Armstrong April W, Watson Alice J, Makredes Maryanne, Frangos Jason E, Kimball Alexandra B, Kvedar Joseph C
Teledermatology Program, Department of Dermatology, University of California-Davis Health System, 3301 C St, Ste1400, Sacramento, CA 95816, USA.
Arch Dermatol. 2009 Nov;145(11):1230-6. doi: 10.1001/archdermatol.2009.269.
To evaluate the effectiveness of cellular telephone text messaging as a reminder tool for improving adherence to sunscreen application.
We conducted a randomized, controlled trial of the effect of an electronic text-message reminder system on adherence to sunscreen application. Adherence to daily sunscreen use was evaluated using a novel electronic monitoring device.
Participants were recruited from the general community.
Seventy participants constituted a volunteer sample from the general community. The inclusion criteria required participants to be 18 years or older, to own a cellular telephone with text-message features, and to know how to retrieve text messages. Intervention Half of the participants received daily text-message reminders via cellular telephone for 6 weeks, and the other half did not receive reminders. The text-message reminders consisted of 2 components: a "hook" text detailing daily local weather information and a "prompt" text reminding users to apply sunscreen. Main Outcome Measure The primary end point of the study was adherence to sunscreen application measured by the number of days participants applied sunscreen during the 6-week study period.
All 70 participants completed the 6-week study. There were no statistically significant differences in baseline characteristics between the 2 study groups. At the end of the study period, the 35 participants who did not receive reminders had a mean daily adherence rate of 30.0% (95% confidence interval, 23.1%-36.9%). In comparison, the 35 participants who received daily text-message reminders had a mean daily adherence rate of 56.1% (95% confidence interval, 48.1%-64.1%) (P < .001). Among the participants in the reminder group, 24 (69%) reported that they would keep using the text-message reminders after the study, and 31 (89%) reported that they would recommend the text-message reminder system to others. Subgroup analysis did not reveal any significant demographic factors that predicted adherence.
Despite awareness of the benefits of sunscreen, adherence is low, even in this population, for whom adherence was knowingly monitored. Short-term data demonstrate that using existing cellular telephone text-message technology offers an innovative, low-cost, and effective method of improving adherence to sunscreen application. The use of ubiquitous communications technology, such as text messaging, may have implications for large-scale public health initiatives. Trial Registration clinicaltrials.gov Identifier: NCT00535769.
评估手机短信作为一种提醒工具，在提高防晒霜涂抹依从性方面的有效性。
我们进行了一项随机对照试验，研究电子短信提醒系统对防晒霜涂抹依从性的影响。使用一种新型电子监测设备评估每日使用防晒霜的依从性。
参与者从普通社区招募。
70名参与者构成了来自普通社区的志愿者样本。纳入标准要求参与者年龄在18岁及以上，拥有具备短信功能的手机，并且知道如何接收短信。干预措施：一半参与者通过手机接收为期6周的每日短信提醒，另一半不接收提醒。短信提醒包含两个部分：一条详细说明当地每日天气信息的“引导”短信和一条提醒用户涂抹防晒霜的“提示”短信。主要观察指标：研究的主要终点是通过参与者在6周研究期间涂抹防晒霜的天数来衡量的防晒霜涂抹依从性。
所有70名参与者均完成了为期6周的研究。两个研究组的基线特征在统计学上无显著差异。在研究期结束时，未收到提醒的35名参与者的平均每日依从率为30.0%（95%置信区间，23.1%-36.9%）。相比之下，收到每日短信提醒的35名参与者的平均每日依从率为56.1%（95%置信区间，48.1%-64.1%）（P <.001）。在提醒组的参与者中，24名（69%）报告他们在研究结束后会继续使用短信提醒，31名（89%）报告他们会向他人推荐短信提醒系统。亚组分析未发现任何预测依从性的显著人口统计学因素。
尽管人们意识到防晒霜的益处，但即使在这个特意监测依从性的人群中，依从性也很低。短期数据表明，使用现有的手机短信技术提供了一种创新、低成本且有效的提高防晒霜涂抹依从性的方法。使用如短信这样普遍存在的通信技术可能对大规模公共卫生举措具有启示意义。试验注册：clinicaltrials.gov标识符：NCT00535769。
