The number of U.S. adults treated annually for melanoma, the most deadly form of skin cancer, has nearly
doubled in the past 15 years and the incidence rate is projected to again double by 2030. This growth is partly
attributed to the popularity of artificial ultraviolet-emitting indoor tanning beds. Despite recognition by numerous
national and international health organizations as being carcinogenic to humans, nearly 10 million Americans
use indoor tanning beds each year. An estimated 1 in 10 of all new U.S. cases of melanoma and 400,000
annual cases of non-melanoma skin cancer are directly attributable to indoor tanning. Most concerning, nearly
1 in 5 young adult white females engage in high-risk indoor tanning, defined as using indoor tanning beds at
least ten times a year, which is associated with a substantially increased risk of melanoma. As indoor tanning
gained popularity among young women over the past two decades, melanoma has recently become one of the
most common cancers among this population. The 2014 Surgeon General's Call to Action to Prevent Skin
Cancer identified a critical research gap related to an absence of interventions that target high risk indoor
tanners and address underlying motives for tanning, including ?the desire to look attractive and healthy and to
conform to societal beauty standards?. The purpose of this application is to implement and test an intervention
designed to encourage indoor tanning cessation among high-risk tanners. The intervention is unique in using
persuasive techniques and content to reduce perceived pressure to be tan, reduce the value placed on tanning,
and promote positive body image rather than focusing on information about the risks of tanning. The
intervention will be delivered via the social media site Facebook through the ?secret groups? feature. The use
of Facebook groups will allow group-based interactions among participants, which can facilitate stronger
changes in attitudes and behaviors, and provides a platform to embed the intervention into individuals' normal
routines. The first proposed aim is to refine the existing intervention content from our preliminary intervention
studies with user-generated feedback. The second aim is to conduct a randomized controlled trial of the
intervention in a sample of 400 young women engaged in high-risk tanning. Our primary hypothesis is that
participants who receive the intervention will report less indoor tanning at a 6-month follow-up compared to
those who participate in a control Facebook group. Our third aim will examine hypothesized psychosocial
mediators of the intervention effects. The intervention has strong potential for cost-effective, widespread
dissemination and targets a group at high-risk for future cancer development. If effective, the intervention has
the potential to significantly reduce the growing burden of melanoma and other skin cancers.
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