Skin Cancer
Conditions
Brief summary
The purpose of this research is to develop a social media delivered intervention to reduce unprotected sun exposure in young adults with a history of tanning.
Detailed description
We will use social marketing theory and a user-centered design approach to develop a social media intervention that engages young adults with a history of tanning to practice sun safety behaviors. We will incentivize young adults who have a history of tanning to create social media posts that encourage their peers to engage in sun safety. Focus groups of tanners guided the development of the intervention. Investigators will conduct a pilot feasibility trial where participants will be randomized to a condition in which they are incentivized to create sun safety social media messages to be posted on a sun safety social media account or a condition in which they are incentivized to create social media messages about how to use technology to support healthy lifestyle behaviors to be posted on a health technology social media account. The intervention will last 4 weeks. Feasibility outcomes include recruitment, retention, acceptability, participation, social media message engagement (likes, comments, shares), persuasive impact of messages, unprotected sun exposure, sun protection, and tanning behavior. This work will inform a fully powered randomized trial testing the efficacy of this intervention.
Interventions
BEHAVIORALSun Safety Social Media Challenge
Participants will attend a webinar to learn how to create effective social media posts about sun safety and be oriented to the social media accounts on which the messages will be posted. They will be informed that posts should include a sun safety message (e.g., promoting sunscreen use and protective clothing/hats or discouraging risk behaviors like tanning and burning). They will be encouraged to be creative so that the message gets likes and shares. Participants will be encouraged to follow the feeds to see the engagement on their posts, to share the posts in their feed, and to see other participants' posts. Participants will receive a $10 Amazon gift card per post for a maximum of 6 posts ($60). The participant who created the post that receives the most likes, comments, and shares each week will win a $50 Amazon gift card.
BEHAVIORALDigital Health Social Media Challenge
Participants will attend a webinar to learn how to create effective social media posts about using technology to get healthy and be oriented to the social media accounts on which the messages will be posted. They will be informed that posts should mention some way that technology (e.g., mobile apps, wearables) can be used to promote a healthy habit (e.g., diet, exercise). They will be encouraged to be creative so that the message gets likes and shares. Participants will be encouraged to follow the feeds to see the engagement on their posts, to share the posts in their feed, and to see other participants' posts. Participants will receive a $10 Amazon gift card per post for a maximum of 6 posts ($60). The participant who created the post that receives the most likes, comments, and shares each week will win a $50 Amazon gift card.
Sponsors
National Cancer Institute (NCI)
University of Connecticut
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
18 Years to 30 Years
Healthy volunteers
Yes
Inclusion criteria
* Ages 18-30 * Tanned indoors or outdoors at least once in the past year * Intends to tan indoors or outdoors this summer * Daily user of any social media platform
Exclusion criteria
* No smartphone * Does not use a social media platform daily * Lives in a state with an average temperature \<75 degrees in May * Inability to provide consent due to mental illness or a cognitive impairment * Non-English speaking * Prisoner
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Contamination | 4-week follow-up | The number of participants who report they saw the opposite conditions Facebook or Twitter feeds. |
| Retention | 4-week follow-up | The % of participants in each condition who complete the follow-up assessment. |
| Acceptability | 4-week follow-up | Number of participants who selected agree or strongly agree on 5-point Likert scale rating of how likely participants would be to recommend the intervention to a friend, and how likely they would be to participate again. |
| Participation | 4-week follow-up | The number of posts created by participants |
| Post Engagement | 4 weeks | The median number of likes, shares and retweets, and unique commenters each participant post received. |
| Desirability of Tanning | Baseline | Scale measuring participants' belief that a tan is attractive. Scale ranges from 0-12 with higher scores indicating higher levels of belief that a tan is attractive. |
| Desirability of Tanning Alternatives | Baseline | Average score on items relating to tanning alternative desirability. Scale ranges from 1 to 5, with higher scores indicating more positive attitudes towards tanning alternatives. |
| Persuasive Impact of Participant Messages | 4-week follow-up | The mean of participants ratings for how persuasive they found each post (other than those they created) on a scale of 0-100, with higher scores indicating more persuasive. |
| Recruitment | Baseline | The number of completed respondents to recruitment ads, number of respondents eligible at initial screening, and number of respondents who completed baseline. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Outdoor Tanning Intentions | Baseline | Three items assessed intentions to tan even once, intentions to tan regularly in the next year, and intentions to quit on a 7-point scale (0=definitely will not, 6=definitely will). |
| Outdoor Tanning | Baseline | How many times in the last 4 weeks the participant went outside for the purpose of tanning in the sun. |
| Sun Protection | Baseline | Number of participants who reported using sun protection (sunscreen, protective clothing) often or always in the past month |
| Indoor Tanning Behavior | Baseline | Number of indoor tanning visits in the previous month |
| Sunburn | baseline | Number of participants with 1 or more sunburns in the past month |
| Outdoor Tanning Duration | 4 weeks | Median reported average number of minutes tanned per episode in the past 4 weeks, among participants who tanned in the past 4 weeks. |
| Sun Exposure | Baseline | How many hours the participant spent outside per week between the hours of 10am and 4pm. |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Sun Safety Social Media Challenge During this 4-week intervention, participants will be incentivized to create sun safety social media messages that will be distributed on our sun safety Twitter and Facebook feeds.
Sun Safety Social Media Challenge: Participants will attend a webinar to learn how to create effective social media posts about sun safety and be oriented to the social media accounts on which the messages will be posted. They will be informed that posts should include a sun safety message (e.g., promoting sunscreen use and protective clothing/hats or discouraging risk behaviors like tanning and burning). They will be encouraged to be creative so that the message gets likes and shares. Participants will be encouraged to follow the feeds to see the engagement on their posts, to share the posts in their feed, and to see other participants' posts. Participants will receive a $10 Amazon gift card per post for a maximum of 6 posts ($60). The participant who created the post that receives the most likes, comments, and shares each week will win a $50 Amazon gift card. | 34 |
| Digital Health Social Media Challenge During this 4-week intervention, participants will be incentivized to create posts that promote the use of technology to engage in healthy lifestyle behaviors (diet, exercise) on our digital health Twitter and Facebook feeds.
Digital Health Social Media Challenge: Participants will attend a webinar to learn how to create effective social media posts about using technology to get healthy and be oriented to the social media accounts on which the messages will be posted. They will be informed that posts should mention some way that technology (e.g., mobile apps, wearables) can be used to promote a healthy habit (e.g., diet, exercise). They will be encouraged to be creative so that the message gets likes and shares. Participants will be encouraged to follow the feeds to see the engagement on their posts, to share the posts in their feed, and to see other participants' posts. Participants will receive a $10 Amazon gift card per post for a maximum of 6 posts ($60). The participant who created the post that receives the most likes, comments, and shares each week will win a $50 Amazon gift card. | 32 |
| Total | 66 |
Baseline characteristics
| Characteristic | Digital Health Social Media Challenge | Total | Sun Safety Social Media Challenge |
|---|---|---|---|
| Age, Continuous | 23.5 years | 24.0 years | 24.0 years |
| Race/Ethnicity, Customized Race/ethnicity Hispanic/Latino of any race | 7 Participants | 12 Participants | 5 Participants |
| Race/Ethnicity, Customized Race/ethnicity Native Hawaiian or Other Pacific Islander, Native, Other, and Multiracial (Non-Hispanic) | 4 Participants | 5 Participants | 1 Participants |
| Race/Ethnicity, Customized Race/ethnicity Non-Hispanic Asian | 3 Participants | 12 Participants | 9 Participants |
| Race/Ethnicity, Customized Race/ethnicity Non-Hispanic Black/African American | 1 Participants | 2 Participants | 1 Participants |
| Race/Ethnicity, Customized Race/ethnicity Non-Hispanic White | 17 Participants | 35 Participants | 18 Participants |
| Sex/Gender, Customized Gender Female | 27 Participants | 55 Participants | 28 Participants |
| Sex/Gender, Customized Gender Male | 5 Participants | 10 Participants | 5 Participants |
| Sex/Gender, Customized Gender Non-Binary/Third Gender | 0 Participants | 1 Participants | 1 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 34 | 0 / 32 |
| other Total, other adverse events | 0 / 34 | 0 / 32 |
| serious Total, serious adverse events | 0 / 34 | 0 / 32 |
Outcome results
Primary
Acceptability
Number of participants who selected agree or strongly agree on 5-point Likert scale rating of how likely participants would be to recommend the intervention to a friend, and how likely they would be to participate again.
Time frame: 4-week follow-up
Population: Randomized participants
| Arm | Measure | Group | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Prospective Participants | Acceptability | I would participate in this study competition on this health topic again. | 31 Participants |
| Prospective Participants | Acceptability | I would recommend this study competition to a friend. | 32 Participants |
| Digital Health Social Media Challenge | Acceptability | I would participate in this study competition on this health topic again. | 29 Participants |
| Digital Health Social Media Challenge | Acceptability | I would recommend this study competition to a friend. | 31 Participants |
Primary
Contamination
The number of participants who report they saw the opposite conditions Facebook or Twitter feeds.
Time frame: 4-week follow-up
Population: Randomized participants
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Prospective Participants | Contamination | 7 Participants |
| Digital Health Social Media Challenge | Contamination | 10 Participants |
Primary
Desirability of Tanning
Scale measuring participants' belief that a tan is attractive. Scale ranges from 0-12 with higher scores indicating higher levels of belief that a tan is attractive.
Time frame: Baseline
Population: Randomized participants
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Prospective Participants | Desirability of Tanning | 11 score on a scale |
| Digital Health Social Media Challenge | Desirability of Tanning | 11 score on a scale |
Primary
Desirability of Tanning
Scale measuring participants' belief that a tan is attractive. Scale ranges from 0-12 with higher scores indicating higher levels of belief that a tan is attractive.
Time frame: 4-week follow-up
Population: Randomized participants
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Prospective Participants | Desirability of Tanning | 10 score on a scale |
| Digital Health Social Media Challenge | Desirability of Tanning | 10.5 score on a scale |
Primary
Desirability of Tanning Alternatives
Average score on items relating to tanning alternative desirability. Scale ranges from 1 to 5, with higher scores indicating more positive attitudes towards tanning alternatives.
Time frame: Baseline
Population: Randomized participants
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Prospective Participants | Desirability of Tanning Alternatives | 3.0 score on a scale | Standard Deviation 1.2 |
| Digital Health Social Media Challenge | Desirability of Tanning Alternatives | 3.5 score on a scale | Standard Deviation 1.2 |
Primary
Desirability of Tanning Alternatives
Average score on items relating to tanning alternative desirability. Scale ranges from 1 to 5, with higher scores indicating more positive attitudes towards tanning alternatives.
Time frame: 4-week follow-up
Population: Randomized participants
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Prospective Participants | Desirability of Tanning Alternatives | 2.8 score on a scale | Standard Deviation 1.1 |
| Digital Health Social Media Challenge | Desirability of Tanning Alternatives | 3.5 score on a scale | Standard Deviation 1.1 |
Primary
Participation
The number of posts created by participants
Time frame: 4-week follow-up
Population: Randomized participants
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Prospective Participants | Participation | 148 number of posts |
| Digital Health Social Media Challenge | Participation | 129 number of posts |
Primary
Persuasive Impact of Participant Messages
The mean of participants ratings for how persuasive they found each post (other than those they created) on a scale of 0-100, with higher scores indicating more persuasive.
Time frame: 4-week follow-up
Population: Randomized participants
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Prospective Participants | Persuasive Impact of Participant Messages | 62.2 score on a sliding scale | Standard Deviation 13.3 |
| Digital Health Social Media Challenge | Persuasive Impact of Participant Messages | 62.5 score on a sliding scale | Standard Deviation 14.7 |
Primary
Post Engagement
The median number of likes, shares and retweets, and unique commenters each participant post received.
Time frame: 4 weeks
Population: Randomized participants
| Arm | Measure | Group | Value (MEDIAN) |
|---|---|---|---|
| Prospective Participants | Post Engagement | Twitter Likes and Facebook Reactions | 4 Engagement |
| Prospective Participants | Post Engagement | Twitter Retweets and Facebook Shares | 2 Engagement |
| Prospective Participants | Post Engagement | Unique Commenters on Facebook and Twitter | 0 Engagement |
| Digital Health Social Media Challenge | Post Engagement | Twitter Likes and Facebook Reactions | 2 Engagement |
| Digital Health Social Media Challenge | Post Engagement | Twitter Retweets and Facebook Shares | 0 Engagement |
| Digital Health Social Media Challenge | Post Engagement | Unique Commenters on Facebook and Twitter | 0 Engagement |
Primary
Recruitment
The number of completed respondents to recruitment ads, number of respondents eligible at initial screening, and number of respondents who completed baseline.
Time frame: Baseline
Population: All prospective participants
| Arm | Measure | Group | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Prospective Participants | Recruitment | Number of completed respondents to recruitment ads | 549 Participants |
| Prospective Participants | Recruitment | Number of respondents eligible at initial screening | 79 Participants |
| Prospective Participants | Recruitment | Number of respondents who completed baseline | 66 Participants |
Primary
Retention
The % of participants in each condition who complete the follow-up assessment.
Time frame: 4-week follow-up
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Prospective Participants | Retention | 34 Participants |
| Digital Health Social Media Challenge | Retention | 32 Participants |
Secondary
Indoor Tanning Behavior
Number of indoor tanning visits in the previous month
Time frame: 4 weeks
Population: Randomized participants
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Prospective Participants | Indoor Tanning Behavior | 0.0 indoor tanning sessions |
| Digital Health Social Media Challenge | Indoor Tanning Behavior | 0.0 indoor tanning sessions |
Secondary
Indoor Tanning Behavior
Number of indoor tanning visits in the previous month
Time frame: Baseline
Population: Randomized participants
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Prospective Participants | Indoor Tanning Behavior | 0.0 indoor tanning sessions |
| Digital Health Social Media Challenge | Indoor Tanning Behavior | 0.0 indoor tanning sessions |
Secondary
Outdoor Tanning
How many times in the last 4 weeks the participant went outside for the purpose of tanning in the sun.
Time frame: 4-week follow-up
Population: Randomized participants
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Prospective Participants | Outdoor Tanning | 0.0 outdoor tanning sessions |
| Digital Health Social Media Challenge | Outdoor Tanning | 2.0 outdoor tanning sessions |
Comparison: Null hypothesis: There would be no difference in tanning outside at follow-upp-value: <0.0002Wilcoxon (Mann-Whitney)
Secondary
Outdoor Tanning
How many times in the last 4 weeks the participant went outside for the purpose of tanning in the sun.
Time frame: Baseline
Population: Randomized participants
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Prospective Participants | Outdoor Tanning | 4.0 outdoor tanning sessions |
| Digital Health Social Media Challenge | Outdoor Tanning | 5.0 outdoor tanning sessions |
Secondary
Outdoor Tanning Duration
Median reported average number of minutes tanned per episode in the past 4 weeks, among participants who tanned in the past 4 weeks.
Time frame: Baseline
Population: Randomized participants who reported tanning one or more times in the past 4 weeks
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Prospective Participants | Outdoor Tanning Duration | 60.0 minutes |
| Digital Health Social Media Challenge | Outdoor Tanning Duration | 60.0 minutes |
Secondary
Outdoor Tanning Duration
Median reported average number of minutes tanned per episode in the past 4 weeks, among participants who tanned in the past 4 weeks.
Time frame: 4 weeks
Population: Randomized participants who reported tanning one or more times in the past 4 weeks
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Prospective Participants | Outdoor Tanning Duration | 45.0 minutes |
| Digital Health Social Media Challenge | Outdoor Tanning Duration | 60.0 minutes |
Secondary
Outdoor Tanning Intentions
Three items assessed intentions to tan even once, intentions to tan regularly in the next year, and intentions to quit on a 7-point scale (0=definitely will not, 6=definitely will).
Time frame: Baseline
Population: Randomized participants
| Arm | Measure | Group | Value (MEDIAN) |
|---|---|---|---|
| Prospective Participants | Outdoor Tanning Intentions | Tan outside in the sun sometime later in my life. | 6.0 score on a scale |
| Prospective Participants | Outdoor Tanning Intentions | Tan outside in the sun more than 10 times in the next year. | 6.0 score on a scale |
| Prospective Participants | Outdoor Tanning Intentions | Quit tanning outside in the next year. | 0.0 score on a scale |
| Digital Health Social Media Challenge | Outdoor Tanning Intentions | Tan outside in the sun sometime later in my life. | 6.0 score on a scale |
| Digital Health Social Media Challenge | Outdoor Tanning Intentions | Tan outside in the sun more than 10 times in the next year. | 6.0 score on a scale |
| Digital Health Social Media Challenge | Outdoor Tanning Intentions | Quit tanning outside in the next year. | 0.0 score on a scale |
Secondary
Outdoor Tanning Intentions
Three items assessed intentions to tan even once, intentions to tan regularly in the next year, and intentions to quit on a 7-point scale (0=definitely will not, 6=definitely will).
Time frame: 4-week follow-up
Population: Randomized participants
| Arm | Measure | Group | Value (MEDIAN) |
|---|---|---|---|
| Prospective Participants | Outdoor Tanning Intentions | Tan outside in the sun sometime later in my life. | 5.0 score on a scale |
| Prospective Participants | Outdoor Tanning Intentions | Tan outside in the sun more than 10 times in the next year. | 3.0 score on a scale |
| Prospective Participants | Outdoor Tanning Intentions | Quite tanning outside in the next year. | 1.0 score on a scale |
| Digital Health Social Media Challenge | Outdoor Tanning Intentions | Tan outside in the sun sometime later in my life. | 6.0 score on a scale |
| Digital Health Social Media Challenge | Outdoor Tanning Intentions | Tan outside in the sun more than 10 times in the next year. | 5.0 score on a scale |
| Digital Health Social Media Challenge | Outdoor Tanning Intentions | Quite tanning outside in the next year. | 0.0 score on a scale |
Comparison: Null hypothesis: There would be no difference in change in intent to tan outdoors 10 or more times in the next year.p-value: <0.0286Wilcoxon (Mann-Whitney)
Comparison: Null hypothesis: There would be no difference in change in in intent to tan later in life.p-value: 0.0937Wilcoxon (Mann-Whitney)
Secondary
Sunburn
Number of participants with 1 or more sunburns in the past month
Time frame: baseline
Population: Randomized participants
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Prospective Participants | Sunburn | 15 Participants |
| Digital Health Social Media Challenge | Sunburn | 13 Participants |
Secondary
Sunburn
Number of participants with 1 or more sunburns in the past month
Time frame: 4 weeks
Population: Randomized participants
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Prospective Participants | Sunburn | 5 Participants |
| Digital Health Social Media Challenge | Sunburn | 2 Participants |
Secondary
Sun Exposure
How many hours the participant spent outside per week between 10am and 4pm
Time frame: 4-week follow-up
Population: all randomized participants
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Prospective Participants | Sun Exposure | 11.4 hours per week | Standard Deviation 5.9 |
| Digital Health Social Media Challenge | Sun Exposure | 13.2 hours per week | Standard Deviation 8.2 |
Secondary
Sun Exposure
How many hours the participant spent outside per week between the hours of 10am and 4pm.
Time frame: Baseline
Population: all randomized participants
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Prospective Participants | Sun Exposure | 16.1 hours per week | Standard Deviation 10.4 |
| Digital Health Social Media Challenge | Sun Exposure | 15.6 hours per week | Standard Deviation 7.3 |
Secondary
Sun Protection
Number of participants who reported using sun protection (sunscreen, protective clothing) often or always in the past month
Time frame: 4-week follow-up
Population: Randomized participants
| Arm | Measure | Group | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Prospective Participants | Sun Protection | How often did you wear a shirt with sleeves that covered your shoulders? | 20 Participants |
| Prospective Participants | Sun Protection | How often did you stay in the shade or under an umbrella? | 12 Participants |
| Prospective Participants | Sun Protection | How often did you wear a hat? | 6 Participants |
| Prospective Participants | Sun Protection | How often did you wear sunglasses? | 18 Participants |
| Prospective Participants | Sun Protection | How often did you wear sunscreen? | 19 Participants |
| Digital Health Social Media Challenge | Sun Protection | How often did you wear sunglasses? | 22 Participants |
| Digital Health Social Media Challenge | Sun Protection | How often did you wear sunscreen? | 16 Participants |
| Digital Health Social Media Challenge | Sun Protection | How often did you wear a shirt with sleeves that covered your shoulders? | 14 Participants |
| Digital Health Social Media Challenge | Sun Protection | How often did you wear a hat? | 4 Participants |
| Digital Health Social Media Challenge | Sun Protection | How often did you stay in the shade or under an umbrella? | 5 Participants |
Secondary
Sun Protection
Number of participants who reported using sun protection (sunscreen, protective clothing) often or always in the past month
Time frame: Baseline
Population: Randomized participants
| Arm | Measure | Group | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Prospective Participants | Sun Protection | How often did you wear a shirt with sleeves that covered your shoulders? | 15 Participants |
| Prospective Participants | Sun Protection | How often did you stay in the shade or under an umbrella? | 3 Participants |
| Prospective Participants | Sun Protection | How often did you wear a hat? | 8 Participants |
| Prospective Participants | Sun Protection | How often did you wear sunglasses? | 19 Participants |
| Prospective Participants | Sun Protection | How often did you wear sunscreen? | 18 Participants |
| Digital Health Social Media Challenge | Sun Protection | How often did you wear sunglasses? | 21 Participants |
| Digital Health Social Media Challenge | Sun Protection | How often did you wear sunscreen? | 16 Participants |
| Digital Health Social Media Challenge | Sun Protection | How often did you wear a shirt with sleeves that covered your shoulders? | 9 Participants |
| Digital Health Social Media Challenge | Sun Protection | How often did you wear a hat? | 2 Participants |
| Digital Health Social Media Challenge | Sun Protection | How often did you stay in the shade or under an umbrella? | 0 Participants |