Technology to stop skin cancer: can new technology improve sun protection behaviours in organ transplant recipients?

The aim of this feasibility study is to make engaging sun protection health messages and test them in organ transplant recipients. Organ transplant recipients have an 80 per cent higher risk of skin cancer due to the immune system suppressing medication they must take for life. We have constructed a Gold coast specific version of the SunVisor app for smartphones, tablets and smartwatches to provide sun-protective messages to athletes and spectators at the Australian Transplant Games 2018 on the Gold Coast, Queensland Sept 30-Oct 06 2018. Friends, family and spectators (general population group) at the event are also encouraged to participate, as sun safety is important for everyone in a high UV environment such as Queensland. The SunVisor app will broadcast real-time-weather data, including temperature, humidity, and UV level. Personalised messages (via push notifications) will be delivered through the app with the aim to decrease risk of sunburn and allow people spending time outdoors to adequately prepare and respond to conditions. This is a 1-arm intervention. We will explore if the impact of the intervention differs for sub-groups (transplant recipients, and general population). Arm 1: To enrol in the project, interested participants can enrol prior to attending the games, or researchers will be recruiting at the venue where the Games are being held. The study will be advertised to the public and members of Transplant Australia prior to the event in member newsletters and social media. Interested participants must first contact the research team and they will be sent an online participant information and consent form, asked to confirm consent online (tick box) and proceed to complete a 10-15 minute baseline survey. The baseline survey will ask demographic details, skin type, and regular sun protection practices. If participants do not enrol prior to the event, research staff will be at the Australian Transplant Games recruiting attendees. Participants will be screened by the staff prior to enrolment. Participants undertake a 5 – 10 minute information enrolment process. Consent will involve handing out the information sheet to interested participants at the venue. The researchers will allow adequate time for participants to read the information sheet, ask questions and discuss elements of the project. All participants who enrol will be provided with a free tube of sunscreen after the baseline survey is complete and the app is on the participants’ smartphone (tube 35ml, 30 + SPF Cancer Council Brand). Participants who enrol prior to the event can collect their sunscreen at the event by providing their full name. Once the baseline survey is completed online (either prior to the event or at the event), all participants will be directed to download the app (called the SunVisor app). The participants will be asked to use the app at the Australian Transplant Games. Participants will be asked to go about their everyday activities whilst using the app, and engage in the app as they see fit. They are asked to use the app for 7 days both at the Transplant Games or during any outdoor activity at peak UV times. Participants will be asked to allow push notifications, so they receive the daily messages. Participants will receive one message a day for the one week intervention period, but can use the app as many times as they like to use its core weather functions. The SunVisor app features a prediction tool that gives transplant recipients a speedometer of risk calculation indicating at any particular moment the amount of sun exposure they would receive. During the install process questions will be used to allocate the user into their specific groups (athlete or general population), questions will also be used to determine gender, age and how sensitive their skin is to UV enabling personalized messages to be developed. Software algorithms will work at the back-end of the app to process the weather data into three categories based on the World Health Organisation Guidelines 1) Extreme, Very High, High, 2) Moderate and 3) Low). The app will allow tailored messages (via app push notifications) with the aim to decrease risk of sunburn. Telephone numbers will also be collected at enrollment so we can conduct a telephone evaluation interview up to 2 weeks following the study to determine satisfaction with the app, prediction tool and messages, and identify any barriers to use. The evaluation interview will take 20 minutes to complete. Participants will also be asked about their sun exposure practices and rates of sunburn during the one week of app use, as well as satisfaction with the app. Participants who complete all the study procedures may choose to enter a prize draw to win one of 5 x $100 gift vouchers. Participants will be asked if they would like to the prize draw entry (optional) after completing the evaluation interview. Metric data will be collected via the app such as number of downloads, uninstalls, retention rate, daily active users, frequency of app sessions and app rating will also be collected and analysed