Comportamento de fotoproteção e de autoexame da pele em usuários da atenção básica: impacto da utilização do smartphone como ferramenta de educação.

Abstract

Introduction: "mobile health" or "mHealth" can be defined as a rapid transfer of information about health, using smartphones or other devices, to support public policies and healthier behaviour. Objectives: observe the habits of photoprotection and self-examination of the skin in users of the public service and, then, compare the impact of a single multimedia presentation to regular Whatsapp messages sent for a period of 8 weeks. Methodology: experimental study, carried out in a basic health unit of the municipality of São Luis, Maranhão. 300 users were selected and interviewed during 4 weeks in July 2018. In the first moment, SEPI (Sun Exposure and Protection Index) and SSEAS (Self Skin Examination Attitudes Scale) questionnaires were used in their Portuguese version to evaluate the habits of photoprotection and self-examination of the skin and it was also performed an oral presentation, supported by image, about photoprotection and self-examination. After randomization, 150 users received 2 WhatsApp messages weekly with informations about photoprotection and self-examination for a period of 8 weeks. At the end, all 300 users received links, via WhatsApp, to the same questionnaires answered at the beginning. In order to analyse the data, Stata version 14 for Windows was used. Categorical variables were displayed in simple frequency tables and continuum variables (age, SEPI 1, SEPI 2 and SSEAS score), in central tendency and variance measures. Statistical differences between groups were analysed using unpaired Student's t test for continuum variables and score tendencies were determined by simple linear regression for the variables "age", "sex", "phototype" and "level of education" of the participants. A significance level of p <0.05 was used in all analyses. Results: SEPI 1, SEPI 2 and SSEAS final scores improved in both groups (p <0.05) compared to initial ones. As for photoprotection, inicially, 39.66% of customers said they used sunscreen always or frequently. In intervention group, this habit ascended to 47.91% (p = 0.0014) and no change was observed in control group. With regard to self-examination, high percentage of users (92.33%) considered it was important since the beginning of the research and this number remained stable. However, inicially, only 48.67% considered self-examination a priority and this percentage increased to 73.91% in the control group (p = 0.0179) and 69.8% (p = 0.0001) in the intervention group, without difference between groups. Conclusion: initially, less than half of the sample used photoprotection always or frequently and, even after an improvement at the end of 8 weeks, this habit remained below ideal. As for self-examination of the skin, after 8 weeks, it has turned into a priority for two-thirds of users. Nonetheless, it was not possible to stablish that the results were superior in the group that received educational messages via Whatsapp.