Basal Cell Carcinoma, Skin Cancer, Skin Cancer Melanoma, Squamous Cell Carcinoma
Conditions
Keywords
Sunbathing, Indoor Tanning, Facial Morphing, Skin Cancer Risk
Brief summary
The purpose of the intended proposed research is to investigate and determine best strategies for preventing skin cancer for emerging adults. To answer this question, the investigators intended to pilot a randomized control trial with three arms: 1) Facial Morphing, 2) Mindfulness, and 3) Treatment as usual. The population from which the sample was drawn from was undergraduate psychology students from a large public university in Southern California, who report recent indoor/outdoor tanning, and intentions for future tanning.
Detailed description
Indoor and outdoor tanning are two of the most common risk factors for developing skin cancer. Predictors of indoor and outdoor tanning including negative body image and negative affect. Thus, to subsequently prevent skin cancer, interventions should focus on appearance concerns and negative affect. To date, limited brief efficacious skin cancer preventions exist. One potential program (APRIL AGE) a facial morphing software program, has recently been evaluated as a potential prevention program of skin cancer. However, limited data exists on the long term benefits of this program. Additionally, brief mindfulness programs have been found to be efficacious in preventing other health risk behaviors (e.g., smoking, negative affect, eating behaviors). To the investigators' knowledge, these brief mindfulness interventions have yet to be applied in skin cancer prevention. Thus, the investigators sought to compare the relative efficacy of the facial morphing intervention and the mindfulness intervention vs. control condition (treatment as usual). It was hypothesized that both facial morphing and mindfulness would lead to reductions in tanning behavior compared to the TAU condition. The investigators also tested contrasts between the facial morphing and mindfulness conditions, however, no directional hypotheses could be generated, due to the dearth of prior data on these interventions in skin cancer prevention.
Interventions
BEHAVIORALFacial Morphing Intervention
Participants assigned to this condition were exposed to facial morphing technology that displays the progression of facial-ageing up to 72years, both with and without damage from UV exposure.
BEHAVIORALMindfulness Intervention
Participants assigned to this condition engaged in a self-guided mindfulness intervention audio tape. This intervention instructed participants to pay attention to the present moment, with a non-judgemental stance. For example, participants were instructed to notice their breath, thoughts, feelings, physical sensations, and to internally describe them, without passing judgement
Sponsors
San Diego State University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Intervention model description
At initial visit, participants were screened for study eligibility, consented, and randomized to a study condition. Participants first completed baseline assessment. Following, all participants completed intervention as determined by randomized assignment (i.e., control, facial morphing or mindfulness). At the initial visit, all subjects were assigned a subject ID number. Each subject ID was pre-assigned to a study condition, determined by an online randomization program, prior to recruitment. Each eligible participant had a 1/3 chance to be assigned to each of the three study conditions. Immediately after intervention, participants completed acute assessment, also consisting of self-report questionnaires. At the end of the initial visit, participants provided researchers a valid email address to be sent a subsequent follow-up survey. Approximately one month from the intervention date, participants received and completed the online follow-up survey.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* 1\) aged 18 years old or older * 2\) enrolled as a student at the University * 3\) engaged in either indoor or outdoor tanning in the last 30 days * 4\) intended to tan (indoor or outdoor) in the last 30 days * 5\) English speaking
Exclusion criteria
* Failure to meet any of the above mentioned inclusion criteria
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of Indoor Tanning Sessions in the Last 30 Days | 1-month assessment | One free-response item measuring intentional indoor frequency in the last 30 days |
| Number of Outdoor Tanning Sessions in the Last 30 Days | 1-month assessment | One free-response item measuring intentional outdoor frequency in the last 30 days |
| Indoor Tanning Intentions | Post assessment & 1-month assessment | A free-response items measuring intentional indoor intentions in the next 30 days. |
| Outdoor Tanning Intentions | Post Assessment & 1-month assessment | A free-response items measuring intentional outdoor intentions in the next 30 days. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Appearance Orientation | 1-month assessment | Trait level appearance orientation satisfaction was measured using the Appearance Schemas Inventory-Revised Short Form (ASI-R; Cash, Melnyk, & Hrabosky, 2004). This twenty-item self-report instrument assesses cognitive and behavioral investment in one's physical appearance. This measure utilizes a five-point scale (1 \[definitely disagree\] to 5 \[definitely agree\]), with total scores ranging from 20-100; higher scores indicate greater appearance investment. This measure is scored by averaging all scores to these twenty items (higher scores indicating greater appearance investment). |
| State Positive Affect | Post assessment | State positive affect was measured using the positive affect subscale of the Positive and Negative Affect Scale-Short Form (PANAS-SF; Thompson, 2007). This self-report subscale consists of five items of the full ten-item measure. This subscale utilizes a five-point Likert-type scale ranging from 1 (never) to 5 (always). This measure is scored by summing all scores to these five items (range 5-25), with higher scores indicating greater state positive affect. For the purposes of this project, participants' item scores to these five items were averaged. |
| State Negative Affect | Post assessment | State negative affect was measured using the negative affect subscale of the Positive and Negative Affect Scale-Short Form (PANAS-SF; Thompson, 2007). This self-report subscale consists of five items of the full ten-item measure. This subscale utilizes a five-point Likert-type scale ranging from 1 (never) to 5 (always). This measure is scored by summing all scores to these five items (range 5-25), with higher scores indicating greater state negative affect. For the purposes of this project, participants' item scores to these five items were averaged. |
| Appearance Attitudes to Tan | Post assessment & 1-month assessment | Participants completed the Appearance Reasons to Tan latent subscale of the Physical Appearance Reasons for Tanning Scale (PARTS; Cafri et al., 2006, 2008). This scale consists of three manifest subscales: General Attractiveness, Acne, and Body Shape. These 19 items were scored along a five-point scale: 1 (definitely disagree) to 5 (definitely agree), with a possible total score range of 19-95 (higher scores indicating greater agreement). Total scores are averaged to reflect the average agreement with attitudes which may motivate one to tan (higher average scores indicating greater agreement). |
| Anxiety Symptoms | 1-month assessment | Participants completed the Depression Anxiety Stress Scales Short Version (DASS-21) as a marker of trait level negative affect (Henry & Crawford, 2005). This 21-item self-report measure consists of three seven-item subscales: depression, anxiety, and stress. Items are measured along a 4-point scale (0 \[not at all like me\] to 3 \[applied to me very much, or most of the time\]); higher scores denote increased symptoms. Total sum scores for this instrument ranges from 0-63; scores for the anxiety symptom subscale range from 0-21. |
| Stress | 1-month assessment | Participants completed the Depression Anxiety Stress Scales Short Version (DASS-21) as a marker of trait level negative affect (Henry & Crawford, 2005). This 21-item self-report measure consists of three seven-item subscales: depression, anxiety, and stress. Items are measured along a 4-point scale (0 \[not at all like me\] to 3 \[applied to me very much, or most of the time\]); higher scores denote increased symptoms. Total sum scores for this instrument ranges from 0-63; scores for the stress symptom subscale range from 0-21. |
| Depressive Symptoms | 1-month assessment | Participants completed the Depression Anxiety Stress Scales Short Version (DASS-21) as a marker of trait level negative affect (Henry & Crawford, 2005). This 21-item self-report measure consists of three seven-item subscales: depression, anxiety, and stress. Items are measured along a 4-point scale (0 \[not at all like me\] to 3 \[applied to me very much, or most of the time\]); higher scores denote increased symptoms. Total sum scores for this instrument ranges from 0-63; scores for the depressive symptom subscale range from 0-21. |
| Appearance Reasons Not to Tan | Post assessment and 1-month assessment | Participants completed the Appearance Reasons Not to Tan latent subscale of the Physical Appearance Reasons for Tanning Scale (PARTS; Cafri et al., 2006, 2008). This scale consists of two manifest subscales: Skin Damage and Skin Aging. These 9 items were scored along a five-point scale 1 (definitely disagree) to 5 (definitely agree) with a possible total score range of 9-45 (higher scores indicating greater agreement). Total scores are averaged to reflect the average agreement with attitudes to not tan; (higher average scores indicating greater agreement). |
| State Body Satisfaction | Post-assessment | State level body satisfaction was measured using the Body Image States Scale (BISS; Cash, Fleming, Alindogan, Steadman, & Whitehead, 2002). This six-item self-report instrument utilizes a nine-point scale (1 \[extremely dissatisfied\] to 9 \[extremely satisfied\]); possible total scores range 6-54; higher scores indicate greater satisfaction. This measure is scored by averaging all scores to these six items, with higher average scores indicating greater body satisfaction. |
| Trait Body Satisfaction | 1-month assessment | Trait level body satisfaction was measured using the Multidimensional Body-Self Relations Questionnaire-Appearance Evaluation subscale (MSBRQ-AE; Brown, Cash, & Mikulka, 1990; Cash, 2000). This seven-item self-report subscale utilizes a five-point scale (1 \[definitely disagree\] to 5 \[definitely agree\]) with possible score range of 7-35. This measure was scored by averaging all scores to these seven items, with higher scores indicating greater body satisfaction. |
Countries
United States
Participant flow
Recruitment details
Study was conducted between February and December 2016. Participants were recruited from an undergraduate research participation website at a large, public American university. A general description of the study's purpose, which specified study inclusion criteria and one's time commitment was provided for potential participants
Participants by arm
| Arm | Count |
|---|---|
| Control (Treatment as Usual Only) Following baseline assessment, all participants were given health literature on tanning behavior from the U.S. Centers for Disease Control and Prevention (CDC). These materials included informational pamphlets addressing common myths regarding tanning behaviors, including Tanned skin is not healthy skin, and A base tan is not a safe tan. These misconceptions were accompanied by burning truth, scientific data debunking these myths. Additionally, all participants received a packet on sun protective practices for oneself and family, which include skin cancer statistics and information on UV rays. | 73 |
| Treatment as Usual + Facial Morphing In addition to the health literature, participants completed the Facial Morphing Intervention. Participants had a digital photograph taken and uploaded to the APRIL® software, accompanied by information about their current age and self-identified race. Participants were presented with two, side-by-side identical 2D images of their face. Participants first viewed an image of their face from their current age, in two-year intervals, to age 72, the maximum age, with the UV exposure setting turned on. This process was repeated. Next, participants viewed the projected aging process, toggling the UV exposure setting (on and off), every ten year interval. The process was repeated using 3D images to view projected changes to their facial profiles.
Facial Morphing Intervention: Participants assigned to this condition were exposed to facial morphing technology that displays the progression of facial-ageing up to 72years, both with and without damage from UV exposure. | 73 |
| Treatment as Usual + Mindfulness In addition to the health literature, participants completed the Mindfulness Intervention. Participants listened to a 10-minute self-guided mindfulness audio exercise. The audio file is a scripted reading of an established brief mindfulness exercise (Erisman & Roemer, 2010). During this guided session, participants learned what mindfulness was, when it can be used, and benefits from practice. Listeners were led through steps, focusing on the physical sensations, breathing, and thoughts. After the exercise, participants were provided a handout highlighting key points about mindfulness and how to incorporate informal mindfulness practice into their daily life.
Mindfulness Intervention: Participants assigned to this condition engaged in a self-guided mindfulness intervention audio tape. This intervention instructed participants to pay attention to the present moment, with a non-judgemental stance. For example, participants were instructed to notice their breath, thoughts, feelings, ph | 73 |
| Total | 219 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 | FG002 |
|---|---|---|---|---|
| Immediate Post-treatment to 1-mo F/u | Lost to Follow-up | 43 | 30 | 37 |
Baseline characteristics
| Characteristic | Treatment as Usual + Facial Morphing | Treatment as Usual + Mindfulness | Total | Control (Treatment as Usual Only) |
|---|---|---|---|---|
| Age, Continuous | 19.65 years STANDARD_DEVIATION 2.77 | 19.90 years STANDARD_DEVIATION 2.85 | 19.72 years STANDARD_DEVIATION 2.5 | 19.60 years STANDARD_DEVIATION 1.75 |
| Anxiety Symptoms | 7.86 units on a scale STANDARD_DEVIATION 7.83 | 6.38 units on a scale STANDARD_DEVIATION 5.86 | 6.95 units on a scale STANDARD_DEVIATION 6.57 | 6.63 units on a scale STANDARD_DEVIATION 5.82 |
| Appearance Attitudes Not to Tan | 3.31 units on a scale STANDARD_DEVIATION 0.78 | 3.36 units on a scale STANDARD_DEVIATION 0.77 | 3.36 units on a scale STANDARD_DEVIATION 0.77 | 3.41 units on a scale STANDARD_DEVIATION 0.76 |
| Appearance Attitudes to Tan | 3.29 units on a scale STANDARD_DEVIATION 0.91 | 3.46 units on a scale STANDARD_DEVIATION 0.74 | 3.42 units on a scale STANDARD_DEVIATION 0.81 | 3.41 units on a scale STANDARD_DEVIATION 0.76 |
| Appearance Orientation | 3.54 units on a scale STANDARD_DEVIATION 0.58 | 3.64 units on a scale STANDARD_DEVIATION 0.56 | 3.61 units on a scale STANDARD_DEVIATION 0.55 | 3.66 units on a scale STANDARD_DEVIATION 0.5 |
| Depressive Symptoms | 6.32 units on a scale STANDARD_DEVIATION 8.84 | 5.97 units on a scale STANDARD_DEVIATION 7.59 | 5.70 units on a scale STANDARD_DEVIATION 7.3 | 4.82 units on a scale STANDARD_DEVIATION 4.95 |
| Ethnicity (NIH/OMB) Hispanic or Latino | 19 Participants | 19 Participants | 54 Participants | 16 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 54 Participants | 54 Participants | 165 Participants | 57 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Indoor Tanning Frequency | 1.51 Sessions in last month STANDARD_DEVIATION 2.83 | 1.28 Sessions in last month STANDARD_DEVIATION 2.41 | 1.36 Sessions in last month STANDARD_DEVIATION 2.62 | 1.30 Sessions in last month STANDARD_DEVIATION 2.68 |
| Indoor Tanning Intentions | 4.13 Sessions in next month STANDARD_DEVIATION 2.17 | 4.27 Sessions in next month STANDARD_DEVIATION 2.2 | 4.25 Sessions in next month STANDARD_DEVIATION 2.17 | 4.36 Sessions in next month STANDARD_DEVIATION 2.17 |
| Outdoor Tanning Frequency | 7.25 Sessions in last month STANDARD_DEVIATION 5.04 | 7.02 Sessions in last month STANDARD_DEVIATION 4.84 | 7.32 Sessions in last month STANDARD_DEVIATION 5.06 | 7.69 Sessions in last month STANDARD_DEVIATION 5.35 |
| Outdoor Tanning Intentions | 5.56 Sessions in next month STANDARD_DEVIATION 1.59 | 5.90 Sessions in next month STANDARD_DEVIATION 1.2 | 5.81 Sessions in next month STANDARD_DEVIATION 1.39 | 5.96 Sessions in next month STANDARD_DEVIATION 1.37 |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants | 1 Participants | 2 Participants | 1 Participants |
| Race (NIH/OMB) Asian | 11 Participants | 14 Participants | 34 Participants | 9 Participants |
| Race (NIH/OMB) Black or African American | 1 Participants | 0 Participants | 3 Participants | 2 Participants |
| Race (NIH/OMB) More than one race | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 18 Participants | 9 Participants | 39 Participants | 12 Participants |
| Race (NIH/OMB) White | 43 Participants | 49 Participants | 141 Participants | 49 Participants |
| Region of Enrollment United States | 73 participants | 73 participants | 219 participants | 73 participants |
| Sex: Female, Male Female | 64 Participants | 57 Participants | 178 Participants | 57 Participants |
| Sex: Female, Male Male | 9 Participants | 16 Participants | 41 Participants | 16 Participants |
| Skin Type Skin Type 2 | 9 Participants | 6 Participants | 25 Participants | 10 Participants |
| Skin Type Skin Type 3 | 36 Participants | 40 Participants | 112 Participants | 36 Participants |
| Skin Type Skin Type 4 | 24 Participants | 27 Participants | 74 Participants | 23 Participants |
| Skin Type Skin Type 5 | 4 Participants | 0 Participants | 6 Participants | 2 Participants |
| Skin Type Skin Type 6 | 0 Participants | 0 Participants | 1 Participants | 1 Participants |
| Skin Type Skin Type I | 0 Participants | 0 Participants | 1 Participants | 1 Participants |
| State Body Satisfaction | 5.48 units on a scale STANDARD_DEVIATION 1.37 | 5.32 units on a scale STANDARD_DEVIATION 1.37 | 5.50 units on a scale STANDARD_DEVIATION 1.3 | 5.70 units on a scale STANDARD_DEVIATION 1.35 |
| State Negative Affect | 2.07 units on a scale STANDARD_DEVIATION 0.75 | 2.02 units on a scale STANDARD_DEVIATION 0.72 | 2.09 units on a scale STANDARD_DEVIATION 0.72 | 2.20 units on a scale STANDARD_DEVIATION 0.7 |
| State Positive Affect | 3.45 units on a scale STANDARD_DEVIATION 0.76 | 3.33 units on a scale STANDARD_DEVIATION 0.79 | 3.46 units on a scale STANDARD_DEVIATION 0.74 | 3.59 units on a scale STANDARD_DEVIATION 0.63 |
| Stress | 11.39 units on a scale STANDARD_DEVIATION 9.28 | 11.56 units on a scale STANDARD_DEVIATION 8.82 | 11.11 units on a scale STANDARD_DEVIATION 8.63 | 10.38 units on a scale STANDARD_DEVIATION 7.82 |
| Trait Body Satisfaction | 3.42 units on a scale STANDARD_DEVIATION 0.68 | 3.39 units on a scale STANDARD_DEVIATION 0.74 | 3.44 units on a scale STANDARD_DEVIATION 0.73 | 3.52 units on a scale STANDARD_DEVIATION 0.78 |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk |
|---|---|---|---|
| deaths Total, all-cause mortality | 0 / 73 | 0 / 73 | 0 / 73 |
| other Total, other adverse events | 0 / 73 | 0 / 73 | 0 / 73 |
| serious Total, serious adverse events | 0 / 73 | 0 / 73 | 0 / 73 |
Outcome results
Primary
Indoor Tanning Intentions
A free-response items measuring intentional indoor intentions in the next 30 days.
Time frame: Post assessment & 1-month assessment
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Control (Treatment as Usual Only) | Indoor Tanning Intentions | Post-Assessment | 3.10 sessions in next month | Standard Deviation 2.05 |
| Control (Treatment as Usual Only) | Indoor Tanning Intentions | 1-Month Assessment | 3.12 sessions in next month | Standard Deviation 1.9 |
| Treatment as Usual + Facial Morphing | Indoor Tanning Intentions | Post-Assessment | 2.21 sessions in next month | Standard Deviation 1.59 |
| Treatment as Usual + Facial Morphing | Indoor Tanning Intentions | 1-Month Assessment | 2.60 sessions in next month | Standard Deviation 1.76 |
| Treatment as Usual + Mindfulness | Indoor Tanning Intentions | Post-Assessment | 2.74 sessions in next month | Standard Deviation 2.07 |
| Treatment as Usual + Mindfulness | Indoor Tanning Intentions | 1-Month Assessment | 3.16 sessions in next month | Standard Deviation 1.82 |
Primary
Number of Indoor Tanning Sessions in the Last 30 Days
One free-response item measuring intentional indoor frequency in the last 30 days
Time frame: 1-month assessment
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Control (Treatment as Usual Only) | Number of Indoor Tanning Sessions in the Last 30 Days | 1.98 Sessions in last month | Standard Deviation 3.21 |
| Treatment as Usual + Facial Morphing | Number of Indoor Tanning Sessions in the Last 30 Days | 1.35 Sessions in last month | Standard Deviation 2.81 |
| Treatment as Usual + Mindfulness | Number of Indoor Tanning Sessions in the Last 30 Days | 1.92 Sessions in last month | Standard Deviation 2.86 |
Primary
Number of Outdoor Tanning Sessions in the Last 30 Days
One free-response item measuring intentional outdoor frequency in the last 30 days
Time frame: 1-month assessment
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Control (Treatment as Usual Only) | Number of Outdoor Tanning Sessions in the Last 30 Days | 3.96 Sessions in last month | Standard Deviation 4.07 |
| Treatment as Usual + Facial Morphing | Number of Outdoor Tanning Sessions in the Last 30 Days | 2.69 Sessions in last month | Standard Deviation 3.31 |
| Treatment as Usual + Mindfulness | Number of Outdoor Tanning Sessions in the Last 30 Days | 3.24 Sessions in last month | Standard Deviation 3.6 |
Primary
Outdoor Tanning Intentions
A free-response items measuring intentional outdoor intentions in the next 30 days.
Time frame: Post Assessment & 1-month assessment
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Control (Treatment as Usual Only) | Outdoor Tanning Intentions | Post-Assessment | 4.53 sessions in next month | Standard Deviation 1.74 |
| Control (Treatment as Usual Only) | Outdoor Tanning Intentions | 1-Month Assessment | 3.48 sessions in next month | Standard Deviation 1.97 |
| Treatment as Usual + Facial Morphing | Outdoor Tanning Intentions | Post-Assessment | 3.41 sessions in next month | Standard Deviation 1.85 |
| Treatment as Usual + Facial Morphing | Outdoor Tanning Intentions | 1-Month Assessment | 3.37 sessions in next month | Standard Deviation 1.83 |
| Treatment as Usual + Mindfulness | Outdoor Tanning Intentions | Post-Assessment | 4.53 sessions in next month | Standard Deviation 1.62 |
| Treatment as Usual + Mindfulness | Outdoor Tanning Intentions | 1-Month Assessment | 3.89 sessions in next month | Standard Deviation 1.76 |
Secondary
Anxiety Symptoms
Participants completed the Depression Anxiety Stress Scales Short Version (DASS-21) as a marker of trait level negative affect (Henry & Crawford, 2005). This 21-item self-report measure consists of three seven-item subscales: depression, anxiety, and stress. Items are measured along a 4-point scale (0 \[not at all like me\] to 3 \[applied to me very much, or most of the time\]); higher scores denote increased symptoms. Total sum scores for this instrument ranges from 0-63; scores for the anxiety symptom subscale range from 0-21.
Time frame: 1-month assessment
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Control (Treatment as Usual Only) | Anxiety Symptoms | 13.22 units on a scale | Standard Deviation 8.4 |
| Treatment as Usual + Facial Morphing | Anxiety Symptoms | 10.74 units on a scale | Standard Deviation 8.63 |
| Treatment as Usual + Mindfulness | Anxiety Symptoms | 12.82 units on a scale | Standard Deviation 8.81 |
Secondary
Appearance Attitudes to Tan
Participants completed the Appearance Reasons to Tan latent subscale of the Physical Appearance Reasons for Tanning Scale (PARTS; Cafri et al., 2006, 2008). This scale consists of three manifest subscales: General Attractiveness, Acne, and Body Shape. These 19 items were scored along a five-point scale: 1 (definitely disagree) to 5 (definitely agree), with a possible total score range of 19-95 (higher scores indicating greater agreement). Total scores are averaged to reflect the average agreement with attitudes which may motivate one to tan (higher average scores indicating greater agreement).
Time frame: Post assessment & 1-month assessment
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Control (Treatment as Usual Only) | Appearance Attitudes to Tan | Post-assessment | 3.28 units on a scale | Standard Deviation 0.9 |
| Control (Treatment as Usual Only) | Appearance Attitudes to Tan | 1-Month Assessment | 3.22 units on a scale | Standard Deviation 0.66 |
| Treatment as Usual + Facial Morphing | Appearance Attitudes to Tan | Post-assessment | 2.90 units on a scale | Standard Deviation 0.99 |
| Treatment as Usual + Facial Morphing | Appearance Attitudes to Tan | 1-Month Assessment | 3.13 units on a scale | Standard Deviation 0.8 |
| Treatment as Usual + Mindfulness | Appearance Attitudes to Tan | Post-assessment | 3.25 units on a scale | Standard Deviation 0.76 |
| Treatment as Usual + Mindfulness | Appearance Attitudes to Tan | 1-Month Assessment | 3.13 units on a scale | Standard Deviation 0.61 |
Secondary
Appearance Orientation
Trait level appearance orientation satisfaction was measured using the Appearance Schemas Inventory-Revised Short Form (ASI-R; Cash, Melnyk, & Hrabosky, 2004). This twenty-item self-report instrument assesses cognitive and behavioral investment in one's physical appearance. This measure utilizes a five-point scale (1 \[definitely disagree\] to 5 \[definitely agree\]), with total scores ranging from 20-100; higher scores indicate greater appearance investment. This measure is scored by averaging all scores to these twenty items (higher scores indicating greater appearance investment).
Time frame: 1-month assessment
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Control (Treatment as Usual Only) | Appearance Orientation | 3.50 units on a scale | Standard Deviation 0.47 |
| Treatment as Usual + Facial Morphing | Appearance Orientation | 3.34 units on a scale | Standard Deviation 0.49 |
| Treatment as Usual + Mindfulness | Appearance Orientation | 3.42 units on a scale | Standard Deviation 0.44 |
Secondary
Appearance Reasons Not to Tan
Participants completed the Appearance Reasons Not to Tan latent subscale of the Physical Appearance Reasons for Tanning Scale (PARTS; Cafri et al., 2006, 2008). This scale consists of two manifest subscales: Skin Damage and Skin Aging. These 9 items were scored along a five-point scale 1 (definitely disagree) to 5 (definitely agree) with a possible total score range of 9-45 (higher scores indicating greater agreement). Total scores are averaged to reflect the average agreement with attitudes to not tan; (higher average scores indicating greater agreement).
Time frame: Post assessment and 1-month assessment
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Control (Treatment as Usual Only) | Appearance Reasons Not to Tan | Post-Assessment | 3.74 units on a scale | Standard Deviation 0.79 |
| Control (Treatment as Usual Only) | Appearance Reasons Not to Tan | 1-Month Assessment | 3.40 units on a scale | Standard Deviation 0.72 |
| Treatment as Usual + Facial Morphing | Appearance Reasons Not to Tan | Post-Assessment | 3.83 units on a scale | Standard Deviation 0.93 |
| Treatment as Usual + Facial Morphing | Appearance Reasons Not to Tan | 1-Month Assessment | 3.61 units on a scale | Standard Deviation 0.82 |
| Treatment as Usual + Mindfulness | Appearance Reasons Not to Tan | Post-Assessment | 3.63 units on a scale | Standard Deviation 0.83 |
| Treatment as Usual + Mindfulness | Appearance Reasons Not to Tan | 1-Month Assessment | 3.59 units on a scale | Standard Deviation 0.62 |
Secondary
Depressive Symptoms
Participants completed the Depression Anxiety Stress Scales Short Version (DASS-21) as a marker of trait level negative affect (Henry & Crawford, 2005). This 21-item self-report measure consists of three seven-item subscales: depression, anxiety, and stress. Items are measured along a 4-point scale (0 \[not at all like me\] to 3 \[applied to me very much, or most of the time\]); higher scores denote increased symptoms. Total sum scores for this instrument ranges from 0-63; scores for the depressive symptom subscale range from 0-21.
Time frame: 1-month assessment
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Control (Treatment as Usual Only) | Depressive Symptoms | 11.35 units on a scale | Standard Deviation 7.91 |
| Treatment as Usual + Facial Morphing | Depressive Symptoms | 9.16 units on a scale | Standard Deviation 8 |
| Treatment as Usual + Mindfulness | Depressive Symptoms | 12.06 units on a scale | Standard Deviation 8.56 |
Secondary
State Body Satisfaction
State level body satisfaction was measured using the Body Image States Scale (BISS; Cash, Fleming, Alindogan, Steadman, & Whitehead, 2002). This six-item self-report instrument utilizes a nine-point scale (1 \[extremely dissatisfied\] to 9 \[extremely satisfied\]); possible total scores range 6-54; higher scores indicate greater satisfaction. This measure is scored by averaging all scores to these six items, with higher average scores indicating greater body satisfaction.
Time frame: Post-assessment
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Control (Treatment as Usual Only) | State Body Satisfaction | 5.67 units on a scale | Standard Deviation 1.28 |
| Treatment as Usual + Facial Morphing | State Body Satisfaction | 5.36 units on a scale | Standard Deviation 1.41 |
| Treatment as Usual + Mindfulness | State Body Satisfaction | 5.49 units on a scale | Standard Deviation 1.34 |
Secondary
State Negative Affect
State negative affect was measured using the negative affect subscale of the Positive and Negative Affect Scale-Short Form (PANAS-SF; Thompson, 2007). This self-report subscale consists of five items of the full ten-item measure. This subscale utilizes a five-point Likert-type scale ranging from 1 (never) to 5 (always). This measure is scored by summing all scores to these five items (range 5-25), with higher scores indicating greater state negative affect. For the purposes of this project, participants' item scores to these five items were averaged.
Time frame: Post assessment
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Control (Treatment as Usual Only) | State Negative Affect | 1.95 units on a scale | Standard Deviation 0.73 |
| Treatment as Usual + Facial Morphing | State Negative Affect | 2.22 units on a scale | Standard Deviation 0.8 |
| Treatment as Usual + Mindfulness | State Negative Affect | 1.72 units on a scale | Standard Deviation 0.77 |
Secondary
State Positive Affect
State positive affect was measured using the positive affect subscale of the Positive and Negative Affect Scale-Short Form (PANAS-SF; Thompson, 2007). This self-report subscale consists of five items of the full ten-item measure. This subscale utilizes a five-point Likert-type scale ranging from 1 (never) to 5 (always). This measure is scored by summing all scores to these five items (range 5-25), with higher scores indicating greater state positive affect. For the purposes of this project, participants' item scores to these five items were averaged.
Time frame: Post assessment
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Control (Treatment as Usual Only) | State Positive Affect | 3.45 units on a scale | Standard Deviation 0.82 |
| Treatment as Usual + Facial Morphing | State Positive Affect | 3.32 units on a scale | Standard Deviation 0.92 |
| Treatment as Usual + Mindfulness | State Positive Affect | 3.31 units on a scale | Standard Deviation 0.8 |
Secondary
Stress
Participants completed the Depression Anxiety Stress Scales Short Version (DASS-21) as a marker of trait level negative affect (Henry & Crawford, 2005). This 21-item self-report measure consists of three seven-item subscales: depression, anxiety, and stress. Items are measured along a 4-point scale (0 \[not at all like me\] to 3 \[applied to me very much, or most of the time\]); higher scores denote increased symptoms. Total sum scores for this instrument ranges from 0-63; scores for the stress symptom subscale range from 0-21.
Time frame: 1-month assessment
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Control (Treatment as Usual Only) | Stress | 16.75 units on a scale | Standard Deviation 9.29 |
| Treatment as Usual + Facial Morphing | Stress | 14.02 units on a scale | Standard Deviation 9.02 |
| Treatment as Usual + Mindfulness | Stress | 15.43 units on a scale | Standard Deviation 8.96 |
Secondary
Trait Body Satisfaction
Trait level body satisfaction was measured using the Multidimensional Body-Self Relations Questionnaire-Appearance Evaluation subscale (MSBRQ-AE; Brown, Cash, & Mikulka, 1990; Cash, 2000). This seven-item self-report subscale utilizes a five-point scale (1 \[definitely disagree\] to 5 \[definitely agree\]) with possible score range of 7-35. This measure was scored by averaging all scores to these seven items, with higher scores indicating greater body satisfaction.
Time frame: 1-month assessment
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Control (Treatment as Usual Only) | Trait Body Satisfaction | 3.32 units on a scale | Standard Deviation 0.68 |
| Treatment as Usual + Facial Morphing | Trait Body Satisfaction | 3.33 units on a scale | Standard Deviation 0.66 |
| Treatment as Usual + Mindfulness | Trait Body Satisfaction | 3.30 units on a scale | Standard Deviation 0.7 |