Sun protection education for adolescents: a feasibility study of a wait-list controlled trial of an intervention involving a presentation, action planning, and SMS messages and using objective measurement of sun exposure

Hubbard, Gill; Cherrie, John; Gray, Jonathan; Kyle, Richard G.; Nioi, Amanda; Wendelboe-Nelson, Charlotte; Cowie, Hilary; Dombrowski, Stephan

Abstract

Background: People increase their risk of melanoma unless they are protected from the harmful effects of sun exposure during childhood and adolescence. We aimed to assess the feasibility of a three-component sun protection intervention- presentation, action planning, and SMS messages - and trial parameters.

Methods: This feasibility wait-list trial was conducted in the United Kingdom in 2018. Students aged 13–15 years were eligible. Feasibility outcomes were collected for recruitment rates; data availability rates for objective measurements of melanin and erythema using a Mexameter and self-reported sunburn occurrences, severity and body location, tanning, sun protection behaviours and Skin Self-Examination (SSE) collected before (baseline) and after the school summer holidays (follow-up); intervention reach, adherence, perceived impact and acceptability. Quantitative data were analysed using descriptive statistics; qualitative data were analysed thematically.

Results: Five out of eight schools expressing an interest in participating with four allocated to act as intervention and one control. Four parents/carers opted their child out of the study. Four hundred and eighty-seven out of 724 students on the school register consented to the study at baseline (67%). Three hundred and eighty-five were in intervention group schools. Objective skin measurements were available for 255 (66%) of the intervention group at baseline and 237 (61%) of the group at follow up. Melanin increased; erythema decreased. Complete self-report data were available for 247 (64%) students in the intervention group. The number of students on the school register who attended the presentation and given the booklet was 379 (98%) and gave their mobile phone number was 155 (40%). No intervention component was perceived as more impactful on sun protection behaviours. Adolescents did not see the relevance of sun protection in the UK or for their age group.

Conclusions: This is the first study to use a Mexameter to measure skin colour in adolescents. Erythema (visible redness) lasts no more than three days and its measurement before and after a six week summer holiday may not yield relevant or meaningful data. A major challenge is that adolescents do not see the relevance of sun protection and SSE.

Trial registration: International Standard Randomised Controlled Trial Number ISRCTN11141528. Date registered 0/2/03/2018; last edited 31/05/2018. Retrospectively registered.

Citation

Hubbard, G., Cherrie, J., Gray, J., Kyle, R. G., Nioi, A., Wendelboe-Nelson, C., …Dombrowski, S. (2020). Sun protection education for adolescents: a feasibility study of a wait-list controlled trial of an intervention involving a presentation, action planning, and SMS messages and using objective measurement of sun exposure. BMC Public Health, 20, Article 131 (2020). https://doi.org/10.1186/s12889-020-8265-0

• Journal Article Type: Article
• Acceptance Date: Jan 22, 2020
• Online Publication Date: Jan 30, 2020
• Publication Date: Jan 30, 2020
• Deposit Date: Feb 3, 2020
• Publicly Available Date: Feb 3, 2020
• Journal: BMC Public Health
• Publisher: BMC
• Peer Reviewed: Peer Reviewed
• Volume: 20
• Article Number: 131 (2020)
• DOI: https://doi.org/10.1186/s12889-020-8265-0
• Keywords: Skin cancer, Skin self-examination, Adolescence
• Public URL: http://researchrepository.napier.ac.uk/Output/2531157