Facial-aging apps implemented in physician office waiting rooms have the potential to provide an opportunity to motivate a large number of patients who visit a healthcare setting to enhance their ultraviolet (UV) protection. Results of the analysis were published in JAMA Dermatology.1

With the realization that approximately 90% of skin cancer cases are caused by UV exposure, the investigators sought to develop a skin cancer prevention intervention that could be available to most patients who visit healthcare professionals and that would highlight the risks associated with UV exposure.

The researchers provided a standalone version of a free facial-aging app called Sunface, which was available in the waiting room of their HIV outpatient clinic. The Sunface app altered a 3-dimensional, animated selfie of the participant to approximate his or her future appearance based on UV exposure.2

A tablet with the Sunface app running was placed on a table in the middle of a waiting room and connected to a large monitor that was hanging on the opposite wall. Within 30 seconds of entering the waiting room, an “interviewer” encouraged patients to try the app if they had not already done so on their own. Participants filled out an anonymous questionnaire that was designed to measure their perceptions of the intervention and requested pertinent socioeconomic data.


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A total of 272 patients (207 men) entered the waiting room during the 13 days that the facial-aging app was available. Among these individuals, 74.3% (201 of 272) were encouraged to try the app 30 seconds after they had entered the waiting room. Overall, 9.6% (26 of 272) of patients tried the app within 30 seconds of entering the waiting room without any encouragement on the part of the interviewer. Additionally, 16.2% (44 of 272) of patients remained beyond the waiting area or were in the waiting room for <30 seconds.

A total of 119 patients tried the app and also agreed to fill out the anonymous questionnaire. Of those who filled out the questionnaire, 37.0% (44 of 119) had Fitzpatrick skin type 1 or 2, and 84 patients were men. Median age was 48 years (range, 24 to 74 years). Moreover, 16.9% (46 of 272) of the patients watched another patient try the app without doing so themselves. Therefore, 60.7% (165 of 272) of the patients who visited the waiting room (mean wait time, 19.54 minutes) were actually exposed to the intervention.

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Of the 119 individuals who tried the app, 105 noted that the intervention encouraged them to increase their sun protection (89.2% of men; 91.2% of women) and 104 indicated that it motivated them to avoid indoor tanning beds (87.9% of men; 91.2% of women). Further, 117 participants (98.8% of men; 97.1% of women) reported that they perceived the intervention to be fun.

The investigators concluded that additional studies are warranted to examine prospective effects on patients’ behavior, a potential increase in the frequency of discussing UV protection at future dermatologist appointments, and different modes of initiation and analyses of the effects in various population subgroups.

References

1. Brinker TJ, Klode J, Esser S, Schadendorf D. Facial-aging app availability in waiting rooms as a potential opportunity for skin cancer prevention. JAMA Dermatol. 2018;154:1085-1086.

2. Brinker TJ, Schadendorf D, Klode J, et al. Photoaging mobile apps as a novel opportunity for melanoma prevention: pilot study. JMIR Mhealth Uhealth. 2017;5(7):e101.