Piloting the Use of Smartphones, Reminders, and Accountability Partners to Promote Skin Self-Examinations in Patients with Total Body Photography: A Randomized Controlled Trial
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The aim of this study was to evaluate the use of a mobile application (app) in patients already using total body photography (TBP) to increase skin self-examination (SSE) rates and pilot the effectiveness of examination reminders and accountability partners.
Randomized controlled trial with computer generated randomization table to allocate interventions.
University of Pennsylvania pigmented lesion clinic.
69 patients aged 18 years or older with an iPhone/iPad, who were already in possession of TBP photographs.
A mobile app loaded with digital TBP photos for all participants, and either (1) the mobile app only, (2) skin examination reminders, (3) an accountability partner, or (4) reminders and an accountability partner.
Main Outcome Measure
Change in SSE rates as assessed by enrollment and end-of-study surveys 6 months later.
Eighty one patients completed informed consent, however 12 patients did not complete trial enrollment procedures due to device incompatibility, leaving 69 patients who were randomized and analyzed [mean age 54.3 years, standard deviation 13.9). SSE rates increased significantly from 58% at baseline to 83% at 6 months (odds ratio 2.64, 95% confidence interval 1.20–4.09), with no difference among the intervention groups. The group with examination reminders alone had the highest (94%) overall satisfaction, and the group with accountability partners alone accounted for the lowest (71%).
A mobile app alone, or with reminders and/or accountability partners, was found to be an effective tool that can help to increase SSE rates. Skin examination reminders may help provide a better overall experience for a subset of patients.
ClinicalTrials.gov Identifier: NCT02520622.
Compliance with Ethical Standards
AJM is supported in part by the Institute for Translational Medicine and Therapeutics (ITMAT) and the National Center for Advancing Translational Sciences of the National Institutes of Health under award number TL1TR000138 and Grant number UL1TR000003, respectively. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Center for Advancing Translational Science or the National Institutes of Health. EYC is supported by a Dermatology Foundation Dermatopathology Research Career Development Award.
Conflict of interest
Andrew J. Marek, Emily Y. Chu, Michael E. Ming, Zeeshan A. Khan, and Carrie L. Kovarik declare that they have no conflicts of interest.
This study was conducted with the approval of the University of Pennsylvania IRB. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.
Informed consent was obtained from all individual participants included in the study.
- 3.Mayer JE, Swetter SM, Fu T, Geller AC. Screening, early detection, education, and trends for melanoma: current status (2007–2013) and future directions: Part I. Epidemiology, high-risk groups, clinical strategies, and diagnostic technology. J Am Acad Dermatol. 2014;71:599.e1–12.CrossRefGoogle Scholar
- 6.Melanoma of the Skin–Cancer Stat Facts [cited 25 Jan 2018]. https://seer.cancer.gov/statfacts/html/melan.html.
- 13.Marek AJ, Chu EY, Ming ME, Khan ZA, Kovarik CL. Impact of a smartphone application on skin self-examination rates in patients that are new to total body photography: a randomized controlled trial. J Am Acad Dermatol. 2018. https://doi.org/10.1016/j.jaad.2018.02.025 (Epub 10 Feb 2018).PubMedCrossRefGoogle Scholar
- 14.DeBarr KA. A review of current health education theories, Californian. J Health Promot. 2004;2:14.Google Scholar
- 15.Fishbein M. A theory of reasoned action: some applications and implications. Neb Symp Motiv. 1980;27:65–116.Google Scholar
- 16.Fishbein M, Ajzen I. Belief, attitude, intention and behaviour: an introduction to theory and research. Reading, MA: Addison-Wesley; 1975.Google Scholar
- 18.Ajzen I. From Intentions to Actions: A Theory of Planned Behavior. Action Control. Berlin, Heidelberg: Springer; 1985. pp 11–39 [cited 26 Jun 2018]. https://link.springer.com/chapter/10.1007/978-3-642-69746-3_2.
- 19.Triandis HC. Interpersonal behavior. Monterey: Brooks/Cole; 1977.Google Scholar
- 26.Koshy E, Car J, Majeed A. Effectiveness of mobile-phone short message service (SMS) reminders for ophthalmology outpatient appointments: observational study. BMC Ophthalmol. 2008;8:9 [cited 2 Feb 2018]. http://bmcophthalmol.biomedcentral.com/articles/10.1186/1471-2415-8-9.