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Founded Year

1998

Stage

Acquired | Acquired

Total Raised

$31.35M

About Reactivity

Companies rely on Racktivity for quick and efficient deployment of SOA applications. Racktivity provides organizations with the technology to secure, accelerate and manage XML and Web Services environments. With Racktivity, customers realize the cost saving and time-to-market promise of Web services and SOA. Racktivity's products deliver security, reliability, and scalability functions in an application oriented networking layer.

Reactivity Headquarter Location

1301 Shoreway Road Suite 425

Belmont, California, 94002,

United States

650-551-7800

Latest Reactivity News

Reactivity to UV Radiation Exposure Monitoring Using Personal Exposure Devices for Skin Cancer Prevention: Longitudinal Observational Study

Sep 28, 2021

JMIR mHealth and uHealth This paper is in the following e-collection/theme issue: April 22, 2021 . Reactivity to UV Radiation Exposure Monitoring Using Personal Exposure Devices for Skin Cancer Prevention: Longitudinal Observational Study Reactivity to UV Radiation Exposure Monitoring Using Personal Exposure Devices for Skin Cancer Prevention: Longitudinal Observational Study Authors of this article: 2Department of Public Health, Westminster College, Salt Lake City, UT, United States 3Department of Biostatistics, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, United States 4Department of Communication, University of Utah, Salt Lake City, UT, United States 5Department of Dermatology, University of Utah, Salt Lake City, UT, United States Corresponding Author: Salt Lake City, UT, 84112 United States Abstract Background: Emerging UV radiation (UVR) monitoring devices may present an opportunity to integrate such technology into skin cancer prevention interventions. However, little is known about the effects of using a wearable UVR monitor on adults’ and children’s sun protection–related behaviors and attitudes (eg, cancer worry and perceived risk). Understanding the potential role of reactivity and seasonal effects will help inform the use of objective monitors in the context of skin cancer prevention research, including intervention studies. Objective: The aim of this study is to examine the potential reactivity associated with a wearable personal UVR monitor, specifically the effects associated with reported sun-protective behaviors and skin cancer–related attitudes, which are often the targets of skin cancer preventive interventions. Methods: Child-parent dyads (n=97 dyads) were asked to wear a UVR monitoring device during waking hours for 2 weeks. Participants were asked to sync the device daily with a smartphone app that stored the UVR exposure data. Participants were blinded to their UVR exposure data during the 2-week period; thus, the smartphone app provided no feedback to the participants on their UVR exposure. Participants completed self-report questionnaires assessing sun-protective behaviors, sunburn, tanning, skin self-examination, skin cancer–related knowledge, perceived risk, cancer worry, response efficacy, and intentions to change behaviors over the 2-week period. Linear regressions were conducted to investigate changes in the outcomes over time and to account for the role of the season of study participation. Results: Regression results revealed that there was a significant decrease over time for several sun protection outcomes in children, including time spent outdoors on weekends (P=.02) and weekdays (P=.008), sunscreen use (P=.03), reapplication (P<.001), and unintentional tanning (P<.001). There were no significant changes over time in children’s and parents’ UVR exposure, sunburn occurrence, or sun protection attitudes. Season of participation was associated with several outcomes, including lower sunscreen use (P<.001), reapplication (P<.001), sunburns (P=.01), intentions to change sun-protective behaviors (P=.02), and intentional (P=.008) and unintentional tanning (P=.01) for participants who participated in the fall versus the summer. Conclusions: The findings from this study suggest that daily use of a UVR monitoring device over a 2-week period may result in changes in certain sun-protective behaviors. These results highlight the importance of identifying and addressing potential reactivity to UVR monitoring devices, especially in the context of skin cancer preventive intervention research. Ultimately, objectively assessed UVR exposure could be integrated into the outcome assessment for future testing of skin cancer prevention interventions. JMIR Mhealth Uhealth 2021;9(9):e29694 Background Mobile or personal health monitors are frequently used by the general public and in the context of health behavior research [ 1 ]. For example, FitBit, one of the most popular wearable activity monitors, reported 2 million new users in 2019, bringing its total active users to 29.6 million [ 2 ]. In the past decade, >300 studies using FitBit as an outcome measure were registered with the National Institutes of Health [ 3 ]. Although physical activity monitors are frequently used in research settings, monitors related to environmental exposures and their associated health behaviors are in the early phases of development, testing, and dissemination [ 4 - 6 ]. In the context of skin cancer prevention, assessment of an individual’s UV radiation (UVR) exposure is essential and is becoming more feasible given the availability of personal UVR monitors. Melanoma is the deadliest type of skin cancer and the fifth most common form of cancer [ 7 ]. UVR exposure from the sun or artificial sources is the primary modifiable risk factor for melanoma [ 8 ]. Efforts to prevent melanoma focus on decreasing individuals’ UVR exposure through sun-protective behaviors, such as wearing sunscreen and clothing that covers the skin, and avoiding peak UVR hours, which are typically assessed through self-report measures [ 9 ]. There has been a growing number of objective UVR assessment methods that can quantify personal UVR exposure and be useful for documenting the efficacy of melanoma preventive interventions [ 4 , 10 ]. However, a potential concern with using objective UVR exposure assessments is reactivity or the possibility that simply monitoring a behavior may in and of itself result in behavior change [ 11 , 12 ]. For example, it is possible that individuals who are aware that their UVR exposure is being monitored could choose to use sun-protection methods more consistently. For example, in the physical activity assessment literature, it has been found that after individuals use objective assessments of their exercise behaviors, changes can be seen in both their behaviors and exercise-related attitudes (eg, covering more distance and reporting great perceived exertion) [ 13 ]. In addition, it is not known to what extent personal UVR exposure based on objective assessments could differ depending on environmental factors such as the season. For instance, individuals may make different sun-protection choices based on seasonal differences in weather and temperature [ 14 ]. Studies have found that individuals who rely on ambient temperature as a method for determining the need for sun protection, particularly in the winter [ 15 , 16 ], are more likely to receive sunburns in cool weather [ 17 ] and tend to use clothing such as long sleeves and pants for warmth rather than sun protection [ 14 ]. Although prior studies of objective UVR exposure monitors have not yet examined potential reactivity effects, this phenomenon has been more fully explored in physical activity research [ 18 ]. In the literature, there are mixed findings regarding whether monitoring behavior alone is associated with behavior change. Most studies reporting on behavioral changes among adults and children related to monitoring used devices such as pedometers that provided feedback to the participants on physical activity outcomes (eg, number of steps taken daily) [ 19 - 22 ]. In the studies of monitors that did not provide feedback, most found that monitoring alone was not associated with behavior change [ 23 - 26 ]. Objective In relation to melanoma prevention, studies have examined the effects of providing periodic feedback to adults, adolescents, and children on UVR exposure; information on the risk of sunburn; and advice about sun protection methods [ 27 - 29 ]. For example, the provision of UVR exposure feedback is associated with less UVR exposure on weekends and an increase in the use of some forms of sun protection [ 27 - 29 ]. Other studies have examined variability in UVR exposure and sun-protective behaviors among different populations, such as rural and urban children, and periods, such as during vacation [ 30 - 34 ]. However, it remains unknown to what extent UVR measurement itself, in the absence of providing feedback on UVR exposure, is associated with changes in sun-protective behaviors and attitudes (eg, cancer worry and perceived risk) in adults and children. Some sun-protection behaviors (eg, sunscreen use, hat use, and wearing pants) are not directly measured by the device. Our hypothesis, based on the literature on physical activity and limited UVR exposure reactivity, is that wearing a UVR monitoring device could lead individuals to become more aware of their UVR exposure and, as a result, change their behaviors and attitudes related to sun exposure. For example, in the physical activity literature, attitudes related to exercise such as perceived efficiency, intensity of effort, and fatigue have been found to increase with accelerometer use [ 13 ]. We hypothesize that sun-protection behaviors increase over the monitoring period and that UVR measured by the device would decrease as a result of increased UVR exposure awareness. Understanding the potential role of reactivity and seasonal effects will help inform the use of objective monitors in the context of skin cancer prevention research, including intervention studies. This pilot study was designed to validate the use of a UVR monitoring device in larger skin cancer prevention interventions designed for parents and children [ 5 ]. The goal of this study is to assess the potential reactivity associated with UVR exposure monitoring among adults and children as it relates to sun-protective behaviors and skin cancer prevention–related attitudes, which are often the targets of skin cancer preventive interventions [ 35 - 37 ]. Methods Participants Potential participants were recruited through health and community events (eg, health fairs and farmers’ markets) and invitation letters that were mailed to residents with a child aged between of 8 and 17 years. A web-based marketing resource was used to obtain the addresses of potential participants living in Utah [ 38 ]. To be eligible to participate in this study, adults who were residents of Utah, aged ≥18 years, had at least one child aged between 8 and 17 years, had a smartphone with Bluetooth and Wi-Fi capabilities, were willing to use a smartphone app that shared their UVR exposure information with the research team, did not have a pacemaker (because of potential interference from the UVR monitor), and were able to read and write in English were included. For children to be eligible to participate, they had to be aged between 8 and 17 years, live with a primary caregiver in Utah, have no previous melanoma diagnosis, and not have a pacemaker. In total, 224 adults expressed interest in participating in the study. Of the 224 adults, 150 (67.0%) were screened for eligibility. Of the 150 adults screened, 116 (77.3%) were screened as eligible and 34 (22.7%) as ineligible. Reasons for ineligibility included not having a child in the desired age range (28/34, 82%), not having a smartphone with the necessary specifications (5/34, 15%), and not being able to read or write in English (1/34, 3%). A total of 97 parents (77% biological mothers) and 97 children (mean age 12.7 years, SD 2.7) were enrolled between June 2018 and October 2018. These months were selected because of the high ambient UVR levels in the region during those months [ 39 ]. All study procedures were approved by the relevant institutional review board. Procedures Participants were asked to wear a UVR monitoring device (Shade wearable UVR sensor, model V1.00, YouV Labs Inc) [ 4 , 40 ] on their clothing for a 2-week period. They completed the baseline assessment before being given the UVR monitoring devices to wear. A monitoring period of 2 weeks was selected to allow the capture of data from both weekdays and weekends for >1 week (to minimize missing data for either weekdays or weekend days). Participants were asked to synchronize the Shade device daily with a smartphone app that stored the UVR exposure data in a cloud-based server accessed by the research team. Participants were blinded to their UVR exposure data during the 2-week period; thus, the smartphone app provided no feedback to the participants on their UVR exposure. Changes in UVR exposure were analyzed by comparing total UVR exposure in the first week of study participation with total UVR exposure in the second week of study participation. Participants were asked to complete electronically delivered questionnaires via REDCap (Research Electronic Data Capture) [ 41 ] at the beginning and end of the 2-week period about sun-protective behaviors—such as wearing sunscreen and protective clothing (10 items) [ 42 ], number of sunburns received (one item) [ 42 ], tanning (two items) [ 43 ], skin self-examination (one item) [ 44 ], skin cancer–related knowledge (10 items) [ 45 ]—and relevant attitudes such as cancer worry (four items) [ 46 ], perceived risk (two items) [ 47 ], efficacy of skin cancer preventive behaviors (four items) [ 48 ], and intentions to change preventive behaviors (five items) [ 49 - 51 ]. Parents reported on these constructs for both themselves and their child, and children provided self-reports. All items except knowledge (true or false items) were asked on a 5-point Likert scale. The multi-item scales, including skin cancer–related knowledge, cancer worry (α=.87, child report; α=.90, parent report; parents not asked to report on child), perceived risk (α=.75, child report; α=.82, parent report; α=.84, parent report on child), efficacy of preventive behaviors (α=.89, child report; α=.94, parent report; α=.95, parent report on child), and intention to change preventive behaviors (α=.39, child report; α=.55, parent report; α=.66, parent report on child), were summed. After completing their study participation, each participant was provided with a gift card and a report summarizing their UVR exposure over the 2-week period. Analyses Descriptive statistics were used to summarize the participants’ demographic information and summary statistics for the outcomes of interest. Linear regressions were used to examine potential changes over the 2-week period in UVR exposure measured from the device, sun-protective behaviors, sunburn, tanning, skin self-examination, and in summed scales for skin cancer–related knowledge, perceived risk, cancer worry, response efficacy, and intentions to change behaviors. Additional linear regressions were conducted with seasonal (summer [June-August] vs fall [September-October]) assessment time points (baseline vs exit) and their interactions as predictors and the same outcomes as dependent variables [ 52 ]. Season was included in these models based on the existing literature [ 53 ], and it was significantly related to multiple outcomes in this study. Results Sample Characteristics In total, 97 parent-child dyads participated in the study. Of the 97 parents, 73 (77%) were biological mothers, 83 (87%) were non-Hispanic White, and 5 (5%) were Hispanic. Of the 97 children (mean age 12.7 years, SD 2.7), 81 (85%) were non-Hispanic White, 8 (8%) were Hispanic, and 56 (59%) were female ( Table 1 ). Table 1. Demographic characteristics of participating parents and children (N=97)a. Characteristics cN/A: not applicable (parents not asked to report this on children). dFirst 7 days versus last 7 days of the 2-week wearing period adjusted to include participants that had at least 4 days of UVR data. eResponse options included never=1 to always=5. f0=false, 1=true. Possible range of 0-5, or 0-10 for total knowledge. g1=very unlikely, 5=very likely. Possible range of 1-10. h1=not at all, 5=very much. Possible range of 1-20. i1=strongly disagree, 5=strongly agree. Possible range of 1-20. j1=no and I do not intend to start doing so in the next 6 months, 5=yes, I have been for more than 6 months. Possible range of 1-25. Regression Analyses Regression results revealed that there was a significant change over time for several outcomes ( Tables 3-5 ). In addition, separate analyses examining the relationship between season alone and these outcomes are provided in the table footnotes. Table 3. Child self-report regression models examining association between time and season of participation and sun-protective behaviorsa. Outcome

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Reactivity Patents

Reactivity has filed 2 patents.

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2/14/2006

8/11/2009

Federated identity, Cryptography, Identity management, Units of information, Identity management systems

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2/14/2006

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Federated identity, Cryptography, Identity management, Units of information, Identity management systems

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