A national hybrid type II effectiveness-implementation trial

Abstract

Background: Young adults engage in risky ultraviolet radiation (UV) exposure, both solar and artificial, and minimal sun protection. Melanoma is one of the most common cancers among young adults, particularly
women. We developed UV4me, which is an online sun safety intervention for at-risk individuals 18-25 years old.
Methods: After establishing initial efficacy, we have since completed a hybrid type II effectiveness-implementation trial. Participants for the hybrid trial were recruited primarily using paid ads on social media. 1691 participants completed baseline surveys and were randomized to one of three intervention conditions: the original UV4me, enhanced UV4me2 with more interactive and engaging features, or e-pamphlet education
control.
Results: UV4me2 demonstrated better outcomes than the e-pamphlet for wearing facial sunscreen at 12 weeks, overall sun protection weeks 12-52, habitual (automatic) sun protection at 12-24 weeks, and skin self-examination at 52 weeks (70% retention). UV4me2 performed better than the e-pamphlet for overall UV exposure at 24 weeks, but this trend was not significant (p = 0.056). Significant differences were not found comparing UV4me2 to UV4me. When considering implementation costs after initial “sunk costs” for intervention development, and estimating costs for larger samples (e.g., >1000 individuals), costs are similar across the intervention conditions (USD$12-16 per person). Additional analyses will focus on intervention engagement, satisfaction, and cost-effectiveness.
Conclusions: These results are some of the first outcomes reported for a dissemination trial for a skin cancer prevention intervention. Successful behavioral interventions for young adults may lead to future reduction in
their risks of and morbidity from skin cancer.

6th International Congress of Behavioral Medicine, Brisbane, Australia (15–18 November, 2000).