<clinical_study>
  <!-- This xml conforms to an XML Schema at:
    https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
  <required_header>
    <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
    <link_text>Link to the current ClinicalTrials.gov record.</link_text>
    <url>https://clinicaltrials.gov/ct2/show/NCT03237013</url>
  </required_header>
  <id_info>
    <org_study_id>2253101</org_study_id>
    <nct_id>NCT03237013</nct_id>
  </id_info>
  <brief_title>Strategies to Promote Skin Health</brief_title>
  <official_title>Strategies to Promote Skin Health</official_title>
  <sponsors>
    <lead_sponsor>
      <agency>San Diego State University</agency>
      <agency_class>Other</agency_class>
    </lead_sponsor>
  </sponsors>
  <source>San Diego State University</source>
  <oversight_info>
    <has_dmc>No</has_dmc>
    <is_fda_regulated_drug>No</is_fda_regulated_drug>
    <is_fda_regulated_device>No</is_fda_regulated_device>
  </oversight_info>
  <brief_summary>
    <textblock>
      The purpose of the intended proposed research is to investigate and determine best strategies&#xD;
      for preventing skin cancer for emerging adults. To answer this question, the investigators&#xD;
      intended to pilot a randomized control trial with three arms: 1) Facial Morphing, 2)&#xD;
      Mindfulness, and 3) Treatment as usual. The population from which the sample was drawn from&#xD;
      was undergraduate psychology students from a large public university in Southern California,&#xD;
      who report recent indoor/outdoor tanning, and intentions for future tanning.&#xD;
    </textblock>
  </brief_summary>
  <detailed_description>
    <textblock>
      Indoor and outdoor tanning are two of the most common risk factors for developing skin&#xD;
      cancer. Predictors of indoor and outdoor tanning including negative body image and negative&#xD;
      affect. Thus, to subsequently prevent skin cancer, interventions should focus on appearance&#xD;
      concerns and negative affect. To date, limited brief efficacious skin cancer preventions&#xD;
      exist. One potential program (APRIL AGE) a facial morphing software program, has recently&#xD;
      been evaluated as a potential prevention program of skin cancer. However, limited data exists&#xD;
      on the long term benefits of this program. Additionally, brief mindfulness programs have been&#xD;
      found to be efficacious in preventing other health risk behaviors (e.g., smoking, negative&#xD;
      affect, eating behaviors). To the investigators' knowledge, these brief mindfulness&#xD;
      interventions have yet to be applied in skin cancer prevention. Thus, the investigators&#xD;
      sought to compare the relative efficacy of the facial morphing intervention and the&#xD;
      mindfulness intervention vs. control condition (treatment as usual). It was hypothesized that&#xD;
      both facial morphing and mindfulness would lead to reductions in tanning behavior compared to&#xD;
      the TAU condition. The investigators also tested contrasts between the facial morphing and&#xD;
      mindfulness conditions, however, no directional hypotheses could be generated, due to the&#xD;
      dearth of prior data on these interventions in skin cancer prevention.&#xD;
    </textblock>
  </detailed_description>
  <overall_status>Completed</overall_status>
  <start_date type="Actual">February 18, 2016</start_date>
  <completion_date type="Actual">January 14, 2017</completion_date>
  <primary_completion_date type="Actual">December 14, 2016</primary_completion_date>
  <phase>N/A</phase>
  <study_type>Interventional</study_type>
  <has_expanded_access>No</has_expanded_access>
  <study_design_info>
    <allocation>Randomized</allocation>
    <intervention_model>Parallel Assignment</intervention_model>
    <intervention_model_description>At initial visit, participants were screened for study eligibility, consented, and randomized to a study condition. Participants first completed baseline assessment. Following, all participants completed intervention as determined by randomized assignment (i.e., control, facial morphing or mindfulness). At the initial visit, all subjects were assigned a subject ID number. Each subject ID was pre-assigned to a study condition, determined by an online randomization program, prior to recruitment. Each eligible participant had a 1/3 chance to be assigned to each of the three study conditions. Immediately after intervention, participants completed acute assessment, also consisting of self-report questionnaires. At the end of the initial visit, participants provided researchers a valid email address to be sent a subsequent follow-up survey. Approximately one month from the intervention date, participants received and completed the online follow-up survey.</intervention_model_description>
    <primary_purpose>Prevention</primary_purpose>
    <masking>None (Open Label)</masking>
  </study_design_info>
  <primary_outcome>
    <measure>Number of Indoor Tanning Sessions in the Last 30 Days</measure>
    <time_frame>1-month assessment</time_frame>
    <description>One free-response item measuring intentional indoor frequency in the last 30 days</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Number of Outdoor Tanning Sessions in the Last 30 Days</measure>
    <time_frame>1-month assessment</time_frame>
    <description>One free-response item measuring intentional outdoor frequency in the last 30 days</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Indoor Tanning Intentions</measure>
    <time_frame>Post assessment &amp; 1-month assessment</time_frame>
    <description>A free-response items measuring intentional indoor intentions in the next 30 days.</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Outdoor Tanning Intentions</measure>
    <time_frame>Post Assessment &amp; 1-month assessment</time_frame>
    <description>A free-response items measuring intentional outdoor intentions in the next 30 days.</description>
  </primary_outcome>
  <secondary_outcome>
    <measure>Appearance Attitudes to Tan</measure>
    <time_frame>Post assessment &amp; 1-month assessment</time_frame>
    <description>Participants completed the Appearance Reasons to Tan latent subscale of the Physical Appearance Reasons for Tanning Scale (PARTS; Cafri et al., 2006, 2008). This scale consists of three manifest subscales: General Attractiveness, Acne, and Body Shape. These 19 items were scored along a five-point scale: 1 (definitely disagree) to 5 (definitely agree), with a possible total score range of 19-95 (higher scores indicating greater agreement). Total scores are averaged to reflect the average agreement with attitudes which may motivate one to tan (higher average scores indicating greater agreement).</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Appearance Reasons Not to Tan</measure>
    <time_frame>Post assessment and 1-month assessment</time_frame>
    <description>Participants completed the Appearance Reasons Not to Tan latent subscale of the Physical Appearance Reasons for Tanning Scale (PARTS; Cafri et al., 2006, 2008). This scale consists of two manifest subscales: Skin Damage and Skin Aging. These 9 items were scored along a five-point scale 1 (definitely disagree) to 5 (definitely agree) with a possible total score range of 9-45 (higher scores indicating greater agreement). Total scores are averaged to reflect the average agreement with attitudes to not tan; (higher average scores indicating greater agreement).</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>State Body Satisfaction</measure>
    <time_frame>Post-assessment</time_frame>
    <description>State level body satisfaction was measured using the Body Image States Scale (BISS; Cash, Fleming, Alindogan, Steadman, &amp; Whitehead, 2002). This six-item self-report instrument utilizes a nine-point scale (1 [extremely dissatisfied] to 9 [extremely satisfied]); possible total scores range 6-54; higher scores indicate greater satisfaction. This measure is scored by averaging all scores to these six items, with higher average scores indicating greater body satisfaction.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Trait Body Satisfaction</measure>
    <time_frame>1-month assessment</time_frame>
    <description>Trait level body satisfaction was measured using the Multidimensional Body-Self Relations Questionnaire-Appearance Evaluation subscale (MSBRQ-AE; Brown, Cash, &amp; Mikulka, 1990; Cash, 2000). This seven-item self-report subscale utilizes a five-point scale (1 [definitely disagree] to 5 [definitely agree]) with possible score range of 7-35. This measure was scored by averaging all scores to these seven items, with higher scores indicating greater body satisfaction.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Appearance Orientation</measure>
    <time_frame>1-month assessment</time_frame>
    <description>Trait level appearance orientation satisfaction was measured using the Appearance Schemas Inventory-Revised Short Form (ASI-R; Cash, Melnyk, &amp; Hrabosky, 2004). This twenty-item self-report instrument assesses cognitive and behavioral investment in one's physical appearance. This measure utilizes a five-point scale (1 [definitely disagree] to 5 [definitely agree]), with total scores ranging from 20-100; higher scores indicate greater appearance investment. This measure is scored by averaging all scores to these twenty items (higher scores indicating greater appearance investment).</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>State Positive Affect</measure>
    <time_frame>Post assessment</time_frame>
    <description>State positive affect was measured using the positive affect subscale of the Positive and Negative Affect Scale-Short Form (PANAS-SF; Thompson, 2007). This self-report subscale consists of five items of the full ten-item measure. This subscale utilizes a five-point Likert-type scale ranging from 1 (never) to 5 (always). This measure is scored by summing all scores to these five items (range 5-25), with higher scores indicating greater state positive affect. For the purposes of this project, participants' item scores to these five items were averaged.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>State Negative Affect</measure>
    <time_frame>Post assessment</time_frame>
    <description>State negative affect was measured using the negative affect subscale of the Positive and Negative Affect Scale-Short Form (PANAS-SF; Thompson, 2007). This self-report subscale consists of five items of the full ten-item measure. This subscale utilizes a five-point Likert-type scale ranging from 1 (never) to 5 (always). This measure is scored by summing all scores to these five items (range 5-25), with higher scores indicating greater state negative affect. For the purposes of this project, participants' item scores to these five items were averaged.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Depressive Symptoms</measure>
    <time_frame>1-month assessment</time_frame>
    <description>Participants completed the Depression Anxiety Stress Scales Short Version (DASS-21) as a marker of trait level negative affect (Henry &amp; Crawford, 2005). This 21-item self-report measure consists of three seven-item subscales: depression, anxiety, and stress. Items are measured along a 4-point scale (0 [not at all like me] to 3 [applied to me very much, or most of the time]); higher scores denote increased symptoms. Total sum scores for this instrument ranges from 0-63; scores for the depressive symptom subscale range from 0-21.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Anxiety Symptoms</measure>
    <time_frame>1-month assessment</time_frame>
    <description>Participants completed the Depression Anxiety Stress Scales Short Version (DASS-21) as a marker of trait level negative affect (Henry &amp; Crawford, 2005). This 21-item self-report measure consists of three seven-item subscales: depression, anxiety, and stress. Items are measured along a 4-point scale (0 [not at all like me] to 3 [applied to me very much, or most of the time]); higher scores denote increased symptoms. Total sum scores for this instrument ranges from 0-63; scores for the anxiety symptom subscale range from 0-21.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Stress</measure>
    <time_frame>1-month assessment</time_frame>
    <description>Participants completed the Depression Anxiety Stress Scales Short Version (DASS-21) as a marker of trait level negative affect (Henry &amp; Crawford, 2005). This 21-item self-report measure consists of three seven-item subscales: depression, anxiety, and stress. Items are measured along a 4-point scale (0 [not at all like me] to 3 [applied to me very much, or most of the time]); higher scores denote increased symptoms. Total sum scores for this instrument ranges from 0-63; scores for the stress symptom subscale range from 0-21.</description>
  </secondary_outcome>
  <number_of_arms>3</number_of_arms>
  <enrollment type="Actual">219</enrollment>
  <condition>Skin Cancer</condition>
  <condition>Skin Cancer Melanoma</condition>
  <condition>Squamous Cell Carcinoma</condition>
  <condition>Basal Cell Carcinoma</condition>
  <arm_group>
    <arm_group_label>Control (Treatment as Usual only)</arm_group_label>
    <arm_group_type>No Intervention</arm_group_type>
    <description>Following baseline assessment, all participants were given health literature on tanning behavior from the U.S. Centers for Disease Control and Prevention (CDC). These materials included informational pamphlets addressing common myths regarding tanning behaviors, including &quot;Tanned skin is not healthy skin&quot;, and &quot;A base tan is not a safe tan. These misconceptions were accompanied by &quot;burning truth&quot;, scientific data debunking these myths. Additionally, all participants received a packet on sun protective practices for oneself and family, which include skin cancer statistics and information on UV rays.</description>
  </arm_group>
  <arm_group>
    <arm_group_label>Treatment as Usual + Facial Morphing</arm_group_label>
    <arm_group_type>Experimental</arm_group_type>
    <description>In addition to the health literature, participants completed the Facial Morphing Intervention. Participants had a digital photograph taken and uploaded to the APRIL® software, accompanied by information about their current age and self-identified race. Participants were presented with two, side-by-side identical 2D images of their face. Participants first viewed an image of their face from their current age, in two-year intervals, to age 72, the maximum age, with the &quot;UV exposure&quot; setting turned on. This process was repeated. Next, participants viewed the projected aging process, toggling the &quot;UV exposure&quot; setting (on and off), every ten year interval. The process was repeated using 3D images to view projected changes to their facial profiles.</description>
  </arm_group>
  <arm_group>
    <arm_group_label>Treatment as Usual + Mindfulness</arm_group_label>
    <arm_group_type>Placebo Comparator</arm_group_type>
    <description>In addition to the health literature, participants completed the Mindfulness Intervention. Participants listened to a 10-minute self-guided mindfulness audio exercise. The audio file is a scripted reading of an established, brief mindfulness exercise (Erisman &amp; Roemer, 2010). During this guided session, participants learned what mindfulness was, when it can be used, and benefits from practice. Listeners were led through steps, focusing on the physical sensations, breathing, and thoughts. After the exercise, participants were provided a handout highlighting key points about mindfulness and how to incorporate informal mindfulness practice into their daily life.</description>
  </arm_group>
  <intervention>
    <intervention_type>Behavioral</intervention_type>
    <intervention_name>Facial Morphing Intervention</intervention_name>
    <description>Participants assigned to this condition were exposed to facial morphing technology that displays the progression of facial-ageing up to 72years, both with and without damage from UV exposure.</description>
    <arm_group_label>Treatment as Usual + Facial Morphing</arm_group_label>
    <other_name>Facial Morphing</other_name>
  </intervention>
  <intervention>
    <intervention_type>Behavioral</intervention_type>
    <intervention_name>Mindfulness Intervention</intervention_name>
    <description>Participants assigned to this condition engaged in a self-guided mindfulness intervention audio tape. This intervention instructed participants to pay attention to the present moment, with a non-judgemental stance. For example, participants were instructed to notice their breath, thoughts, feelings, physical sensations, and to internally describe them, without passing judgement</description>
    <arm_group_label>Treatment as Usual + Mindfulness</arm_group_label>
    <other_name>Mindfulness</other_name>
  </intervention>
  <eligibility>
    <criteria>
      <textblock>
        Inclusion Criteria:&#xD;
&#xD;
          -  1) aged 18 years old or older&#xD;
&#xD;
          -  2) enrolled as a student at the University&#xD;
&#xD;
          -  3) engaged in either indoor or outdoor tanning in the last 30 days&#xD;
&#xD;
          -  4) intended to tan (indoor or outdoor) in the last 30 days&#xD;
&#xD;
          -  5) English speaking&#xD;
&#xD;
        Exclusion Criteria:&#xD;
&#xD;
          -  Failure to meet any of the above mentioned inclusion criteria&#xD;
      </textblock>
    </criteria>
    <gender>All</gender>
    <minimum_age>18 Years</minimum_age>
    <maximum_age>N/A</maximum_age>
    <healthy_volunteers>Accepts Healthy Volunteers</healthy_volunteers>
  </eligibility>
  <overall_official>
    <last_name>Aaron J Blashill, PhD</last_name>
    <role>Principal Investigator</role>
    <affiliation>San Diego State University</affiliation>
  </overall_official>
  <location>
    <facility>
      <name>San Diego State University</name>
      <address>
        <city>San Diego</city>
        <state>California</state>
        <zip>92182</zip>
        <country>United States</country>
      </address>
    </facility>
  </location>
  <location_countries>
    <country>United States</country>
  </location_countries>
  <reference>
    <citation>Ashrafioun L, Bonar EE. Tanning addiction and psychopathology: Further evaluation of anxiety disorders and substance abuse. J Am Acad Dermatol. 2014 Mar;70(3):473-80. doi: 10.1016/j.jaad.2013.10.057. Epub 2013 Dec 25.</citation>
    <PMID>24373775</PMID>
  </reference>
  <reference>
    <citation>Ramos Diaz NS, Jimenez Jimenez O, Lopes PN. The role of mindfulness in coping with recollections of acute stressors: a laboratory study. Psicothema. 2014;26(4):505-10. doi: 10.7334/psicothema2014.71.</citation>
    <PMID>25340898</PMID>
  </reference>
  <reference>
    <citation>Erisman SM, Roemer L. A preliminary investigation of the effects of experimentally induced mindfulness on emotional responding to film clips. Emotion. 2010 Feb;10(1):72-82. doi: 10.1037/a0017162.</citation>
    <PMID>20141304</PMID>
  </reference>
  <reference>
    <citation>Hillhouse J, Stapleton J, Turrisi R. Association of frequent indoor UV tanning with seasonal affective disorder. Arch Dermatol. 2005 Nov;141(11):1465. doi: 10.1001/archderm.141.11.1465. No abstract available.</citation>
    <PMID>16301398</PMID>
  </reference>
  <reference>
    <citation>Marchiori D, Papies EK. A brief mindfulness intervention reduces unhealthy eating when hungry, but not the portion size effect. Appetite. 2014 Apr;75:40-5. doi: 10.1016/j.appet.2013.12.009. Epub 2013 Dec 20.</citation>
    <PMID>24361312</PMID>
  </reference>
  <reference>
    <citation>Rogojanski J, Vettese LC, Antony MM. Coping with cigarette cravings: Comparison of suppression versus mindfulness-based strategies. Mindfulness, 2(1): 14-26, 2011.</citation>
  </reference>
  <reference>
    <citation>Williams AL, Grogan S, Buckley E, Clark-Carter D. Men's experiences of an appearance-focussed facial-ageing sun protection intervention: a qualitative study. Body Image. 2013 Mar;10(2):263-6. doi: 10.1016/j.bodyim.2013.01.003. Epub 2013 Feb 9.</citation>
    <PMID>23402802</PMID>
  </reference>
  <verification_date>April 2019</verification_date>
  <study_first_submitted>July 26, 2017</study_first_submitted>
  <study_first_submitted_qc>August 1, 2017</study_first_submitted_qc>
  <study_first_posted type="Actual">August 2, 2017</study_first_posted>
  <results_first_submitted>May 8, 2018</results_first_submitted>
  <results_first_submitted_qc>April 18, 2019</results_first_submitted_qc>
  <results_first_posted type="Actual">July 5, 2019</results_first_posted>
  <last_update_submitted>April 18, 2019</last_update_submitted>
  <last_update_submitted_qc>April 18, 2019</last_update_submitted_qc>
  <last_update_posted type="Actual">July 5, 2019</last_update_posted>
  <responsible_party>
    <responsible_party_type>Principal Investigator</responsible_party_type>
    <investigator_affiliation>San Diego State University</investigator_affiliation>
    <investigator_full_name>Aaron Blashill</investigator_full_name>
    <investigator_title>Assistant Professor</investigator_title>
  </responsible_party>
  <keyword>Sunbathing</keyword>
  <keyword>Indoor Tanning</keyword>
  <keyword>Facial Morphing</keyword>
  <keyword>Skin Cancer Risk</keyword>
  <condition_browse>
    <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
    <mesh_term>Carcinoma</mesh_term>
    <mesh_term>Carcinoma, Basal Cell</mesh_term>
    <mesh_term>Skin Neoplasms</mesh_term>
  </condition_browse>
  <patient_data>
    <sharing_ipd>No</sharing_ipd>
    <ipd_description>There is no IPD sharing plan at this time.</ipd_description>
  </patient_data>

  <clinical_results>

    <participant_flow>
      <recruitment_details>Study was conducted between February and December 2016. Participants were recruited from an undergraduate research participation website at a large, public American university. A general description of the study's purpose, which specified study inclusion criteria and one's time commitment was provided for potential participants</recruitment_details>
      <group_list>
        <group group_id="P1">
          <title>Control (Treatment as Usual Only)</title>
          <description>Following baseline assessment, all participants were given health literature on tanning behavior from the U.S. Centers for Disease Control and Prevention (CDC). These materials included informational pamphlets addressing common myths regarding tanning behaviors, including &quot;Tanned skin is not healthy skin&quot;, and &quot;A base tan is not a safe tan. These misconceptions were accompanied by &quot;burning truth&quot;, scientific data debunking these myths. Additionally, all participants received a packet on sun protective practices for oneself and family, which include skin cancer statistics and information on UV rays.</description>
        </group>
        <group group_id="P2">
          <title>Treatment as Usual + Facial Morphing</title>
          <description>In addition to the health literature, participants completed the Facial Morphing Intervention. Participants had a digital photograph taken and uploaded to the APRIL® software, accompanied by information about their current age and self-identified race. Participants were presented with two, side-by-side identical 2D images of their face. Participants first viewed an image of their face from their current age, in two-year intervals, to age 72, the maximum age, with the &quot;UV exposure&quot; setting turned on. This process was repeated. Next, participants viewed the projected aging process, toggling the &quot;UV exposure&quot; setting (on and off), every ten year interval. The process was repeated using 3D images to view projected changes to their facial profiles.&#xD;
Facial Morphing Intervention: Participants assigned to this condition were exposed to facial morphing technology that displays the progression of facial-ageing up to 72years, both with and without damage from UV exposure.</description>
        </group>
        <group group_id="P3">
          <title>Treatment as Usual + Mindfulness</title>
          <description>In addition to the health literature, participants completed the Mindfulness Intervention. Participants listened to a 10-minute self-guided mindfulness audio exercise. The audio file is a scripted reading of an established brief mindfulness exercise (Erisman &amp; Roemer, 2010). During this guided session, participants learned what mindfulness was, when it can be used, and benefits from practice. Listeners were led through steps, focusing on the physical sensations, breathing, and thoughts. After the exercise, participants were provided a handout highlighting key points about mindfulness and how to incorporate informal mindfulness practice into their daily life.&#xD;
Mindfulness Intervention: Participants assigned to this condition engaged in a self-guided mindfulness intervention audio tape. This intervention instructed participants to pay attention to the present moment, with a non-judgemental stance. For example, participants were instructed to notice their breath, thoughts, feelings, ph</description>
        </group>
      </group_list>
      <period_list>
        <period>
          <title>Baseline to Immediate Post-treatment</title>
          <milestone_list>
            <milestone>
              <title>STARTED</title>
              <participants_list>
                <participants group_id="P1" count="73"/>
                <participants group_id="P2" count="73"/>
                <participants group_id="P3" count="73"/>
              </participants_list>
            </milestone>
            <milestone>
              <title>COMPLETED</title>
              <participants_list>
                <participants group_id="P1" count="73"/>
                <participants group_id="P2" count="73"/>
                <participants group_id="P3" count="73"/>
              </participants_list>
            </milestone>
            <milestone>
              <title>NOT COMPLETED</title>
              <participants_list>
                <participants group_id="P1" count="0"/>
                <participants group_id="P2" count="0"/>
                <participants group_id="P3" count="0"/>
              </participants_list>
            </milestone>
          </milestone_list>
        </period>
        <period>
          <title>Immediate Post-treatment to 1-mo F/u</title>
          <milestone_list>
            <milestone>
              <title>STARTED</title>
              <participants_list>
                <participants group_id="P1" count="73"/>
                <participants group_id="P2" count="73"/>
                <participants group_id="P3" count="73"/>
              </participants_list>
            </milestone>
            <milestone>
              <title>COMPLETED</title>
              <participants_list>
                <participants group_id="P1" count="30"/>
                <participants group_id="P2" count="43"/>
                <participants group_id="P3" count="36"/>
              </participants_list>
            </milestone>
            <milestone>
              <title>NOT COMPLETED</title>
              <participants_list>
                <participants group_id="P1" count="43"/>
                <participants group_id="P2" count="30"/>
                <participants group_id="P3" count="37"/>
              </participants_list>
            </milestone>
          </milestone_list>
          <drop_withdraw_reason_list>
            <drop_withdraw_reason>
              <title>Lost to Follow-up</title>
              <participants_list>
                <participants group_id="P1" count="43"/>
                <participants group_id="P2" count="30"/>
                <participants group_id="P3" count="37"/>
              </participants_list>
            </drop_withdraw_reason>
          </drop_withdraw_reason_list>
        </period>
      </period_list>
    </participant_flow>

    <baseline>
      <group_list>
        <group group_id="B1">
          <title>Control (Treatment as Usual Only)</title>
          <description>Following baseline assessment, all participants were given health literature on tanning behavior from the U.S. Centers for Disease Control and Prevention (CDC). These materials included informational pamphlets addressing common myths regarding tanning behaviors, including &quot;Tanned skin is not healthy skin&quot;, and &quot;A base tan is not a safe tan. These misconceptions were accompanied by &quot;burning truth&quot;, scientific data debunking these myths. Additionally, all participants received a packet on sun protective practices for oneself and family, which include skin cancer statistics and information on UV rays.</description>
        </group>
        <group group_id="B2">
          <title>Treatment as Usual + Facial Morphing</title>
          <description>In addition to the health literature, participants completed the Facial Morphing Intervention. Participants had a digital photograph taken and uploaded to the APRIL® software, accompanied by information about their current age and self-identified race. Participants were presented with two, side-by-side identical 2D images of their face. Participants first viewed an image of their face from their current age, in two-year intervals, to age 72, the maximum age, with the &quot;UV exposure&quot; setting turned on. This process was repeated. Next, participants viewed the projected aging process, toggling the &quot;UV exposure&quot; setting (on and off), every ten year interval. The process was repeated using 3D images to view projected changes to their facial profiles.&#xD;
Facial Morphing Intervention: Participants assigned to this condition were exposed to facial morphing technology that displays the progression of facial-ageing up to 72years, both with and without damage from UV exposure.</description>
        </group>
        <group group_id="B3">
          <title>Treatment as Usual + Mindfulness</title>
          <description>In addition to the health literature, participants completed the Mindfulness Intervention. Participants listened to a 10-minute self-guided mindfulness audio exercise. The audio file is a scripted reading of an established brief mindfulness exercise (Erisman &amp; Roemer, 2010). During this guided session, participants learned what mindfulness was, when it can be used, and benefits from practice. Listeners were led through steps, focusing on the physical sensations, breathing, and thoughts. After the exercise, participants were provided a handout highlighting key points about mindfulness and how to incorporate informal mindfulness practice into their daily life.&#xD;
Mindfulness Intervention: Participants assigned to this condition engaged in a self-guided mindfulness intervention audio tape. This intervention instructed participants to pay attention to the present moment, with a non-judgemental stance. For example, participants were instructed to notice their breath, thoughts, feelings, ph</description>
        </group>
        <group group_id="B4">
          <title>Total</title>
          <description>Total of all reporting groups</description>
        </group>
      </group_list>
      <analyzed_list>
        <analyzed>
          <units>Participants</units>
          <scope>Overall</scope>
          <count_list>
            <count group_id="B1" value="73"/>
            <count group_id="B2" value="73"/>
            <count group_id="B3" value="73"/>
            <count group_id="B4" value="219"/>
          </count_list>
        </analyzed>
      </analyzed_list>
      <measure_list>
        <measure>
          <title>Age</title>
          <units>years</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="B1" value="19.60" spread="1.75"/>
                    <measurement group_id="B2" value="19.65" spread="2.77"/>
                    <measurement group_id="B3" value="19.90" spread="2.85"/>
                    <measurement group_id="B4" value="19.72" spread="2.50"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
        <measure>
          <title>Sex: Female, Male</title>
          <units>Participants</units>
          <param>Count of Participants</param>
          <class_list>
            <class>
              <category_list>
                <category>
                  <title>Female</title>
                  <measurement_list>
                    <measurement group_id="B1" value="57"/>
                    <measurement group_id="B2" value="64"/>
                    <measurement group_id="B3" value="57"/>
                    <measurement group_id="B4" value="178"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Male</title>
                  <measurement_list>
                    <measurement group_id="B1" value="16"/>
                    <measurement group_id="B2" value="9"/>
                    <measurement group_id="B3" value="16"/>
                    <measurement group_id="B4" value="41"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
        <measure>
          <title>Ethnicity (NIH/OMB)</title>
          <units>Participants</units>
          <param>Count of Participants</param>
          <class_list>
            <class>
              <category_list>
                <category>
                  <title>Hispanic or Latino</title>
                  <measurement_list>
                    <measurement group_id="B1" value="16"/>
                    <measurement group_id="B2" value="19"/>
                    <measurement group_id="B3" value="19"/>
                    <measurement group_id="B4" value="54"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Not Hispanic or Latino</title>
                  <measurement_list>
                    <measurement group_id="B1" value="57"/>
                    <measurement group_id="B2" value="54"/>
                    <measurement group_id="B3" value="54"/>
                    <measurement group_id="B4" value="165"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Unknown or Not Reported</title>
                  <measurement_list>
                    <measurement group_id="B1" value="0"/>
                    <measurement group_id="B2" value="0"/>
                    <measurement group_id="B3" value="0"/>
                    <measurement group_id="B4" value="0"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
        <measure>
          <title>Race (NIH/OMB)</title>
          <units>Participants</units>
          <param>Count of Participants</param>
          <class_list>
            <class>
              <category_list>
                <category>
                  <title>American Indian or Alaska Native</title>
                  <measurement_list>
                    <measurement group_id="B1" value="1"/>
                    <measurement group_id="B2" value="0"/>
                    <measurement group_id="B3" value="1"/>
                    <measurement group_id="B4" value="2"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Asian</title>
                  <measurement_list>
                    <measurement group_id="B1" value="9"/>
                    <measurement group_id="B2" value="11"/>
                    <measurement group_id="B3" value="14"/>
                    <measurement group_id="B4" value="34"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Native Hawaiian or Other Pacific Islander</title>
                  <measurement_list>
                    <measurement group_id="B1" value="0"/>
                    <measurement group_id="B2" value="0"/>
                    <measurement group_id="B3" value="0"/>
                    <measurement group_id="B4" value="0"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Black or African American</title>
                  <measurement_list>
                    <measurement group_id="B1" value="2"/>
                    <measurement group_id="B2" value="1"/>
                    <measurement group_id="B3" value="0"/>
                    <measurement group_id="B4" value="3"/>
                  </measurement_list>
                </category>
                <category>
                  <title>White</title>
                  <measurement_list>
                    <measurement group_id="B1" value="49"/>
                    <measurement group_id="B2" value="43"/>
                    <measurement group_id="B3" value="49"/>
                    <measurement group_id="B4" value="141"/>
                  </measurement_list>
                </category>
                <category>
                  <title>More than one race</title>
                  <measurement_list>
                    <measurement group_id="B1" value="0"/>
                    <measurement group_id="B2" value="0"/>
                    <measurement group_id="B3" value="0"/>
                    <measurement group_id="B4" value="0"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Unknown or Not Reported</title>
                  <measurement_list>
                    <measurement group_id="B1" value="12"/>
                    <measurement group_id="B2" value="18"/>
                    <measurement group_id="B3" value="9"/>
                    <measurement group_id="B4" value="39"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
        <measure>
          <title>Region of Enrollment</title>
          <units>participants</units>
          <param>Number</param>
          <class_list>
            <class>
              <title>United States</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="B1" value="73"/>
                    <measurement group_id="B2" value="73"/>
                    <measurement group_id="B3" value="73"/>
                    <measurement group_id="B4" value="219"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
        <measure>
          <title>Skin Type</title>
          <description>Participants were asked to self-report their skin type among six options representing a range of light to dark skin tones indicating greater burning and tanning characteristics using the Fitzpatrick Skin Type Scale (Fitzpatrick, 1988). Participants were provided with six skin types (i.e., Skin Type I: Very Fair--always burns cannot tan; Skin Type 2: Fair--usually burns sometimes tans; Skin Type 3: Medium--sometimes burns usually tans; Skin Type 4: Olive--rarely burns always tans; Skin Type 5: Brown--never burns always tans; and Skin Type 6: Black--never burns always tans) to self-select from.</description>
          <units>Participants</units>
          <param>Count of Participants</param>
          <class_list>
            <class>
              <category_list>
                <category>
                  <title>Skin Type I</title>
                  <measurement_list>
                    <measurement group_id="B1" value="1"/>
                    <measurement group_id="B2" value="0"/>
                    <measurement group_id="B3" value="0"/>
                    <measurement group_id="B4" value="1"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Skin Type 2</title>
                  <measurement_list>
                    <measurement group_id="B1" value="10"/>
                    <measurement group_id="B2" value="9"/>
                    <measurement group_id="B3" value="6"/>
                    <measurement group_id="B4" value="25"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Skin Type 3</title>
                  <measurement_list>
                    <measurement group_id="B1" value="36"/>
                    <measurement group_id="B2" value="36"/>
                    <measurement group_id="B3" value="40"/>
                    <measurement group_id="B4" value="112"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Skin Type 4</title>
                  <measurement_list>
                    <measurement group_id="B1" value="23"/>
                    <measurement group_id="B2" value="24"/>
                    <measurement group_id="B3" value="27"/>
                    <measurement group_id="B4" value="74"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Skin Type 5</title>
                  <measurement_list>
                    <measurement group_id="B1" value="2"/>
                    <measurement group_id="B2" value="4"/>
                    <measurement group_id="B3" value="0"/>
                    <measurement group_id="B4" value="6"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Skin Type 6</title>
                  <measurement_list>
                    <measurement group_id="B1" value="1"/>
                    <measurement group_id="B2" value="0"/>
                    <measurement group_id="B3" value="0"/>
                    <measurement group_id="B4" value="1"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
        <measure>
          <title>Indoor Tanning Frequency</title>
          <description>Participants reported the number of sessions of indoor tanning they experienced in the past month</description>
          <units>Sessions in last month</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="B1" value="1.30" spread="2.68"/>
                    <measurement group_id="B2" value="1.51" spread="2.83"/>
                    <measurement group_id="B3" value="1.28" spread="2.41"/>
                    <measurement group_id="B4" value="1.36" spread="2.62"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
        <measure>
          <title>Outdoor Tanning Frequency</title>
          <description>Participants were asked to self-report the number of sessions of outdoor tanning they engaged in within the last month</description>
          <units>Sessions in last month</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="B1" value="7.69" spread="5.35"/>
                    <measurement group_id="B2" value="7.25" spread="5.04"/>
                    <measurement group_id="B3" value="7.02" spread="4.84"/>
                    <measurement group_id="B4" value="7.32" spread="5.06"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
        <measure>
          <title>Indoor Tanning Intentions</title>
          <description>Participants were asked to estimate the number of times they plan to indoor tan in the next month</description>
          <units>Sessions in next month</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="B1" value="4.36" spread="2.17"/>
                    <measurement group_id="B2" value="4.13" spread="2.17"/>
                    <measurement group_id="B3" value="4.27" spread="2.20"/>
                    <measurement group_id="B4" value="4.25" spread="2.17"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
        <measure>
          <title>Outdoor Tanning Intentions</title>
          <description>Participants were asked to estimate the number of times they plan to outdoor tan in the next month</description>
          <units>Sessions in next month</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="B1" value="5.96" spread="1.37"/>
                    <measurement group_id="B2" value="5.56" spread="1.59"/>
                    <measurement group_id="B3" value="5.90" spread="1.20"/>
                    <measurement group_id="B4" value="5.81" spread="1.39"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
        <measure>
          <title>Appearance Attitudes to Tan</title>
          <description>Participants completed the Appearance Reasons to Tan latent subscale of the Physical Appearance Reasons for Tanning Scale (PARTS; Cafri et al., 2006, 2008). This scale consists of three manifest subscales: General Attractiveness, Acne, and Body Shape. These 19 items were scored along a five-point scale: 1 (definitely disagree) to 5 (definitely agree), with a possible total score range of 19-95 (higher scores indicating greater agreement). Total scores are averaged to reflect the average agreement with attitudes which may motivate one to tan (higher average scores indicating greater agreement).</description>
          <units>units on a scale</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="B1" value="3.41" spread="0.76"/>
                    <measurement group_id="B2" value="3.29" spread="0.91"/>
                    <measurement group_id="B3" value="3.46" spread="0.74"/>
                    <measurement group_id="B4" value="3.42" spread="0.81"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
        <measure>
          <title>Appearance Attitudes Not to Tan</title>
          <description>Participants completed the Appearance Reasons Not to Tan latent subscale of the Physical Appearance Reasons for Tanning Scale (PARTS; Cafri et al., 2006, 2008). This scale consists of two manifest subscales: Skin Damage and Skin Aging. These 9 items were scored along a five-point scale 1 (definitely disagree) to 5 (definitely agree) with a possible total score range of 9-45 (higher scores indicating greater agreement). Total scores are averaged to reflect the average agreement with attitudes to not tan; (higher average scores indicating greater agreement).</description>
          <units>units on a scale</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="B1" value="3.41" spread="0.76"/>
                    <measurement group_id="B2" value="3.31" spread="0.78"/>
                    <measurement group_id="B3" value="3.36" spread="0.77"/>
                    <measurement group_id="B4" value="3.36" spread="0.77"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
        <measure>
          <title>State Body Satisfaction</title>
          <description>State level body satisfaction was measured using the Body Image States Scale (BISS; Cash, Fleming, Alindogan, Steadman, &amp; Whitehead, 2002). This six-item self-report instrument utilizes a nine-point scale (1 [extremely dissatisfied] to 9 [extremely satisfied]); possible total scores range 6-54; higher scores indicate greater satisfaction. This measure is scored by averaging all scores to these six items, with higher average scores indicating greater body satisfaction.</description>
          <units>units on a scale</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="B1" value="5.70" spread="1.35"/>
                    <measurement group_id="B2" value="5.48" spread="1.37"/>
                    <measurement group_id="B3" value="5.32" spread="1.37"/>
                    <measurement group_id="B4" value="5.50" spread="1.30"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
        <measure>
          <title>Trait Body Satisfaction</title>
          <description>Trait level body satisfaction was measured using the Multidimensional Body-Self Relations Questionnaire-Appearance Evaluation subscale (MSBRQ-AE; Brown, Cash, &amp; Mikulka, 1990; Cash, 2000). This seven-item self-report subscale utilizes a five-point scale (1 [definitely disagree] to 5 [definitely agree]) with possible score range of 7-35. This measure was scored by averaging all scores to these seven items, with higher scores indicating greater body satisfaction.</description>
          <units>units on a scale</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="B1" value="3.52" spread="0.78"/>
                    <measurement group_id="B2" value="3.42" spread="0.68"/>
                    <measurement group_id="B3" value="3.39" spread="0.74"/>
                    <measurement group_id="B4" value="3.44" spread="0.73"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
        <measure>
          <title>Appearance Orientation</title>
          <description>Trait level appearance orientation satisfaction was measured using the Appearance Schemas Inventory-Revised Short Form (ASI-R; Cash, Melnyk, &amp; Hrabosky, 2004). This twenty-item self-report instrument assesses cognitive and behavioral investment in one's physical appearance. This measure utilizes a five-point scale (1 [definitely disagree] to 5 [definitely agree]), with total scores ranging from 20-100; higher scores indicate greater appearance investment. This measure is scored by averaging all scores to these twenty items (higher scores indicating greater appearance investment).</description>
          <units>units on a scale</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="B1" value="3.66" spread="0.50"/>
                    <measurement group_id="B2" value="3.54" spread="0.58"/>
                    <measurement group_id="B3" value="3.64" spread="0.56"/>
                    <measurement group_id="B4" value="3.61" spread="0.55"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
        <measure>
          <title>State Positive Affect</title>
          <description>State positive affect was measured using the positive affect subscale of the Positive and Negative Affect Scale-Short Form (PANAS-SF; Thompson, 2007). This self-report subscale consists of five items of the full ten-item measure. This subscale utilizes a five-point Likert-type scale ranging from 1 (never) to 5 (always). This measure is scored by summing all scores to these five items (range 5-25), with higher scores indicating greater state positive affect. For the purposes of this project, participants' item scores to these five items were averaged.</description>
          <units>units on a scale</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="B1" value="3.59" spread="0.63"/>
                    <measurement group_id="B2" value="3.45" spread="0.76"/>
                    <measurement group_id="B3" value="3.33" spread="0.79"/>
                    <measurement group_id="B4" value="3.46" spread="0.74"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
        <measure>
          <title>State Negative Affect</title>
          <description>State negative affect was measured using the negative affect subscale of the Positive and Negative Affect Scale-Short Form (PANAS-SF; Thompson, 2007). This self-report subscale consists of five items of the full ten-item measure. This subscale utilizes a five-point Likert-type scale ranging from 1 (never) to 5 (always). This measure is scored by summing all scores to these five items (range 5-25), with higher scores indicating greater state negative affect. For the purposes of this project, participants' item scores to these five items were averaged.</description>
          <units>units on a scale</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="B1" value="2.20" spread="0.70"/>
                    <measurement group_id="B2" value="2.07" spread="0.75"/>
                    <measurement group_id="B3" value="2.02" spread="0.72"/>
                    <measurement group_id="B4" value="2.09" spread="0.72"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
        <measure>
          <title>Depressive Symptoms</title>
          <description>Participants completed the Depression Anxiety Stress Scales Short Version (DASS-21) as a marker of trait level negative affect (Henry &amp; Crawford, 2005). This 21-item self-report measure consists of three seven-item subscales: depression, anxiety, and stress. Items are measured along a 4-point scale (0 [not at all like me] to 3 [applied to me very much, or most of the time]); higher scores denote increased symptoms. Total sum scores for this instrument ranges from 0-63; scores for the depressive symptom subscale range from 0-21.</description>
          <units>units on a scale</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="B1" value="4.82" spread="4.95"/>
                    <measurement group_id="B2" value="6.32" spread="8.84"/>
                    <measurement group_id="B3" value="5.97" spread="7.59"/>
                    <measurement group_id="B4" value="5.70" spread="7.30"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
        <measure>
          <title>Anxiety Symptoms</title>
          <description>Participants completed the Depression Anxiety Stress Scales Short Version (DASS-21) as a marker of trait level negative affect (Henry &amp; Crawford, 2005). This 21-item self-report measure consists of three seven-item subscales: depression, anxiety, and stress. Items are measured along a 4-point scale (0 [not at all like me] to 3 [applied to me very much, or most of the time]); higher scores denote increased symptoms. Total sum scores for this instrument ranges from 0-63; scores for the anxiety symptom subscale range from 0-21.</description>
          <units>units on a scale</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="B1" value="6.63" spread="5.82"/>
                    <measurement group_id="B2" value="7.86" spread="7.83"/>
                    <measurement group_id="B3" value="6.38" spread="5.86"/>
                    <measurement group_id="B4" value="6.95" spread="6.57"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
        <measure>
          <title>Stress</title>
          <description>Participants completed the Depression Anxiety Stress Scales Short Version (DASS-21) as a marker of trait level negative affect (Henry &amp; Crawford, 2005). This 21-item self-report measure consists of three seven-item subscales: depression, anxiety, and stress. Items are measured along a 4-point scale (0 [not at all like me] to 3 [applied to me very much, or most of the time]); higher scores denote increased symptoms. Total sum scores for this instrument ranges from 0-63; scores for the stress symptom subscale range from 0-21.</description>
          <units>units on a scale</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="B1" value="10.38" spread="7.82"/>
                    <measurement group_id="B2" value="11.39" spread="9.28"/>
                    <measurement group_id="B3" value="11.56" spread="8.82"/>
                    <measurement group_id="B4" value="11.11" spread="8.63"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </measure_list>
    </baseline>

    <outcome_list>
      <outcome>
        <type>Primary</type>
        <title>Number of Indoor Tanning Sessions in the Last 30 Days</title>
        <description>One free-response item measuring intentional indoor frequency in the last 30 days</description>
        <time_frame>1-month assessment</time_frame>
        <group_list>
          <group group_id="O1">
            <title>Control (Treatment as Usual Only)</title>
            <description>Following baseline assessment, all participants were given health literature on tanning behavior from the U.S. Centers for Disease Control and Prevention (CDC). These materials included informational pamphlets addressing common myths regarding tanning behaviors, including &quot;Tanned skin is not healthy skin&quot;, and &quot;A base tan is not a safe tan. These misconceptions were accompanied by &quot;burning truth&quot;, scientific data debunking these myths. Additionally, all participants received a packet on sun protective practices for oneself and family, which include skin cancer statistics and information on UV rays.</description>
          </group>
          <group group_id="O2">
            <title>Treatment as Usual + Facial Morphing</title>
            <description>In addition to the health literature, participants completed the Facial Morphing Intervention. Participants had a digital photograph taken and uploaded to the APRIL® software, accompanied by information about their current age and self-identified race. Participants were presented with two, side-by-side identical 2D images of their face. Participants first viewed an image of their face from their current age, in two-year intervals, to age 72, the maximum age, with the &quot;UV exposure&quot; setting turned on. This process was repeated. Next, participants viewed the projected aging process, toggling the &quot;UV exposure&quot; setting (on and off), every ten year interval. The process was repeated using 3D images to view projected changes to their facial profiles.&#xD;
Facial Morphing Intervention: Participants assigned to this condition were exposed to facial morphing technology that displays the progression of facial-ageing up to 72years, both with and without damage from UV exposure.</description>
          </group>
          <group group_id="O3">
            <title>Treatment as Usual + Mindfulness</title>
            <description>In addition to the health literature, participants completed the Mindfulness Intervention. Participants listened to a 10-minute self-guided mindfulness audio exercise. The audio file is a scripted reading of an established, brief mindfulness exercise (Erisman &amp; Roemer, 2010). During this guided session, participants learned what mindfulness was, when it can be used, and benefits from practice. Listeners were led through steps, focusing on the physical sensations, breathing, and thoughts. After the exercise, participants were provided a handout highlighting key points about mindfulness and how to incorporate informal mindfulness practice into their daily life.&#xD;
Mindfulness Intervention: Participants assigned to this condition engaged in a self-guided mindfulness intervention audio tape. This intervention instructed participants to pay attention to the present moment, with a non-judgemental stance.</description>
          </group>
        </group_list>
        <measure>
          <title>Number of Indoor Tanning Sessions in the Last 30 Days</title>
          <description>One free-response item measuring intentional indoor frequency in the last 30 days</description>
          <units>Sessions in last month</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="30"/>
                <count group_id="O2" value="43"/>
                <count group_id="O3" value="36"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="1.98" spread="3.21"/>
                    <measurement group_id="O2" value="1.35" spread="2.81"/>
                    <measurement group_id="O3" value="1.92" spread="2.86"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Primary</type>
        <title>Number of Outdoor Tanning Sessions in the Last 30 Days</title>
        <description>One free-response item measuring intentional outdoor frequency in the last 30 days</description>
        <time_frame>1-month assessment</time_frame>
        <group_list>
          <group group_id="O1">
            <title>Control (Treatment as Usual Only)</title>
            <description>Following baseline assessment, all participants were given health literature on tanning behavior from the U.S. Centers for Disease Control and Prevention (CDC). These materials included informational pamphlets addressing common myths regarding tanning behaviors, including &quot;Tanned skin is not healthy skin&quot;, and &quot;A base tan is not a safe tan. These misconceptions were accompanied by &quot;burning truth&quot;, scientific data debunking these myths. Additionally, all participants received a packet on sun protective practices for oneself and family, which include skin cancer statistics and information on UV rays.</description>
          </group>
          <group group_id="O2">
            <title>Treatment as Usual + Facial Morphing</title>
            <description>In addition to the health literature, participants completed the Facial Morphing Intervention. Participants had a digital photograph taken and uploaded to the APRIL® software, accompanied by information about their current age and self-identified race. Participants were presented with two, side-by-side identical 2D images of their face. Participants first viewed an image of their face from their current age, in two-year intervals, to age 72, the maximum age, with the &quot;UV exposure&quot; setting turned on. This process was repeated. Next, participants viewed the projected aging process, toggling the &quot;UV exposure&quot; setting (on and off), every ten year interval. The process was repeated using 3D images to view projected changes to their facial profiles.&#xD;
Facial Morphing Intervention: Participants assigned to this condition were exposed to facial morphing technology that displays the progression of facial-ageing up to 72years, both with and without damage from UV exposure.</description>
          </group>
          <group group_id="O3">
            <title>Treatment as Usual + Mindfulness</title>
            <description>In addition to the health literature, participants completed the Mindfulness Intervention. Participants listened to a 10-minute self-guided mindfulness audio exercise. The audio file is a scripted reading of an established, brief mindfulness exercise (Erisman &amp; Roemer, 2010). During this guided session, participants learned what mindfulness was, when it can be used, and benefits from practice. Listeners were led through steps, focusing on the physical sensations, breathing, and thoughts. After the exercise, participants were provided a handout highlighting key points about mindfulness and how to incorporate informal mindfulness practice into their daily life.&#xD;
Mindfulness Intervention: Participants assigned to this condition engaged in a self-guided mindfulness intervention audio tape. This intervention instructed participants to pay attention to the present moment, with a non-judgemental stance.</description>
          </group>
        </group_list>
        <measure>
          <title>Number of Outdoor Tanning Sessions in the Last 30 Days</title>
          <description>One free-response item measuring intentional outdoor frequency in the last 30 days</description>
          <units>Sessions in last month</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="30"/>
                <count group_id="O2" value="43"/>
                <count group_id="O3" value="36"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="3.96" spread="4.07"/>
                    <measurement group_id="O2" value="2.69" spread="3.31"/>
                    <measurement group_id="O3" value="3.24" spread="3.60"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Primary</type>
        <title>Indoor Tanning Intentions</title>
        <description>A free-response items measuring intentional indoor intentions in the next 30 days.</description>
        <time_frame>Post assessment &amp; 1-month assessment</time_frame>
        <group_list>
          <group group_id="O1">
            <title>Control (Treatment as Usual Only)</title>
            <description>Following baseline assessment, all participants were given health literature on tanning behavior from the U.S. Centers for Disease Control and Prevention (CDC). These materials included informational pamphlets addressing common myths regarding tanning behaviors, including &quot;Tanned skin is not healthy skin&quot;, and &quot;A base tan is not a safe tan. These misconceptions were accompanied by &quot;burning truth&quot;, scientific data debunking these myths. Additionally, all participants received a packet on sun protective practices for oneself and family, which include skin cancer statistics and information on UV rays.</description>
          </group>
          <group group_id="O2">
            <title>Treatment as Usual + Facial Morphing</title>
            <description>In addition to the health literature, participants completed the Facial Morphing Intervention. Participants had a digital photograph taken and uploaded to the APRIL® software, accompanied by information about their current age and self-identified race. Participants were presented with two, side-by-side identical 2D images of their face. Participants first viewed an image of their face from their current age, in two-year intervals, to age 72, the maximum age, with the &quot;UV exposure&quot; setting turned on. This process was repeated. Next, participants viewed the projected aging process, toggling the &quot;UV exposure&quot; setting (on and off), every ten year interval. The process was repeated using 3D images to view projected changes to their facial profiles.&#xD;
Facial Morphing Intervention: Participants assigned to this condition were exposed to facial morphing technology that displays the progression of facial-ageing up to 72years, both with and without damage from UV exposure.</description>
          </group>
          <group group_id="O3">
            <title>Treatment as Usual + Mindfulness</title>
            <description>In addition to the health literature, participants completed the Mindfulness Intervention. Participants listened to a 10-minute self-guided mindfulness audio exercise. The audio file is a scripted reading of an established, brief mindfulness exercise (Erisman &amp; Roemer, 2010). During this guided session, participants learned what mindfulness was, when it can be used, and benefits from practice. Listeners were led through steps, focusing on the physical sensations, breathing, and thoughts. After the exercise, participants were provided a handout highlighting key points about mindfulness and how to incorporate informal mindfulness practice into their daily life.&#xD;
Mindfulness Intervention: Participants assigned to this condition engaged in a self-guided mindfulness intervention audio tape. This intervention instructed participants to pay attention to the present moment, with a non-judgemental stance.</description>
          </group>
        </group_list>
        <measure>
          <title>Indoor Tanning Intentions</title>
          <description>A free-response items measuring intentional indoor intentions in the next 30 days.</description>
          <units>sessions in next month</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="30"/>
                <count group_id="O2" value="43"/>
                <count group_id="O3" value="36"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <title>Post-Assessment</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="3.10" spread="2.05"/>
                    <measurement group_id="O2" value="2.21" spread="1.59"/>
                    <measurement group_id="O3" value="2.74" spread="2.07"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>1-Month Assessment</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="3.12" spread="1.90"/>
                    <measurement group_id="O2" value="2.60" spread="1.76"/>
                    <measurement group_id="O3" value="3.16" spread="1.82"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Primary</type>
        <title>Outdoor Tanning Intentions</title>
        <description>A free-response items measuring intentional outdoor intentions in the next 30 days.</description>
        <time_frame>Post Assessment &amp; 1-month assessment</time_frame>
        <group_list>
          <group group_id="O1">
            <title>Control (Treatment as Usual Only)</title>
            <description>Following baseline assessment, all participants were given health literature on tanning behavior from the U.S. Centers for Disease Control and Prevention (CDC). These materials included informational pamphlets addressing common myths regarding tanning behaviors, including &quot;Tanned skin is not healthy skin&quot;, and &quot;A base tan is not a safe tan. These misconceptions were accompanied by &quot;burning truth&quot;, scientific data debunking these myths. Additionally, all participants received a packet on sun protective practices for oneself and family, which include skin cancer statistics and information on UV rays.</description>
          </group>
          <group group_id="O2">
            <title>Treatment as Usual + Facial Morphing</title>
            <description>In addition to the health literature, participants completed the Facial Morphing Intervention. Participants had a digital photograph taken and uploaded to the APRIL® software, accompanied by information about their current age and self-identified race. Participants were presented with two, side-by-side identical 2D images of their face. Participants first viewed an image of their face from their current age, in two-year intervals, to age 72, the maximum age, with the &quot;UV exposure&quot; setting turned on. This process was repeated. Next, participants viewed the projected aging process, toggling the &quot;UV exposure&quot; setting (on and off), every ten year interval. The process was repeated using 3D images to view projected changes to their facial profiles.&#xD;
Facial Morphing Intervention: Participants assigned to this condition were exposed to facial morphing technology that displays the progression of facial-ageing up to 72years, both with and without damage from UV exposure.</description>
          </group>
          <group group_id="O3">
            <title>Treatment as Usual + Mindfulness</title>
            <description>In addition to the health literature, participants completed the Mindfulness Intervention. Participants listened to a 10-minute self-guided mindfulness audio exercise. The audio file is a scripted reading of an established, brief mindfulness exercise (Erisman &amp; Roemer, 2010). During this guided session, participants learned what mindfulness was, when it can be used, and benefits from practice. Listeners were led through steps, focusing on the physical sensations, breathing, and thoughts. After the exercise, participants were provided a handout highlighting key points about mindfulness and how to incorporate informal mindfulness practice into their daily life.&#xD;
Mindfulness Intervention: Participants assigned to this condition engaged in a self-guided mindfulness intervention audio tape. This intervention instructed participants to pay attention to the present moment, with a non-judgemental stance.</description>
          </group>
        </group_list>
        <measure>
          <title>Outdoor Tanning Intentions</title>
          <description>A free-response items measuring intentional outdoor intentions in the next 30 days.</description>
          <units>sessions in next month</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="30"/>
                <count group_id="O2" value="43"/>
                <count group_id="O3" value="36"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <title>Post-Assessment</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="4.53" spread="1.74"/>
                    <measurement group_id="O2" value="3.41" spread="1.85"/>
                    <measurement group_id="O3" value="4.53" spread="1.62"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>1-Month Assessment</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="3.48" spread="1.97"/>
                    <measurement group_id="O2" value="3.37" spread="1.83"/>
                    <measurement group_id="O3" value="3.89" spread="1.76"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Appearance Attitudes to Tan</title>
        <description>Participants completed the Appearance Reasons to Tan latent subscale of the Physical Appearance Reasons for Tanning Scale (PARTS; Cafri et al., 2006, 2008). This scale consists of three manifest subscales: General Attractiveness, Acne, and Body Shape. These 19 items were scored along a five-point scale: 1 (definitely disagree) to 5 (definitely agree), with a possible total score range of 19-95 (higher scores indicating greater agreement). Total scores are averaged to reflect the average agreement with attitudes which may motivate one to tan (higher average scores indicating greater agreement).</description>
        <time_frame>Post assessment &amp; 1-month assessment</time_frame>
        <group_list>
          <group group_id="O1">
            <title>Control (Treatment as Usual Only)</title>
            <description>Following baseline assessment, all participants were given health literature on tanning behavior from the U.S. Centers for Disease Control and Prevention (CDC). These materials included informational pamphlets addressing common myths regarding tanning behaviors, including &quot;Tanned skin is not healthy skin&quot;, and &quot;A base tan is not a safe tan. These misconceptions were accompanied by &quot;burning truth&quot;, scientific data debunking these myths. Additionally, all participants received a packet on sun protective practices for oneself and family, which include skin cancer statistics and information on UV rays.</description>
          </group>
          <group group_id="O2">
            <title>Treatment as Usual + Facial Morphing</title>
            <description>In addition to the health literature, participants completed the Facial Morphing Intervention. Participants had a digital photograph taken and uploaded to the APRIL® software, accompanied by information about their current age and self-identified race. Participants were presented with two, side-by-side identical 2D images of their face. Participants first viewed an image of their face from their current age, in two-year intervals, to age 72, the maximum age, with the &quot;UV exposure&quot; setting turned on. This process was repeated. Next, participants viewed the projected aging process, toggling the &quot;UV exposure&quot; setting (on and off), every ten year interval. The process was repeated using 3D images to view projected changes to their facial profiles.&#xD;
Facial Morphing Intervention: Participants assigned to this condition were exposed to facial morphing technology that displays the progression of facial-ageing up to 72years, both with and without damage from UV exposure.</description>
          </group>
          <group group_id="O3">
            <title>Treatment as Usual + Mindfulness</title>
            <description>In addition to the health literature, participants completed the Mindfulness Intervention. Participants listened to a 10-minute self-guided mindfulness audio exercise. The audio file is a scripted reading of an established, brief mindfulness exercise (Erisman &amp; Roemer, 2010). During this guided session, participants learned what mindfulness was, when it can be used, and benefits from practice. Listeners were led through steps, focusing on the physical sensations, breathing, and thoughts. After the exercise, participants were provided a handout highlighting key points about mindfulness and how to incorporate informal mindfulness practice into their daily life.&#xD;
Mindfulness Intervention: Participants assigned to this condition engaged in a self-guided mindfulness intervention audio tape. This intervention instructed participants to pay attention to the present moment, with a non-judgemental stance.</description>
          </group>
        </group_list>
        <measure>
          <title>Appearance Attitudes to Tan</title>
          <description>Participants completed the Appearance Reasons to Tan latent subscale of the Physical Appearance Reasons for Tanning Scale (PARTS; Cafri et al., 2006, 2008). This scale consists of three manifest subscales: General Attractiveness, Acne, and Body Shape. These 19 items were scored along a five-point scale: 1 (definitely disagree) to 5 (definitely agree), with a possible total score range of 19-95 (higher scores indicating greater agreement). Total scores are averaged to reflect the average agreement with attitudes which may motivate one to tan (higher average scores indicating greater agreement).</description>
          <units>units on a scale</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="30"/>
                <count group_id="O2" value="43"/>
                <count group_id="O3" value="36"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <title>Post-assessment</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="3.28" spread="0.90"/>
                    <measurement group_id="O2" value="2.90" spread="0.99"/>
                    <measurement group_id="O3" value="3.25" spread="0.76"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>1-Month Assessment</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="3.22" spread="0.66"/>
                    <measurement group_id="O2" value="3.13" spread="0.80"/>
                    <measurement group_id="O3" value="3.13" spread="0.61"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Appearance Reasons Not to Tan</title>
        <description>Participants completed the Appearance Reasons Not to Tan latent subscale of the Physical Appearance Reasons for Tanning Scale (PARTS; Cafri et al., 2006, 2008). This scale consists of two manifest subscales: Skin Damage and Skin Aging. These 9 items were scored along a five-point scale 1 (definitely disagree) to 5 (definitely agree) with a possible total score range of 9-45 (higher scores indicating greater agreement). Total scores are averaged to reflect the average agreement with attitudes to not tan; (higher average scores indicating greater agreement).</description>
        <time_frame>Post assessment and 1-month assessment</time_frame>
        <group_list>
          <group group_id="O1">
            <title>Control (Treatment as Usual Only)</title>
            <description>Following baseline assessment, all participants were given health literature on tanning behavior from the U.S. Centers for Disease Control and Prevention (CDC). These materials included informational pamphlets addressing common myths regarding tanning behaviors, including &quot;Tanned skin is not healthy skin&quot;, and &quot;A base tan is not a safe tan. These misconceptions were accompanied by &quot;burning truth&quot;, scientific data debunking these myths. Additionally, all participants received a packet on sun protective practices for oneself and family, which include skin cancer statistics and information on UV rays.</description>
          </group>
          <group group_id="O2">
            <title>Treatment as Usual + Facial Morphing</title>
            <description>In addition to the health literature, participants completed the Facial Morphing Intervention. Participants had a digital photograph taken and uploaded to the APRIL® software, accompanied by information about their current age and self-identified race. Participants were presented with two, side-by-side identical 2D images of their face. Participants first viewed an image of their face from their current age, in two-year intervals, to age 72, the maximum age, with the &quot;UV exposure&quot; setting turned on. This process was repeated. Next, participants viewed the projected aging process, toggling the &quot;UV exposure&quot; setting (on and off), every ten year interval. The process was repeated using 3D images to view projected changes to their facial profiles.&#xD;
Facial Morphing Intervention: Participants assigned to this condition were exposed to facial morphing technology that displays the progression of facial-ageing up to 72years, both with and without damage from UV exposure.</description>
          </group>
          <group group_id="O3">
            <title>Treatment as Usual + Mindfulness</title>
            <description>In addition to the health literature, participants completed the Mindfulness Intervention. Participants listened to a 10-minute self-guided mindfulness audio exercise. The audio file is a scripted reading of an established, brief mindfulness exercise (Erisman &amp; Roemer, 2010). During this guided session, participants learned what mindfulness was, when it can be used, and benefits from practice. Listeners were led through steps, focusing on the physical sensations, breathing, and thoughts. After the exercise, participants were provided a handout highlighting key points about mindfulness and how to incorporate informal mindfulness practice into their daily life.&#xD;
Mindfulness Intervention: Participants assigned to this condition engaged in a self-guided mindfulness intervention audio tape. This intervention instructed participants to pay attention to the present moment, with a non-judgemental stance.</description>
          </group>
        </group_list>
        <measure>
          <title>Appearance Reasons Not to Tan</title>
          <description>Participants completed the Appearance Reasons Not to Tan latent subscale of the Physical Appearance Reasons for Tanning Scale (PARTS; Cafri et al., 2006, 2008). This scale consists of two manifest subscales: Skin Damage and Skin Aging. These 9 items were scored along a five-point scale 1 (definitely disagree) to 5 (definitely agree) with a possible total score range of 9-45 (higher scores indicating greater agreement). Total scores are averaged to reflect the average agreement with attitudes to not tan; (higher average scores indicating greater agreement).</description>
          <units>units on a scale</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="30"/>
                <count group_id="O2" value="43"/>
                <count group_id="O3" value="36"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <title>Post-Assessment</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="3.74" spread="0.79"/>
                    <measurement group_id="O2" value="3.83" spread="0.93"/>
                    <measurement group_id="O3" value="3.63" spread="0.83"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>1-Month Assessment</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="3.40" spread="0.72"/>
                    <measurement group_id="O2" value="3.61" spread="0.82"/>
                    <measurement group_id="O3" value="3.59" spread="0.62"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>State Body Satisfaction</title>
        <description>State level body satisfaction was measured using the Body Image States Scale (BISS; Cash, Fleming, Alindogan, Steadman, &amp; Whitehead, 2002). This six-item self-report instrument utilizes a nine-point scale (1 [extremely dissatisfied] to 9 [extremely satisfied]); possible total scores range 6-54; higher scores indicate greater satisfaction. This measure is scored by averaging all scores to these six items, with higher average scores indicating greater body satisfaction.</description>
        <time_frame>Post-assessment</time_frame>
        <group_list>
          <group group_id="O1">
            <title>Control (Treatment as Usual Only)</title>
            <description>Following baseline assessment, all participants were given health literature on tanning behavior from the U.S. Centers for Disease Control and Prevention (CDC). These materials included informational pamphlets addressing common myths regarding tanning behaviors, including &quot;Tanned skin is not healthy skin&quot;, and &quot;A base tan is not a safe tan. These misconceptions were accompanied by &quot;burning truth&quot;, scientific data debunking these myths. Additionally, all participants received a packet on sun protective practices for oneself and family, which include skin cancer statistics and information on UV rays.</description>
          </group>
          <group group_id="O2">
            <title>Treatment as Usual + Facial Morphing</title>
            <description>In addition to the health literature, participants completed the Facial Morphing Intervention. Participants had a digital photograph taken and uploaded to the APRIL® software, accompanied by information about their current age and self-identified race. Participants were presented with two, side-by-side identical 2D images of their face. Participants first viewed an image of their face from their current age, in two-year intervals, to age 72, the maximum age, with the &quot;UV exposure&quot; setting turned on. This process was repeated. Next, participants viewed the projected aging process, toggling the &quot;UV exposure&quot; setting (on and off), every ten year interval. The process was repeated using 3D images to view projected changes to their facial profiles.&#xD;
Facial Morphing Intervention: Participants assigned to this condition were exposed to facial morphing technology that displays the progression of facial-ageing up to 72years, both with and without damage from UV exposure.</description>
          </group>
          <group group_id="O3">
            <title>Treatment as Usual + Mindfulness</title>
            <description>In addition to the health literature, participants completed the Mindfulness Intervention. Participants listened to a 10-minute self-guided mindfulness audio exercise. The audio file is a scripted reading of an established, brief mindfulness exercise (Erisman &amp; Roemer, 2010). During this guided session, participants learned what mindfulness was, when it can be used, and benefits from practice. Listeners were led through steps, focusing on the physical sensations, breathing, and thoughts. After the exercise, participants were provided a handout highlighting key points about mindfulness and how to incorporate informal mindfulness practice into their daily life.&#xD;
Mindfulness Intervention: Participants assigned to this condition engaged in a self-guided mindfulness intervention audio tape. This intervention instructed participants to pay attention to the present moment, with a non-judgemental stance.</description>
          </group>
        </group_list>
        <measure>
          <title>State Body Satisfaction</title>
          <description>State level body satisfaction was measured using the Body Image States Scale (BISS; Cash, Fleming, Alindogan, Steadman, &amp; Whitehead, 2002). This six-item self-report instrument utilizes a nine-point scale (1 [extremely dissatisfied] to 9 [extremely satisfied]); possible total scores range 6-54; higher scores indicate greater satisfaction. This measure is scored by averaging all scores to these six items, with higher average scores indicating greater body satisfaction.</description>
          <units>units on a scale</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="30"/>
                <count group_id="O2" value="43"/>
                <count group_id="O3" value="36"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="5.67" spread="1.28"/>
                    <measurement group_id="O2" value="5.36" spread="1.41"/>
                    <measurement group_id="O3" value="5.49" spread="1.34"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Trait Body Satisfaction</title>
        <description>Trait level body satisfaction was measured using the Multidimensional Body-Self Relations Questionnaire-Appearance Evaluation subscale (MSBRQ-AE; Brown, Cash, &amp; Mikulka, 1990; Cash, 2000). This seven-item self-report subscale utilizes a five-point scale (1 [definitely disagree] to 5 [definitely agree]) with possible score range of 7-35. This measure was scored by averaging all scores to these seven items, with higher scores indicating greater body satisfaction.</description>
        <time_frame>1-month assessment</time_frame>
        <group_list>
          <group group_id="O1">
            <title>Control (Treatment as Usual Only)</title>
            <description>Following baseline assessment, all participants were given health literature on tanning behavior from the U.S. Centers for Disease Control and Prevention (CDC). These materials included informational pamphlets addressing common myths regarding tanning behaviors, including &quot;Tanned skin is not healthy skin&quot;, and &quot;A base tan is not a safe tan. These misconceptions were accompanied by &quot;burning truth&quot;, scientific data debunking these myths. Additionally, all participants received a packet on sun protective practices for oneself and family, which include skin cancer statistics and information on UV rays.</description>
          </group>
          <group group_id="O2">
            <title>Treatment as Usual + Facial Morphing</title>
            <description>In addition to the health literature, participants completed the Facial Morphing Intervention. Participants had a digital photograph taken and uploaded to the APRIL® software, accompanied by information about their current age and self-identified race. Participants were presented with two, side-by-side identical 2D images of their face. Participants first viewed an image of their face from their current age, in two-year intervals, to age 72, the maximum age, with the &quot;UV exposure&quot; setting turned on. This process was repeated. Next, participants viewed the projected aging process, toggling the &quot;UV exposure&quot; setting (on and off), every ten year interval. The process was repeated using 3D images to view projected changes to their facial profiles.&#xD;
Facial Morphing Intervention: Participants assigned to this condition were exposed to facial morphing technology that displays the progression of facial-ageing up to 72years, both with and without damage from UV exposure.</description>
          </group>
          <group group_id="O3">
            <title>Treatment as Usual + Mindfulness</title>
            <description>In addition to the health literature, participants completed the Mindfulness Intervention. Participants listened to a 10-minute self-guided mindfulness audio exercise. The audio file is a scripted reading of an established, brief mindfulness exercise (Erisman &amp; Roemer, 2010). During this guided session, participants learned what mindfulness was, when it can be used, and benefits from practice. Listeners were led through steps, focusing on the physical sensations, breathing, and thoughts. After the exercise, participants were provided a handout highlighting key points about mindfulness and how to incorporate informal mindfulness practice into their daily life.&#xD;
Mindfulness Intervention: Participants assigned to this condition engaged in a self-guided mindfulness intervention audio tape. This intervention instructed participants to pay attention to the present moment, with a non-judgemental stance.</description>
          </group>
        </group_list>
        <measure>
          <title>Trait Body Satisfaction</title>
          <description>Trait level body satisfaction was measured using the Multidimensional Body-Self Relations Questionnaire-Appearance Evaluation subscale (MSBRQ-AE; Brown, Cash, &amp; Mikulka, 1990; Cash, 2000). This seven-item self-report subscale utilizes a five-point scale (1 [definitely disagree] to 5 [definitely agree]) with possible score range of 7-35. This measure was scored by averaging all scores to these seven items, with higher scores indicating greater body satisfaction.</description>
          <units>units on a scale</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="30"/>
                <count group_id="O2" value="43"/>
                <count group_id="O3" value="36"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="3.32" spread="0.68"/>
                    <measurement group_id="O2" value="3.33" spread="0.66"/>
                    <measurement group_id="O3" value="3.30" spread="0.70"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Appearance Orientation</title>
        <description>Trait level appearance orientation satisfaction was measured using the Appearance Schemas Inventory-Revised Short Form (ASI-R; Cash, Melnyk, &amp; Hrabosky, 2004). This twenty-item self-report instrument assesses cognitive and behavioral investment in one's physical appearance. This measure utilizes a five-point scale (1 [definitely disagree] to 5 [definitely agree]), with total scores ranging from 20-100; higher scores indicate greater appearance investment. This measure is scored by averaging all scores to these twenty items (higher scores indicating greater appearance investment).</description>
        <time_frame>1-month assessment</time_frame>
        <group_list>
          <group group_id="O1">
            <title>Control (Treatment as Usual Only)</title>
            <description>Following baseline assessment, all participants were given health literature on tanning behavior from the U.S. Centers for Disease Control and Prevention (CDC). These materials included informational pamphlets addressing common myths regarding tanning behaviors, including &quot;Tanned skin is not healthy skin&quot;, and &quot;A base tan is not a safe tan. These misconceptions were accompanied by &quot;burning truth&quot;, scientific data debunking these myths. Additionally, all participants received a packet on sun protective practices for oneself and family, which include skin cancer statistics and information on UV rays.</description>
          </group>
          <group group_id="O2">
            <title>Treatment as Usual + Facial Morphing</title>
            <description>In addition to the health literature, participants completed the Facial Morphing Intervention. Participants had a digital photograph taken and uploaded to the APRIL® software, accompanied by information about their current age and self-identified race. Participants were presented with two, side-by-side identical 2D images of their face. Participants first viewed an image of their face from their current age, in two-year intervals, to age 72, the maximum age, with the &quot;UV exposure&quot; setting turned on. This process was repeated. Next, participants viewed the projected aging process, toggling the &quot;UV exposure&quot; setting (on and off), every ten year interval. The process was repeated using 3D images to view projected changes to their facial profiles.&#xD;
Facial Morphing Intervention: Participants assigned to this condition were exposed to facial morphing technology that displays the progression of facial-ageing up to 72years, both with and without damage from UV exposure.</description>
          </group>
          <group group_id="O3">
            <title>Treatment as Usual + Mindfulness</title>
            <description>In addition to the health literature, participants completed the Mindfulness Intervention. Participants listened to a 10-minute self-guided mindfulness audio exercise. The audio file is a scripted reading of an established, brief mindfulness exercise (Erisman &amp; Roemer, 2010). During this guided session, participants learned what mindfulness was, when it can be used, and benefits from practice. Listeners were led through steps, focusing on the physical sensations, breathing, and thoughts. After the exercise, participants were provided a handout highlighting key points about mindfulness and how to incorporate informal mindfulness practice into their daily life.&#xD;
Mindfulness Intervention: Participants assigned to this condition engaged in a self-guided mindfulness intervention audio tape. This intervention instructed participants to pay attention to the present moment, with a non-judgemental stance.</description>
          </group>
        </group_list>
        <measure>
          <title>Appearance Orientation</title>
          <description>Trait level appearance orientation satisfaction was measured using the Appearance Schemas Inventory-Revised Short Form (ASI-R; Cash, Melnyk, &amp; Hrabosky, 2004). This twenty-item self-report instrument assesses cognitive and behavioral investment in one's physical appearance. This measure utilizes a five-point scale (1 [definitely disagree] to 5 [definitely agree]), with total scores ranging from 20-100; higher scores indicate greater appearance investment. This measure is scored by averaging all scores to these twenty items (higher scores indicating greater appearance investment).</description>
          <units>units on a scale</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="30"/>
                <count group_id="O2" value="43"/>
                <count group_id="O3" value="36"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="3.50" spread="0.47"/>
                    <measurement group_id="O2" value="3.34" spread="0.49"/>
                    <measurement group_id="O3" value="3.42" spread="0.44"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>State Positive Affect</title>
        <description>State positive affect was measured using the positive affect subscale of the Positive and Negative Affect Scale-Short Form (PANAS-SF; Thompson, 2007). This self-report subscale consists of five items of the full ten-item measure. This subscale utilizes a five-point Likert-type scale ranging from 1 (never) to 5 (always). This measure is scored by summing all scores to these five items (range 5-25), with higher scores indicating greater state positive affect. For the purposes of this project, participants' item scores to these five items were averaged.</description>
        <time_frame>Post assessment</time_frame>
        <group_list>
          <group group_id="O1">
            <title>Control (Treatment as Usual Only)</title>
            <description>Following baseline assessment, all participants were given health literature on tanning behavior from the U.S. Centers for Disease Control and Prevention (CDC). These materials included informational pamphlets addressing common myths regarding tanning behaviors, including &quot;Tanned skin is not healthy skin&quot;, and &quot;A base tan is not a safe tan. These misconceptions were accompanied by &quot;burning truth&quot;, scientific data debunking these myths. Additionally, all participants received a packet on sun protective practices for oneself and family, which include skin cancer statistics and information on UV rays.</description>
          </group>
          <group group_id="O2">
            <title>Treatment as Usual + Facial Morphing</title>
            <description>In addition to the health literature, participants completed the Facial Morphing Intervention. Participants had a digital photograph taken and uploaded to the APRIL® software, accompanied by information about their current age and self-identified race. Participants were presented with two, side-by-side identical 2D images of their face. Participants first viewed an image of their face from their current age, in two-year intervals, to age 72, the maximum age, with the &quot;UV exposure&quot; setting turned on. This process was repeated. Next, participants viewed the projected aging process, toggling the &quot;UV exposure&quot; setting (on and off), every ten year interval. The process was repeated using 3D images to view projected changes to their facial profiles.&#xD;
Facial Morphing Intervention: Participants assigned to this condition were exposed to facial morphing technology that displays the progression of facial-ageing up to 72years, both with and without damage from UV exposure.</description>
          </group>
          <group group_id="O3">
            <title>Treatment as Usual + Mindfulness</title>
            <description>In addition to the health literature, participants completed the Mindfulness Intervention. Participants listened to a 10-minute self-guided mindfulness audio exercise. The audio file is a scripted reading of an established, brief mindfulness exercise (Erisman &amp; Roemer, 2010). During this guided session, participants learned what mindfulness was, when it can be used, and benefits from practice. Listeners were led through steps, focusing on the physical sensations, breathing, and thoughts. After the exercise, participants were provided a handout highlighting key points about mindfulness and how to incorporate informal mindfulness practice into their daily life.&#xD;
Mindfulness Intervention: Participants assigned to this condition engaged in a self-guided mindfulness intervention audio tape. This intervention instructed participants to pay attention to the present moment, with a non-judgemental stance.</description>
          </group>
        </group_list>
        <measure>
          <title>State Positive Affect</title>
          <description>State positive affect was measured using the positive affect subscale of the Positive and Negative Affect Scale-Short Form (PANAS-SF; Thompson, 2007). This self-report subscale consists of five items of the full ten-item measure. This subscale utilizes a five-point Likert-type scale ranging from 1 (never) to 5 (always). This measure is scored by summing all scores to these five items (range 5-25), with higher scores indicating greater state positive affect. For the purposes of this project, participants' item scores to these five items were averaged.</description>
          <units>units on a scale</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="30"/>
                <count group_id="O2" value="43"/>
                <count group_id="O3" value="36"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="3.45" spread="0.82"/>
                    <measurement group_id="O2" value="3.32" spread="0.92"/>
                    <measurement group_id="O3" value="3.31" spread="0.80"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>State Negative Affect</title>
        <description>State negative affect was measured using the negative affect subscale of the Positive and Negative Affect Scale-Short Form (PANAS-SF; Thompson, 2007). This self-report subscale consists of five items of the full ten-item measure. This subscale utilizes a five-point Likert-type scale ranging from 1 (never) to 5 (always). This measure is scored by summing all scores to these five items (range 5-25), with higher scores indicating greater state negative affect. For the purposes of this project, participants' item scores to these five items were averaged.</description>
        <time_frame>Post assessment</time_frame>
        <group_list>
          <group group_id="O1">
            <title>Control (Treatment as Usual Only)</title>
            <description>Following baseline assessment, all participants were given health literature on tanning behavior from the U.S. Centers for Disease Control and Prevention (CDC). These materials included informational pamphlets addressing common myths regarding tanning behaviors, including &quot;Tanned skin is not healthy skin&quot;, and &quot;A base tan is not a safe tan. These misconceptions were accompanied by &quot;burning truth&quot;, scientific data debunking these myths. Additionally, all participants received a packet on sun protective practices for oneself and family, which include skin cancer statistics and information on UV rays.</description>
          </group>
          <group group_id="O2">
            <title>Treatment as Usual + Facial Morphing</title>
            <description>In addition to the health literature, participants completed the Facial Morphing Intervention. Participants had a digital photograph taken and uploaded to the APRIL® software, accompanied by information about their current age and self-identified race. Participants were presented with two, side-by-side identical 2D images of their face. Participants first viewed an image of their face from their current age, in two-year intervals, to age 72, the maximum age, with the &quot;UV exposure&quot; setting turned on. This process was repeated. Next, participants viewed the projected aging process, toggling the &quot;UV exposure&quot; setting (on and off), every ten year interval. The process was repeated using 3D images to view projected changes to their facial profiles.&#xD;
Facial Morphing Intervention: Participants assigned to this condition were exposed to facial morphing technology that displays the progression of facial-ageing up to 72years, both with and without damage from UV exposure.</description>
          </group>
          <group group_id="O3">
            <title>Treatment as Usual + Mindfulness</title>
            <description>In addition to the health literature, participants completed the Mindfulness Intervention. Participants listened to a 10-minute self-guided mindfulness audio exercise. The audio file is a scripted reading of an established, brief mindfulness exercise (Erisman &amp; Roemer, 2010). During this guided session, participants learned what mindfulness was, when it can be used, and benefits from practice. Listeners were led through steps, focusing on the physical sensations, breathing, and thoughts. After the exercise, participants were provided a handout highlighting key points about mindfulness and how to incorporate informal mindfulness practice into their daily life.&#xD;
Mindfulness Intervention: Participants assigned to this condition engaged in a self-guided mindfulness intervention audio tape. This intervention instructed participants to pay attention to the present moment, with a non-judgemental stance.</description>
          </group>
        </group_list>
        <measure>
          <title>State Negative Affect</title>
          <description>State negative affect was measured using the negative affect subscale of the Positive and Negative Affect Scale-Short Form (PANAS-SF; Thompson, 2007). This self-report subscale consists of five items of the full ten-item measure. This subscale utilizes a five-point Likert-type scale ranging from 1 (never) to 5 (always). This measure is scored by summing all scores to these five items (range 5-25), with higher scores indicating greater state negative affect. For the purposes of this project, participants' item scores to these five items were averaged.</description>
          <units>units on a scale</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="30"/>
                <count group_id="O2" value="43"/>
                <count group_id="O3" value="36"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="1.95" spread="0.73"/>
                    <measurement group_id="O2" value="2.22" spread="0.80"/>
                    <measurement group_id="O3" value="1.72" spread="0.77"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Depressive Symptoms</title>
        <description>Participants completed the Depression Anxiety Stress Scales Short Version (DASS-21) as a marker of trait level negative affect (Henry &amp; Crawford, 2005). This 21-item self-report measure consists of three seven-item subscales: depression, anxiety, and stress. Items are measured along a 4-point scale (0 [not at all like me] to 3 [applied to me very much, or most of the time]); higher scores denote increased symptoms. Total sum scores for this instrument ranges from 0-63; scores for the depressive symptom subscale range from 0-21.</description>
        <time_frame>1-month assessment</time_frame>
        <group_list>
          <group group_id="O1">
            <title>Control (Treatment as Usual Only)</title>
            <description>Following baseline assessment, all participants were given health literature on tanning behavior from the U.S. Centers for Disease Control and Prevention (CDC). These materials included informational pamphlets addressing common myths regarding tanning behaviors, including &quot;Tanned skin is not healthy skin&quot;, and &quot;A base tan is not a safe tan. These misconceptions were accompanied by &quot;burning truth&quot;, scientific data debunking these myths. Additionally, all participants received a packet on sun protective practices for oneself and family, which include skin cancer statistics and information on UV rays.</description>
          </group>
          <group group_id="O2">
            <title>Treatment as Usual + Facial Morphing</title>
            <description>In addition to the health literature, participants completed the Facial Morphing Intervention. Participants had a digital photograph taken and uploaded to the APRIL® software, accompanied by information about their current age and self-identified race. Participants were presented with two, side-by-side identical 2D images of their face. Participants first viewed an image of their face from their current age, in two-year intervals, to age 72, the maximum age, with the &quot;UV exposure&quot; setting turned on. This process was repeated. Next, participants viewed the projected aging process, toggling the &quot;UV exposure&quot; setting (on and off), every ten year interval. The process was repeated using 3D images to view projected changes to their facial profiles.&#xD;
Facial Morphing Intervention: Participants assigned to this condition were exposed to facial morphing technology that displays the progression of facial-ageing up to 72years, both with and without damage from UV exposure.</description>
          </group>
          <group group_id="O3">
            <title>Treatment as Usual + Mindfulness</title>
            <description>In addition to the health literature, participants completed the Mindfulness Intervention. Participants listened to a 10-minute self-guided mindfulness audio exercise. The audio file is a scripted reading of an established, brief mindfulness exercise (Erisman &amp; Roemer, 2010). During this guided session, participants learned what mindfulness was, when it can be used, and benefits from practice. Listeners were led through steps, focusing on the physical sensations, breathing, and thoughts. After the exercise, participants were provided a handout highlighting key points about mindfulness and how to incorporate informal mindfulness practice into their daily life.&#xD;
Mindfulness Intervention: Participants assigned to this condition engaged in a self-guided mindfulness intervention audio tape. This intervention instructed participants to pay attention to the present moment, with a non-judgemental stance.</description>
          </group>
        </group_list>
        <measure>
          <title>Depressive Symptoms</title>
          <description>Participants completed the Depression Anxiety Stress Scales Short Version (DASS-21) as a marker of trait level negative affect (Henry &amp; Crawford, 2005). This 21-item self-report measure consists of three seven-item subscales: depression, anxiety, and stress. Items are measured along a 4-point scale (0 [not at all like me] to 3 [applied to me very much, or most of the time]); higher scores denote increased symptoms. Total sum scores for this instrument ranges from 0-63; scores for the depressive symptom subscale range from 0-21.</description>
          <units>units on a scale</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="30"/>
                <count group_id="O2" value="43"/>
                <count group_id="O3" value="36"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="11.35" spread="7.91"/>
                    <measurement group_id="O2" value="9.16" spread="8.00"/>
                    <measurement group_id="O3" value="12.06" spread="8.56"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Anxiety Symptoms</title>
        <description>Participants completed the Depression Anxiety Stress Scales Short Version (DASS-21) as a marker of trait level negative affect (Henry &amp; Crawford, 2005). This 21-item self-report measure consists of three seven-item subscales: depression, anxiety, and stress. Items are measured along a 4-point scale (0 [not at all like me] to 3 [applied to me very much, or most of the time]); higher scores denote increased symptoms. Total sum scores for this instrument ranges from 0-63; scores for the anxiety symptom subscale range from 0-21.</description>
        <time_frame>1-month assessment</time_frame>
        <group_list>
          <group group_id="O1">
            <title>Control (Treatment as Usual Only)</title>
            <description>Following baseline assessment, all participants were given health literature on tanning behavior from the U.S. Centers for Disease Control and Prevention (CDC). These materials included informational pamphlets addressing common myths regarding tanning behaviors, including &quot;Tanned skin is not healthy skin&quot;, and &quot;A base tan is not a safe tan. These misconceptions were accompanied by &quot;burning truth&quot;, scientific data debunking these myths. Additionally, all participants received a packet on sun protective practices for oneself and family, which include skin cancer statistics and information on UV rays.</description>
          </group>
          <group group_id="O2">
            <title>Treatment as Usual + Facial Morphing</title>
            <description>In addition to the health literature, participants completed the Facial Morphing Intervention. Participants had a digital photograph taken and uploaded to the APRIL® software, accompanied by information about their current age and self-identified race. Participants were presented with two, side-by-side identical 2D images of their face. Participants first viewed an image of their face from their current age, in two-year intervals, to age 72, the maximum age, with the &quot;UV exposure&quot; setting turned on. This process was repeated. Next, participants viewed the projected aging process, toggling the &quot;UV exposure&quot; setting (on and off), every ten year interval. The process was repeated using 3D images to view projected changes to their facial profiles.&#xD;
Facial Morphing Intervention: Participants assigned to this condition were exposed to facial morphing technology that displays the progression of facial-ageing up to 72years, both with and without damage from UV exposure.</description>
          </group>
          <group group_id="O3">
            <title>Treatment as Usual + Mindfulness</title>
            <description>In addition to the health literature, participants completed the Mindfulness Intervention. Participants listened to a 10-minute self-guided mindfulness audio exercise. The audio file is a scripted reading of an established, brief mindfulness exercise (Erisman &amp; Roemer, 2010). During this guided session, participants learned what mindfulness was, when it can be used, and benefits from practice. Listeners were led through steps, focusing on the physical sensations, breathing, and thoughts. After the exercise, participants were provided a handout highlighting key points about mindfulness and how to incorporate informal mindfulness practice into their daily life.&#xD;
Mindfulness Intervention: Participants assigned to this condition engaged in a self-guided mindfulness intervention audio tape. This intervention instructed participants to pay attention to the present moment, with a non-judgemental stance.</description>
          </group>
        </group_list>
        <measure>
          <title>Anxiety Symptoms</title>
          <description>Participants completed the Depression Anxiety Stress Scales Short Version (DASS-21) as a marker of trait level negative affect (Henry &amp; Crawford, 2005). This 21-item self-report measure consists of three seven-item subscales: depression, anxiety, and stress. Items are measured along a 4-point scale (0 [not at all like me] to 3 [applied to me very much, or most of the time]); higher scores denote increased symptoms. Total sum scores for this instrument ranges from 0-63; scores for the anxiety symptom subscale range from 0-21.</description>
          <units>units on a scale</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="30"/>
                <count group_id="O2" value="43"/>
                <count group_id="O3" value="36"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="13.22" spread="8.40"/>
                    <measurement group_id="O2" value="10.74" spread="8.63"/>
                    <measurement group_id="O3" value="12.82" spread="8.81"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Stress</title>
        <description>Participants completed the Depression Anxiety Stress Scales Short Version (DASS-21) as a marker of trait level negative affect (Henry &amp; Crawford, 2005). This 21-item self-report measure consists of three seven-item subscales: depression, anxiety, and stress. Items are measured along a 4-point scale (0 [not at all like me] to 3 [applied to me very much, or most of the time]); higher scores denote increased symptoms. Total sum scores for this instrument ranges from 0-63; scores for the stress symptom subscale range from 0-21.</description>
        <time_frame>1-month assessment</time_frame>
        <group_list>
          <group group_id="O1">
            <title>Control (Treatment as Usual Only)</title>
            <description>Following baseline assessment, all participants were given health literature on tanning behavior from the U.S. Centers for Disease Control and Prevention (CDC). These materials included informational pamphlets addressing common myths regarding tanning behaviors, including &quot;Tanned skin is not healthy skin&quot;, and &quot;A base tan is not a safe tan. These misconceptions were accompanied by &quot;burning truth&quot;, scientific data debunking these myths. Additionally, all participants received a packet on sun protective practices for oneself and family, which include skin cancer statistics and information on UV rays.</description>
          </group>
          <group group_id="O2">
            <title>Treatment as Usual + Facial Morphing</title>
            <description>In addition to the health literature, participants completed the Facial Morphing Intervention. Participants had a digital photograph taken and uploaded to the APRIL® software, accompanied by information about their current age and self-identified race. Participants were presented with two, side-by-side identical 2D images of their face. Participants first viewed an image of their face from their current age, in two-year intervals, to age 72, the maximum age, with the &quot;UV exposure&quot; setting turned on. This process was repeated. Next, participants viewed the projected aging process, toggling the &quot;UV exposure&quot; setting (on and off), every ten year interval. The process was repeated using 3D images to view projected changes to their facial profiles.&#xD;
Facial Morphing Intervention: Participants assigned to this condition were exposed to facial morphing technology that displays the progression of facial-ageing up to 72years, both with and without damage from UV exposure.</description>
          </group>
          <group group_id="O3">
            <title>Treatment as Usual + Mindfulness</title>
            <description>In addition to the health literature, participants completed the Mindfulness Intervention. Participants listened to a 10-minute self-guided mindfulness audio exercise. The audio file is a scripted reading of an established, brief mindfulness exercise (Erisman &amp; Roemer, 2010). During this guided session, participants learned what mindfulness was, when it can be used, and benefits from practice. Listeners were led through steps, focusing on the physical sensations, breathing, and thoughts. After the exercise, participants were provided a handout highlighting key points about mindfulness and how to incorporate informal mindfulness practice into their daily life.&#xD;
Mindfulness Intervention: Participants assigned to this condition engaged in a self-guided mindfulness intervention audio tape. This intervention instructed participants to pay attention to the present moment, with a non-judgemental stance.</description>
          </group>
        </group_list>
        <measure>
          <title>Stress</title>
          <description>Participants completed the Depression Anxiety Stress Scales Short Version (DASS-21) as a marker of trait level negative affect (Henry &amp; Crawford, 2005). This 21-item self-report measure consists of three seven-item subscales: depression, anxiety, and stress. Items are measured along a 4-point scale (0 [not at all like me] to 3 [applied to me very much, or most of the time]); higher scores denote increased symptoms. Total sum scores for this instrument ranges from 0-63; scores for the stress symptom subscale range from 0-21.</description>
          <units>units on a scale</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="30"/>
                <count group_id="O2" value="43"/>
                <count group_id="O3" value="36"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="16.75" spread="9.29"/>
                    <measurement group_id="O2" value="14.02" spread="9.02"/>
                    <measurement group_id="O3" value="15.43" spread="8.96"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
    </outcome_list>

    <reported_events>
      <time_frame>11 months</time_frame>
      <desc>Adverse events were monitored/assessed, however, no adverse events occurred/were reported to study personnel. No adverse events to report.</desc>
      <group_list>
        <group group_id="E1">
          <title>Control (Treatment as Usual Only)</title>
          <description>Following baseline assessment, all participants were given health literature on tanning behavior from the U.S. Centers for Disease Control and Prevention (CDC). These materials included informational pamphlets addressing common myths regarding tanning behaviors, including &quot;Tanned skin is not healthy skin&quot;, and &quot;A base tan is not a safe tan. These misconceptions were accompanied by &quot;burning truth&quot;, scientific data debunking these myths. Additionally, all participants received a packet on sun protective practices for oneself and family, which include skin cancer statistics and information on UV rays.</description>
        </group>
        <group group_id="E2">
          <title>Treatment as Usual + Facial Morphing</title>
          <description>In addition to the health literature, participants completed the Facial Morphing Intervention. Participants had a digital photograph taken and uploaded to the APRIL® software, accompanied by information about their current age and self-identified race. Participants were presented with two, side-by-side identical 2D images of their face. Participants first viewed an image of their face from their current age, in two-year intervals, to age 72, the maximum age, with the &quot;UV exposure&quot; setting turned on. This process was repeated. Next, participants viewed the projected aging process, toggling the &quot;UV exposure&quot; setting (on and off), every ten year interval. The process was repeated using 3D images to view projected changes to their facial profiles.&#xD;
Facial Morphing Intervention: Participants assigned to this condition were exposed to facial morphing technology that displays the progression of facial-ageing up to 72years, both with and without damage from UV exposure.</description>
        </group>
        <group group_id="E3">
          <title>Treatment as Usual + Mindfulness</title>
          <description>In addition to the health literature, participants completed the Mindfulness Intervention. Participants listened to a 10-minute self-guided mindfulness audio exercise. The audio file is a scripted reading of an established brief mindfulness exercise (Erisman &amp; Roemer, 2010). During this guided session, participants learned what mindfulness was, when it can be used, and benefits from practice. Listeners were led through steps, focusing on the physical sensations, breathing, and thoughts. After the exercise, participants were provided a handout highlighting key points about mindfulness and how to incorporate informal mindfulness practice into their daily life.&#xD;
Mindfulness Intervention: Participants assigned to this condition engaged in a self-guided mindfulness intervention audio tape. This intervention instructed participants to pay attention to the present moment, with a non-judgemental stance. For example, participants were instructed to notice their breath, thoughts, feelings, ph</description>
        </group>
      </group_list>
      <serious_events>
        <category_list>
          <category>
            <title>Total</title>
            <event_list>
              <event>
                <sub_title>Total, all-cause mortality</sub_title>
                <counts group_id="E1" subjects_affected="0" subjects_at_risk="73"/>
                <counts group_id="E2" subjects_affected="0" subjects_at_risk="73"/>
                <counts group_id="E3" subjects_affected="0" subjects_at_risk="73"/>
              </event>
              <event>
                <sub_title>Total, serious adverse events</sub_title>
                <counts group_id="E1" subjects_affected="0" subjects_at_risk="73"/>
                <counts group_id="E2" subjects_affected="0" subjects_at_risk="73"/>
                <counts group_id="E3" subjects_affected="0" subjects_at_risk="73"/>
              </event>
            </event_list>
          </category>
        </category_list>
      </serious_events>
      <other_events>
        <frequency_threshold>0</frequency_threshold>
        <category_list>
          <category>
            <title>Total</title>
            <event_list>
              <event>
                <sub_title>Total, other adverse events</sub_title>
                <counts group_id="E1" subjects_affected="0" subjects_at_risk="73"/>
                <counts group_id="E2" subjects_affected="0" subjects_at_risk="73"/>
                <counts group_id="E3" subjects_affected="0" subjects_at_risk="73"/>
              </event>
            </event_list>
          </category>
        </category_list>
      </other_events>
    </reported_events>

    <certain_agreements>
      <pi_employee>All Principal Investigators ARE employed by the organization sponsoring the study.</pi_employee>
      <restrictive_agreement>There is NOT an agreement between Principal Investigators and the Sponsor (or its agents) that restricts the PI's rights to discuss or publish trial results after the trial is completed. </restrictive_agreement>
    </certain_agreements>
    <point_of_contact>
      <name_or_title>Dr. Aaron Blashill</name_or_title>
      <organization>San Diego State University</organization>
      <phone>619-594-2245</phone>
      <email>ajblashill@sdsu.edu</email>
    </point_of_contact>
  </clinical_results>
</clinical_study>


download date: ClinicalTrials.gov processed this data on September 20, 2023
link text: Link to the current ClinicalTrials.gov record.
url: https://clinicaltrials.gov/ct2/show/NCT03237013
org study id: 2253101
nct id: NCT03237013
lead sponsor: 
has dmc: No
is fda regulated drug: No
is fda regulated device: No
The purpose of the intended proposed research is to investigate and determine best strategies
      for preventing skin cancer for emerging adults. To answer this question, the investigators
      intended to pilot a randomized control trial with three arms: 1) Facial Morphing, 2)
      Mindfulness, and 3) Treatment as usual. The population from which the sample was drawn from
      was undergraduate psychology students from a large public university in Southern California,
      who report recent indoor/outdoor tanning, and intentions for future tanning.
Indoor and outdoor tanning are two of the most common risk factors for developing skin
      cancer. Predictors of indoor and outdoor tanning including negative body image and negative
      affect. Thus, to subsequently prevent skin cancer, interventions should focus on appearance
      concerns and negative affect. To date, limited brief efficacious skin cancer preventions
      exist. One potential program (APRIL AGE) a facial morphing software program, has recently
      been evaluated as a potential prevention program of skin cancer. However, limited data exists
      on the long term benefits of this program. Additionally, brief mindfulness programs have been
      found to be efficacious in preventing other health risk behaviors (e.g., smoking, negative
      affect, eating behaviors). To the investigators' knowledge, these brief mindfulness
      interventions have yet to be applied in skin cancer prevention. Thus, the investigators
      sought to compare the relative efficacy of the facial morphing intervention and the
      mindfulness intervention vs. control condition (treatment as usual). It was hypothesized that
      both facial morphing and mindfulness would lead to reductions in tanning behavior compared to
      the TAU condition. The investigators also tested contrasts between the facial morphing and
      mindfulness conditions, however, no directional hypotheses could be generated, due to the
      dearth of prior data on these interventions in skin cancer prevention.
allocation: Randomized
intervention model: Parallel Assignment
intervention model description: At initial visit, participants were screened for study eligibility, consented, and randomized to a study condition. Participants first completed baseline assessment. Following, all participants completed intervention as determined by randomized assignment (i.e., control, facial morphing or mindfulness). At the initial visit, all subjects were assigned a subject ID number. Each subject ID was pre-assigned to a study condition, determined by an online randomization program, prior to recruitment. Each eligible participant had a 1/3 chance to be assigned to each of the three study conditions. Immediately after intervention, participants completed acute assessment, also consisting of self-report questionnaires. At the end of the initial visit, participants provided researchers a valid email address to be sent a subsequent follow-up survey. Approximately one month from the intervention date, participants received and completed the online follow-up survey.
primary purpose: Prevention
masking: None (Open Label)
measure: Number of Indoor Tanning Sessions in the Last 30 Days
time frame: 1-month assessment
description: One free-response item measuring intentional indoor frequency in the last 30 days
measure: Number of Outdoor Tanning Sessions in the Last 30 Days
time frame: 1-month assessment
description: One free-response item measuring intentional outdoor frequency in the last 30 days
measure: Indoor Tanning Intentions
time frame: Post assessment & 1-month assessment
description: A free-response items measuring intentional indoor intentions in the next 30 days.
measure: Outdoor Tanning Intentions
time frame: Post Assessment & 1-month assessment
description: A free-response items measuring intentional outdoor intentions in the next 30 days.
measure: Appearance Attitudes to Tan
time frame: Post assessment & 1-month assessment
description: Participants completed the Appearance Reasons to Tan latent subscale of the Physical Appearance Reasons for Tanning Scale (PARTS; Cafri et al., 2006, 2008). This scale consists of three manifest subscales: General Attractiveness, Acne, and Body Shape. These 19 items were scored along a five-point scale: 1 (definitely disagree) to 5 (definitely agree), with a possible total score range of 19-95 (higher scores indicating greater agreement). Total scores are averaged to reflect the average agreement with attitudes which may motivate one to tan (higher average scores indicating greater agreement).
measure: Appearance Reasons Not to Tan
time frame: Post assessment and 1-month assessment
description: Participants completed the Appearance Reasons Not to Tan latent subscale of the Physical Appearance Reasons for Tanning Scale (PARTS; Cafri et al., 2006, 2008). This scale consists of two manifest subscales: Skin Damage and Skin Aging. These 9 items were scored along a five-point scale 1 (definitely disagree) to 5 (definitely agree) with a possible total score range of 9-45 (higher scores indicating greater agreement). Total scores are averaged to reflect the average agreement with attitudes to not tan; (higher average scores indicating greater agreement).
measure: State Body Satisfaction
time frame: Post-assessment
description: State level body satisfaction was measured using the Body Image States Scale (BISS; Cash, Fleming, Alindogan, Steadman, & Whitehead, 2002). This six-item self-report instrument utilizes a nine-point scale (1 [extremely dissatisfied] to 9 [extremely satisfied]); possible total scores range 6-54; higher scores indicate greater satisfaction. This measure is scored by averaging all scores to these six items, with higher average scores indicating greater body satisfaction.
measure: Trait Body Satisfaction
time frame: 1-month assessment
description: Trait level body satisfaction was measured using the Multidimensional Body-Self Relations Questionnaire-Appearance Evaluation subscale (MSBRQ-AE; Brown, Cash, & Mikulka, 1990; Cash, 2000). This seven-item self-report subscale utilizes a five-point scale (1 [definitely disagree] to 5 [definitely agree]) with possible score range of 7-35. This measure was scored by averaging all scores to these seven items, with higher scores indicating greater body satisfaction.
measure: Appearance Orientation
time frame: 1-month assessment
description: Trait level appearance orientation satisfaction was measured using the Appearance Schemas Inventory-Revised Short Form (ASI-R; Cash, Melnyk, & Hrabosky, 2004). This twenty-item self-report instrument assesses cognitive and behavioral investment in one's physical appearance. This measure utilizes a five-point scale (1 [definitely disagree] to 5 [definitely agree]), with total scores ranging from 20-100; higher scores indicate greater appearance investment. This measure is scored by averaging all scores to these twenty items (higher scores indicating greater appearance investment).
measure: State Positive Affect
time frame: Post assessment
description: State positive affect was measured using the positive affect subscale of the Positive and Negative Affect Scale-Short Form (PANAS-SF; Thompson, 2007). This self-report subscale consists of five items of the full ten-item measure. This subscale utilizes a five-point Likert-type scale ranging from 1 (never) to 5 (always). This measure is scored by summing all scores to these five items (range 5-25), with higher scores indicating greater state positive affect. For the purposes of this project, participants' item scores to these five items were averaged.
measure: State Negative Affect
time frame: Post assessment
description: State negative affect was measured using the negative affect subscale of the Positive and Negative Affect Scale-Short Form (PANAS-SF; Thompson, 2007). This self-report subscale consists of five items of the full ten-item measure. This subscale utilizes a five-point Likert-type scale ranging from 1 (never) to 5 (always). This measure is scored by summing all scores to these five items (range 5-25), with higher scores indicating greater state negative affect. For the purposes of this project, participants' item scores to these five items were averaged.
measure: Depressive Symptoms
time frame: 1-month assessment
description: Participants completed the Depression Anxiety Stress Scales Short Version (DASS-21) as a marker of trait level negative affect (Henry & Crawford, 2005). This 21-item self-report measure consists of three seven-item subscales: depression, anxiety, and stress. Items are measured along a 4-point scale (0 [not at all like me] to 3 [applied to me very much, or most of the time]); higher scores denote increased symptoms. Total sum scores for this instrument ranges from 0-63; scores for the depressive symptom subscale range from 0-21.
measure: Anxiety Symptoms
time frame: 1-month assessment
description: Participants completed the Depression Anxiety Stress Scales Short Version (DASS-21) as a marker of trait level negative affect (Henry & Crawford, 2005). This 21-item self-report measure consists of three seven-item subscales: depression, anxiety, and stress. Items are measured along a 4-point scale (0 [not at all like me] to 3 [applied to me very much, or most of the time]); higher scores denote increased symptoms. Total sum scores for this instrument ranges from 0-63; scores for the anxiety symptom subscale range from 0-21.
measure: Stress
time frame: 1-month assessment
description: Participants completed the Depression Anxiety Stress Scales Short Version (DASS-21) as a marker of trait level negative affect (Henry & Crawford, 2005). This 21-item self-report measure consists of three seven-item subscales: depression, anxiety, and stress. Items are measured along a 4-point scale (0 [not at all like me] to 3 [applied to me very much, or most of the time]); higher scores denote increased symptoms. Total sum scores for this instrument ranges from 0-63; scores for the stress symptom subscale range from 0-21.
arm group label: Control (Treatment as Usual only)
arm group type: No Intervention
description: Following baseline assessment, all participants were given health literature on tanning behavior from the U.S. Centers for Disease Control and Prevention (CDC). These materials included informational pamphlets addressing common myths regarding tanning behaviors, including "Tanned skin is not healthy skin", and "A base tan is not a safe tan. These misconceptions were accompanied by "burning truth", scientific data debunking these myths. Additionally, all participants received a packet on sun protective practices for oneself and family, which include skin cancer statistics and information on UV rays.
arm group label: Treatment as Usual + Facial Morphing
arm group type: Experimental
description: In addition to the health literature, participants completed the Facial Morphing Intervention. Participants had a digital photograph taken and uploaded to the APRIL® software, accompanied by information about their current age and self-identified race. Participants were presented with two, side-by-side identical 2D images of their face. Participants first viewed an image of their face from their current age, in two-year intervals, to age 72, the maximum age, with the "UV exposure" setting turned on. This process was repeated. Next, participants viewed the projected aging process, toggling the "UV exposure" setting (on and off), every ten year interval. The process was repeated using 3D images to view projected changes to their facial profiles.
arm group label: Treatment as Usual + Mindfulness
arm group type: Placebo Comparator
description: In addition to the health literature, participants completed the Mindfulness Intervention. Participants listened to a 10-minute self-guided mindfulness audio exercise. The audio file is a scripted reading of an established, brief mindfulness exercise (Erisman & Roemer, 2010). During this guided session, participants learned what mindfulness was, when it can be used, and benefits from practice. Listeners were led through steps, focusing on the physical sensations, breathing, and thoughts. After the exercise, participants were provided a handout highlighting key points about mindfulness and how to incorporate informal mindfulness practice into their daily life.
intervention type: Behavioral
intervention name: Facial Morphing Intervention
description: Participants assigned to this condition were exposed to facial morphing technology that displays the progression of facial-ageing up to 72years, both with and without damage from UV exposure.
arm group label: Treatment as Usual + Facial Morphing
other name: Facial Morphing
intervention type: Behavioral
intervention name: Mindfulness Intervention
description: Participants assigned to this condition engaged in a self-guided mindfulness intervention audio tape. This intervention instructed participants to pay attention to the present moment, with a non-judgemental stance. For example, participants were instructed to notice their breath, thoughts, feelings, physical sensations, and to internally describe them, without passing judgement
arm group label: Treatment as Usual + Mindfulness
other name: Mindfulness
criteria: 
gender: All
minimum age: 18 Years
maximum age: N/A
healthy volunteers: Accepts Healthy Volunteers
last name: Aaron J Blashill, PhD
role: Principal Investigator
affiliation: San Diego State University
facility: 
country: United States
citation: Ashrafioun L, Bonar EE. Tanning addiction and psychopathology: Further evaluation of anxiety disorders and substance abuse. J Am Acad Dermatol. 2014 Mar;70(3):473-80. doi: 10.1016/j.jaad.2013.10.057. Epub 2013 Dec 25.
PMID: 24373775
citation: Ramos Diaz NS, Jimenez Jimenez O, Lopes PN. The role of mindfulness in coping with recollections of acute stressors: a laboratory study. Psicothema. 2014;26(4):505-10. doi: 10.7334/psicothema2014.71.
PMID: 25340898
citation: Erisman SM, Roemer L. A preliminary investigation of the effects of experimentally induced mindfulness on emotional responding to film clips. Emotion. 2010 Feb;10(1):72-82. doi: 10.1037/a0017162.
PMID: 20141304
citation: Hillhouse J, Stapleton J, Turrisi R. Association of frequent indoor UV tanning with seasonal affective disorder. Arch Dermatol. 2005 Nov;141(11):1465. doi: 10.1001/archderm.141.11.1465. No abstract available.
PMID: 16301398
citation: Marchiori D, Papies EK. A brief mindfulness intervention reduces unhealthy eating when hungry, but not the portion size effect. Appetite. 2014 Apr;75:40-5. doi: 10.1016/j.appet.2013.12.009. Epub 2013 Dec 20.
PMID: 24361312
citation: Rogojanski J, Vettese LC, Antony MM. Coping with cigarette cravings: Comparison of suppression versus mindfulness-based strategies. Mindfulness, 2(1): 14-26, 2011.
citation: Williams AL, Grogan S, Buckley E, Clark-Carter D. Men's experiences of an appearance-focussed facial-ageing sun protection intervention: a qualitative study. Body Image. 2013 Mar;10(2):263-6. doi: 10.1016/j.bodyim.2013.01.003. Epub 2013 Feb 9.
PMID: 23402802
responsible party type: Principal Investigator
investigator affiliation: San Diego State University
investigator full name: Aaron Blashill
investigator title: Assistant Professor
mesh term: Carcinoma
mesh term: Carcinoma, Basal Cell
mesh term: Skin Neoplasms
sharing ipd: No
ipd description: There is no IPD sharing plan at this time.
participant flow: 
baseline: 
outcome list: 
reported events: 
certain agreements: 
point of contact: 