Real-Time Mobile App Improved Some Sun-Protection Behaviors

Two studies published recently in JAMA:Dermatology showed that the use of a smartphone application was able to improve certain sun protection behaviors among study participants.

In the first study, David B. Buller, PhD, of Klein Buendel Inc., Golden, Colo., and colleagues randomly assigned 604 participants to use a smartphone application that provided personalized, real-time sun protection advice (n = 305) or to a control group (n = 232). The mobile application provided advice based on the UV index forecasts, personal information provided by the participant users, and reminders to apply or reapply sunscreen. Of the participants assigned to the treatment group, only 125 participants (41%) used the mobile application.

Participants assigned to the treatment group had significantly more mean days staying in the shade compared with participants in the control group (41% vs 33.7%; P = .03). In addition, those participants using the mobile application reported spending less time in the sun (mean days keeping time in the sun to a minimum 60.4% vs 49.3%; P = .04), and using all of the recommended protection behaviors combined (mean days 39.4% vs 33.8%; P = .04).

However, those participants assigned to the treatment group also reported less sunscreen use than controls (28.6% vs 34.5%; P = .048), and participants in both groups had similar rates of sunburns in the past 3 months.

“The Solar Cell mobile app seemed to promote sun protection practices, especially when it was used,” the researchers wrote. “Specifically, it increased use of shade. Shade can substantially reduce exposure to solar UV radiation, but it needs to be available for it to be used.”

In the second study, also by Buller and colleagues, a group of 202 volunteers were recruited to evaluate the same mobile application. This time, of the 96 participants assigned to the intervention, 74 participants used the application. Results from these participants were compared with a group of control participants at 3 weeks and 8 weeks after trial randomization.

In this group of participants, those assigned to the mobile application had increased use of wide-brimmed hats at 7 weeks compared with control participants (23.8% vs 17.4%; P = .045). Women assigned to the intervention were more likely to use all of the suggested sun protection behaviors than were men (P = .04). Men and older individuals enrolled reported overall less use of sunscreen (32.7% vs 35.5%; P = .04) and were less likely to use hats (15.6% vs 17.9%; P = .03).

Although the results indicated that the use of the mobile application was greater in the second study, the researchers acknowledged that strategies to increase use of the application are required in order to effectively deploy it to the general population.

In an editorial published with the two studies, A. Shadi Kourosh, MD, and Joseph C. Kvedar, MD, of the Massachusetts General Hospital, Boston, wrote: “The studies by Buller et al in this issue of JAMA Dermatology, in which smartphone apps were used to provide patients with personalized sun protection education, offer interesting examples of the creativity and educational tools that can be applied to health care delivery in this era of increasing penetration of mobile technology. They also illustrate important lessons for those developing and testing health interventions that are patient and/or consumer focused in terms of the pitfalls reported by the authors.”

According to the company website, the Solar Cell application was developed by Klein Buendel under a contract with the National Cancer Institute.