Please use this identifier to cite or link to this item:
Title: A skin cancer prevention facial-aging mobile app for secondary schools in Brazil : appearance-focused interventional study.
Authors: Brinker, Titus Josef
Heckl, Marlene
Gatzka, Martina
Heppt, Markus V.
Rodrigues, Henrique Resende
Schneider, Sven
Sondermann, Wiebke
Silva, Carolina de Almeida e
Kirchberge, Michael C.
Klode, Joachim
Enk, Alexander H.
Knispel, Sarah
Kalle, Christof von
Stoffels, Ingo
Schadendorf, Dirk
Nakamuro, Yasuhiro
Esser, Stefan
Assis, Aisllan Diego de
Souza, Breno Bernardes
Keywords: Skin neoplasms
Primary prevention
Issue Date: 2017
Citation: BRINKER, T. J. et al. A skin cancer prevention facial-aging mobile app for secondary schools in Brazil : appearance-focused interventional study. JMIR Mhealth Uhealth, v. 6, n. 3, p. 1-14, 2018. Disponível em: <>. Acesso em: 7 mar. 2019.
Abstract: Background: The incidence of melanoma is increasing faster than any other major cancer both in Brazil and worldwide. Southeast Brazil has especially high incidences of melanoma, and early detection is low. Exposure to ultraviolet (UV) radiation is a primary risk factor for developing melanoma. Increasing attractiveness is a major motivation among adolescents for tanning. A medical student-delivered intervention that takes advantage of the broad availability of mobile phones and adolescents’ interest in their appearance indicated effectiveness in a recent study from Germany. However, the effect in a high-UV index country with a high melanoma prevalence and the capability of medical students to implement such an intervention remain unknown. Objective: In this pilot study, our objective was to investigate the preliminary success and implementability of a photoaging intervention to prevent skin cancer in Brazilian adolescents. Methods: We implemented a free photoaging mobile phone app (Sunface) in 15 secondary school classes in southeast Brazil. Medical students “mirrored” the pupils’ altered 3-dimensional (3D) selfies reacting to touch on tablets via a projector in front of their whole grade accompanied by a brief discussion of means of UV protection. An anonymous questionnaire capturing sociodemographic data and risk factors for melanoma measured the perceptions of the intervention on 5-point Likert scales among 356 pupils of both sexes (13-19 years old; median age 16 years) in grades 8 to 12 of 2 secondary schools in Brazil. Results: We measured more than 90% agreement in both items that measured motivation to reduce UV exposure and only 5.6% disagreement: 322 (90.5%) agreed or strongly agreed that their 3D selfie motivated them to avoid using a tanning bed, and 321 (90.2%) that it motivated them to improve their sun protection; 20 pupils (5.6%) disagreed with both items. The perceived effect on motivation was higher in female pupils in both tanning bed avoidance (n=198, 92.6% agreement in females vs n=123, 87.2% agreement in males) and increased use of sun protection (n=197, 92.1% agreement in females vs n=123, 87.2% agreement in males) and independent of age or skin type. All medical students involved filled in a process evaluation revealing that they all perceived the intervention as effective and unproblematic, and that all pupils tried the app in their presence. Conclusions: The photoaging intervention was effective in changing behavioral predictors for UV protection in Brazilian adolescents. The predictors measured indicated an even higher prospective effectiveness in southeast Brazil than in Germany (>90% agreement in Brazil vs >60% agreement in Germany to both items that measured motivation to reduce UV exposure) in accordance with the theory of planned behavior. Medical students are capable of complete implementation. A randomized controlled trial measuring prospective effects in Brazil is planned as a result of this study.
ISSN: 2291-5222
metadata.dc.rights.license: O periódico JMIR mHealth and uHealth permite o arquivamento da versão PDF do editor. Fonte: Sherpa/Romeo <>. Acesso em: 17 abr. 2019.
Appears in Collections:DEMSC - Artigos publicados em periódicos

Files in This Item:
File Description SizeFormat 
ARTIGO_SkinCancerPrevention.pdf2,37 MBAdobe PDFView/Open

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.