DR, Wu HF. Two dimensional α-MoO 3-x nanoflakes as bare eye probe for hydrogen peroxide in biological fluids. Anal Chim Acta 2018. [DOI: 10.1016/j.aca.2018.01.057] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Duffy SA, Hall SV, Tan A, Waltje AH, Cooper SA, Heckman CJ. The Sun Solutions Intervention for Operating Engineers: A Randomized Controlled Trial. Cancer Epidemiol Biomarkers Prev 2018; 27:864-873. [PMID: 29954736 DOI: 10.1158/1055-9965.epi-17-1023] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 12/27/2017] [Accepted: 05/15/2018] [Indexed: 11/16/2022] Open
Abstract
Background: Because Operating Engineers (heavy equipment operators) are outdoor workers at risk for skin cancer, interventions are needed to promote sun safety. The objectives were to determine changes in sunscreen use and sunburning among Operating Engineers randomized to four conditions in the Sun Solutions study: (i) education only; (ii) education and text message reminders; (ii) education and mailed sunscreen; and (iv) education, text message reminders, and mailed sunscreen.Methods: In this randomized controlled trial, Operating Engineers (N = 357) were recruited at required safety training sessions throughout Michigan during winter/spring of 2012 to 2013 and provided baseline surveys. The four interventions were delivered over the summer. Postintervention surveys were collected in the fall (82.1% follow-up).Results: Sunscreen use improved significantly from baseline to follow-up in all four conditions (P < 0.05), except sunscreen use among those receiving education and text message reminders was only marginally significant (P = 0.07). There were significantly greater increases in sunscreen use in the two conditions that were mailed sunscreen (P < 0.001). There was a significant decrease in the number of reported sunburns from baseline to follow-up in all four conditions (P < 0.001), but there were no significant differences in sunburns among the groups. Participant evaluated the interventions highly with those who received mailed sunscreen rating the intervention the highest.Conclusions: Providing proper sun-safety education and minimizing barriers to sunscreen use can increase sunscreen use and decrease reported sunburns.Impact: The implementation of the Sun Solutions intervention may be an effective method to modify skin cancer-related behaviors. Cancer Epidemiol Biomarkers Prev; 27(8); 864-73. ©2018 AACR.
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Affiliation(s)
- Sonia A Duffy
- College of Nursing, Ohio State University, Columbus, Ohio. .,VA Center for Clinical Management and Research, Department of Veterans Affairs Healthcare System, Ann Arbor, Michigan.,Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
| | - Stephanie V Hall
- VA Center for Clinical Management and Research, Department of Veterans Affairs Healthcare System, Ann Arbor, Michigan
| | - Alai Tan
- College of Nursing, Ohio State University, Columbus, Ohio
| | - Andrea H Waltje
- Division of Metabolism, Endocrinology and Diabetes, University of Michigan, Ann Arbor, Michigan
| | - Samantha A Cooper
- Department of Veteran's Affairs, Serious Mental Illness Treatment Resource and Evaluation Center, Ann Arbor, Michigan
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Taber JM, Dickerman BA, Okhovat JP, Geller AC, Dwyer LA, Hartman AM, Perna FM. Skin cancer interventions across the cancer control continuum: Review of technology, environment, and theory. Prev Med 2018; 111:451-458. [PMID: 29277407 PMCID: PMC5949070 DOI: 10.1016/j.ypmed.2017.12.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 11/11/2017] [Accepted: 12/19/2017] [Indexed: 12/12/2022]
Abstract
The National Cancer Institute's Skin Cancer Intervention across the Cancer Control Continuum model was developed to summarize research and identify gaps concerning skin cancer interventions. We conducted a mapping review to characterize whether behavioral interventions addressing skin cancer prevention and control from 2000 to 2015 included (1) technology, (2) environmental manipulations (policy and/or built environment), and (3) a theoretical basis. We included 86 studies with a randomized controlled or quasi-experimental design that targeted behavioral intervention in skin cancer for children and/or adults; seven of these were dissemination or implementation studies. Of the interventions described in the remaining 79 articles, 57 promoted only prevention behaviors (e.g., ultraviolet radiation protection), five promoted only detection (e.g., skin examinations), 10 promoted both prevention and detection, and seven focused on survivorship. Of the 79 non-dissemination studies, two-thirds used some type of technology (n=52; 65.8%). Technology specific to skin cancer was infrequently used: UVR photography was used in 15.2% of studies (n=12), reflectance spectroscopy was used in 12.7% (n=10), and dermatoscopes (n=1) and dosimeters (n=2) were each used in less than 3%. Ten studies (12.7%) targeted the built environment. Fifty-two (65.8%) of the studies included theory-based interventions. The most common theories were Social Cognitive Theory (n=20; 25.3%), Health Belief Model (n=17; 21.5%), and the Theory of Planned Behavior/Reasoned Action (n=12; 15.2%). Results suggest that skin cancer specific technology and environmental manipulations are underutilized in skin cancer behavioral interventions. We discuss implications of these results for researchers developing skin cancer behavioral interventions.
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Affiliation(s)
- Jennifer M Taber
- Behavioral Research Program, National Cancer Institute, United States.
| | | | | | - Alan C Geller
- Harvard TH Chan School of Public Health, United States
| | | | - Anne M Hartman
- Behavioral Research Program, National Cancer Institute, United States
| | - Frank M Perna
- Behavioral Research Program, National Cancer Institute, United States
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Shattuck D, Haile LT, Simmons RG. Lessons From the Dot Contraceptive Efficacy Study: Analysis of the Use of Agile Development to Improve Recruitment and Enrollment for mHealth Research. JMIR Mhealth Uhealth 2018; 6:e99. [PMID: 29678802 PMCID: PMC5935800 DOI: 10.2196/mhealth.9661] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 02/16/2018] [Accepted: 03/07/2018] [Indexed: 11/13/2022] Open
Abstract
Background Smartphone apps that provide women with information about their daily fertility status during their menstrual cycles can contribute to the contraceptive method mix. However, if these apps claim to help a user prevent pregnancy, they must undergo similar rigorous research required for other contraceptive methods. Georgetown University’s Institute for Reproductive Health is conducting a prospective longitudinal efficacy trial on Dot (Dynamic Optimal Timing), an algorithm-based fertility app designed to help women prevent pregnancy. Objective The aim of this paper was to highlight decision points during the recruitment-enrollment process and the effect of modifications on enrollment numbers and demographics. Recruiting eligible research participants for a contraceptive efficacy study and enrolling an adequate number to statistically assess the effectiveness of Dot is critical. Recruiting and enrolling participants for the Dot study involved making decisions based on research and analytic data, constant process modification, and close monitoring and evaluation of the effect of these modifications. Methods Originally, the only option for women to enroll in the study was to do so over the phone with a study representative. On noticing low enrollment numbers, we examined the 7 steps from the time a woman received the recruitment message until she completed enrollment and made modifications accordingly. In modification 1, we added call-back and voicemail procedures to increase the number of completed calls. Modification 2 involved using a chat and instant message (IM) features to facilitate study enrollment. In modification 3, the process was fully automated to allow participants to enroll in the study without the aid of study representatives. Results After these modifications were implemented, 719 women were enrolled in the study over a 6-month period. The majority of participants (494/719, 68.7%) were enrolled during modification 3, in which they had the option to enroll via phone, chat, or the fully automated process. Overall, 29.2% (210/719) of the participants were enrolled via a phone call, 19.9% (143/719) via chat/IM, and 50.9% (366/719) directly through the fully automated process. With respect to the demographic profile of our study sample, we found a significant statistical difference in education level across all modifications (P<.05) but not in age or race or ethnicity (P>.05). Conclusions Our findings show that agile and consistent modifications to the recruitment and enrollment process were necessary to yield an appropriate sample size. An automated process resulted in significantly higher enrollment rates than one that required phone interaction with study representatives. Although there were some differences in demographic characteristics of enrollees as the process was modified, in general, our study population is diverse and reflects the overall United States population in terms of race/ethnicity, age, and education. Additional research is proposed to identify how differences in mode of enrollment and demographic characteristics may affect participants’ performance in the study. Trial Registration ClinicalTrials.gov NCT02833922; http://clinicaltrials.gov/ct2/show/NCT02833922 (Archived by WebCite at http://www.webcitation.org/6yj5FHrBh)
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Affiliation(s)
- Dominick Shattuck
- Institute for Reproductive Health at Georgetown University, Washington, DC, United States
| | - Liya T Haile
- Institute for Reproductive Health at Georgetown University, Washington, DC, United States
| | - Rebecca G Simmons
- Department of Obstetrics & Gynecology, University of Utah, Salt Lake City, UT, United States
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Auerbach MV, Heckman CJ, Darlow S. To protect or not to protect: examining reasons for sun protection among young women at risk for skin cancer. J Behav Med 2018; 41:528-536. [PMID: 29589257 DOI: 10.1007/s10865-018-9920-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Accepted: 03/20/2018] [Indexed: 11/26/2022]
Abstract
We aimed to further the understanding of the low rates of sun protection in young women at risk for skin cancer. Six-hundred-sixty-one daily diary entries were received via text message over 14 days from 56 young women at moderate to high risk of developing skin cancer. Women reported whether or not they used sun protection and also listed what their reasons were for using protection or not using sun protection each day. Multi-level modeling was used to examine the influence of study variables when predicting daily sun protection or lack of protection. The number of days in which sun protection was reported was positively associated with "habit" and "prevention" as reasons for protection and negatively associated with "not-needed" and "unprepared" as reasons for non-protection. Self-reported sun protection increased over the 14-day study period. Results of this study suggest the potential value of interventions aimed at motives for sun-protection behaviors.
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Affiliation(s)
- M V Auerbach
- Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, PA, 19111, USA
- Department of Psychology, Temple University, Philadelphia, PA, 19122, USA
| | - C J Heckman
- Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, PA, 19111, USA.
- Population Science, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, 08903, USA.
| | - S Darlow
- Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, PA, 19111, USA
- National Comprehensive Cancer Network, Fort Washington, PA, 19034, USA
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Rodrigues AM, Sniehotta FF, Birch-Machin MA, Olivier P, Araújo-Soares V. Acceptability and Feasibility of a Trial Testing Allocation to Sunscreen and a Smartphone App for Sun Protection: Discontinued Randomized Controlled Trial. JMIR DERMATOLOGY 2018. [DOI: 10.2196/derma.8608] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Geller AC, Jablonski NG, Pagoto SL, Hay JL, Hillhouse J, Buller DB, Kenney WL, Robinson JK, Weller RB, Moreno MA, Gilchrest BA, Sinclair C, Arndt J, Taber JM, Morris KL, Dwyer LA, Perna FM, Klein WMP, Suls J. Interdisciplinary Perspectives on Sun Safety. JAMA Dermatol 2018; 154:88-92. [PMID: 29117315 PMCID: PMC5839662 DOI: 10.1001/jamadermatol.2017.4201] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Overexposure to the sun is associated with an increased risk of melanoma and nonmelanoma skin cancer, but indications of improvements in sun protection behavior are poor. Attempts to identify emerging themes in skin cancer control have largely been driven by groups of experts from a single field. In December 2016, 19 experts from various disciplines convened for Interdisciplinary Perspectives on Skin Cancer, a 2-day meeting hosted by the National Academy of Sciences. The group discussed knowledge gaps, perspectives on sun exposure, implications for skin cancer risk and other health outcomes, and new directions. Five themes emerged from the discussion: (1) The definition of risk must be expanded, and categories for skin physiology must be refined to incorporate population diversities. (2) Risky sun exposure often co-occurs with other health-related behaviors. (3) Messages must be nuanced to target at-risk populations. (4) Persons at risk for tanning disorder must be recognized and treated. (5) Sun safety interventions must be scalable. Efficient use of technologies will be required to sharpen messages to specific populations and to integrate them within multilevel interventions. Further interdisciplinary research should address these emerging themes to build effective and sustainable approaches to large-scale behavior change.
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Affiliation(s)
- Alan C. Geller
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Nina G. Jablonski
- Department of Anthropology, The Pennsylvania State University, University Park
| | - Sherry L. Pagoto
- Department of Medicine, University of Massachusetts Medical School, Worcester
| | - Jennifer L. Hay
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Joel Hillhouse
- Community and Behavioral Health, East Tennessee State University, Johnson City
| | | | - W. Larry Kenney
- Department of Kinesiology, The Pennsylvania State University
| | - June K. Robinson
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
- Chief Editor, JAMA Dermatology
| | - Richard B. Weller
- MRC Centre for Inflammation Research, Queens Medical Research Institute, University of Edinburgh, Edinburgh, Scotland
| | - Megan A. Moreno
- Division of General Pediatrics, University of Washington, Seattle
| | - Barbara A. Gilchrest
- Department of Dermatology, Harvard Medical School and Massachusetts General Hospital, Boston
| | | | - Jamie Arndt
- Department of Psychological Sciences, University of Missouri, Columbia
| | - Jennifer M. Taber
- Department of Psychological Sciences, Kent State University, Kent, Ohio
| | | | | | | | | | - Jerry Suls
- National Cancer Institute, Rockville, Maryland
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Covolo L, Ceretti E, Moneda M, Castaldi S, Gelatti U. Does evidence support the use of mobile phone apps as a driver for promoting healthy lifestyles from a public health perspective? A systematic review of Randomized Control Trials. PATIENT EDUCATION AND COUNSELING 2017; 100:2231-2243. [PMID: 28855063 DOI: 10.1016/j.pec.2017.07.032] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2017] [Revised: 07/12/2017] [Accepted: 07/28/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE The aim of this systematic review was to find a scientific evidence on the efficacy of apps in promoting healthy lifestyles. METHODS The research was carried out according to PRISMA Statement. Pubmed, Embase and Google Scholar searches were carried out up to September 2016 focusing on randomized control trials (RCTs). RESULTS Forty RCTs were selected. Most of the studies targeted weight management, PA and healthy eating (N=35). A few RCTs focused on apps designed to sun protection, smoking cessation and alcohol consumption (N=5). Only 10 RCTs (25%) found statistical difference between intervention and control groups for all the outcomes measured. Most of the studies had a short follow-up (65%, less than 6 months) and half of them a very small sample size (fewer than 100 subjects). CONCLUSION Overall, the evidence so far showed a modest efficacy of apps in health promotion. PRACTICE IMPLICATIONS There is a need to improve the overall quality of intervention studies focused on mobile apps in order to understand if they could became a valuable tool in support of health professionals and their efforts to promote education and health.
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Affiliation(s)
- L Covolo
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Italy.
| | - E Ceretti
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Italy
| | - M Moneda
- Post-graduate School of Public Health. University of Brescia, Italy
| | - S Castaldi
- Department of Biomedical Sciences for Health, University of Milan, Italy; Quality Unit, Fondazione IRCCS Ca' Granda OMP, Italy
| | - U Gelatti
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Italy
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Tellez W, Nieto-Gutierrez W, Taype-Rondan A. Sunscreen mobile apps: A content analysis. ACTA ACUST UNITED AC 2017. [DOI: 10.1016/j.eurtel.2017.08.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Effect of a Mobile Web App on Kidney Transplant Candidates' Knowledge About Increased Risk Donor Kidneys: A Randomized Controlled Trial. Transplantation 2017; 101:1167-1176. [PMID: 27463536 DOI: 10.1097/tp.0000000000001273] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Kidney transplant candidates (KTCs) must provide informed consent to accept kidneys from increased risk donors (IRD), but poorly understand them. We conducted a multisite, randomized controlled trial to evaluate the efficacy of a mobile Web application, Inform Me, for increasing knowledge about IRDs. METHODS Kidney transplant candidates undergoing transplant evaluation at 2 transplant centers were randomized to use Inform Me after routine transplant education (intervention) or routine transplant education alone (control). Computer adaptive learning method reinforced learning by embedding educational material, and initial (test 1) and additional test questions (test 2) into each chapter. Knowledge (primary outcome) was assessed in person after education (tests 1 and 2), and 1 week later by telephone (test 3). Controls did not receive test 2. Willingness to accept an IRD kidney (secondary outcome) was assessed after tests 1 and 3. Linear regression test 1 knowledge scores were used to test the significance of Inform Me exposure after controlling for covariates. Multiple imputation was used for intention-to-treat analysis. RESULTS Two hundred eighty-eight KTCs participated. Intervention participants had higher test 1 knowledge scores (mean difference, 6.61; 95% confidence interval [95% CI], 5.37-7.86) than control participants, representing a 44% higher score than control participants' scores. Intervention participants' knowledge scores increased with educational reinforcement (test 2) compared with control arm test 1 scores (mean difference, 9.50; 95% CI, 8.27-10.73). After 1 week, intervention participants' knowledge remained greater than controls' knowledge (mean difference, 3.63; 95% CI, 2.49-4.78) (test 3). Willingness to accept an IRD kidney did not differ between study arms at tests 1 and 3. CONCLUSIONS Inform Me use was associated with greater KTC knowledge about IRD kidneys above routine transplant education alone.
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Abstract
With the advancement of mobile technologies, smartphone applications (apps) have become widely available and gained increasing attention as a novel tool to deliver dermatologic care. This article presents a review of various apps for skin monitoring and melanoma detection and a discussion of current limitations in the field of dermatology. Concerns regarding quality, transparency, and reliability have emerged because there are currently no established quality standards or regulatory oversight of mobile medical apps. Only a few apps have been evaluated clinically. Further research is needed to evaluate the utility and efficacy of smartphone apps in skin cancer screening and early melanoma detection.
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Darlow S, Heckman C. Results From a Tailored SMS and Behavior-Tracking Pilot Study on Sun-Safe Behaviors in Young Women. HEALTH EDUCATION & BEHAVIOR 2017; 44:937-944. [PMID: 28363246 DOI: 10.1177/1090198117699507] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The elevated rates of ultraviolet radiation (UVR) exposure and low rates of sun protection in young adult women indicate a need for age- and gender-appropriate interventions that address these behaviors. AIMS To examine the effects of daily behavior tracking and individually tailored text messages on sun protection and UVR exposure behaviors in young adult women at moderate to high risk of developing skin cancer. METHOD One hundred and four young adult women at risk of skin cancer were randomized to receive the behavior-tracking intervention only, tailored text messages only, both interventions, or neither. Outcomes were self-reported UVR exposure and sun protection behaviors. RESULTS Those who received the behavior-tracking intervention reported significantly fewer UVR exposure behaviors at 4-week follow-up, relative to those who did not receive behavior tracking. At 4-week follow-up, those who received daily tailored text messages reported significantly greater UVR exposure behaviors but were more likely to report wearing a hat as a form of sun protection, relative to those who did not receive tailored messages. DISCUSSION Daily behavior tracking may be repetitive, but repetition may facilitate cognitive processing and the development of healthy habits. Health messages that are less interactive, on the other hand, need to be adequately tailored and delivered with the most advantageous timing to be impactful. CONCLUSION Future research should continue to examine how these interventions differentially affect behavior and how they can be adapted to apply to other health behaviors.
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Affiliation(s)
- Susan Darlow
- 1 National Comprehensive Cancer Network, Washington, PA, USA
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Can an educational application increase risk perception accuracy amongst patients attending a high-risk breast cancer clinic? Breast 2017; 32:192-198. [PMID: 28237842 DOI: 10.1016/j.breast.2017.02.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Revised: 02/14/2017] [Accepted: 02/15/2017] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES To design, develop and test the effect of an educational initiative to improve risk perception amongst patients attending a high-risk breast cancer clinic. This was achieved through three objectives - 1. identifying an optimal method of presenting risk data, 2. designing and building a risk application, and 3. testing the ability of the application to successfully modify patients perceived risk of cancer. MATERIALS AND METHODS A mobile application was developed for this project using best practice methods for displaying risk information. Patients (n = 84) were randomly allocated into two groups - 'Control' or 'Treatment'. Both groups underwent standard risk counseling while the application was employed in the 'Treatment' group. The patients were surveyed before their session, immediately after and six weeks later. RESULTS Increases in accuracy were seen in both groups with larger increases demonstrated in the 'Treatment' group with 'Personal 10 Year Risk' statistically significant ('Control' group increase from 21% to 48% vs the 'Treatment' group increase from 33% to 71% - p = 0.003). CONCLUSION This project demonstrated trends towards improved risk perception, however mixed logistic regression was unable to show a 30% difference between groups. Numerical literacy and understanding of risk were identified as issues amongst the general population. Overestimating risk remains high amongst attendees. Using mobile applications to convey risk information to patients is a new and evolving area with a corresponding paucity of data. We have demonstrated its potential and emphasised the importance of designing how this information is communicated to patients in order to make it understandable and meaningful.
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Bowen D, Jabson J, Kamen C. mHealth: an avenue for promoting health among sexual and gender minority populations? Mhealth 2016; 2:36. [PMID: 28293609 PMCID: PMC5344165 DOI: 10.21037/mhealth.2016.09.01] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Accepted: 09/02/2016] [Indexed: 11/06/2022] Open
Affiliation(s)
- Deborah Bowen
- Department of Bioethics and Humanities, University of Washington, Seatle, WA 98195, USA
| | - Jennifer Jabson
- Department of Public Health, University of Tennessee, Knoxville, TN 37902, USA
| | - Charles Kamen
- Department of Surgery, University of Rochester, Rochester, NY 14614, USA
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