A Web-Based Intervention to Reduce Indoor Tanning Motivations in Adolescents: a Randomized Controlled Trial

Hillhouse, Joel; Turrisi, Rob; Scaglione, Nichole M.; Cleveland, Michael J.; Baker, Katie; Florence, L. Carter

doi:10.1007/s11121-016-0698-4

Cited by 31 publications

(39 citation statements)

References 51 publications

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

Section: Resultsmentioning

confidence: 99%

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

Persson

Benn

Dhingra

et al. 2018

British J Health Psychol

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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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Section: Resultsmentioning

confidence: 99%

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

Persson

Benn

Dhingra

et al. 2018

British J Health Psychol

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“…Unhealthy behavior with respect to UV exposure is mostly initiated in early adolescence [ 36 ], commonly with the belief that a tan increases attractiveness [ 26 , 37 , 38 ], and the problems related to melanoma and skin atrophy are too far in the future for them to fathom.…”

Section: Introductionmentioning

confidence: 99%

A Skin Cancer Prevention Facial-Aging Mobile App for Secondary Schools in Brazil: Appearance-Focused Interventional Study

Brinker¹,

Heckl²,

Gatzka³

et al. 2018

JMIR Mhealth Uhealth

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BackgroundThe 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.ObjectiveIn this pilot study, our objective was to investigate the preliminary success and implementability of a photoaging intervention to prevent skin cancer in Brazilian adolescents.MethodsWe 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.ResultsWe 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.ConclusionsThe 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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“…Unhealthy behavior with respect to UV exposure is mostly initiated in early adolescence [42], commonly with the belief that a tan increases attractiveness [43][44][45] and the problems related to melanoma as well as skin atrophy are too far in the future to fathom.…”

Section: Current Knowledge On School-based Skin Cancer Preventionmentioning

confidence: 99%

“…In line with this association, various recent experimental studies to test these effects in young target groups aimed at promoting sunscreen use as an end point [19][20][21][22], and others used various UV protection behaviors (including avoiding sunbeds) or behavior scores [23][24][25][26][27][28][29][30][31][32][33][34]. Given the substantial amount of time that children and adolescents of all social backgrounds spend in the school environment, addressing skin cancer prevention in this setting is crucial and provides a unique opportunity to propel skin cancer prevention programs [35].…”

Section: Introductionmentioning

confidence: 99%