key: cord-1005055-1lcx2vju authors: Robinson, June K; Patel, Shiv; Heo, Seung Yun; Gray, Elizabeth; Lim, Jaeman; Kwon, Kyeongha; Christiansen, Zach; Model, Jeffrey; Trueb, Jacob; Banks, Anthony; Kwasny, Mary; Rogers, John A title: Real-Time UV Measurement With a Sun Protection System for Warning Young Adults About Sunburn: Prospective Cohort Study date: 2021-05-06 journal: JMIR Mhealth Uhealth DOI: 10.2196/25895 sha: 0b111c5c759104ab1926070def5a09eb367ace98 doc_id: 1005055 cord_uid: 1lcx2vju BACKGROUND: Melanoma is attributable to predisposing phenotypical factors, such as skin that easily sunburns and unprotected exposure to carcinogenic UV radiation. Reducing the proportion of young adults who get sunburned may reduce the incidence of melanoma, a deadly form of skin cancer. Advances in technology have enabled the delivery of real-time UV light exposure and content-relevant health interventions. OBJECTIVE: This study aims to examine the feasibility of young adults performing the following tasks daily: wearing a UV dosimeter, receiving text messages and real-time UV-B doses on their smartphone, and responding to daily web-based surveys about sunburn and sun protection. METHODS: Young adults aged 18-39 years (n=42) were recruited in the United States in June 2020 via social media. Participants received the UV Guard sun protection system, which consisted of a UV dosimeter and a smartphone app. During 3 consecutive periods, intervention intensity increased as follows: real-time UV-B dose; UV-B dose and daily behavioral facilitation text messages; and UV-B dose, goal setting, and daily text messages to support self-efficacy and self-regulation. Data were self-reported through daily web-based surveys for 28 days, and UV-B doses were transmitted to cloud-based storage. RESULTS: Patients’ median age was 22 years (IQR 20, 29), and all patients had sun-sensitive skin. Sunburns were experienced during the study by fewer subjects (n=18) than those in the preceding 28 days (n=30). In July and August, the face was the most commonly sunburned area among 13 body locations; 52% (22/42) of sunburns occurred before the study and 45% (19/42) occurred during the study. The mean daily UV-B dose decreased during the 3 periods; however, this was not statistically significant. Young adults were most often exercising outdoors from 2 to 6 PM, walking from 10 AM to 6 PM, and relaxing from noon to 2 PM. Sunburn was most often experienced during exercise (odds ratio [OR] 5.65, 95% CI 1.60-6.10) and relaxation (OR 3.69, 95% CI 1.03-4.67) relative to those that did not exercise or relax in each category. The self-reported exit survey indicated that participants felt that they spent less time outdoors this summer compared to the last summer because of the COVID-19 pandemic and work. In addition, 38% (16/42) of the participants changed their use of sun protection based on their app-reported UV exposure, and 48% (20/42) shifted the time they went outside to periods with less-intense UV exposure. A total of 79% (33/42) of the participants were willing to continue using the UV Guard system outside of a research setting. CONCLUSIONS: In this proof-of-concept research, young adults demonstrated that they used the UV Guard system; however, optimization was needed. Although some sun protection behaviors changed, sunburn was not prevented in all participants, especially during outdoor exercise. TRIAL REGISTRATION: ClinicalTrials.gov NCT03344796; http://clinicaltrials.gov/ct2/show/NCT03344796 In the past 28 days, on average, how many hours are 30 minutes or less you outside per day between 10 AM and 4 PM on 31 minutes to 1 hour WEEKDAYS (Monday-Friday)? Select one answer. More than 1 hour and up to 2 hours More than 2 hours and up to 3 hours More than 3 hours and up to 4 hours More than 4 hours and up to 5 hours More than 5 hours In the past 28 days, on average, how many hours are 30 minutes or less you outside per day between 10 AM and 4 PM on 31 minutes to 1 hour WEEKEND DAYS (Saturday & Sunday) ? Select one answer. More than 1 hour and up to 2 hours More than 2 hours and up to 3 hours More than 3 hours and up to 4 hours More than 4 hours and up to 5 hours More than 5 hours In the past 28 days, how many times did you get a 0 sunburn (a small part of your skin turned pink ) 1 for more than 12 hours? Select one answer. 2 3 4 5 or more In the past 28 days, how many times did you get a 0 sunburn (a small part of your skin was sensitive to 1 touch ) for more than 12 hours? Select one answer. 2 3 4 5 or more 07/29/2020 9:49am projectredcap.org Please complete the survey below. 2 I am very confident that I will NOT forget to reapply sunscreen. I am very confident that in summer, I will remember to wear a hat when I go outside. 07/29/2020 9:49am projectredcap.org I am very confident that in summer, I will be able to find shade when I am outside. summer, I will use sunglasses to protect my eyes when I am outside. 18) I am very confident that in summer, I will apply sunscreen before I go outside. summer, I will be sure to be in the shade when I am outside. summer, I will wear a shirt (blouse) that covers my upper arms when I am outside. protection can prevent the development of skin cancer. protection of my face will prevent me from getting wrinkles. 07/29/2020 9:49am projectredcap.org Please complete the survey below. Please complete the survey below. Thank you! 1) 1. I think that I would like to use this system frequently. 2) 2. I found the system unnecessarily complex. 3) 3. I thought the system was easy to use. 4) 4. I think that I would need the support of a technical person to be able to use this system. Disagree Neither Agree nor Disagree Agree Strongly Agree 5) 5. I found the various functions in this system were well integrated. 6) 6. I thought there was too much inconsistency in this system. 7) 7. I would imagine that most people would learn to use this system very quickly. 8) 8. I found the system very cumbersome to use. 9) 9. I felt very confident using the system. 10) 10. I needed to learn a lot of things before I could get going with this system. 07/31/2020 11:06am projectredcap.org Please complete the survey below. Knee-length shorts or skirt 3. Mid-calf length shorts/skirts/capris 4. Long pants Foot Coverage Please select your foot coverage 1. Bare feet/flip flops/sandals 2. Sneakers/closed-toe shoes 3 Please complete the survey below.Thank you! Yesterday you picked as a goal:Yes No "Apply sunscreen to all of the areas of my body that may be exposed to the sun" Did you shift the time you went outside to periods with less intense UV exposure? For example, did you go outside early in the morning or late in the afternoon? Did you change how much time you spent outside based on your observed UV exposure as seen on the graph presented on your phone? Did you change your use of sun protection based on your observed UV exposure as seen on the graph presented on your phone? How did you change your use of sun protection?