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Published in: Archives of Dermatological Research 8/2021

01-10-2021 | Melanoma | Original Paper

Sun exposure reduction by melanoma survivors with wearable sensor providing real-time UV exposure and daily text messages with structured goal setting

Authors: June K. Robinson, Dalya A. Durst, Elizabeth Gray, Mary Kwasny, Seung Yun Heo, Anthony Banks, John A. Rogers

Published in: Archives of Dermatological Research | Issue 8/2021

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Abstract

Despite knowledge of subsequent melanoma risk and the benefit of sun protection in risk reduction, melanoma survivors often do not engage in adequate sun protection and continue to sunburn at rates similar to individuals without a history of skin cancer. This novel intensive intervention provided a wearable UV sensor delivering real-time UV exposure with a smartphone and daily text messages. On days 1–10 (period 1), behavioral facilitation and outcome expectancies messages were provided. On day 10, participants reviewed and reflected on their daily UV exposure on the previous 10 days and set goals for improving sun protection. Then on days 11–21 (period 2) self-efficacy and self-regulation messages were provided. Sixty melanoma survivors were randomized (1:1) to receive structured or unstructured goal setting queries on day 10. Controlling for cloudy/rain conditions with less UV due to weather, there was a time effect with a significant decrease in UV exposure from periods 1–2 [period 1–2, F (59) = 22.60, p < 0.0001]. In this short-term study, melanoma survivors managed their daily UV exposure to stay below their maximum tolerated UV dose. ClinicalTrials.gov Protocol Record NCT0334796, date of registration Nov 15, 2017.
Literature
1.
go back to reference Wu YP, Aspinwall LG, Conn BM, Stump T, Grahmann B, Leachman SA (2016) A systematic review of interventions to improve adherence to melanoma preventive behaviors for individuals at elevated risk. Prev Med 88:153–167PubMedPubMedCentralCrossRef Wu YP, Aspinwall LG, Conn BM, Stump T, Grahmann B, Leachman SA (2016) A systematic review of interventions to improve adherence to melanoma preventive behaviors for individuals at elevated risk. Prev Med 88:153–167PubMedPubMedCentralCrossRef
2.
go back to reference Bränström R, Kasparian NA, Chang YM, Affleck P, Tibben A, Aspinwall LG et al (2010) Predictors of sun protection behaviors and severe sunburn in an international online study. Cancer Epidemiol Biomark Prev 19(9):2199–2210CrossRef Bränström R, Kasparian NA, Chang YM, Affleck P, Tibben A, Aspinwall LG et al (2010) Predictors of sun protection behaviors and severe sunburn in an international online study. Cancer Epidemiol Biomark Prev 19(9):2199–2210CrossRef
3.
go back to reference Holman DM, Berkowitz Z, Guy GP Jr, Hartman AM, Perna FM (2014) The association between demographic and behavioral characteristics and sunburn among U.S. adults - National Health Interview Survey, 2014. Prev Med 63:6–12PubMedPubMedCentralCrossRef Holman DM, Berkowitz Z, Guy GP Jr, Hartman AM, Perna FM (2014) The association between demographic and behavioral characteristics and sunburn among U.S. adults - National Health Interview Survey, 2014. Prev Med 63:6–12PubMedPubMedCentralCrossRef
4.
go back to reference Buller DB, Cokkinides V, Hall HI et al (2011) Prevalence of sunburn, sun protection, and indoor tanning behaviors among Americans: review from national surveys and case studies of 3 states. J Am Acad Dermatol 65:S114–S123PubMedCrossRef Buller DB, Cokkinides V, Hall HI et al (2011) Prevalence of sunburn, sun protection, and indoor tanning behaviors among Americans: review from national surveys and case studies of 3 states. J Am Acad Dermatol 65:S114–S123PubMedCrossRef
5.
go back to reference Holman DM, Ding H, Guy GP et al (2018) Prevalence of sun protection use and sunburn and association of demographic and behavioral characteristics with sunburn among US adults. JAMA Dermatol 154(5):51–568CrossRef Holman DM, Ding H, Guy GP et al (2018) Prevalence of sun protection use and sunburn and association of demographic and behavioral characteristics with sunburn among US adults. JAMA Dermatol 154(5):51–568CrossRef
6.
go back to reference Erdmann F, Lortet-Tieulent J, Schuz J et al (2013) International trends in the incidence of malignant melanoma 1953–2008–are recent generations at higher or lower risk? Int J Cancer 132(2):385–400PubMedCrossRef Erdmann F, Lortet-Tieulent J, Schuz J et al (2013) International trends in the incidence of malignant melanoma 1953–2008–are recent generations at higher or lower risk? Int J Cancer 132(2):385–400PubMedCrossRef
7.
go back to reference Whiteman DC, Green AC, Olsen CM (2016) The growing burden of invasive melanoma: projections of incidence rates and numbers of new cases in six susceptible populations through 2031. J Investig Dermatol 136(6):1161–1171PubMedCrossRef Whiteman DC, Green AC, Olsen CM (2016) The growing burden of invasive melanoma: projections of incidence rates and numbers of new cases in six susceptible populations through 2031. J Investig Dermatol 136(6):1161–1171PubMedCrossRef
8.
go back to reference Green AC, Williams GM, Logan V, Strutton GM (2010) Reduced melanoma after regular sunscreen use: randomized trial follow-up. J Clin Oncol 29:257–263PubMedCrossRef Green AC, Williams GM, Logan V, Strutton GM (2010) Reduced melanoma after regular sunscreen use: randomized trial follow-up. J Clin Oncol 29:257–263PubMedCrossRef
9.
go back to reference Diao DY, Lee TK (2013) Sun-protective behaviors in populations at high risk for skin cancer. Psychol Res Behav Manag 20:9–18 Diao DY, Lee TK (2013) Sun-protective behaviors in populations at high risk for skin cancer. Psychol Res Behav Manag 20:9–18
10.
go back to reference Freiman A, Yu J, Loutfi A, Wang B (2004) Impact of melanoma diagnosis on sun-awareness and protection: efficacy of education campaigns in a high-risk population. J Cutan Med Surg 8:303–309PubMedCrossRef Freiman A, Yu J, Loutfi A, Wang B (2004) Impact of melanoma diagnosis on sun-awareness and protection: efficacy of education campaigns in a high-risk population. J Cutan Med Surg 8:303–309PubMedCrossRef
11.
go back to reference Soto E, Lee H, Saladi RN, Gerson Y, Manginani S, Lam K, Persaud AN, Wong R, Alexandrescu DT, Fox JL (2010) Behavioral factors of patients before and after diagnosis with melanoma: a cohort study–are sun-protection measures being implemented? Melanoma Res 20:147–152PubMedCrossRef Soto E, Lee H, Saladi RN, Gerson Y, Manginani S, Lam K, Persaud AN, Wong R, Alexandrescu DT, Fox JL (2010) Behavioral factors of patients before and after diagnosis with melanoma: a cohort study–are sun-protection measures being implemented? Melanoma Res 20:147–152PubMedCrossRef
12.
go back to reference Idorn LW, Datta P, Heydenreich J, Philipsen PA, Wulf HC (2013) Sun behaviour after cutaneous malignant melanoma: a study based on ultraviolet radiation measurements and sun diary data. Br J Dermatol 168(2):367–373PubMedCrossRef Idorn LW, Datta P, Heydenreich J, Philipsen PA, Wulf HC (2013) Sun behaviour after cutaneous malignant melanoma: a study based on ultraviolet radiation measurements and sun diary data. Br J Dermatol 168(2):367–373PubMedCrossRef
13.
go back to reference Idorn LW, Datta P, Heydenreich J, Philipsen PA, Wulf HC (2014) A 3-year follow-up of sun behavior in patients with cutaneous malignant melanoma. JAMA Dermatol 150:163–168PubMedCrossRef Idorn LW, Datta P, Heydenreich J, Philipsen PA, Wulf HC (2014) A 3-year follow-up of sun behavior in patients with cutaneous malignant melanoma. JAMA Dermatol 150:163–168PubMedCrossRef
14.
go back to reference Nahar VK, Allison Ford M, Brodell RT et al (2016) Skin cancer prevention practices among malignant melanoma survivors: a systematic review. J Cancer Res Clin Oncol 142:1273–1283PubMedCrossRef Nahar VK, Allison Ford M, Brodell RT et al (2016) Skin cancer prevention practices among malignant melanoma survivors: a systematic review. J Cancer Res Clin Oncol 142:1273–1283PubMedCrossRef
15.
go back to reference Vogel RI, Strayer LG, Engelman L, Nelson HH, Blaes AH, Anderson KE, Lazovitch D (2017) Sun exposure and protection behaviors among long-term melanoma survivors and population controls. Cancer Epidemiol Biomark Prev 26(4):607–613CrossRef Vogel RI, Strayer LG, Engelman L, Nelson HH, Blaes AH, Anderson KE, Lazovitch D (2017) Sun exposure and protection behaviors among long-term melanoma survivors and population controls. Cancer Epidemiol Biomark Prev 26(4):607–613CrossRef
16.
go back to reference Moore SC, Lee IM, Weiderpass E et al (2016) Association of leisure-time physical activity with risk of 26 types of cancer in 1.44 million adults. JAMA Int Med 176(6):8160825CrossRef Moore SC, Lee IM, Weiderpass E et al (2016) Association of leisure-time physical activity with risk of 26 types of cancer in 1.44 million adults. JAMA Int Med 176(6):8160825CrossRef
17.
go back to reference Coups EJ, Ostroff JA (2005) A population-based estimate of the prevalence of behavioral risk factors among adult cancer survivors and noncancer controls. Prev Med 40:702–711PubMedCrossRef Coups EJ, Ostroff JA (2005) A population-based estimate of the prevalence of behavioral risk factors among adult cancer survivors and noncancer controls. Prev Med 40:702–711PubMedCrossRef
19.
go back to reference Thieden E, Philipsen PA, Sandby-Moller J, Wulf HC (2005) Sunscreen use related to UV exposure, age, sex, and occupation based on personal dosimeter readings and sun-exposure behavior diaries. Arch Dermatol 141(8):967–973PubMedCrossRef Thieden E, Philipsen PA, Sandby-Moller J, Wulf HC (2005) Sunscreen use related to UV exposure, age, sex, and occupation based on personal dosimeter readings and sun-exposure behavior diaries. Arch Dermatol 141(8):967–973PubMedCrossRef
20.
go back to reference Green LW, Kreuter MW (2005) Health program planning: an educational and ecological approach, 4th edn. McGraw-Hill, New York Green LW, Kreuter MW (2005) Health program planning: an educational and ecological approach, 4th edn. McGraw-Hill, New York
21.
go back to reference Diffey B (2017) Sun protection: a risk management. IOP Publishing Lts, Bristol Diffey B (2017) Sun protection: a risk management. IOP Publishing Lts, Bristol
22.
go back to reference Kollias N, Ruvolor E, Sayre RM (2011) The value of the ratio of UVA to UVB in sunlight. Photochem Photobiol 87:1474–1475PubMedCrossRef Kollias N, Ruvolor E, Sayre RM (2011) The value of the ratio of UVA to UVB in sunlight. Photochem Photobiol 87:1474–1475PubMedCrossRef
23.
go back to reference Parisi AV, Kimlin MG, Wong JC, Wilson M (2000) Personal exposure distribution of solar erythemal ultraviolet radiation in tree shade over summer. Phys Med Biol 45(2):349–356PubMedCrossRef Parisi AV, Kimlin MG, Wong JC, Wilson M (2000) Personal exposure distribution of solar erythemal ultraviolet radiation in tree shade over summer. Phys Med Biol 45(2):349–356PubMedCrossRef
24.
go back to reference Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG (2009) Research electronic data capture (REDCap) – a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform 42:377–381CrossRefPubMed Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG (2009) Research electronic data capture (REDCap) – a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform 42:377–381CrossRefPubMed
25.
go back to reference Robinson JK, Guevara Y, Gaber R, Clayman ML, Kwasny MJ, Friedewald JJ, Gordon EJ (2014) Efficacy of a sun protection workbook for kidney transplant recipients: a randomized controlled trial of a culturally sensitive educational intervention. Am J Transpl 14:2821–2829CrossRef Robinson JK, Guevara Y, Gaber R, Clayman ML, Kwasny MJ, Friedewald JJ, Gordon EJ (2014) Efficacy of a sun protection workbook for kidney transplant recipients: a randomized controlled trial of a culturally sensitive educational intervention. Am J Transpl 14:2821–2829CrossRef
27.
28.
go back to reference Hsieh H-F, Shannon SE (2005) Three approaches to qualitative content analysis. Qual Health Res 15(9):1277–1288CrossRefPubMed Hsieh H-F, Shannon SE (2005) Three approaches to qualitative content analysis. Qual Health Res 15(9):1277–1288CrossRefPubMed
29.
go back to reference Charmaz K (2006) Constructing grounded theory: a practical guide through qualitative analysis. Sage Publications, London Charmaz K (2006) Constructing grounded theory: a practical guide through qualitative analysis. Sage Publications, London
30.
go back to reference Braun V, Clarke V (2006) Using thematic analysis in psychology. Qual Res Psychol 3(2):77–101CrossRef Braun V, Clarke V (2006) Using thematic analysis in psychology. Qual Res Psychol 3(2):77–101CrossRef
31.
go back to reference Robinson JK, Durst DA, Gray E, Kwasny M (2020) Protection-adjusted UV dose estimated for body areas: daily self-reported sun protection modification of wearable UV sensor dose. Photodermatol Photoimmunol Photomed 00:1–8 Robinson JK, Durst DA, Gray E, Kwasny M (2020) Protection-adjusted UV dose estimated for body areas: daily self-reported sun protection modification of wearable UV sensor dose. Photodermatol Photoimmunol Photomed 00:1–8
32.
go back to reference Sache MM, Böttcher S, Pape L, Wagner G, Mehls O, Klaus G et al (2016) Face-to-face sun protection training and text messages improve sun protection behavior in adolescent organ transplant recipients: HIPPOline Feasibility study. Acta Derm Venereol 96:341–345CrossRef Sache MM, Böttcher S, Pape L, Wagner G, Mehls O, Klaus G et al (2016) Face-to-face sun protection training and text messages improve sun protection behavior in adolescent organ transplant recipients: HIPPOline Feasibility study. Acta Derm Venereol 96:341–345CrossRef
35.
36.
go back to reference Kamenisch Y, Baban TSA, Schuller W et al (2016) UVA-irradiation induces melanoma invasion via the enhanced warburg effect. J Investig Dermatol 136(9):1866–1875PubMedCrossRef Kamenisch Y, Baban TSA, Schuller W et al (2016) UVA-irradiation induces melanoma invasion via the enhanced warburg effect. J Investig Dermatol 136(9):1866–1875PubMedCrossRef
37.
go back to reference Young AR (1998) Does UVA exposure cause human malingnant melanoma? In: Rougier A, Schaefer H (eds) Protections of the skin against ultraviolet radiations. John Libbey Eurotext, Paris, pp 25–28 Young AR (1998) Does UVA exposure cause human malingnant melanoma? In: Rougier A, Schaefer H (eds) Protections of the skin against ultraviolet radiations. John Libbey Eurotext, Paris, pp 25–28
38.
go back to reference Miller SA, Hamilton SL, Wester UG, Cyr WH (1998) An analysis of UVA emissions from sunlamps and the potential importance for melanoma. Photochem Photobiol 68:63–70PubMedCrossRef Miller SA, Hamilton SL, Wester UG, Cyr WH (1998) An analysis of UVA emissions from sunlamps and the potential importance for melanoma. Photochem Photobiol 68:63–70PubMedCrossRef
39.
go back to reference Coelho SG, Hearing VJ (2010) UVA tanning is involved in the increased incidence of skin cancers in fair-skinned young women. Pigment Cell Melanoma Res 23:57–63PubMedCrossRef Coelho SG, Hearing VJ (2010) UVA tanning is involved in the increased incidence of skin cancers in fair-skinned young women. Pigment Cell Melanoma Res 23:57–63PubMedCrossRef
40.
go back to reference Noonan FP, Zaidi MR, Wolnicka-Glubisz A et al (2012) Melanoma induction by ultraviolet A but not ultraviolet B radiation requires melanin pigment. Nat Commun 3:1–10CrossRef Noonan FP, Zaidi MR, Wolnicka-Glubisz A et al (2012) Melanoma induction by ultraviolet A but not ultraviolet B radiation requires melanin pigment. Nat Commun 3:1–10CrossRef
42.
go back to reference Tewari A, Grage MM, Harrison GI, Sarkany R, Young AR (2013) UVA1 is skin deep: molecular and clinical implications. Photochem Photobiol Sci 12:95–103PubMedCrossRef Tewari A, Grage MM, Harrison GI, Sarkany R, Young AR (2013) UVA1 is skin deep: molecular and clinical implications. Photochem Photobiol Sci 12:95–103PubMedCrossRef
43.
go back to reference Deci EL, Ryan RM (2000) The ‘what’ and ‘why’ of goal pursuits: human needs and the self-determination of behavior. Psychol Inq 11:227–268CrossRef Deci EL, Ryan RM (2000) The ‘what’ and ‘why’ of goal pursuits: human needs and the self-determination of behavior. Psychol Inq 11:227–268CrossRef
44.
go back to reference Stump TK, Spring B, Marchese SH, Alshurafa N, Robinson JK (2019) Toward a precision behavioral medicine approach to addressing high-risk sun exposure: a qualitative analysis. JAMIA Open 2(4):547–553PubMedPubMedCentralCrossRef Stump TK, Spring B, Marchese SH, Alshurafa N, Robinson JK (2019) Toward a precision behavioral medicine approach to addressing high-risk sun exposure: a qualitative analysis. JAMIA Open 2(4):547–553PubMedPubMedCentralCrossRef
45.
go back to reference Mujumdar UJ, Hay JL, Monroe-Hinds YC, Hummer AJ, Begg CB, Wilcox HB, Oliveria SA, Berwick M (2009) Sun protection and skin self-examination in melanoma survivors. Psychooncology 18:1106–1115PubMedPubMedCentralCrossRef Mujumdar UJ, Hay JL, Monroe-Hinds YC, Hummer AJ, Begg CB, Wilcox HB, Oliveria SA, Berwick M (2009) Sun protection and skin self-examination in melanoma survivors. Psychooncology 18:1106–1115PubMedPubMedCentralCrossRef
46.
go back to reference Bowen D, Jabson J, Haddock N, Hay J, Edwards K (2012) Skin care behaviors among melanoma survivors. Psychooncology 21:1285–1291PubMedCrossRef Bowen D, Jabson J, Haddock N, Hay J, Edwards K (2012) Skin care behaviors among melanoma survivors. Psychooncology 21:1285–1291PubMedCrossRef
Metadata
Title
Sun exposure reduction by melanoma survivors with wearable sensor providing real-time UV exposure and daily text messages with structured goal setting
Authors
June K. Robinson
Dalya A. Durst
Elizabeth Gray
Mary Kwasny
Seung Yun Heo
Anthony Banks
John A. Rogers
Publication date
01-10-2021
Publisher
Springer Berlin Heidelberg
Published in
Archives of Dermatological Research / Issue 8/2021
Print ISSN: 0340-3696
Electronic ISSN: 1432-069X
DOI
https://doi.org/10.1007/s00403-020-02163-1

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