Randomized Trial of a Dissonance-Based Sun Safety Intervention for Young Adult Tanners

In this trial, 278 adults will be randomized to one of two campaigns: the Healthy Skin Campaign or the Healthy Lifestyle campaign. Participants must be ages 18-30 years, and have tanned indoors and/or outdoors at least 5 times in the past year (either intentionally or unintentionally), have intentions of tanning indoors or outdoors in the next 6 months, be regular social media users (i.e., logged into a social media platform every day in the past 4 weeks), and be a resident of the 12 states with average UV Index ≥5 between April-October (CA, AZ, TX, AL, AR, FL, GA, LA, MS, SC, NM, HI).

Recruitment will target 12 states with average UV Index is ≥5 during the intervention and follow-up period of April-September. We will use social media advertisements, Research Match, and Qualtrics (internet panel company).

Recruitment advertisements will link to an online survey to evaluate initial eligibility. Those initially eligible will undergo a screening call where they will give verbal consent, learn about the two campaigns, and share their availability to attend an orientation webinar. Following the screening call, eligible candidates will be sent a baseline survey of study measures and upon completion be randomized.

After randomization, participants will attend an orientation webinar where they will learn about their social media campaign, how to create posts, guidelines for appropriate content (e.g., no nudity, explicit language, brand names, images or language that directly or indirectly promoted unhealthy behaviors, or pictures of people without consent), and campaign-related guidance on what to post about (as described below). In the webinar, staff will state that the researchers "are interested in learning how to develop effective health-related social media messages" and "want to examine how engaging young adults find health-related social media posts created by other young adults." Participants will be asked to create social media posts related to the topic of their condition to be posted to the campaign feeds on Facebook and Instagram. In each condition, participants will be instructed to create up to 12 social media posts during the 6-week social media campaign (maximum of 2 in any week). This number of posts would result in a maximum of 5-6 per day in each condition which is consistent with norms reported in social media marketing outlets.

Participants will receive a $10 gift card for each post they create and have a chance to win an additional $50 gift card each week if their post receives the most engagement points in their respective condition within the first 48 hours of posting. The 48-hour time limit allows all posts posted between Monday and Sunday to have the same time frame to garner engagement. Winners each week will be determined on the Tuesday that follows that week (to allow all posts to garner 48 hours of engagement. Social media posts typically get the vast majority of engagement in less than 48 hours.53 The incentive structure is as follows: reactions ("likes") earn 1 point, comments (from unique users because one user can make >1 comments) earn 2 points, and shares/retweets earn 3 points. Shares/reposts earn the most points because this form of engagement has potential to reach a larger audience. This engagement data from the first 48 hours across both Facebook and Instagram will be tallied.