Sun exposure reduction by melanoma survivors with wearable sensor providing real-time UV exposure and daily text message
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ORIGINAL PAPER
Sun exposure reduction by melanoma survivors with wearable sensor providing real‑time UV exposure and daily text messages with structured goal setting June K. Robinson1 · Dalya A. Durst1 · Elizabeth Gray2 · Mary Kwasny2 · Seung Yun Heo3 · Anthony Banks3 · John A. Rogers3 Received: 30 June 2020 / Revised: 19 October 2020 / Accepted: 30 October 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
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 600) [21]. Participants were shown how to sync the provided android phone with the UV sensor. The app demonstration included screens displaying the real-time UVA exposure. Participants were told that the UVB exposure could be obtained in real-time by dividing the UVA exposure displayed on the smartphone by 20 [22]. At the end of each day, the cumulative daily UVB exposure was provided on the screen of the phone. Participants compared daily UVB exposures received on the preceding days on the phone. Participants were asked to wear the UV sensor daily on their wrist for 21 days from 6 AM to 6 PM or until they remained inside for the evening. If they wore a long-sleeved shirt, they were asked to place the sensor outside the sleeve. This sensor placement was demonstrated by enlarging the band that circled the wrist and placing the sensor of the wrist with the face on the dorsal aspect of the wrist. Participants were informed that the sensor reported exposure of the wrist, which would be different for other locations on the body and did not consider the person’s use of sun protection. Participants received daily text messages to sync the device each morning, mid-day, afternoon and evening. They could sync the sensor as many times during the day as they wished to obtain the UV dose during an outdoor period. Four thematic groups of text messages were provided daily in the following sequence: (a) behavioral facilitation (Some shade structures provide low protection (SPF = 2–5) due to reflection of sun [23]), (b) outcome expectancies (A “base tan” will only give you a SPF of 4 and does not
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