BACKGROUND Harnessing supportive influences in close relationships is an innovative and potentially effective strategy to improve sun protection behaviors. This pilot randomized controlled clinical trial evaluated the feasibility and preliminary impact of Sun Safe Partners Online, an online, couple-focused intervention to improve sun protection behavior. Seventy five couples reporting suboptimal levels of sun protection recruited from Facebook advertisements were randomized to receive a

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... d intervention called Sun Safe Partners Online or a Generic Online Sun Safety Information intervention. Sun Safe Partners Online had four individual-focused modules and four couple-focused modules. Feasibility was assessed by study enrollment, engagement, follow-up survey completion, and intervention evaluation. Participants completed baseline and a one month post-intervention surveys assessing sun protection and sun exposure, along with individual and relationship attitudes about the importance of sun protection. Using Facebook as a recruitment strategy resulted in rapid enrollment and higher acceptance than for the prior telephone and print trial. The follow-up survey completion was higher in the Generic Online condition (100%) than the Sun Safe Partners Online condition (87.2%). Engagement in Sun Safe Partners Online was high with more than two-thirds of participants completing all modules. Evaluations of Sun Safe Partners Online content and features as well as ease of navigation were excellent. Sun Safe Partners Online showed small effects on sun protection behaviors and sun exposure on weekends compared with the Generic Online intervention and moderate effect size increases in the Sun Safe Partners Online condition. This study utilized a novel approach to facilitating engagement in sun protection by harnessing relationship influences among spouses and co-habiting partners. A couple-focused intervention may hold promise as a way to improve sun protection behaviors beyond interventions focused solely on individuals by leveraging the concern, collaboration, and support among intimate partners and addressing relationship-based barriers to sun protection. OBJECTIVE Harnessing supportive influences in close relationships is an innovative and potentially effective strategy to improve sun protection behaviors METHODS Seventy five couples reporting suboptimal levels of sun protection recruited from Facebook advertisements were randomized to receive a web-based intervention called Sun Safe Partners Online or a Generic Online Sun Safety Information intervention. Sun Safe Partners Online had four individual-focused modules and four couple-focused modules. Feasibility was assessed by study enrollment, engagement, follow-up survey completion, and intervention evaluation. Participants completed baseline and a one month post-intervention surveys assessing sun protection and sun exposure, along with individual and relationship attitudes about the importance of sun protection. Using Facebook as a recruitment strategy resulted in rapid enrollment and higher acceptance than for the prior telephone and print trial. The follow-up survey completion was higher in the Generic Online condition (100%) than the Sun Safe Partners Online condition (87.2%). RESULTS Sun Safe Partners Online also showed small to moderate-size effects on relationship benefits and support provided to the partner. The small to moderate effect sizes for individual factors suggested that participants in Sun Safe Partners Online increased sun protection intentions and sun protection benefits. CONCLUSIONS A couple-focused intervention may hold promise as a way to improve sun protection behaviors beyond interventions focused solely on individuals by leveraging the concern, collaboration, and support among intimate partners and addressing relationship-based barriers to sun protection. CLINICALTRIAL none