Can skin cancer prevention and early detection be improved via mobile phone text messaging? A randomised, attention control trial

•SMS-delivered health promotion programs are far-reaching and can be individualised.•The intervention improved some sun protection and skin self-examination behaviours.•The intervention was not effective for consistent increase of whole-body skin self-examinations.•The intervention did not lead to a reduction in sunburn frequency.•Multimedia text messages and more flexible design could future impact.

ObjectiveTo test the impact of a theory-based, SMS (text message)-delivered behavioural intervention (Healthy Text) targeting sun protection or skin self-examination behaviours compared to attention control.MethodOverall, 546 participants aged 18-42 years were randomised using a computer-generated number list to the skin self-examination (N = 176), sun protection (N = 187), or attention control (N = 183) text messages group. Each group received 21 text messages about their assigned topic over 12 months (12 weekly messages for 3 months, then monthly messages for the next 9 months). Data were collected via telephone survey at baseline, 3, and 12 months across Queensland from January 2012 to August 2013.ResultsOne year after baseline, the sun protection (mean change 0.12; P = 0.030) and skin self-examination groups (mean change 0.12; P = 0.035) had significantly greater improvement in their sun protection habits (SPH) index compared to the attention control group (reference mean change 0.02). The increase in the proportion of participants who reported any skin self-examination from baseline to 12 months was significantly greater in the skin self-examination intervention group (103/163; 63%; P < 0.001) than the sun protection (83/173; 48%) or attention control (65/165; 36%) groups. There was no significant effect of the intervention for participants' self-reported whole-body skin self-examination, sun tanning, or sunburn behaviours.ConclusionThe Healthy Text intervention was effective in inducing significant improvements in sun protection and any type of skin self-examination behaviours.Trial registrationThe Australian and New Zealand Clinical Trials register (ACTRN12612000577819).FundingCancer Australia 1011999.