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CompletedNCT03344796Updated Jul 27, 2023Results posted

UV Exposure Assessed With Wearable Sensor and Sun Protection

An interventional study of Goal attainment in Sunburn, Erythema and Sun Protection, sponsored by Northwestern University. Completed at 1 site in United States. Open to participants aged 18 Years to 70 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2023-07-27.

Sponsored by Northwestern University · Not applicable, Interventional, and Prevention

Phase
Not applicable
Study type
Interventional
Enrollment
164
Allocation
Randomized
Ages
18 Years to 70 Years
Sex
All
01

Study summary

The goal is to prevent ultraviolet light (UV) overexposure by providing consumers with relevant, easy-to-access, specifically actionable information. This research proposal will develop a UV protection system consisting of an automated real-time counseling framework and a personal dosimeter that overcomes barriers to consumer adoption. These new, wearable sensors take the form of small (\< 1 cm), thin (\<0.1 mm), lightweight (\<0.1 g), battery-free "stickers" that are fundamentally differentiated from other wearable electronics in their modes of use, cost structures and accuracy.

Read the detailed description

The proposed work is to refine and validate a UV protection system based on a dosimeter "sticker." The key innovations of the system are automated personalized intervention messaging triggered by the exposure levels measured by a novel charge accumulation device applied to ultraminiaturized circuit forms. The research will validate the system's accuracy and acceptability to users, refine the device, and prove its robustness and efficacy in real world use cases. Focus groups and structured interviews will develop sun protection strategies to be communicated by text messages to participants. Successful completion of the research will yield a system to prevent excessive UV exposure and sunburn, thus reducing the incidence of skin cancer by equipping large numbers of general-population consumers and at-risk people to practice digitally-informed healthy sun behavior.

02

Conditions studied

  • Sunburn, Erythema
  • Sun Protection

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Keywords

  • Skin Cancer
  • Sunburn, erythema
  • UV Exposure, Sunburn
  • Wearable UV Device
03

Who can participate

Ages eligible
18 Years to 70 Years
Sexes eligible
All
Accepts healthy volunteers
Yes

Eligibility criteria

Cohort Study 1:

Inclusion Criteria:

  1. history of Stage 0 to IIB melanoma treated within the last five years, age 18-70 years old
  2. have a smartphone
  3. familiarity with use of mobile apps
  4. have skin type 1-3
  5. willing to wear the sensor and able to transmit data which requires Wi-Fi in the home
  6. Come to the Chicago campus of the medical school

Exclusion Criteria:

-

Cohort Study 2: Young adults with sun sensitive skin

Inclusion Criteria:

  1. history of sun sensitive skin, skin type 1-3
  2. have a smartphone and willing to use the UV guard application on the smartphone
  3. reliable wireless internet connection to complete daily surveys
  4. willing to wear the sensor for 28 days and transmit data and complete daily surveys
  5. willing to receive SMS text messages on their personal phone and potentially sync sensor to personal phone using Bluetooth
  6. If weather permits, person will spend at least one hour outdoors each day, with at least 30 minutes of that hour being consecutive between the hours of 8 AM and 5 PM

Exclusion Criteria:

  1. unable to speak English
  2. lacking a secure Internet connection or very little experience with smartphones and mobile applications .
  3. unable to walk inside and outside independently
  4. unable to be outdoors for at least one hour each day (weather permitting)
  5. unable to be outdoors for 30 consecutive minutes a day between 8 AM and 5 PM.
04

Study design

Phase
Not applicable
Primary purpose
Prevention
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Triple (Participant, Investigator, Outcomes assessor)
Enrollment
164 participants (actual)

Study arms

  • No intervention
    Focus Group

    32 subjects Focus group: It is expected that each participant will provide comments during the 2 hours of the focus group. It will take about one month to enroll the subjects. The audio files should be transcribed and the analysis completed in 60 days. The analysis will determine enablers and barriers to sun protected outdoor activities and determine strategies for achieving sun protected outdoor activities. Baseline knowledge of sun protection performed prior to and at end of focus group.

  • No intervention
    Usability testing

    10 subjects Usability test with structured interview: Each participant will use the sensor for 14 days and transmit data with the app installed on their mobile phone. It will take about one month to enroll the subjects. The analysis of the structured interview is completed in one week. Baseline knowledge of sun protection performed prior to and at end of usability test.

  • Active comparator
    Cohort Study 1-Arm 1

    31 subjects First cohort study: It is expected that melanoma survivors will wear the sensor and transmit data for 21 days in the warm weather months of June-Aug 2019. It will take about 2 months to enroll the subjects. Subjects will receive daily text messages in a sequence starting with behavioral facilitation, outcome expectancies, self-efficacy, and self-regulation. On day 10, participants will receive a text message prompting review and reflection on the prior 10 days of UV exposure. Participants will be randomized in Arm 1 to receive a survey item inviting selection of strategies to achieve sun-protected outdoor activities (structured goal attainment). Baseline knowledge of sun protection performed prior to and at end of intervention.

    Behavioral: Goal attainment

  • No intervention
    Structured Interviews

    20 young adults, ages 18-39 will participate in structured interviews to determine their barriers and enablers of sun exposure and sun protection. Eligible subjects will have at least one hour a day outdoors with 30 minutes of the hour being consecutive. It will take about 3 months to enroll the subjects. The audio files will be transcribed and analysis completed in 60 days. Baseline knowledge of sun protection will be performed prior to and after structured interviews.

  • No intervention
    Cohort Study 2

    Second cohort study: 42 young adult participants will recall the number of sunburns experienced in the 28 days prior to enrolling in the study. Then, the same young adult participants will wear the UV sensor daily for 28 summer days. Participants will receive a warning on their mobile phone if the UV dose approaches the dose anticipated to cause sunburn in unprotected skin. Participants will record the number of days in which they get a sunburn. Baseline knowledge of sun protection performed prior to and at end of study.

  • Active comparator
    Cohort Study 1- Arm 2

    29 subjects will receive daily text messages in a sequence starting with behavioral facilitation, outcome expectancies, self-efficacy, and self-regulation. On day 10, participants will receive a text message prompting review and reflection on the prior 10 days of UV exposure. Participants will be randomized in Arm 2 to submit a free text description of their strategy (unstructured goal attainment). Baseline knowledge of sun protection performed prior to and at end of intervention.

    Behavioral: Goal attainment

Interventions

  • BehavioralGoal attainment

    After reviewing daily UV exposure in the prior 10 days, participants will be randomized to structured (select strategies from a list of 7 items) or unstructured (submit a free text description of a strategy) goal attainment.

05

What researchers measure

Primary outcomes

  1. Acceptability of Wearing UV Sensor and Receiving Text Messages

    Online system usability 6 item scale (Likert 7 items range from strongly disagree to strongly agree Minimum value 6, maximum value 42, higher score better outcome

    Time frame: cohort study 1 (arms 1 and 2) at end of 21 days, cohort study 2 (only one arm) at end of 28 days

Secondary outcomes

  1. Sun Exposure in Participants With Structured vs Unstructured Goal Setting

    Change in daily UV exposure recorded by UV sensor (J/m\^2/day) between period prior to and after goal setting among melanoma survivors

    Time frame: 21 days

Other outcomes

  1. Participant Reported Sunburns Prior to Intervention and During the Intervention

    Young adult participants with sun sensitive skin reported sunburns in the 28 days prior to the intervention and during the 28 days of the intervention.

    Time frame: 56 days

  2. Knowledge of Sun Protection

    Knowledge of sun protection using the scale after completing focus group after completing an arm of the study. The same scale was administered at baseline for each arm. 9 item scale (Minimum= 9, Maximum=18) Total range is 9-18. Higher value is better knowledge and a better outcome.

    Time frame: 2 months

06

Results

Posted Jul 27, 2023

Participant flow

Recruitment for the overall study: June 30, 2018 - June 30, 2020. Participants for the first cohort (cohort 1) were recruited using the Enterprise Data Warehouse of Northwestern University, which searches the electronic medical records of Northwestern Medicine for eligible participants. Participants for the second cohort (cohort 2) were recruited by posting electronic announcements on college websites and high school alumnae organizations in the Midwestern and Southeastern United States.

Participant flow — Overall Study
MilestoneFocus GroupUsability TestingCohort Study 1- Arm 1Cohort Study 1 Arm 2Structured InterviewsCohort Study 2
Started321031292042
Completed321031292040
Not completed000002
Withdrew: Lost to follow-up000002

Outcome measures

PrimaryAcceptability of Wearing UV Sensor and Receiving Text Messages

Online system usability 6 item scale (Likert 7 items range from strongly disagree to strongly agree Minimum value 6, maximum value 42, higher score better outcome

Time frame:
cohort study 1 (arms 1 and 2) at end of 21 days, cohort study 2 (only one arm) at end of 28 days
Reported as:
Mean · score on a scale
Acceptability of Wearing UV Sensor and Receiving Text Messages
score on a scaleUsability TestingCohort Study 1 Arm1Cohort Study 1 Arm 2Cohort Study 2
Acceptability of Wearing UV Sensor and Receiving Text Messages22 ± 3.539.1 ± 6.240.1 ± 5.340.6 ± 2.9
Statistical analysis
  • Cohort Study 1 Arm1 vs Cohort Study 1 Arm 2 vs Cohort Study 2 · Chi-squared · p = <0.01
SecondarySun Exposure in Participants With Structured vs Unstructured Goal Setting

Change in daily UV exposure recorded by UV sensor (J/m\^2/day) between period prior to and after goal setting among melanoma survivors

Time frame:
21 days
Reported as:
Least squares mean · J/m^2/day
Sun Exposure in Participants With Structured vs Unstructured Goal Setting
J/m^2/dayCohort Study 1 Arm 1Cohort Study 1 Arm 2
Sun Exposure in Participants With Structured vs Unstructured Goal Setting399.9 ± 10.6196.8 ± 129.1
Statistical analysis
  • Cohort Study 1 Arm 1 vs Cohort Study 1 Arm 2 · Chi-squared, Corrected · p = <0.001
Other pre-specifiedParticipant Reported Sunburns Prior to Intervention and During the Intervention

Young adult participants with sun sensitive skin reported sunburns in the 28 days prior to the intervention and during the 28 days of the intervention.

Time frame:
56 days
Reported as:
Number · participants
Participant Reported Sunburns Prior to Intervention and During the Intervention
participantsParticipant Reported Sunburns
Sunburns prior to intervention30
Sunburns during intervention18
Statistical analysis
  • Participant Reported Sunburns · Chi-squared · p = <0.01
Other pre-specifiedKnowledge of Sun Protection

Knowledge of sun protection using the scale after completing focus group after completing an arm of the study. The same scale was administered at baseline for each arm. 9 item scale (Minimum= 9, Maximum=18) Total range is 9-18. Higher value is better knowledge and a better outcome.

Time frame:
2 months
Reported as:
Mean · score on a scale
Knowledge of Sun Protection
score on a scaleFocus GroupUsability TestingCohort Study 1-Arm 1Cohort Study 1- Arm 2Structured InterviewsCohort Study 2
Knowledge of Sun Protection13.2 ± 0.213.1 ± 0.517.9 ± 1.117.1 ± 1.212.2 ± 0.414.3 ± 0.6
Statistical analysis
  • Focus Group vs Usability Testing vs Cohort Study 1-Arm 1 vs Cohort Study 1- Arm 2 vs Structured Interviews vs Cohort Study 2 · Chi-squared · p = < 0.1

Adverse events

Collected over 1 year. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Focus Group0/32 (0%)0/32 (0%)0/32 (0%)
Usability Testing0/10 (0%)0/10 (0%)0/10 (0%)
Cohort Study 1-arm 10/31 (0%)0/31 (0%)0/31 (0%)
Cohort Study 1-arm 20/29 (0%)0/29 (0%)0/29 (0%)
Structured Interviews0/20 (0%)0/20 (0%)0/20 (0%)
Cohort Study 20/42 (0%)0/42 (0%)0/42 (0%)

Baseline characteristics

Age, Categorical
Age, Categorical(Participants)Focus GroupUsability TestingCohort Study 1 Arm 1Cohort Study 1 Arm 2Structured InterviewsCohort Study 2Total
<=18 years0000000
Between 18 and 65 years251025242042146
>=65 years70650018
Age, Continuous
Age, Continuous(years)Focus GroupUsability TestingCohort Study 1 Arm 1Cohort Study 1 Arm 2Structured InterviewsCohort Study 2Total
Mean57.4 ± 11.524.3 ± 3.259.3 ± 12.558.8 ± 10.221.2 ± 1.422.6 ± 4.548.2 ± 15.7
Sex: Female, Male
Sex: Female, Male(Participants)Focus GroupUsability TestingCohort Study 1 Arm 1Cohort Study 1 Arm 2Structured InterviewsCohort Study 2Total
Female1751818102896
Male1551311101468
Race (NIH/OMB)
Race (NIH/OMB)(Participants)Focus GroupUsability TestingCohort Study 1 Arm 1Cohort Study 1 Arm 2Structured InterviewsCohort Study 2Total
American Indian or Alaska Native0000000
Asian2100137
Native Hawaiian or Other Pacific Islander0000000
Black or African American0000101
White30931291836153
More than one race0000022
Unknown or Not Reported0000011
Region of Enrollment
Region of Enrollment(Participants)Focus GroupUsability TestingCohort Study 1 Arm 1Cohort Study 1 Arm 2Structured InterviewsCohort Study 2Total
United States321031292042164
Knowledge of Sun Protection
Knowledge of Sun Protection(units on a scale)Focus GroupUsability TestingCohort Study 1 Arm 1Cohort Study 1 Arm 2Structured InterviewsCohort Study 2Total
Mean12 ± 1.713 ± 3.117 ± 2.318 ± 1.911 ± 1.411 ± 2.114 ± 2.1
07

Study locations

1 site
  • Northwestern University Feinberg School of Medicine Department of Dermatology
    Chicago, Illinois 60611, United States
08

References and documents

Publications

  • Robinson JK, Durst DA, Gray E, Kwasny M, Heo SY, Banks A, Rogers JA. Sun exposure reduction by melanoma survivors with wearable sensor providing real-time UV exposure and daily text messages with structured goal setting. Arch Dermatol Res. 2021 Oct;313(8):685-694. doi: 10.1007/s00403-020-02163-1. Epub 2020 Nov 13. PubMed 33185716 ↗
  • Stump TK, Aspinwall LG, Gray EL, Xu S, Maganti N, Leachman SA, Alshurafa N, Robinson JK. Daily Minutes of Unprotected Sun Exposure (MUSE) Inventory: Measure description and comparisons to UVR sensor and sun protection survey data. Prev Med Rep. 2018 Jul 24;11:305-311. doi: 10.1016/j.pmedr.2018.07.010. eCollection 2018 Sep. PubMed 30116702 ↗
  • Robinson JK, Patel S, Heo SY, Gray E, Lim J, Kwon K, Christiansen Z, Model J, Trueb J, Banks A, Kwasny M, Rogers JA. Real-Time UV Measurement With a Sun Protection System for Warning Young Adults About Sunburn: Prospective Cohort Study. JMIR Mhealth Uhealth. 2021 May 6;9(5):e25895. doi: 10.2196/25895. PubMed 33955844 ↗

Study documents

  • Protocol and statistical analysis plan · Mar 18, 2019
  • Informed consent form · Mar 11, 2019

Documents are hosted by the registry — open the source record to download them.

Individual participant data

Plan to share: No

09

Registry details

Key details

Study ID
NCT03344796
Lead sponsor
Northwestern University
Collaborators
National Cancer Institute (NCI)
Responsible party
June Robinson (Primary Investigator, Northwestern University) — Principal investigator
First posted
Nov 17, 2017
Start date
Jun 30, 2018
Primary completion
Sep 30, 2020
Completion
Sep 30, 2020
Results posted
Jul 27, 2023
Last update
Jul 27, 2023

Study contacts

June K. Robinson, MD
principal investigator · Northwestern University

Oversight

FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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