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Gosselin S, Thaivalappil A, Papadopoulos A, McWHIRTER JE. Public Health Messaging to Address Indoor Tanning: A Scoping Review. JOURNAL OF HEALTH COMMUNICATION 2023; 28:241-253. [PMID: 36992625 DOI: 10.1080/10810730.2023.2196519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Indoor tanning (IT) is an avoidable skin cancer risk. Although numerous communication interventions have been assessed for IT deterrence, less attention has been paid to the persuasive messages within these interventions. This scoping review summarizes the current peer-reviewed literature on persuasive messages for IT. Overall, 20 articles (21 studies) were included. Most were experimental or quasi-experimental and conducted in the US. Participants were mostly young women who had tanned indoors before. Few studies evaluated persuasive theme; in those that did, health and appearance themes were effective. Narrative and statistical evidence formats were also effective. The included studies also supported normative messages, loss-framed messages, and images. Improved reporting on message design and evaluation would be beneficial for future evidence synthesis. Our understanding of persuasive messages for IT has expanded in recent years, but more research is needed to optimize them.
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Affiliation(s)
- Sydney Gosselin
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - Abhinand Thaivalappil
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - Andrew Papadopoulos
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - Jennifer E McWHIRTER
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
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2
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Buller DB, Pagoto S, Henry KL, Baker K, Walkosz BJ, Hillhouse J, Berteletti J, Bibeau J. Effects of Engagement with a Social Media Campaign for Mothers to Prevent Indoor Tanning by Teens in a Randomized Trial. JOURNAL OF HEALTH COMMUNICATION 2022; 27:394-406. [PMID: 35993376 PMCID: PMC9643633 DOI: 10.1080/10810730.2022.2113839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
In a social media campaign aimed at reducing mothers' permissiveness for indoor tanning (IT) by their teenage daughters, a secondary analysis of campaign engagement effects on IT outcomes was performed. Mothers (n = 869) with daughters aged 14-17 were recruited in 34 states that did not ban IT by minors under age 18 for a randomized trial with follow-up at 12 months (end of intervention) and 18 months (6 months after intervention) post-randomization. Daughters' (n = 469) baseline and follow-up responses were analyzed too. Mothers received a Facebook feed on adolescent health topics that included posts about preventing IT (intervention) or prescription drug misuse (control). Engagement was measured by extracting reactions (e.g., like, sad, etc.) and comments posted by mothers to the campaign posts. Overall, 76.4% of posts received a reaction and/or comment. Mothers who engaged with IT posts were less permissive of daughters' IT immediately at the conclusion of the campaign (permit IT: -0.39, p < .05; facilitate IT: -0.29, p < .05) and 6 months after intervention (permit IT: -0.32, p < .05; facilitate IT: -0.31, p < .05) than mothers who did not engage with posts. Engagement with posts was essential to the success of a social media campaign for preventing IT by minors by reducing mothers' permissiveness.
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Affiliation(s)
| | - Sherry Pagoto
- Department of Allied Health Sciences, University of Connecticut, Storrs, Connecticut, USA
| | - Kimberly L Henry
- Department of Psychology, Colorado State University, Ft. Collins, Colorado, USA
| | - Katie Baker
- Department of Community and Behavioral Health, College of Public Health, Sherrod Library 353, East Tennessee State University, Johnson City, Tennessee, USA
| | | | - Joel Hillhouse
- Department of Community and Behavioral Health, College of Public Health, Lamb Hall, Suite 300, East Tennessee State University, Johnson City, Tennessee, USA
| | | | - Jessica Bibeau
- Department of Allied Health Sciences, University of Connecticut, Storrs, Connecticut, USA
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Myrick JG, Waldron KA, Cohen O, DiRusso C, Shao R, Cho E, Willoughby JF, Turrisi R. The Effects of Embedded Skin Cancer Interventions on Sun-Safety Attitudes and Attention Paid to Tan Women on Instagram. Front Psychol 2022; 13:838297. [PMID: 35465513 PMCID: PMC9029166 DOI: 10.3389/fpsyg.2022.838297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 02/28/2022] [Indexed: 11/13/2022] Open
Abstract
Background and Objectives Because of high skin cancer risks for young women, it is vital that effective interventions reach and influence this demographic. Visual social media platforms, like Instagram, are popular with young women and are an appropriate intervention site; yet, they also host competing images idealizing tan skin. The present study tested the ability of digital sun-safety interventions to affect self-control-related emotions and visual attention to subsequent tan-ideal images as well as sun-safety attitudes. Methods Women were recruited from a large public Mid-Atlantic university in the United States. Participants (N = 120) were randomly assigned to view an appearance benefits intervention, a self-control emotions intervention, or a control message, each designed to look like an Instagram sponsored story. After self-reporting self-compassion and anticipated pride, participants then viewed seven pairs of Instagram posts featuring either tan or pale women while an eye tracker assessed visual attention. Finally, participants self-reported their responses to questions assessing sun-safety-related norms, efficacy, and attitudes. Results A mixed design analysis of covariance revealed that women who first viewed the appearance benefits intervention story spent less time visually fixated on Instagram images of tan women than did those who viewed the self-control emotions intervention or control message (p = 0.005, ηp2 = 0.087). Regressions also revealed interactions between the intervention conditions and feelings of anticipated pride on both visual attention and sun-safety attitudes. Conclusion Sponsored stories on Instagram can promote sun-safety attitudes, depending on the emotional responses they generate. Additionally, sponsored interventions can affect subsequent visual attention.
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Affiliation(s)
- Jessica Gall Myrick
- Donald P. Bellisario College of Communications, Pennsylvania State University, University Park, PA, United States
- *Correspondence: Jessica Gall Myrick,
| | - Katja Anne Waldron
- College of Health and Human Development, Pennsylvania State University, University Park, PA, United States
| | - Olivia Cohen
- Donald P. Bellisario College of Communications, Pennsylvania State University, University Park, PA, United States
| | | | - Ruosi Shao
- Donald P. Bellisario College of Communications, Pennsylvania State University, University Park, PA, United States
| | - Eugene Cho
- Department of Communication Studies, The College of New Jersey, Ewing Township, NJ, United States
| | - Jessica Fitts Willoughby
- Edward R. Murrow College of Communication, Washington State University, Pullman, WA, United States
| | - Rob Turrisi
- College of Health and Human Development, Pennsylvania State University, University Park, PA, United States
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Bowers JM, Hamilton JG, Wu YP, Moyer A, Hay JL. Acculturation, Sun Tanning Behavior, and Tanning Attitudes Among Asian College Students in the Northeastern USA. Int J Behav Med 2022; 29:25-35. [PMID: 33942255 PMCID: PMC9272584 DOI: 10.1007/s12529-021-09993-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND College students participate in high levels of tanning, a skin cancer risk behavior due to ultraviolet radiation exposure, yet little is known about Asian college students' behavior. This study examined the relationship between tanning attitudes, acculturation to the USA (cultural assimilation), and tanning behavior. METHOD An online survey was used to recruit 211 Asian college students in the northeastern USA (47.4% born outside of the USA) to respond to questions about recent tanning behavior, sun protection strategies, attitudes about tanning, and acculturation to the USA. RESULTS Attitudes about tanning, particularly desire for a darker skin tone and social norms, along with acculturation to the USA, were predictive of intentional tanning. The sample reported high levels of sun protection, which was associated with low acculturation. CONCLUSION The significant role of acculturation in this study indicates that it may be a useful factor to include in future tanning intervention studies of relevant populations.
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Affiliation(s)
- Jennifer M. Bowers
- Department of Psychology, Stony Brook University, 100 Nichols Road, Stony Brook, NY 11794-2500, USA,Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY 10022, USA
| | - Jada G. Hamilton
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY 10022, USA
| | - Yelena P. Wu
- Department of Dermatology, University of Utah, Salt Lake City, UT 84132, USA
| | - Anne Moyer
- Department of Psychology, Stony Brook University, 100 Nichols Road, Stony Brook, NY 11794-2500, USA
| | - Jennifer L. Hay
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY 10022, USA
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Persisting Effects of a Social Media Campaign to Prevent Indoor Tanning: A Randomized Trial. Cancer Epidemiol Biomarkers Prev 2022; 31:885-892. [DOI: 10.1158/1055-9965.epi-21-0059] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 05/10/2021] [Accepted: 01/10/2022] [Indexed: 11/16/2022] Open
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Beattie MM, Konttinen HM, Volanen SM, Hankonen NE. Latent profile analysis as a method for process evaluations: Discovering response subgroups in a mindfulness intervention. Soc Sci Med 2022; 296:114748. [DOI: 10.1016/j.socscimed.2022.114748] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 12/16/2021] [Accepted: 01/24/2022] [Indexed: 11/16/2022]
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Buller DB, Pagoto S, Baker K, Walkosz BJ, Hillhouse J, Henry KL, Berteletti J, Bibeau J. Results of a social media campaign to prevent indoor tanning by teens: A randomized controlled trial. Prev Med Rep 2021; 22:101382. [PMID: 33996394 PMCID: PMC8100627 DOI: 10.1016/j.pmedr.2021.101382] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 04/07/2021] [Accepted: 04/10/2021] [Indexed: 01/01/2023] Open
Abstract
Indoor tanning (IT) increases risk of developing skin cancer. A social media campaign to reduce mother’s permissiveness toward their teenage daughters IT was evaluated. Mothers (N = 869) of daughters aged 14–17 in 34 states without bans on IT by minors were enrolled in a randomized trial with assessments at baseline and 12-months follow-up in 2017–19. A year-long adolescent health campaign was delivered to all mothers. The intervention group received posts on preventing IT and the control group, posts about preventing prescription drug misuse. Daughters (n = 469; 54.0%) completed the assessments at baseline and 12 months. At 12-month follow-up, intervention-group mothers were less permissive of IT by daughters (unadjusted means = 1.70 [95% CI: 1.59, 1.80] v. 1.85 [1.73, 1.97] [5-point Likert scale], b = -0.152), reported more communication about avoiding IT with daughters (4.09 [3.84, 4.35] v. 3.42 [3.16, 3.68] [sum of 7 yes/no items], b = 0.213), and had lower intentions to indoor tan (1.41 [1.28, 1.55] v. 1.60 [1.43, 1.76] [7-point likelihood scale], b = -0.221) than control-group mothers. Daughters confirmed intervention-group mothers communicated about IT (3.81 [3.49, 4.14] v. 3.20 [2.87, 3.53] [sum of 7 yes/no items], b = 0.237) and shared IT posts (unadjusted percentages = 52.4% v. 36.4%, b = 0.438) more than control-group mothers. No differences were found in IT behavior, self-efficacy to refuse permission, and negative attitudes toward IT. A social media campaign may be an effective strategy to convince mothers to withhold permission for IT, which may help increase the effectiveness of state laws designed to reduce IT by minors by requiring parental permission.
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Affiliation(s)
- David B Buller
- Klein Buendel, Inc., 1667 Cole Boulevard, Suite 225, Golden, CO 80401, United States
| | - Sherry Pagoto
- Department of Allied Health Sciences, Koons Hall, University of Connecticut, Storrs, CT 06269, United States
| | - Katie Baker
- Department of Community and Behavioral Health, College of Public Health, Lamb Hall, Suite 300, East Tennessee State University, Johnson City, TN 37614, United States
| | - Barbara J Walkosz
- Klein Buendel, Inc., 1667 Cole Boulevard, Suite 225, Golden, CO 80401, United States
| | - Joel Hillhouse
- Department of Community and Behavioral Health, College of Public Health, Lamb Hall, Suite 300, East Tennessee State University, Johnson City, TN 37614, United States
| | - Kimberly L Henry
- Department of Psychology, Colorado State University, Ft. Collins, CO 80523, United States
| | - Julia Berteletti
- Klein Buendel, Inc., 1667 Cole Boulevard, Suite 225, Golden, CO 80401, United States
| | - Jessica Bibeau
- Department of Allied Health Sciences, Koons Hall, University of Connecticut, Storrs, CT 06269, United States
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Basch CH, Hillyer GC, Kecojevic A, Ku CS, Basch CE. Indoor tanning and poor mental health among adolescents in New York City (2015). J Health Psychol 2019; 26:870-879. [DOI: 10.1177/1359105319852668] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This study explored relationships between mental health and indoor tanning among high school students in New York City using 2015 data from the Youth Risk Behavior Surveillance System. Those more likely to use indoor tanning were females (odds ratio = 6.26, 95% confidence interval = 6.08–6.45) and non-Hispanic White (odds ratio = 1.10, 95% confidence interval = 1.06–1.14). Being bullied on school property (odds ratio = 1.30, 95% confidence interval = 1.25–1.34), having attempted suicide (odds ratio = 2.08, 95% confidence interval = 1.99–2.18), and having sought counseling (odds ratio = 1.22, 95% confidence interval = 1.18–1.26) were significantly associated with indoor tanning. This study indicates that engaging in indoor tanning is associated with a number of mental health factors.
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Qin J, Holman DM, Jones SE, Berkowitz Z, Guy GP. State Indoor Tanning Laws and Prevalence of Indoor Tanning Among US High School Students, 2009-2015. Am J Public Health 2018; 108:951-956. [PMID: 29771612 DOI: 10.2105/ajph.2018.304414] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVES To examine the association between state indoor tanning laws and indoor tanning behavior using nationally representative samples of US high school students younger than 18 years. METHODS We combined data from the 2009, 2011, 2013, and 2015 national Youth Risk Behavior Surveys (n = 41 313) to analyze the association between 2 types of state indoor tanning laws (age restriction and parental permission) and the prevalence of indoor tanning during the 12 months before the survey, adjusting for age, race/ethnicity, and survey year, and stratified by gender. RESULTS Age restriction laws were associated with a 47% (P < .001) lower indoor tanning prevalence among female high school students. Parental permission laws were not found to be associated with indoor tanning prevalence among either female or male high school students. CONCLUSIONS Age restriction laws could contribute to less indoor tanning, particularly among female high school students. Such reductions may reduce the health and economic burden of skin cancer.
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Affiliation(s)
- Jin Qin
- Jin Qin, Dawn M. Holman, Zahava Berkowitz, and Gery P. Guy Jr are with the Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA. Sherry Everett Jones is with the Division of Adolescent and School Health, Centers for Disease Control and Prevention, Atlanta, GA
| | - Dawn M Holman
- Jin Qin, Dawn M. Holman, Zahava Berkowitz, and Gery P. Guy Jr are with the Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA. Sherry Everett Jones is with the Division of Adolescent and School Health, Centers for Disease Control and Prevention, Atlanta, GA
| | - Sherry Everett Jones
- Jin Qin, Dawn M. Holman, Zahava Berkowitz, and Gery P. Guy Jr are with the Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA. Sherry Everett Jones is with the Division of Adolescent and School Health, Centers for Disease Control and Prevention, Atlanta, GA
| | - Zahava Berkowitz
- Jin Qin, Dawn M. Holman, Zahava Berkowitz, and Gery P. Guy Jr are with the Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA. Sherry Everett Jones is with the Division of Adolescent and School Health, Centers for Disease Control and Prevention, Atlanta, GA
| | - Gery P Guy
- Jin Qin, Dawn M. Holman, Zahava Berkowitz, and Gery P. Guy Jr are with the Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA. Sherry Everett Jones is with the Division of Adolescent and School Health, Centers for Disease Control and Prevention, Atlanta, GA
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Brinker TJ, Heckl M, Gatzka M, Heppt MV, Resende Rodrigues H, Schneider S, Sondermann W, de Almeida E Silva C, Kirchberger MC, Klode J, Enk AH, Knispel S, von Kalle C, Stoffels I, Schadendorf D, Nakamura Y, Esser S, Assis A, Bernardes-Souza B. A Skin Cancer Prevention Facial-Aging Mobile App for Secondary Schools in Brazil: Appearance-Focused Interventional Study. JMIR Mhealth Uhealth 2018. [PMID: 29523502 PMCID: PMC5866300 DOI: 10.2196/mhealth.9794] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Background The incidence of melanoma is increasing faster than any other major cancer both in Brazil and worldwide. Southeast Brazil has especially high incidences of melanoma, and early detection is low. Exposure to ultraviolet (UV) radiation is a primary risk factor for developing melanoma. Increasing attractiveness is a major motivation among adolescents for tanning. A medical student-delivered intervention that takes advantage of the broad availability of mobile phones and adolescents’ interest in their appearance indicated effectiveness in a recent study from Germany. However, the effect in a high-UV index country with a high melanoma prevalence and the capability of medical students to implement such an intervention remain unknown. Objective In this pilot study, our objective was to investigate the preliminary success and implementability of a photoaging intervention to prevent skin cancer in Brazilian adolescents. Methods We implemented a free photoaging mobile phone app (Sunface) in 15 secondary school classes in southeast Brazil. Medical students “mirrored” the pupils’ altered 3-dimensional (3D) selfies reacting to touch on tablets via a projector in front of their whole grade accompanied by a brief discussion of means of UV protection. An anonymous questionnaire capturing sociodemographic data and risk factors for melanoma measured the perceptions of the intervention on 5-point Likert scales among 356 pupils of both sexes (13-19 years old; median age 16 years) in grades 8 to 12 of 2 secondary schools in Brazil. Results We measured more than 90% agreement in both items that measured motivation to reduce UV exposure and only 5.6% disagreement: 322 (90.5%) agreed or strongly agreed that their 3D selfie motivated them to avoid using a tanning bed, and 321 (90.2%) that it motivated them to improve their sun protection; 20 pupils (5.6%) disagreed with both items. The perceived effect on motivation was higher in female pupils in both tanning bed avoidance (n=198, 92.6% agreement in females vs n=123, 87.2% agreement in males) and increased use of sun protection (n=197, 92.1% agreement in females vs n=123, 87.2% agreement in males) and independent of age or skin type. All medical students involved filled in a process evaluation revealing that they all perceived the intervention as effective and unproblematic, and that all pupils tried the app in their presence. Conclusions The photoaging intervention was effective in changing behavioral predictors for UV protection in Brazilian adolescents. The predictors measured indicated an even higher prospective effectiveness in southeast Brazil than in Germany (>90% agreement in Brazil vs >60% agreement in Germany to both items that measured motivation to reduce UV exposure) in accordance with the theory of planned behavior. Medical students are capable of complete implementation. A randomized controlled trial measuring prospective effects in Brazil is planned as a result of this study.
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Affiliation(s)
- Titus Josef Brinker
- Department of Dermatology, University Hospital Heidelberg, University of Heidelberg, Heidelberg, Germany.,Department of Translational Oncology, National Center for Tumor Diseases, German Cancer Research Center, Heidelberg, Germany
| | - Marlene Heckl
- Department of Dermatology, University Medical Center Munich, University of Munich, Munich, Germany
| | - Martina Gatzka
- Department of Dermatology and Allergic Diseases, Ulm University Hospital, University of Ulm, Ulm, Germany
| | - Markus V Heppt
- Department of Dermatology, University Medical Center Munich, University of Munich, Munich, Germany
| | | | - Sven Schneider
- Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Wiebke Sondermann
- Department of Dermatology, Venereology and Allergology, University-Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | | | - Michael C Kirchberger
- Department of Dermatology, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | - Joachim Klode
- Department of Dermatology, Venereology and Allergology, University-Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Alexander H Enk
- Department of Dermatology, University Hospital Heidelberg, University of Heidelberg, Heidelberg, Germany
| | - Sarah Knispel
- Department of Dermatology, Venereology and Allergology, University-Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Christof von Kalle
- Department of Translational Oncology, National Center for Tumor Diseases, German Cancer Research Center, Heidelberg, Germany
| | - Ingo Stoffels
- Department of Dermatology, Venereology and Allergology, University-Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Dirk Schadendorf
- Department of Dermatology, Venereology and Allergology, University-Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Yasuhiro Nakamura
- Department of Skin Oncology/Dermatology, Saitama Medical University International Medical Center, Saitama, Germany
| | - Stefan Esser
- Department of Dermatology, Venereology and Allergology, University-Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Aisllan Assis
- School of Medicine, Federal University of Ouro Preto, Ouro Preto, Brazil
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Brinker TJ, Faria BL, Gatzka M, de Faria OM, Heppt MV, Kirchberger MC, Schadendorf D, Nakamura Y, Buslaff F, Lisboa OC, Oliveira ACC, Lino HA, Bernardes-Souza B. A skin cancer prevention photoageing intervention for secondary schools in Brazil delivered by medical students: protocol for a randomised controlled trial. BMJ Open 2018; 8:e018299. [PMID: 29511007 PMCID: PMC5855446 DOI: 10.1136/bmjopen-2017-018299] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2017] [Revised: 12/05/2017] [Accepted: 12/07/2017] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION The incidence of melanoma is increasing faster than any other major cancer both in Brazil and worldwide. The Southeast of Brazil has especially high incidences of melanoma, and early detection is low. Exposure to UV radiation represents a primary risk factor for developing melanoma. Increasing attractiveness is a major motivation for adolescents for tanning. A medical student-delivered intervention that harnesses the broad availability of mobile phones as well as adolescents' interest in their appearance may represent a novel method to improve skin cancer prevention. METHODS AND ANALYSIS We developed a free mobile app (Sunface), which will be implemented in at least 30 secondary school classes, each with 21 students (at least 30 classes with 21 students for control) in February 2018 in Southeast Brazil via a novel method called mirroring. In a 45 min classroom seminar, the students' altered three-dimensional selfies on tablets are 'mirrored' via a projector in front of their entire class, showing the effects of unprotected UV exposure on their future faces. External block randomisation via computer is performed on the class level with a 1:1 allocation. Sociodemographic data, as well as skin type, ancestry, UV protection behaviour and its predictors are measured via a paper-pencil questionnaire before as well as at 3 and 6 months postintervention. The primary end point is the group difference in the 30-day prevalence of daily sunscreen use at a 6-month follow-up. Secondary end points include (1) the difference in daily sunscreen use at a 3-month follow-up, (2) if a self-skin examination in accordance with the ABCDE rule was performed within the 6-month follow-up and (3) the number of tanning sessions. ETHICS AND DISSEMINATION Ethical approval was obtained from the ethics committee of the University of Itauna. Results will be disseminated at conferences and in peer-reviewed journals. TRIAL REGISTRATION NUMBER NCT03178240; Pre-results.
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Affiliation(s)
- Titus Josef Brinker
- Department of Dermatology, University Hospital Heidelberg, University of Heidelberg, Heidelberg, Germany
- National Center for Tumor Diseases (NCT), University Hospital Heidelberg, University of Heidelberg, Heidelberg, Germany
- Department of Dermatology, Venerology and Allergology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | | | - Martina Gatzka
- Department of Dermatology and Allergic Diseases, University of Ulm, Ulm, Germany
| | | | - Markus V Heppt
- Department of Dermatology and Allergology, University Medical Center Munich, Munich, Germany
| | - Michael C Kirchberger
- Department of Dermatology, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Dirk Schadendorf
- Department of Dermatology, Venerology and Allergology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Yasuhiro Nakamura
- Department of Skin Oncology/Dermatology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Fabian Buslaff
- Department of Dermatology, University Hospital Heidelberg, University of Heidelberg, Heidelberg, Germany
- National Center for Tumor Diseases (NCT), University Hospital Heidelberg, University of Heidelberg, Heidelberg, Germany
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Persson S, Benn Y, Dhingra K, Clark-Carter D, Owen AL, Grogan S. Appearance-based interventions to reduce UV exposure: A systematic review. Br J Health Psychol 2018; 23:334-351. [PMID: 29356215 DOI: 10.1111/bjhp.12291] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Revised: 12/12/2017] [Indexed: 01/17/2023]
Abstract
PURPOSE As a majority of skin cancer cases are behaviourally preventable, it is crucial to develop effective strategies to reduce UV exposure. Health-focused interventions have not proved to be sufficiently effective, and it has been suggested that people might be more susceptible to information about the negative effects of the sun on their appearance. METHOD This systematic review of 30 separate papers, reporting 33 individual studies published between 2005 and 2017, assesses the overall effectiveness of appearance interventions on participants' UV exposure and sun protection behaviour. RESULTS Appearance-based interventions have positive effects on sun exposure and sun protection, immediately after the intervention as well as up to 12 months afterwards. The meta-analysis found a medium effect size on sun protection intentions for interventions which combined UV photography and photoageing information: r+ = .424; k = 3, N = 319, CI = 0.279-0.568, p = .023. CONCLUSIONS This review provides a current perspective on the effectiveness of appearance-based interventions to reduce UV exposure, and also highlights methodological issues. It recommends that practitioners administer a UV photo intervention in combination with photoageing information to reduce UV exposure. Furthermore, the review specifically recommends that future research focuses on the use of theoretical constructs to enhance photoageing information and is conducted with older participants and in countries where people have less opportunity for sun exposure. Statement of contribution What is already known on this subject? Appearance-focused interventions may in some cases be more effective than health-focused interventions in reducing UV exposure, as the underlying motivations for tanning are associated with appearance concerns. Previous reviews and meta-analyses have indicated that appearance-focused interventions such as photoageing and UV photo are associated with positive effects in reducing UV exposure and/or increasing sun protection. Previous reviews identified methodological issues with research on this topic, which included limited a priori power calculations and a general lack of long-term follow-ups. What does this study add? This review concludes that photoageing information in combination with UV photo is associated with a medium positive effect size on sun protection intentions. Photoageing can be manipulated according to theoretical constructs (e.g., Theory of Alternative Behaviours), which may contribute to its effectiveness. Issues such as homogeneity of settings and participants and limited a priori power calculations in the included studies have been identified. This review specifically recommends that future research is conducted in locations with less overall sun exposure, and with a more diverse participant range (e.g., more males and older participants).
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Affiliation(s)
| | - Yael Benn
- Manchester Metropolitan University, UK
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13
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Hillhouse J, Turrisi R, Scaglione NM, Cleveland MJ, Baker K, Florence LC. A Web-Based Intervention to Reduce Indoor Tanning Motivations in Adolescents: a Randomized Controlled Trial. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2017; 18:131-140. [PMID: 27549602 DOI: 10.1007/s11121-016-0698-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Youthful indoor tanning as few as ten sessions can increase the risk of melanoma by two to four times with each additional session adding another 2 % to the risk. Recent research estimates that indoor tanning can be linked to approximately 450,000 cases of skin cancer annually in the USA, Europe, and Australia. Despite these risks, indoor tanning remains popular with adolescents. This study tested the efficacy of a web-based skin cancer prevention intervention designed to reduce indoor tanning motivations in adolescent females. A nationally representative sample of 443 female teens was enrolled from an online panel into a two-arm, parallel group design, randomized controlled trial. Treatment participants received an appearance-focused intervention grounded in established health behavior change models. Controls viewed a teen alcohol prevention website. Outcome variables included willingness and intentions to indoor tan, willingness to sunless tan, and measures of indoor tanning attitudes and beliefs. The intervention decreased willingness and intentions to indoor tan and increased sunless tanning willingness relative to controls. We also examined indirect mechanisms of change through intervening variables (e.g., indoor tanning attitudes, norms, positive and negative expectancies) using the product of coefficient approach. The web-based intervention demonstrated efficacy in changing adolescent indoor tanning motivations and improving their orientation toward healthier alternatives. Results from the intervening variable analyses give guidance to future adolescent skin cancer prevention interventions.
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Affiliation(s)
- Joel Hillhouse
- Department of Community and Behavioral Health, College of Public Health, The Academic Health Sciences Center, East Tennessee State University, Johnson City, TN, 37614, USA.
| | - Rob Turrisi
- Department of Biobehavioral Health, Pennsylvania State University, University Park, PA, 16802, USA.,Bennett Pierce Prevention Research Center, Pennsylvania State University, University Park, PA, 16802, USA
| | - Nichole M Scaglione
- Department of Biobehavioral Health, Pennsylvania State University, University Park, PA, 16802, USA
| | - Michael J Cleveland
- Bennett Pierce Prevention Research Center, Pennsylvania State University, University Park, PA, 16802, USA.,Department of Human Development, Washington State University, Pullman, WA, 99164, USA
| | - Katie Baker
- Department of Community and Behavioral Health, College of Public Health, The Academic Health Sciences Center, East Tennessee State University, Johnson City, TN, 37614, USA
| | - L Carter Florence
- Department of Community and Behavioral Health, College of Public Health, The Academic Health Sciences Center, East Tennessee State University, Johnson City, TN, 37614, USA
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14
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Mays D, Atkins MB, Ahn J, Tercyak KP. Indoor Tanning Dependence in Young Adult Women. Cancer Epidemiol Biomarkers Prev 2017; 26:1636-1643. [PMID: 29051341 DOI: 10.1158/1055-9965.epi-17-0403] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 07/05/2017] [Accepted: 08/10/2017] [Indexed: 11/16/2022] Open
Abstract
Background: There is mounting evidence that young people can develop a dependence on indoor tanning, but research on factors associated with indoor tanning dependence remains limited.Methods: This cross-sectional study investigated factors associated with indoor tanning dependence in a community sample of 389 non-Hispanic white young adult women ages 18 to 30 who had indoor tanned ≥1 time in the past year. Participants completed measures of indoor tanning dependence, including the modified CAGE and modified Diagnostic and Statistical Manual for Mental Disorders-IV psychiatric screening assessments, indoor tanning behavior and beliefs, and behavioral and psychiatric comorbidity.Results: Overall, 22.6% of the sample screened positive for indoor tanning dependence. In multivariable analyses, indoor tanning dependence was associated with younger age of indoor tanning initiation [adjusted odds ratio (aOR) = 0.79; P = 0.017], indoor tanning ≥20 times in the past year (aOR = 3.03; P = 0.015), stronger beliefs about the benefits of tanning (aOR = 2.15; P = 0.004), greater perceived susceptibility to indoor tanning risks (aOR = 2.72; P < 0.001), stronger beliefs about physical appearance (aOR = 1.73; P = 0.037), and depressive symptoms (aOR = 3.79; P < 0.001).Conclusions: Indoor tanning dependence among young, non-Hispanic white women is associated with behaviors that increase the risk of skin cancer, beliefs favoring the perceived benefits of tanning, and comorbid risks such as stronger beliefs about physical appearance and depressed mood.Impact: Comprehensive skin cancer prevention efforts should address indoor tanning dependence among young women and its leading risk factors. Cancer Epidemiol Biomarkers Prev; 26(11); 1636-43. ©2017 AACR.
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Affiliation(s)
- Darren Mays
- Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC.
| | - Michael B Atkins
- Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC
| | - Jaeil Ahn
- Department of Biostatistics, Bioinformatics, and Biomathematics, Georgetown University Medical Center, Washington, DC
| | - Kenneth P Tercyak
- Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC
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15
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Brinker TJ, Brieske CM, Schaefer CM, Buslaff F, Gatzka M, Petri MP, Sondermann W, Schadendorf D, Stoffels I, Klode J. Photoaging Mobile Apps in School-Based Melanoma Prevention: Pilot Study. J Med Internet Res 2017; 19:e319. [PMID: 28887295 PMCID: PMC5610355 DOI: 10.2196/jmir.8661] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 08/30/2017] [Accepted: 08/30/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Around 90% of melanomas are caused by exposure to ultraviolet (UV) radiation and are therefore eminently preventable. Tanning behavior is mostly initiated in early adolescence, often with the belief that it increases attractiveness; the problems related to malignant melanoma and other skin cancers are too far in the future to fathom. Given the substantial amount of time children and adolescents spend in schools, as well as with their mobile phones, addressing melanoma prevention via both of these ways is crucial. However, no school-based intervention using mobile apps has been evaluated to date. We recently released a photoaging mobile app, in which a selfie is altered to predict future appearance dependent on UV protection behavior and skin type. OBJECTIVE In this pilot study, we aimed to use mobile phone technology to improve school-based melanoma prevention and measure its preliminary success in different subgroups of students with regard to their UV protection behavior, Fitzpatrick skin type and age. METHODS We implemented a free photoaging mobile phone app (Sunface) in 2 German secondary schools via a method called mirroring. We "mirrored" the students' altered 3-dimensional (3D) selfies reacting to touch on mobile phones or tablets via a projector in front of their whole grade. Using an anonymous questionnaire capturing sociodemographic data as well as risk factors for melanoma we then measured their perceptions of the intervention on a 5-point Likert scale among 205 students of both sexes aged 13-19 years (median 15 years). RESULTS We measured more than 60% agreement in both items that measured motivation to reduce UV exposure and only 12.5% disagreement: 126 (63.0%) agreed or strongly agreed that their 3D selfie motivated them to avoid using a tanning bed, and 124 (61.7%) to increase use of sun protection. However, only 25 (12.5%) disagreed with both items. The perceived effect on motivation was increased in participants with Fitzpatrick skin types 1-2 in both tanning bed avoidance (n=74, 71.8% agreement in skin types 1-2 vs n=50, 53.8% agreement in skin types 3-6) and increased use of sun protection (n=70, 68.0% agreement in skin types 1-2 vs n=52, 55.3% agreement in skin types 3-6), and also positively correlated with higher age. CONCLUSIONS We present a novel way of integrating photoaging in school-based melanoma prevention that affects the students' peer group, considers the predictors of UV exposure in accordance with the theory of planned behavior, and is particularly effective in changing behavioral predictors in fair-skinned adolescents (Fitzpatrick skin types 1-2). Further research is required to evaluate the intervention's prospective effects on adolescents of various cultural backgrounds.
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Affiliation(s)
- Titus Josef Brinker
- Department of Dermatology, Venereology and Allergology, University-Hospital Essen, University of Duisburg-Essen, Essen, Germany.,Department of Dermatology and National Center for Tumor Diseases (NCT), University Hospital Heidelberg, University of Heidelberg, Heidelberg, Germany.,German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Christian Martin Brieske
- Department of Dermatology, Venereology and Allergology, University-Hospital Essen, University of Duisburg-Essen, Essen, Germany.,German Cancer Consortium (DKTK), Heidelberg, Germany.,West German Cancer Center, University Duisburg-Essen, Essen, Germany
| | - Christoph Matthias Schaefer
- Department of Dermatology, Venereology and Allergology, University-Hospital Essen, University of Duisburg-Essen, Essen, Germany.,German Cancer Consortium (DKTK), Heidelberg, Germany.,West German Cancer Center, University Duisburg-Essen, Essen, Germany
| | - Fabian Buslaff
- Department of Dermatology and National Center for Tumor Diseases (NCT), University Hospital Heidelberg, University of Heidelberg, Heidelberg, Germany.,German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Martina Gatzka
- Department of Dermatology and Allergic Diseases, University of Ulm, Ulm, Germany
| | - Maximilian Philip Petri
- Department of Dermatology, Venereology and Allergology, University-Hospital Essen, University of Duisburg-Essen, Essen, Germany.,German Cancer Consortium (DKTK), Heidelberg, Germany.,West German Cancer Center, University Duisburg-Essen, Essen, Germany
| | - Wiebke Sondermann
- Department of Dermatology, Venereology and Allergology, University-Hospital Essen, University of Duisburg-Essen, Essen, Germany.,German Cancer Consortium (DKTK), Heidelberg, Germany.,West German Cancer Center, University Duisburg-Essen, Essen, Germany
| | - Dirk Schadendorf
- Department of Dermatology, Venereology and Allergology, University-Hospital Essen, University of Duisburg-Essen, Essen, Germany.,German Cancer Consortium (DKTK), Heidelberg, Germany.,West German Cancer Center, University Duisburg-Essen, Essen, Germany
| | - Ingo Stoffels
- Department of Dermatology, Venereology and Allergology, University-Hospital Essen, University of Duisburg-Essen, Essen, Germany.,German Cancer Consortium (DKTK), Heidelberg, Germany.,West German Cancer Center, University Duisburg-Essen, Essen, Germany
| | - Joachim Klode
- Department of Dermatology, Venereology and Allergology, University-Hospital Essen, University of Duisburg-Essen, Essen, Germany.,German Cancer Consortium (DKTK), Heidelberg, Germany.,West German Cancer Center, University Duisburg-Essen, Essen, Germany
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16
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Brinker TJ, Schadendorf D, Klode J, Cosgarea I, Rösch A, Jansen P, Stoffels I, Izar B. Photoaging Mobile Apps as a Novel Opportunity for Melanoma Prevention: Pilot Study. JMIR Mhealth Uhealth 2017; 5:e101. [PMID: 28747297 PMCID: PMC5550737 DOI: 10.2196/mhealth.8231] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2017] [Revised: 07/03/2017] [Accepted: 07/12/2017] [Indexed: 12/13/2022] Open
Abstract
Background Around 90% of melanomas are caused by ultraviolet (UV) exposure and are therefore eminently preventable. Unhealthy tanning behavior is mostly initiated in early adolescence, often with the belief that it increases attractiveness; the problems related to skin atrophy and malignant melanoma are too far in the future to fathom. Photoaging desktop programs, in which an image is altered to predict future appearance, have been successful in positively influencing behavior in adiposity or tobacco prevention settings. Objective To develop and test a photoaging app designed for melanoma prevention. Methods We harnessed the widespread availability of mobile phones and adolescents’ interest in appearance to develop a free mobile app called Sunface. This app has the user take a self-portrait (ie, a selfie), and then photoages the image based on Fitzpatrick skin type and individual UV protection behavior. Afterward, the app explains the visual results and aims at increasing self-competence on skin cancer prevention by providing guideline recommendations on sun protection and the ABCDE rule for melanoma self-detection. The underlying aging algorithms are based on publications showing UV-induced skin damage by outdoor as well as indoor tanning. To get a first impression on how well the app would be received in a young target group, we included a total sample of 25 students in our cross-sectional pilot study with a median age of 22 (range 19-25) years of both sexes (11/25, 44% female; 14/25, 56% male) attending the University of Essen in Germany. Results The majority of enrolled students stated that they would download the app (22/25, 88%), that the intervention had the potential to motivate them to use sun protection (23/25, 92%) and that they thought such an app could change their perceptions that tanning makes you attractive (19/25, 76%). Only a minority of students disagreed or fully disagreed that they would download such an app (2/25, 8%) or that such an app could change their perceptions on tanning and attractiveness (4/25, 16%). Conclusions Based on previous studies and the initial study results presented here, it is reasonable to speculate that the app may induce behavioral change in the target population. Further work is required to implement and examine the effectiveness of app-based photoaging interventions within risk groups from various cultural backgrounds.
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Affiliation(s)
- Titus Josef Brinker
- Department of Dermatology, Venerology and Allergology, University-Hospital Essen, University of Duisburg-Essen, Essen, Germany.,West German Cancer Center, University of Duisburg-Essen, Essen, Germany.,German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Dirk Schadendorf
- Department of Dermatology, Venerology and Allergology, University-Hospital Essen, University of Duisburg-Essen, Essen, Germany.,West German Cancer Center, University of Duisburg-Essen, Essen, Germany.,German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Joachim Klode
- Department of Dermatology, Venerology and Allergology, University-Hospital Essen, University of Duisburg-Essen, Essen, Germany.,West German Cancer Center, University of Duisburg-Essen, Essen, Germany.,German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Ioana Cosgarea
- Department of Dermatology, Venerology and Allergology, University-Hospital Essen, University of Duisburg-Essen, Essen, Germany.,West German Cancer Center, University of Duisburg-Essen, Essen, Germany.,German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Alexander Rösch
- Department of Dermatology, Venerology and Allergology, University-Hospital Essen, University of Duisburg-Essen, Essen, Germany.,West German Cancer Center, University of Duisburg-Essen, Essen, Germany.,German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Philipp Jansen
- Department of Dermatology, Venerology and Allergology, University-Hospital Essen, University of Duisburg-Essen, Essen, Germany.,West German Cancer Center, University of Duisburg-Essen, Essen, Germany.,German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Ingo Stoffels
- Department of Dermatology, Venerology and Allergology, University-Hospital Essen, University of Duisburg-Essen, Essen, Germany.,West German Cancer Center, University of Duisburg-Essen, Essen, Germany.,German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Benjamin Izar
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, United States.,Broad Institute of MIT and Harvard, Cambridge, MA, United States
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Affiliation(s)
- Meg Watson
- Epidemiology and Applied Research Branch, Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia2National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Meredith Shoemaker
- Epidemiology and Applied Research Branch, Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia2National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Katie Baker
- Department of Community & Behavioral Health, College of Public Health, East Tennessee State University, Johnson City
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18
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Pagoto SL, Baker K, Griffith J, Oleski JL, Palumbo A, Walkosz BJ, Hillhouse J, Henry KL, Buller DB. Engaging Moms on Teen Indoor Tanning Through Social Media: Protocol of a Randomized Controlled Trial. JMIR Res Protoc 2016; 5:e228. [PMID: 27899339 PMCID: PMC5147712 DOI: 10.2196/resprot.6624] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 10/25/2016] [Accepted: 10/28/2016] [Indexed: 12/13/2022] Open
Abstract
Background Indoor tanning elevates the risk for melanoma, which is now the most common cancer in US women aged 25-29. Public policies restricting access to indoor tanning by minors to reduce melanoma morbidity and mortality in teens are emerging. In the United States, the most common policy restricting indoor tanning in minors involves parents providing either written or in person consent for the minor to purchase a tanning visit. The effectiveness of this policy relies on parents being properly educated about the harms of indoor tanning to their children. Objective This randomized controlled trial will test the efficacy of a Facebook-delivered health communication intervention targeting mothers of teenage girls. The intervention will use health communication and behavioral modification strategies to reduce mothers’ permissiveness regarding their teenage daughters’ use of indoor tanning relative to an attention-control condition with the ultimate goal of reducing indoor tanning in both daughters and mothers. Methods The study is a 12-month randomized controlled trial comparing 2 conditions: an attention control Facebook private group where content will be relevant to teen health with 25% focused on prescription drug abuse, a topic unrelated to tanning; and the intervention condition will enter participants into a Facebook private group where 25% of the teen health content will be focused on indoor tanning. A cohort of 2000 mother-teen daughter dyads will be recruited to participate in this study. Only mothers will participate in the Facebook groups. Both mothers and daughters will complete measures at baseline, end of intervention (1-year) and 6 months post-intervention. Primary outcomes include mothers’ permissiveness regarding their teenage daughters’ use of indoor tanning, teenage daughters’ perception of their mothers’ permissiveness, and indoor tanning by both mothers and daughters. Results The first dyad was enrolled on March 31, 2016, and we anticipate completing this study by October 2019. Conclusions This trial will deliver social media content grounded in theory and will test it in a randomized design with state-of-the-art measures. This will contribute much needed insights on how to employ social media for health behavior change and disease prevention both for indoor tanning and other health risk behaviors and inform future social media efforts by public health and health care organizations. ClinicalTrial Clinicaltrials.gov NCT02835807; https://clinicaltrials.gov/ct2/show/NCT02835807 (Archived by WebCite at http://www.webcitation.org/6mDMICcCE).
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Affiliation(s)
- Sherry L Pagoto
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, United States
| | - Katie Baker
- Department of Community & Behavioral Health, College of Public Health, East Tennessee State University, Johnson City, TN, United States
| | | | - Jessica L Oleski
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, United States
| | - Ashley Palumbo
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, United States
| | | | - Joel Hillhouse
- Department of Community & Behavioral Health, College of Public Health, East Tennessee State University, Johnson City, TN, United States
| | - Kimberly L Henry
- Department of Psychology, Colorado State University, Fort Collins, CO, United States.,Colorado School of Public Health, Colorado State University, Fort Collins, CO, United States
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19
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Myrick JG, Noar SM, Kelley D, Zeitany AE. The Relationships Between Female Adolescents’ Media Use, Indoor Tanning Outcome Expectations, and Behavioral Intentions. HEALTH EDUCATION & BEHAVIOR 2016; 44:403-410. [DOI: 10.1177/1090198116667251] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Background. Unlike other types of cancer, skin cancer incidence rates are on the rise and adolescent females are particularly likely to tan indoors, a major risk factor. However, little research has examined the role of media use in encouraging or discouraging this dangerous behavior in this population. Aims. To empirically assess the links between media use, indoor tanning-related outcome expectations, and behavioral intentions. Method. A survey of adolescent females ( N = 510) ages 15 to 18 in the Southeastern United States assessed demographics, types of media use, and indoor tanning intentions. Results. Significant correlations between media use and indoor tanning outcome expectations were found. Use of interpersonal and social media (i.e., talking on the phone, texting, and online social media) were positively associated with positive outcome expectations about indoor tanning and negatively associated with negative outcome expectations. A path analysis revealed that interpersonal/social media use had indirect associations with indoor tanning intentions via tanning outcome expectations. Mass media use (e.g., news media, entertainment media, and magazines) was not significantly associated with most indoor tanning outcome expectations but did have a direct negative association with behavioral intentions. Discussion. There are important relationships between media use, indoor tanning outcome expectations, and behavioral intentions. Interpersonal and social media use may help cultivate outcome expectations that encourage indoor tanning, which in turn may increase intentions to tan, while news media consumption in particular may reduce intentions to tan. Conclusion. These findings highlight the social nature of adolescent females and point to specific intervention channels for reducing indoor tanning among this population.
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Affiliation(s)
| | - Seth M. Noar
- University of North Carolina at Chapel Hill, NC, USA
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