First, according to the pre-test results regarding PMT variables and skin-cancer preventive behaviors, a total of 45 text messages were designed in Persian. Then, the developed text messages were pre-tested on 15 seafarers (apart from the study participants) in three focus group discussion. After explaining the purpose of the meeting, each message was written on the board and they were asked to discuss the following 10 questions about each message: 1. Who is the target population of this message?, 2. Can you easily understand the concept of the message?, 3. Did the message ask you to do something specific? If yes, What?, 4. Was there anything in the message that you do not believe in? What?, 5. Is there anything in the message that makes you annoyed or ridiculed?, 6. What do you remember about this message?, 7. Did the message contain a specific notion that you do not like? What?, 8. Did the message contain a specific notion that you like? What?, 9. Was the message containing confusing content?, 10. Do you have any suggestions to make this message better?, and 11. Which message did you like the most? Why? [20]. The responses and comments of the participants were written and then applied in the messages. Finally, according to their suggestions, two messages were edited. The final text messages (n = 45) are shown in Table 1. The time and frequency of sending the text messages were mutually agreed by the researcher and the seafarers. Seafarers preferred to receive one message a day at 4.00 pm. For a period of 45 days, one member of the research team sent one of the developed messages (Table (Table1)1) daily at a time (4 p.m.) to the participants’ cell phone. Within the first 21 days, the messages focused on perceived vulnerability, perceived severity, and perceived self-efficacy. In days 22–45, the messages focused on response costs, response efficacy, perceived rewards, fear, protection motivation and sun-protective practices. In order to rectify the possible failure of the system, delivery reports of the mobile phones were checked by one of the researchers of the present study.

SMS messages adopted following the focus group discussions

1. Do you know that skin cancer is a common cancer among seafarers?

2. Do you know that skin cancer is the most common type of cancer in many parts of our country (Iran)?

3. Remember that direct exposure to sunlight is one of the factors predisposing the seafarers to skin cancer.

4. Dear Seafarer: Skin cancer is a serious condition. It may be fatal.

5. Although there is no definitive cure for the skin cancer, it is preventable.

6. Have you ever had sunburn? Have you ever wondered what would be the side-effects of the repeated sunburn on your skin?

7. Health is the chief asset to man. Protect yourself against the skin cancer.

8. If you will, you can adopt preventive behaviors to prevent skin cancer.

9. It may be a difficult task for you to buy sunscreen. You can get help from your wife or your sister to buy it.

10. Don’t be lazy. In case of sweating, swimming, or washing your hands or face, the re-use of sunscreen is essential.

11. Despite the heat, if you want, you may reduce the exposure of your body skin to sunlight while working outdoors by wearing long-sleeved blouse and long pants.

12. It is not so difficult to purchase a cap. It is inexpensive and can be found in most shops.

13. Some people are lazy or unwilling to wear a cap. If health matters to you, make a serious decision to regularly wear a cap.

14. Although it may be difficult and costly for you to buy standard sunglasses, if you value your health, purchase one and use it.

15. Even if others make fun of you, if you want, you can still wear sunglasses with a large screen that covers around your eyes well when exposed to the sunlight.

16. You might say that my job is to always work in the sunlight, and I cannot prevent the sunlight from impacting my body. This may be a bit difficult, but it is very possible. Thus, give it a try.

17. Although buying and using a cap and sunglasses may be difficult for you, with regular use, you may protect yourself from the sun rays.

18. Purchasing foreign sunscreens can be expensive and costly; however, you can buy and use good quality Iranian sunscreen at a much lower price.

19. Some people may think you are wearing sunglasses for beauty or style and always make fun of you. Explain to them why you are using these things. You may even persuade them to use these things as well.

20. Although wearing long sleeves clothes and long pants will make you feel warmer, keep in mind that doing so reduces your skin exposure to the sunlight.

21. Although when you wear a cap, you sweat and feel warm in your hair, you protect the skin of your head against the sun rays.

22. Although buying standard and medical sunglasses that prevent the sun ultraviolet costs a lot, you can buy and use one by a little savings.

23. Although you may worry a little by getting information about skin cancer and its protective measures, remember that it is a good feeling and guarantees your health.

24. Health is the chief asset to man. If you want, you may protect yourself against skin cancer.

25. By adopting precautionary measures (in subsequent SMSs), you may reduce the probability of developing skin cancer in yourself and minimize your concerns. Thus, follow our next SMSs.

27. Many people get scared and worried when they think about skin cancer. This fear is natural, which may be counteracted by reducing the exposure to the sunlight.

28. The fear of skin cancer is a common feeling in most people. This fear may act as a trigger to adopting sun-protective behaviors.

29. Decide right now and protect your skin more than ever before.

30. Although your job is as such to spend most of the day outside, make a decision today and reduce your exposure to the sunlight.

31. Decide today to wear a cap, sunglasses, and sunscreen when exposed to the sunlight.

32. Decide from now to go outside less or get in the shade when the sun has the most radiation during the day (11 AM to 5 PM).

33. See your doctor as soon as possible by observing abnormal nevi and spots on your skin.

34. The amount of ultraviolet ray in the sunlight is very high from 11 AM to 5 PM. Try as much as possible not to expose yourself to the sunlight in unnecessary situations to prevent the skin cancer. If you have to do work under the sunlight, try to be in the shade.

35. There is ultraviolet radiation from the sun even in winter or cloudy weather. Thus, reduce your unnecessary activities between 11 AM and 5 PM as much as possible.

36. Being in the shade (especially between 11 AM and 5 PM) is great and pleasant for anyone. The shade may reduce up to 50% of the intensity of the sun ultraviolet radiation.

37. To reduce the exposure to the sunlight, apply sunscreen 20 min before you leave the house.

38. It is best to re-apply your sunscreen every 2 h. Even when you wash your face or sweat, you should use the sunscreen again.

39. The skin around the eyes has a great potential for skin cancer. Wear standard sunglasses even on cloudy days.

40. Buy your sunglasses from reliable stores, and after buying them, make sure that they are of a medical type using the devices available in eyeglasses stores.

41. Using gloves (preferably dark) may reduce the exposure of your skin to the sunlight.

42. Wearing long-sleeved blouses and long pants (preferably dark) when working outdoors reduces the amount of sun UV rays exposure to your body skin.

43. Wearing a cap (preferably dark) or making a shade reduces the exposure of your face, ears, and neck to the sunlight.

44. Check your entire skin every month. If you see any new nevi, moles, nevi with irregular margin, asymmetric nevi, non-uniform colored nevi, large, itchy, or painful nevi, wounds that are bleeding and do not heal and red masses or spots, see your doctor immediately.

45. See your doctor once every 6 months to examine your skin. Accelerate your treatment and healing process by the early diagnosis of your skin problems.

Note: The content above has been extracted from a research article, so it may not display correctly.



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