Australians' love affair with mobile phones could save their life according to our study using text messages to improve skin cancer prevention and promote sun protection. Funded by Cancer Australia, the 12-month trial of Healthy Text targeted individuals aged between 18 and 42 - an age group in which mobile phone use is almost universal - and the results have just been published in international journal Preventative Medicine.
The Healthy Text trial tested the impact and value of SMS-delivered messages promoting sun protection along with skin self-examination for early detection of skin cancer, while a third group received texts encouraging physical activity. Weekly texts for the first 12 weeks were followed by monthly text messages for another nine months and a final in-depth telephone interview was conducted. The study involved more than 500 participants and concluded that SMS-delivered intervention was effective, far-reaching, flexible and individualized. Australia has the highest rate of skin cancer incidence in the world and melanoma is the most common cancer in those aged 15-44.
SMS messages are an acceptable and feasible way to reach people, particularly those under 45, with personalised skin cancer prevention texts which take into account a person's age, skin type, gender and risk factors. The text messages reminded recipients to wear sunscreen and sun smart clothing as well as limit their time in the sun between 10am and 4pm. They also asked participants whether they or someone other than a doctor, such as a spouse or partner, had checked any part of their skin for early signs of skin cancer.
Text messages are conversational in tone and those used for the trial were designed to suggest and reinforce understanding and behavioural skills in relation to skin cancer prevention and early detection of symptoms. They are highly effective in promoting personal responsibility and providing positive reinforcement. By the end of the 12 months, the self-reported sun protection habits of those who participated in the sun protection and skin self-examination groups showed significant improvement. The proportion conducting any skin self-examination, not specifically of the whole-body, significantly increased in the skin self-examination group from 37 per cent to 63 per cent.
The final sample concluded that those who participated in the trial were probably more health conscious than the general population of a similar age. It was pleasing to see the improvements, and it may be possible to see greater improvements in people who are less health conscious.
It's exciting to think the use of a simple text message, as seen in this trial, may help to reduce skin cancer risk in the future. Around 136,000 Queenslanders are diagnosed with skin cancer every year - around 370 every day. Any effective intervention measures we can use to encourage young people to stay as SunSmart as possible, and to check their own skin regularly, are imperative.
Many participants in our trial would have liked more regular SMS messages and I think future research could incorporate multimedia messages and the opportunity for individuals to have an input into programs to allow them to control the timing and frequency of the messages.
i would be interested in learning your experiences using text messaging to spread evidence-based cancer prevention messages.