Skin Cancer Prevention
Conditions
Brief summary
The purpose of the proposed project is to investigate the efficacy and longevity of two novel approaches to changing skin protection behaviors: 1) UV-detect photos that reveal currently existing skin damage and 2) motivational interviewing (MI), a person-centered, yet directive counseling style used to enhance internal motivation to change health behaviors. The proposed investigations include a pilot study to refine the methodology; a small formal randomized controlled efficacy trial; and a dismantling study. These studies will also expand current knowledge and research in several major ways: 1) the use of UV-detect photos will enable highly salient and personalized feedback, 2) MI will be used in a previously untried health domain (skin cancer prevention), 3) objective skin color changes will be measured using state-of-the-art skin reflectance spectrophotometry, and 4) the proposed studies will test aspects of several major psychological theories (e.g., Transtheoretical Model, Prototype/Willingness Model) to identify moderators/mediators of outcome.
Detailed description
Teens and young adults are at high risk for overexposure to ultraviolet (UV) radiation, a leading factor in the development of skin cancer. The majority of these individuals continue to protect themselves minimally and tan intentionally, including significant increases in tanning booth use recently. Such care-free behaviors exist despite widespread education/awareness about UV radiation and skin cancer. The purpose of the proposed project is to investigate the efficacy and longevity of two novel approaches to changing skin protection behaviors: 1) UV-detect photos that reveal currently existing skin damage and 2) motivational interviewing (MI), a person-centered, yet directive counseling style used to enhance internal motivation to change health behaviors. The proposed investigations include a pilot study to refine the methodology; a small formal randomized controlled efficacy trial; and a dismantling study. These studies will also expand current knowledge and research in several major ways: 1) the use of UV-detect photos will enable highly salient and personalized feedback, 2) MI will be used in a previously untried health domain (skin cancer prevention), 3) objective skin color changes will be measured using state-of-the-art skin reflectance spectrophotometry, and 4) the proposed studies will test aspects of several major psychological theories (e.g., Transtheoretical Model, Prototype/Willingness Model) to identify moderators/mediators of outcome. Therefore, the studies should provide useful information about process and outcome for skin cancer prevention researchers and clinicians.
Interventions
DEVICEUV-Detect Photos
UV-Detect Photos
BEHAVIORALMotivational Interviewing
Motivational Interviewing
BEHAVIORALEducation
Education
Sponsors
National Cancer Institute (NCI)
Fox Chase Cancer Center
Study design
Allocation
RANDOMIZED
Intervention model
FACTORIAL
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 24 Years
Healthy volunteers
Yes
Inclusion criteria
* 18 or older
Exclusion criteria
* Visual impairment
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Sun Stage of Change at 3 Months | 3 months | The Sun Stage of Change (SOC) Scale has 4 items asking participants whether they have been protecting their skin for the past year (maintenance), if they protect their skin now (action), whether they intend to protect their skin in the next 30 days (preparation), whether they intend to protect their skin in the next year (contemplation), or none of the above (pre-contemplation). |
| Sun Stage of Change at 12 Months | 12 months | The Sun Stage of Change (SOC) Scale has 4 items asking participants whether they have been protecting their skin for the past year (maintenance), if they protect their skin now (action), whether they intend to protect their skin in the next 30 days (preparation), whether they intend to protect their skin in the next year (contemplation), or none of the above (pre-contemplation). |
Countries
United States
Participant flow
Pre-assignment details
Participants were consented, baselined, and randomized upon arrival to the in-person session, thus no enrolled participants were excluded from the study before assignment to one of the four treatment conditions.
Participants by arm
| Arm | Count |
|---|---|
| Educational Control Participants were given a packet of standard skin cancer prevention educational brochures and handouts from major professional organizations to review independently for 10-15 minutes. | 48 |
| Motivational Interviewing Participants met with a trained counselor who reviewed any personalized feedback of risk derived from the baseline assessments (e.g., history of sunburns, self-reported UV exposure, protective behaviors). Counselors utilized the basic motivational interviewing skills of open-ended questions, reflection of participant statements, affirmations/positive feedback, and summation of major points throughout the discussion. These sessions took about 22 minutes. | 44 |
| UV-detect Photos Participants were shown a regular black and white photo and a black and white UV-filtered photo of their face. Participants were told that Any dark, spotted, freckled, wrinkled, uneven, or pitted areas indicate existing underlying skin damage that is difficult to reverse. However, protecting the skin from UV radiation can prevent future damage. Participants were asked what they noticed about the photos, what their reactions were, and how this might affect their behavior. These sessions took 12 minutes on average. | 58 |
| UV-detect Photos and Motivational Interviewing Participants met with a trained counselor who reviewed any personalized feedback of risk derived from the baseline assessments (e.g., history of sunburns, self-reported UV exposure, protective behaviors). Counselors utilized the basic motivational interviewing skills of open-ended questions, reflection of participant statements, affirmations/positive feedback, and summation of major points throughout the discussion. In addition to baseline feedback, participants were also interviewed about the black & white and UV-filtered photos of their faces. These sessions took about 25 minutes. | 47 |
| Total | 197 |
Baseline characteristics
| Characteristic | Educational Control | Motivational Interviewing | UV-detect Photos | UV-detect Photos and Motivational Interviewing | Total |
|---|---|---|---|---|---|
| Age, Categorical <=18 years | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical >=65 years | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical Between 18 and 65 years | 48 Participants | 44 Participants | 58 Participants | 47 Participants | 197 Participants |
| Age, Continuous | 20.29 years STANDARD_DEVIATION 1.68 | 20.32 years STANDARD_DEVIATION 1.41 | 20.43 years STANDARD_DEVIATION 1.49 | 20.85 years STANDARD_DEVIATION 1.67 | 20.47 years STANDARD_DEVIATION 1.56 |
| Race/Ethnicity, Customized African American/Black | 4 Participants | 0 Participants | 3 Participants | 2 Participants | 9 Participants |
| Race/Ethnicity, Customized Asian-American/Pacific Islander | 8 Participants | 6 Participants | 5 Participants | 5 Participants | 24 Participants |
| Race/Ethnicity, Customized Caucasian/White | 31 Participants | 32 Participants | 44 Participants | 39 Participants | 146 Participants |
| Race/Ethnicity, Customized Hispanic/Latino | 1 Participants | 0 Participants | 2 Participants | 0 Participants | 3 Participants |
| Race/Ethnicity, Customized Other/Mixed | 4 Participants | 6 Participants | 4 Participants | 1 Participants | 15 Participants |
| Sex: Female, Male Female | 34 Participants | 35 Participants | 49 Participants | 44 Participants | 162 Participants |
| Sex: Female, Male Male | 14 Participants | 9 Participants | 9 Participants | 3 Participants | 35 Participants |
| Stage of Change Scale Action | 5 Participants | 3 Participants | 6 Participants | 2 Participants | 16 Participants |
| Stage of Change Scale Contemplation | 5 Participants | 4 Participants | 4 Participants | 4 Participants | 17 Participants |
| Stage of Change Scale data missing | 0 Participants | 0 Participants | 1 Participants | 2 Participants | 3 Participants |
| Stage of Change Scale Maintenance | 13 Participants | 10 Participants | 9 Participants | 10 Participants | 42 Participants |
| Stage of Change Scale Precontemplation | 17 Participants | 15 Participants | 24 Participants | 15 Participants | 71 Participants |
| Stage of Change Scale Preparation | 8 Participants | 12 Participants | 14 Participants | 14 Participants | 48 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk | EG003 affected / at risk |
|---|---|---|---|---|
| deaths Total, all-cause mortality | — / — | — / — | — / — | — / — |
| other Total, other adverse events | 0 / 0 | 0 / 0 | 0 / 0 | 0 / 0 |
| serious Total, serious adverse events | 0 / 0 | 0 / 0 | 0 / 0 | 0 / 0 |
Outcome results
Primary
Sun Stage of Change at 12 Months
The Sun Stage of Change (SOC) Scale has 4 items asking participants whether they have been protecting their skin for the past year (maintenance), if they protect their skin now (action), whether they intend to protect their skin in the next 30 days (preparation), whether they intend to protect their skin in the next year (contemplation), or none of the above (pre-contemplation).
Time frame: 12 months
| Arm | Measure | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Education Control | Sun Stage of Change at 12 Months | Contemplation | 2 Participants |
| Education Control | Sun Stage of Change at 12 Months | Precontemplation | 10 Participants |
| Education Control | Sun Stage of Change at 12 Months | Preparation | 7 Participants |
| Education Control | Sun Stage of Change at 12 Months | Maintenance | 14 Participants |
| Education Control | Sun Stage of Change at 12 Months | Action | 6 Participants |
| Motivational Interviewing | Sun Stage of Change at 12 Months | Maintenance | 15 Participants |
| Motivational Interviewing | Sun Stage of Change at 12 Months | Precontemplation | 4 Participants |
| Motivational Interviewing | Sun Stage of Change at 12 Months | Contemplation | 3 Participants |
| Motivational Interviewing | Sun Stage of Change at 12 Months | Preparation | 5 Participants |
| Motivational Interviewing | Sun Stage of Change at 12 Months | Action | 3 Participants |
| UV-detect Photos | Sun Stage of Change at 12 Months | Contemplation | 2 Participants |
| UV-detect Photos | Sun Stage of Change at 12 Months | Preparation | 11 Participants |
| UV-detect Photos | Sun Stage of Change at 12 Months | Action | 7 Participants |
| UV-detect Photos | Sun Stage of Change at 12 Months | Precontemplation | 11 Participants |
| UV-detect Photos | Sun Stage of Change at 12 Months | Maintenance | 17 Participants |
| UV-detect Photos and Motivational Interviewing | Sun Stage of Change at 12 Months | Contemplation | 0 Participants |
| UV-detect Photos and Motivational Interviewing | Sun Stage of Change at 12 Months | Action | 5 Participants |
| UV-detect Photos and Motivational Interviewing | Sun Stage of Change at 12 Months | Preparation | 20 Participants |
| UV-detect Photos and Motivational Interviewing | Sun Stage of Change at 12 Months | Precontemplation | 7 Participants |
| UV-detect Photos and Motivational Interviewing | Sun Stage of Change at 12 Months | Maintenance | 5 Participants |
Primary
Sun Stage of Change at 3 Months
The Sun Stage of Change (SOC) Scale has 4 items asking participants whether they have been protecting their skin for the past year (maintenance), if they protect their skin now (action), whether they intend to protect their skin in the next 30 days (preparation), whether they intend to protect their skin in the next year (contemplation), or none of the above (pre-contemplation).
Time frame: 3 months
| Arm | Measure | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Education Control | Sun Stage of Change at 3 Months | Preparation | 7 Participants |
| Education Control | Sun Stage of Change at 3 Months | Maintenance | 15 Participants |
| Education Control | Sun Stage of Change at 3 Months | Precontemplation | 17 Participants |
| Education Control | Sun Stage of Change at 3 Months | Action | 3 Participants |
| Education Control | Sun Stage of Change at 3 Months | Contemplation | 2 Participants |
| Motivational Interviewing | Sun Stage of Change at 3 Months | Preparation | 15 Participants |
| Motivational Interviewing | Sun Stage of Change at 3 Months | Contemplation | 1 Participants |
| Motivational Interviewing | Sun Stage of Change at 3 Months | Maintenance | 10 Participants |
| Motivational Interviewing | Sun Stage of Change at 3 Months | Precontemplation | 5 Participants |
| Motivational Interviewing | Sun Stage of Change at 3 Months | Action | 7 Participants |
| UV-detect Photos | Sun Stage of Change at 3 Months | Contemplation | 3 Participants |
| UV-detect Photos | Sun Stage of Change at 3 Months | Maintenance | 14 Participants |
| UV-detect Photos | Sun Stage of Change at 3 Months | Action | 8 Participants |
| UV-detect Photos | Sun Stage of Change at 3 Months | Preparation | 15 Participants |
| UV-detect Photos | Sun Stage of Change at 3 Months | Precontemplation | 10 Participants |
| UV-detect Photos and Motivational Interviewing | Sun Stage of Change at 3 Months | Maintenance | 10 Participants |
| UV-detect Photos and Motivational Interviewing | Sun Stage of Change at 3 Months | Precontemplation | 12 Participants |
| UV-detect Photos and Motivational Interviewing | Sun Stage of Change at 3 Months | Contemplation | 2 Participants |
| UV-detect Photos and Motivational Interviewing | Sun Stage of Change at 3 Months | Preparation | 15 Participants |
| UV-detect Photos and Motivational Interviewing | Sun Stage of Change at 3 Months | Action | 4 Participants |