title: Engaging Moms on Teen Indoor Tanning Through Social Media: Protocol of a Randomized Controlled Trial.
abstract: BACKGROUND
  Indoor tanning elevates the risk for melanoma, which is now the most common cancer in US women aged 25-29. Public policies restricting access to indoor tanning by minors to reduce melanoma morbidity and mortality in teens are emerging. In the United States, the most common policy restricting indoor tanning in minors involves parents providing either written or in person consent for the minor to purchase a tanning visit. The effectiveness of this policy relies on parents being properly educated about the harms of indoor tanning to their children.
  
  
  OBJECTIVE
  This randomized controlled trial will test the efficacy of a Facebook-delivered health communication intervention targeting mothers of teenage girls. The intervention will use health communication and behavioral modification strategies to reduce mothers' permissiveness regarding their teenage daughters' use of indoor tanning relative to an attention-control condition with the ultimate goal of reducing indoor tanning in both daughters and mothers.
  
  
  METHODS
  The study is a 12-month randomized controlled trial comparing 2 conditions: an attention control Facebook private group where content will be relevant to teen health with 25% focused on prescription drug abuse, a topic unrelated to tanning; and the intervention condition will enter participants into a Facebook private group where 25% of the teen health content will be focused on indoor tanning. A cohort of 2000 mother-teen daughter dyads will be recruited to participate in this study. Only mothers will participate in the Facebook groups. Both mothers and daughters will complete measures at baseline, end of intervention (1-year) and 6 months post-intervention. Primary outcomes include mothers' permissiveness regarding their teenage daughters' use of indoor tanning, teenage daughters' perception of their mothers' permissiveness, and indoor tanning by both mothers and daughters.
  
  
  RESULTS
  The first dyad was enrolled on March 31, 2016, and we anticipate completing this study by October 2019.
  
  
  CONCLUSIONS
  This trial will deliver social media content grounded in theory and will test it in a randomized design with state-of-the-art measures. This will contribute much needed insights on how to employ social media for health behavior change and disease prevention both for indoor tanning and other health risk behaviors and inform future social media efforts by public health and health care organizations.
  
  
  BACKGROUND
  Clinicaltrials.gov NCT02835807; https://clinicaltrials.gov/ct2/show/NCT02835807 (Archived by WebCite at http://www.webcitation.org/6mDMICcCE).
authors.affiliation: Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, United States.
authors.forename: Sherry L
authors.identifier: http://orcid.org/0000-0002-2462-8797
authors.initials: SL
authors.lastname: Pagoto
authors.affiliation: Department of Community & Behavioral Health, College of Public Health, East Tennessee State University, Johnson City, TN, United States.
authors.forename: Katie
authors.identifier: http://orcid.org/0000-0002-8746-1568
authors.initials: K
authors.lastname: Baker
authors.affiliation: Klein Buendel, Inc., Golden, CO, United States.
authors.forename: Julia
authors.identifier: http://orcid.org/0000-0001-9193-8413
authors.initials: J
authors.lastname: Griffith
authors.affiliation: Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, United States.
authors.forename: Jessica L
authors.identifier: http://orcid.org/0000-0001-8270-2302
authors.initials: JL
authors.lastname: Oleski
authors.affiliation: Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, United States.
authors.forename: Ashley
authors.identifier: http://orcid.org/0000-0002-7054-0657
authors.initials: A
authors.lastname: Palumbo
authors.affiliation: Klein Buendel, Inc., Golden, CO, United States.
authors.forename: Barbara J
authors.identifier: http://orcid.org/0000-0003-0950-8575
authors.initials: BJ
authors.lastname: Walkosz
authors.affiliation: Department of Community & Behavioral Health, College of Public Health, East Tennessee State University, Johnson City, TN, United States.
authors.forename: Joel
authors.identifier: http://orcid.org/0000-0002-1055-7828
authors.initials: J
authors.lastname: Hillhouse
authors.affiliation: Department of Psychology, Colorado State University, Fort Collins, CO, United States.|Colorado School of Public Health, Colorado State University, Fort Collins, CO, United States.
authors.forename: Kimberly L
authors.identifier: http://orcid.org/0000-0002-2303-3759
authors.initials: KL
authors.lastname: Henry
authors.affiliation: Klein Buendel, Inc., Golden, CO, United States.
authors.forename: David B
authors.identifier: http://orcid.org/0000-0001-7902-9129
authors.initials: DB
authors.lastname: Buller
keywords: Facebook; health communication; indoor tanning; melanoma; skin cancer; social media