Social Media Indoor Tanning Study

The purpose of this research is to develop a social media delivered intervention to reduce unprotected sun exposure in young adults with a history of tanning.

We will use social marketing theory and a user-centered design approach to develop a social media intervention that engages young adults with a history of tanning to practice sun safety behaviors. We will incentivize young adults who have a history of tanning to create social media posts that encourage their peers to engage in sun safety. Focus groups of tanners guided the development of the intervention. Investigators will conduct a pilot feasibility trial where participants will be randomized to a condition in which they are incentivized to create sun safety social media messages to be posted on a sun safety social media account or a condition in which they are incentivized to create social media messages about how to use technology to support healthy lifestyle behaviors to be posted on a health technology social media account. The intervention will last 4 weeks. Feasibility outcomes include recruitment, retention, acceptability, participation, social media message engagement (likes, comments, shares), persuasive impact of messages, unprotected sun exposure, sun protection, and tanning behavior. This work will inform a fully powered randomized trial testing the efficacy of this intervention.

During this 4-week intervention, participants will be incentivized to create sun safety social media messages that will be distributed on our sun safety Twitter and Facebook feeds.

During this 4-week intervention, participants will be incentivized to create posts that promote the use of technology to engage in healthy lifestyle behaviors (diet, exercise) on our digital health Twitter and Facebook feeds.

Participants will attend a webinar to learn how to create effective social media posts about sun safety and be oriented to the social media accounts on which the messages will be posted. They will be informed that posts should include a sun safety message (e.g., promoting sunscreen use and protective clothing/hats or discouraging risk behaviors like tanning and burning). They will be encouraged to be creative so that the message gets likes and shares. Participants will be encouraged to follow the feeds to see the engagement on their posts, to share the posts in their feed, and to see other participants' posts. Participants will receive a $10 Amazon gift card per post for a maximum of 6 posts ($60). The participant who created the post that receives the most likes, comments, and shares each week will win a $50 Amazon gift card.

Participants will attend a webinar to learn how to create effective social media posts about using technology to get healthy and be oriented to the social media accounts on which the messages will be posted. They will be informed that posts should mention some way that technology (e.g., mobile apps, wearables) can be used to promote a healthy habit (e.g., diet, exercise). They will be encouraged to be creative so that the message gets likes and shares. Participants will be encouraged to follow the feeds to see the engagement on their posts, to share the posts in their feed, and to see other participants' posts. Participants will receive a $10 Amazon gift card per post for a maximum of 6 posts ($60). The participant who created the post that receives the most likes, comments, and shares each week will win a $50 Amazon gift card.

The number of completed respondents to recruitment ads, number of respondents eligible at initial screening, and number of respondents who completed baseline.

Number of participants who selected agree or strongly agree on 5-point Likert scale rating of how likely participants would be to recommend the intervention to a friend, and how likely they would be to participate again.

The median number of likes, shares and retweets, and unique commenters each participant post received.

Scale measuring participants' belief that a tan is attractive. Scale ranges from 0-12 with higher scores indicating higher levels of belief that a tan is attractive.

Scale measuring participants' belief that a tan is attractive. Scale ranges from 0-12 with higher scores indicating higher levels of belief that a tan is attractive.

Average score on items relating to tanning alternative desirability. Scale ranges from 1 to 5, with higher scores indicating more positive attitudes towards tanning alternatives.

Average score on items relating to tanning alternative desirability. Scale ranges from 1 to 5, with higher scores indicating more positive attitudes towards tanning alternatives.

The mean of participants ratings for how persuasive they found each post (other than those they created) on a scale of 0-100, with higher scores indicating more persuasive.

Three items assessed intentions to tan even once, intentions to tan regularly in the next year, and intentions to quit on a 7-point scale (0=definitely will not, 6=definitely will).

Three items assessed intentions to tan even once, intentions to tan regularly in the next year, and intentions to quit on a 7-point scale (0=definitely will not, 6=definitely will).

How many times in the last 4 weeks the participant went outside for the purpose of tanning in the sun.

How many times in the last 4 weeks the participant went outside for the purpose of tanning in the sun.

Number of participants who reported using sun protection (sunscreen, protective clothing) often or always in the past month

Number of participants who reported using sun protection (sunscreen, protective clothing) often or always in the past month

Median reported average number of minutes tanned per episode in the past 4 weeks, among participants who tanned in the past 4 weeks.

Median reported average number of minutes tanned per episode in the past 4 weeks, among participants who tanned in the past 4 weeks.

Inclusion Criteria: Ages 18-30 Tanned indoors or outdoors at least once in the past year Intends to tan indoors or outdoors this summer Daily user of any social media platform Exclusion Criteria: No smartphone Does not use a social media platform daily Lives in a state with an average temperature <75 degrees in May Inability to provide consent due to mental illness or a cognitive impairment Non-English speaking Prisoner

Pagoto SL, Waring ME, Groshon LC, Rosen AO, Schroeder MW, Goetz JM. Proof-of-Concept Feasibility Trial of a Dissonance-Based Sun Safety Intervention for Young Adult Tanners. Ann Behav Med. 2022 Aug 2;56(8):830-841. doi: 10.1093/abm/kaab116.