Introduction
Text messaging is an effective way to reach large populations with health promotion
support. This study aims to establish the optimal text messaging intervention to achieve
behavior change in young adults at risk of skin cancer.
Study Design
Latin square crossover RCT.
Setting/participants
Participants were women and men aged 18–40 years living in Queensland, Australia who
owned a smartphone and had ≥2 skin cancer risk factors.
Intervention
Participants were enrolled from December 2018 to February 2019 and completed an eligibility
survey. Eligible participants were randomized to 4 different text message interventions
using a Latin square design with varying personalization, interactivity, and message
frequency (February 2019‒July 2019). Each intervention lasted for 1 month; between
interventions, participants had a 1-week washout period in which they completed an
online questionnaire. Participants completed a 6-month follow-up online survey in
January 2020.
Main outcome measures
Measures included self-reported sun protection habits and sunburns.
Results
A total of 277 (71.2% response rate) participants completed the 6-month follow-up.
The sun protection habits index was significantly higher in all the 4 text messaging
interventions (p<0.01 for each intervention) than at baseline, with similar sun protection habits
improvements among all interventions (p=0.27). Sunburn rates decreased significantly over time (p<0.01 each intervention), with all the 4 interventions achieving reductions in sunburn
rates during the intervention periods (p=0.78). Overall, the sunburn rates decreased from 40.3% at baseline to 7.0% at the
end of the intervention, and at 6-month follow-up, it remained significantly below
baseline levels at 23.5% (p<0.01).
Conclusions
Regular text messaging interventions result in significantly increased sun protection
and decreased sunburn in young adults.
Trial registration
This study is registered at the Australian and New Zealand Clinical Trials Registry
ACTRN12618001299291.
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Article Info
Publication History
Published online: July 15, 2021
Identification
Copyright
© 2021 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
