Intervention
sun-safe behaviors
RECRUITMENT
Participants were provided a commercially available UVR-sensor-enabled wrist wearable device and asked to wear the device and sync it with the mobile app every day for 12 weeks regardless of planned outdoor activities, except while swimming or doing water sports (device is not waterproof). We originally planned to use the Microsoft Band 2 that measured UVR exposure and additional health behaviors, such as steps and heart rate; it also sent notifications about using sunscreen, wearing a hat, seeking shade, and minimizing midday sun exposure. The Microsoft device, however, was discontinued and no longer supported by the time of study initiation. Instead, we used the Shade 2While all participants were provided the same device, they used different versions of an associated mobile app based on their randomization. Intervention participants received the commercially available version of the mobile app, which helped users set daily UVR exposure limits, taking into account UVR intensity, time of exposure, and sunscreen application. When approaching their daily UVR limit, smartphone notifications were sent to users as a cue to action. The mobile app version used by participants in the control group only collected UVR exposure, not sunscreen use, and did not provide notifications or information about measured UVR exposure to participants. They only received a message indicating that their UVR exposure data had been reported to the study team. We considered multiple options at the time of study design and ultimately chose the attention-control group for three reasons: one, we can objectively measure UVR exposure in both groups; two, providing the device to the control group will help with recruitment, engagement, and retention; and three, the intervention is low risk.Participants in the intervention group also received a study brochure with information about the importance of UVR avoidance and protection, as well as tips for making sun-safe behaviors routine and sustainable. This content was provided both as a printed brochure at baseline and via a website, viewable after completing each subsequent survey. Participants in the control group did not receive the brochure nor were they directed to the website.