1. Participants in the mobile application (app) group reported more time in the shade and less time in the sun.
2. Those participants who used the mobile app reported using all sun protection behaviors combined more often.
Evidence Rating Level: 2 (Good)
Study Rundown: Skin cancer is the most common type of cancer and comes with significant expense and morbidity. Since UV exposure from the sun is a risk factor for its development, dermatologists strongly recommend vigilant sun protection measures. As mobile interventions gain increasing traction in the healthcare setting, one novel app to improve sun protection is Solar Cell, which uses patient- and geographic- information of the user to provide real-time, evidence-based, personalized advice for sun protection. These authors sought to test the efficacy of such an application. Comparisons were made between app and non-app users’ percentage of days using sun protection, time spent outdoors in mid-day sun, and incidence of sunburns. App users had some improved measures of sun protection; however, the app was used less than expected. The large cohort and randomized controlled trial design strengthened the study. However, the study may not by generalizable to the whole population as the sample consisted largely of Caucasians and those with a high level of education.
In-Depth [randomized controlled trial]: In this study, 604 participants were randomized to the treatment or the control arm. After excluding those lost to follow-up, 454 (232 control; 222 treatment) were included in this trial. As compared to the general US population, participants were younger, more educated, lived in larger households, and contained fewer Hispanics. Individuals in the treatment group reported more shade use (mean days staying in the shade, 41.0% vs. 33.7%; p = .03). However, the treatment group reported less sunscreen use than the control group (mean days, 28.6% vs. 34.5%, p= .048) and there was no statistically significant difference between the treatment and control group in number of sunburns (mean 0.60 vs. 0.62, p = .87). Notably, only 76.1% of the treatment group downloaded the app, and only 41.0% of the treatment group used it. Those who used the app within the treatment arm more frequently minimized sun exposure (60.4% vs. 49.3% for non-users; p = .04) and used all protective behaviors more when compared to non-users (mean days, 39.4% vs. 33.8%; p = .04).
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