Effect of appearance-based education compared with health-based education on sunscreen use and knowledge: A randomized controlled trial

Background: Appearance-based education shows promise in promoting sunscreen use although resource-intensive methods used in prior studies preclude wide dissemination. Appearance-based video education can be made easily accessible. Objective: We sought to compare the effectiveness of appearance-based video education with that of health-based video education in improving sunscreen use and knowledge. Design: In a randomized controlled trial, participants viewed either an appearance-based video on ultraviolet-induced premature aging or a health-based video emphasizing ultraviolet exposure and skin cancer risk. Results: Fifty high-school students participated in the study, conducted from February through March 2012. The health-based group had a nonstatistically significant increase in sunscreen use (0.9 ± 1.9 d/wk, P = .096), whereas the appearance-based group demonstrated a statistically significant increase in sunscreen use (2.8 ± 2.2, P < .001). Between-group comparisons revealed that the appearance-based group applied sunscreen at significantly greater frequencies compared with the health-based group (2.2 ± 1.4 vs 0.2 ± 0.6, P < .001). Knowledge scores significantly improved in both study groups. The difference in knowledge scores between the study groups was not significant. Limitations: The study population may not reflect the general population. Conclusion: Appearance-based video education appears to be effective in promoting sunscreen use and knowledge in adolescents.