Engaging Moms on Teen Indoor Tanning Through Social Media

Indoor tanning (IT) elevates the risk for melanoma, which is now the most common cancer in
women aged 25-29. To reduce melanoma morbidity and mortality, some states have issued
complete bans on IT by minors, while others require parental permission for minors to indoor
tan. Unfortunately, parental consent policies have suffered from low compliance due to
industry non-compliance,likely due to insufficient policy enforcement, and parents' lack of
awareness of the dangers of IT. Little attention has been paid to creating health
communication that maximizes the effectiveness of IT policy, including both parental consent
and bans. Mothers are an important target, because their permissiveness and IT behavior are
strong predictors of daughters' IT. Teen girls often initiate IT with their mothers. and
further, girls who first experience IT with their mothers begin at an earlier age, become
more habitual tanners, and are more resistant to change.Thus, mothers of teen girls are a
significant target for interventions to reduce IT and an effective campaign for mothers has
the potential to reduce the prevalence of IT in adolescent girls and the incidence of
melanoma in young women. Recent research indicates that well-crafted communication can reduce
maternal permissiveness but such communication has not been tested as a strategy specifically
for maximizing IT policies. A campaign that aims to a) inform mothers of IT risks b)
highlight how their IT permissiveness will influence their child's current and future
risks,and c) provide them with effective messages to convince daughters not to indoor tan
will be developed and delivered via Facebook to maximize the effectiveness of
parental-permission laws, the most prevalent IT policy in the United States. The campaign
will be evaluated in a group-randomized pretest-posttest controlled trial that enrolls
mothers and adolescent teen daughters aged 14 to 17 years old. Participants will be
randomized to receive entry into one of two private Facebook groups that will deliver health
campaigns lasting one year. In the intervention group, participants will receive a
health-focused feed in which 25% of posts are focused on IT. In the control condition,
participants will receive the same health-focused feed but instead of 25% of posts focused on
IT, 25% of posts will focus on prescription drug abuse and misuse. Randomization will occur
at the level of the Facebook private groups; 30-50 mothers from the same community will
participate in each Facebook private group for a total of 50 Facebook groups recruited over
the trial period. Assessment points will occur at baseline and again at 6-months and 1-year
post-intervention. The primary outcome will be reduction in mothers' permissiveness regarding
their teen daughter's use of indoor tanning and secondary outcomes will be increase in teen
daughters' perception of their mother's permissiveness,and reduction in IT by both mothers
and daughters.

Inclusion Criteria (Mothers):

- Live in Tennessee

- Have a daughter aged 14 to 17

- Register for the social media campaign

- Consent to participate

- Read English

- Complete the online baseline survey

- Daughter provides assent to participate

- Have a Facebook account or be willing to create one

Exclusion Criteria (Mothers):

- Not reading English

- Living outside Tennessee

- Daughter not assenting to participate

Inclusion Criteria (Daughters)

- Age 14-17

- Provide assent for mother to participate