Self-Monitoring App Preferences for Sun Protection: Discrete Choice Experiment Survey Analysis (original) (raw)
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JMIR Research Protocols
Background The incidence of sun-exposure-related skin conditions, such as melanoma, is a gradually increasing and largely preventable public health problem. Simultaneously, the availability of mobile apps that enable the self-monitoring of health behavior and outcomes is ever increasing. Inevitably, recent years have seen an emerging volume of electronic patient-generated health data (PGHD), as well as their targeted application across primary prevention areas, including sun protection and skin health. Despite their preventive potential, the actual impact of these apps relies on the engagement of health care consumers, who are primarily responsible for recording, sharing, and using their PGHD. Exploring preferences is a key step toward facilitating consumer engagement and ultimately realizing their potential. Objective This paper describes an ongoing research project that aims to elicit the preferences of health care consumers for sun protection via app-based self-monitoring. Method...
JMIR Dermatology, 2018
Background: Recreational sun exposure has been associated with melanoma prevalence, and tourism settings are of particular interest for skin cancer prevention. Effective, affordable, and geographically flexible interventions to promote sun protection are needed. Objective: The aim of this study was to describe the protocol for a definitive randomized controlled trial (RCT) evaluating a smartphone mobile intervention (mISkin app) promoting sun protection in holidaymakers and to assess the acceptability and feasibility of the mISkin app and associated trial procedures in an internal pilot study. Methods: Participants were recruited from the general community. Holidaymakers traveling abroad and owning a smartphone were enrolled in the internal pilot of a 2 (mISkin vs control) x 2 (sun protection factor [SPF] 15 vs SPF 30) RCT with a postholiday follow-up. The smartphone app is fully automated and entails a behavioral intervention to promote sun protection. It consisted of five components: skin assessment, educational videos, ultraviolet (UV) photos, gamification, and prompts for sun protection. Participants were also randomly allocated to receive sunscreen SPF 15 or SPF 30. Primary outcomes for the internal pilot study were acceptability and feasibility of trial procedures and intervention features. Secondary outcomes were collected at baseline and after holidays through face-to-face-assessments and included skin sun damage, sunscreen use (residual weight and application events), and sun protection practices (Web-based questionnaire). Results: From 142 registers of interest, 42 participants were randomized (76% [32/42] female; mean age 35.5 years). Outcome assessments were completed by all participants. Random allocation to SPF 15 versus SPF 30 was found not to be feasible in a definitive trial protocol. Of the 21 people allocated to the mISkin intervention, 19 (91%) installed the mISkin on their phones, and 18 (86%) used it at least once. Participants were satisfied with the mISkin app and made suggestions for further improvements. Due to difficulties with the random allocation to SPF and slow uptake, the trial was discontinued. Conclusions: The internal pilot study concluded that randomization to SPF was not feasible and that recruitment rate was slower than expected because of difficulties with gatekeeper engagement. Possible solutions to the problems identified are discussed. Further refinements to the mISkin app are needed before a definitive trial.
Feasibility and acceptability of using an IVRS to assess decision making about sun protection
Psycho-oncology, 2019
Objective: We developed an Interactive Voice Response System (IVRS), an automated telephone survey technology, to assess real-time decision making about sun protection. We examined the feasibility and acceptability of IVRS in this electronic health (eHealth) context. Methods: Melanoma patients who underwent surgery referred their first-degree relatives (FDRs) for participation. Eligible FDRs were contacted twice daily (12:30 p.m.; 5 p.m.) over 14 consecutive days via IVRS to complete a survey about their sun protection behaviors and decisions about those behaviors. Results: Of the 81 eligible FDRs, 69 (85%) consented to the study, and 53 (77%) completed the study. We assessed adherence with the IVRS via the number and pattern of missing survey items across all answered IVRS calls. About 80% of scheduled IVRS calls were answered (1316/1652). Most surveys (93%) of the IVRS-answered calls were completed. To examine acceptability, we analyzed the program satisfaction survey data collected at the end of the study. Most participants viewed the IVRS to be highly acceptable and easy to use. Conclusions: These findings illustrate that use of real-time IVRS data collection regarding sun protection decision-making is feasible and acceptable to higher-risk research participants and could thus be used with time and location-sensitive eHealth support to enhance sun protection decision making.
Research Square (Research Square), 2022
Background Despite the worldwide growth in mHealth tools and the possible bene ts for both patients and healthcare providers, adoption of mHealth is low and only a limited number of studies have examined the intention to download mHealth apps. In the current study, we investigated individuals' preferences in the adoption of a health app. Methods We conducted a discrete choice experimental study in three countries (Spain [N = 800], Germany [N = 800], and the Netherlands [N = 416]) with four different vignettes (i.e., revenue models, data protection models, recommendation models, manufacturer models) with different attributes. Participants were randomly assigned.
Consumer preference to utilise a mobile health app: A stated preference experiment
PLOS ONE, 2020
Background One prominent barrier faced by healthcare consumers when accessing health services is a common requirement to complete repetitive, inefficient paper-based documentation at multiple registration sites. Digital innovation has a potential role to reduce the burden in this area, through the collection and sharing of data between healthcare providers. While there is growing evidence for digital innovations to potentially improve the effectiveness and efficiency of health systems, there is less information on the willingness of healthcare consumers to embrace and utilise technology to provide data. Aim The study aims to improve understanding of consumers' preference for utilising a digital health administration mobile app.
Real-time sun protection decisions in first-degree relatives of melanoma patients
Health Psychology
Objective-Melanoma is the most serious skin cancer, and consistent use of sun protection is recommended to reduce risk. Yet, sun protection use is generally inconsistent. Understanding the decisional factors driving sun protection choices could aid in intervention development to promote sun protection maintenance. Methods-In 59 first-degree relatives of melanoma patients, an interactive voice response system (IVRS) employing participants' cell phones was used to assess twice daily (morning, afternoon) real-time sun protection usage (sunscreen, shade, hats, protective clothing) and decision factors (weather, type of activity, convenience, social support) over a 14-day summer interval where morning and afternoon outdoor exposures were anticipated. Generalized estimating equations and hierarchical linear models were used to examine the effect of demographics and decisional factors on sun protection choices over time. Results-Sun protection use was inconsistent (e.g., 61% used sunscreen inconsistently). Most strategies were used independently, with the exception of moderate overlap of sunscreen and hat usage. Decision factors were highly relevant for sun protection. For instance, sunscreen use was related to the perception of having adequate time to apply it, whereas shade and hat usage were each related to convenience. Few findings emerged by gender, age, or time of day or year. Significant within-subject variation remained, however. Conclusions-The findings support continued examination of decision factors in understanding sun protection consistency in real time. Interventions where cues to action and environmental supports work together in varied settings can be developed to improve sun protection maintenance in populations at risk for this common disease.
Decisional Balance and Self-Efficacy for Sun Protection
Nursing Research, 2014
Background: Sun protection is important for skin cancer prevention, but many adolescents do not protect themselves from the sun. Instrumentation derived from the transtheoretical model (TTM) can be used to study the process of change in health behaviors like sun protection. Objective: The purpose of this study was to translate and adapt TTM-based decisional balance and self-efficacy for sun protection scales from English to Turkish and assess psychometric properties of scores when the scales are used among Turkish adolescents. Methods: The Decisional Balance Scale (DBS) and the Self-Efficacy Scale (SES) for sun protection were adapted to Turkish culture using translation and back-translation. The scales were administered to a total of 900 adolescents in two Turkish schools. Confirmatory factor analysis was used to assess dimensionality. External validity was evaluated by comparing subscale scores across reported stages of change for sun protection. Results: Reliability estimates for scores on the DBS Pros and DBS Cons and the SES Sunscreen Use scales were high and SES Hat Use and Sun Avoidance were moderate. The two-factor correlated model for the DBS and the three-factor correlated model for the SES reported in other studies were confirmed. Means increased across the stages of change for sun protection and sunscreen use for the DBS Pros and the SES subscales as predicted by the TTM, but the pattern of DBS Cons means did not. Discussion: Scores from the Turkish version of the DBS and SES for sun protection were valid, reliable, and appropriate for Turkish culture. The pattern of means for the SES and DBS Pros across the stages of change supported propositions of the TTM. Theoretical inconsistencies in the pattern of DBS Cons scores across the stages of change suggest that greater attention to conceptualization and measurement of the DBS Cons for sun protection and sunscreen use is needed.