Study Protocol

Our chosen intervention was a group chat where participants would be prompted to send photos of themselves or their sunscreen each day of the study. All participants consented to being added to such group chats ahead of time.

Recruitment

We recruited nine young adults (ages 18-25) who were interested in increasing their sunscreen use. Two of the participants came from our baseline study (the rest were filtered out as being not the right fit or did not want to continue) and seven of the participants were new. Of these nine participants, seven are students and two are recent college graduates.

We received feedback that we should have taken into account whether participants knew each other when selecting participants, as that could have an effect on how motivated they might be to participate in the chat. However, due to the tight turnaround time on the study, we were unable to recruit participants that already knew each other well beforehand. As a result, most participants were placed in chats where they knew at most 1 other participant beforehand. However,  we hypothesized that even if participants did not know each other, there would still be some level of accountability and social mass. In addition, we planned to have participants familiarize themselves with each other slightly by having them introduce ourselves.

Data to be Collected

From our pre-study interviews, we collected logistical data about when people apply sunscreen, how long people spend outside each day, and how many times they apply sunscreen each day. We also collected content data about how often people wear sunscreen, their feelings towards sunscreen, why they do or do not wear sunscreen, and details about their morning routines.

From our intervention study, we collected logistical data on each time the participant applied sunscreen (when and where it happened), and logistical data about their morning routine (how long they spent on each activity, when it happened, etc). We also collected content data about how the group chat made them feel, and its impact on their motivation to wear sunscreen.  

During post-study interviews, we focused mostly on collecting content data specific to each participant’s behavior during the study, such as their moods and feelings over the five-day period, and their thoughts on the group chat and how it was executed.

Study Procedure

In order to simulate the social accountability factor, we added each participant to a group chat with 2-3 other participants and 2 members of our research team. One member of our team was the prompter (Wizard of Oz for the “app/computer” itself), and the other member acted as a participant.

Using text message prompts, we prompted the participants to introduce themselves to each other on the first day in order to increase familiarity with each other, in hopes that it would increase social pressure to be active in the chat.

The rest of the study was conducted as follows:

• Each morning, the prompter in each group chat sent a message around 9:15 AM, saying “This is your daily reminder to wear sunscreen! Send a picture of you or your sunscreen if you wore sunscreen today!”
• The other team member in the group sent a photo of them applying sunscreen to further prompt the other participants to act. This also serves as a second reminder.
• We then collected information at the end of each day from each participant using this Google form. The form collected data such as:
  • Day of the study
  • If the participant wore sunscreen today (Yes/No)
    • If yes, further context: (when, what prompted you, etc.)
    • If no, further explanation: (why not?)
  • What they did for their morning routine
  • When did they go outside
  • How did the group chat make them feel
  • Any changes to motivation to wear sunscreen based on the chat

After the 5-day study is over, we conducted post-study interviews to further flesh out responses.

 

Synthesis

Overall, the intervention study seemed to have an impact on the frequency that people wore sunscreen. While only 2 out of the 10 participants in the baseline study wore sunscreen during the study, 6 out of our 9 participants wore sunscreen at least once over the 5 day study.

We extracted the insights from our pre-study interviews onto post-it notes, and synthesized them using post-it notes.

Affinity Map and Frequency View: FigJam

We first grouped similar insights together, which revealed several insights.

• Text notifications became more annoying than helpful as the week went on
• Chat activity significantly dropped after the first couple of days, as did enthusiasm about applying sunscreen
• Human participation in the chat was a better motivator / reminder than the text reminder sent by the “app” (the team member acting as the prompter)
• Fear of missing out was also a large motivator for participation
• Seeing others apply sunscreen helped participants learn
• Interestingly, chat activity helped remind users even when they were running late in the morning

• Even if they didn’t participate in the chat, the chat itself was a prompt

• Participants felt encouraged by positive and cheerful messages

We then grouped the insights by quantity, after which we could see which parts of our intervention had the highest impact.

• The biggest motivator behind the increased sunscreen use seemed to be the social pressure from other participants in the chats
• However, the text notifications seemed to be a big detractor

Models

We took these insights and prompts and mapped them into a connection circle.

We noticed a causal cycle from this model– more people putting sunscreen on would lead to more people posting in the chat, which increased chat activity. This in turn would increase the peer pressure on other participants of the chat, which would increase the frequency of other participants wearing sunscreen, continuing the positive reinforcement cycle. However, the opposite could also occur– some people not putting sunscreen on would lead to less activity in the chat, which would discourage other people from participating.

One other interesting insight was that text notifications actually decreased participation after the first couple days– once people got used to them, they learned to ignore the messages.

We also mapped our insights into a fishtail model broken up into six categories– people, method, reminders, mood, schedule, and environment.

We noticed from this model that people and mood actually had a larger effect on users putting sunscreen on than their environment did. One other interesting thing was that the survey that we used to collect data from participants also served as a reminder for several participants– but they seemed to have less negative reactions to the form as compared to the text reminders. Finally, methods like incorporating sunscreen into skincare and moving sunscreen to a more accessible place still seemed to be effective, especially in conjunction with the reminders from other participants.

Implications for Future Directions

This synthesis informs us that perhaps we should pivot away from text reminders as a medium, and focus more on fostering more human connections and interactions, as those seemed to be the most effective at encouraging our desired behavior change. While text reminders were effective the first couple of times, participants tended to ignore them after the first couple of days, implying it would not be an effective medium for long-term behavior change. In contrast, people felt that reminders that required some action to resolve would be more effective, as they would be harder to ignore.

In addition, there was a worrying drop off in engagement after the first couple days of the study, leading to a similar decrease in sunscreen usage. From our synthesis, we found that users were discouraged by less activity, leading them to want to participate less and exacerbating the issue. Moving forward, we will consider ways that we could encourage sustained participation that doesn’t rely on variable factors like other peoples’ behavior.