Effects of health beliefs, social support, and self-efficacy on sun protection behaviors among medical students: testing of an extended health belief model

Systematic review and analysis of self-efficacy in sun protection measurement instruments

OBJECTIVE

The objective of this study was toidentify and appraise available sun protection self-efficacy instruments and synthesize information.

DATA SOURCE

A systematic search of electronic databases from 2005 to 2023 included PubMed, CINAHL, Embase and PsycINFO .

BACKGROUND

While instruments have been developed to evaluate sun-protective behaviors and self-efficacy separately, sun-protection self-efficacy instruments have yet to be widely studied. Self-efficacy is an essential antecedent to performing health-related behaviors or practices that can promote or hinder the health of individuals and groups.

STUDY INCLUSION AND EXCLUSION CRITERIA

Studies randomized control trials or descriptive studies that used self-efficacy measurement tools to evaluate behaviors, intentions, and sun protection knowledge were included in this review. Sun protection surveys that targeted providers or parents and non-English articles were excluded.

DATA EXTRACTION

Data were extracted by one independent researcher.

DATA SYNTHESIS

Fifteen studies met the inclusion criterion and included 10 scales of self-efficacy in sun protection. Study design and purpose, and the instrument's validity and reliability statistics, including Cronbach's alphas, were extracted.

RESULTS

The two-factor self-efficacy in sun protection scale was the most common measure for primary prevention, with acceptable reliability and validity. However, other instruments also showed reliable psychometric properties, especially measures of sunscreen self-efficacy.

CONCLUSION

More research in self-efficacy measurement is warranted to examine specific populations and determine the appropriate constructs of self-efficacy. It is crucial to design evidence-based interventions that affect self-efficacy, are measured by a reliable, valid instrument, and have the potential to increase sun-protective and screening behaviors.

Cognitive and Emotional Motivation to Explain Infection-Prevention Behaviors with Social Support as a Mediator During the COVID-19 Pandemic: A Nationwide Cross-Sectional Study in Korea

Purpose

To predict the performance of infection-prevention behaviors among adults in Korea based on the health belief model, using social support as a mediator.

Patients and Methods

A nationwide cross-sectional survey of 700 participants from the local community was conducted using both online and offline methods from 8 metropolitan cities and 9 provinces in Korea from November 2021 to March 2022. The questionnaire was composed of 4 sections: demographic information, motivational factors for behavior change, social support, and infection-prevention behaviors. Data were analyzed using structural equation modeling with the AMOS program. The general least-squares method was applied to assess the fit of the model and the bootstrapping method was tested for indirect effect and the total effect.

Results

Motivation factors that directly affected infection-prevention behaviors were self-efficacy (γ=0.58, p<0.001), perceived barriers (γ=-.08, p=0.004), perceived benefits (γ=0.10, p=0.002), perceived threats (γ=0.08, p=0.009), and social support (γ=0.13, p<0.001), after controlling for related demographic variables. Cognitive and emotional motivation factors together explained 59% of the variance in infection-prevention behaviors. Social support exerted significant mediating effects between each cognitive and emotional motivation variable and infection-prevention behaviors, along with a significant direct effect on infection-prevention behaviors (γ=0.12, p<0.001).

Conclusion

The engagement of prevention behaviors among community-dwelling adults was influenced by their self-efficacy, perceived barriers, perceived benefits, and perceived threats with social support as a mediator. Prevention policy approaches could include providing specific information to improve self-efficacy and build awareness of the severity of the disease while establishing a supportive social environment for promoting health behaviors during the COVID-19 pandemic.

Skin Cancer-Related Health Behavior Interventions in the Context of the Health Belief Model

The incidence of skin cancer is increasing around the world every year. Although there are many reasons for the occurrence of skin cancer, UV radiation caused by sunlight is seen as the most important factor. Therefore, reducing exposure to UV radiation should be a top priority for skin cancer prevention. In addition, different demographic features also affect the amount of UV exposure. These include age, gender and professional groups. On the other hand, people can be exposed to UV radiation voluntarily. Sunbathing or using tanning devices can be shown as examples for this. For these reasons, interventions to reduce exposure to UV radiation should focus on demographic features and the desire to tan. At the same time, it is emphasized in the literature that theory-based and systematic interventions are more effective than others. In this context, we think that the Health Belief Model, which is an effective psychosocial model for health behaviors, will be useful in developing sun protection behaviors. In this review, interventions based on the Health Belief Model in the context of tanning behavior, age, gender, and outdoor activities for the prevention of skin cancer and the improvement of sun protection behaviors have been discussed.

Examining intentions to engage in sun protective behaviors among Latino day laborers: An application of the theory of planned behavior

Background: The past two decades has revealed an unprecedented increasing incidence of skin cancer within the Latinx population. Although Latino day laborers (LDLs) are at heightened risk for developing skin cancer because of the outdoor work in which they engage, there is limited research examining their intentions to engage in sun protective behaviors (SPBs). Therefore, this study sought to assess the explanatory power of the theory of planned behavior (TPB) to identify attitudinal, subjective norms, and perceived behavioral control factors associated with intentions to engage in SPB among LDLs.

Methods: This cross-sectional retrospective study consists of a non-random convenience,community-based, sample of 137 LDLs residing in Mississippi and Illinois. Data were collected using a self-report survey centered on health practices and sun-protective behaviors.

Results: Findings revealed that five significant factors shaped intentions to engage in SPBs, including barriers to engaging in SPBs (β =.30, P<0.001), benefits of engaging in SPBs (β =.27,P<0.001), education (β=0.20, P<0.01), and acculturation (β=0.18, P≤0.05). The independent variables tested in the model accounted for 42% of the change in intentions to engage in SPBs.

Conclusion: This study demonstrates TPB’s usefulness for predicting future intentions to engage in SPBs among LDLs. Moreover, the strongest factor associated with predicting intentions to engage in SPBs among LDLs was perceived behavioral control. Thus, since SPBs are malleable, emphasis is placed on implementing interventions for this population that promote intentions and address perceived behavioral control.

Self-efficacy and mental health problems during COVID-19 pandemic: A multiple mediation model based on the Health Belief Model

Confronting COVID-19 pandemic, one's health belief and behavior are essential to mental well-being. Thus conceived, this study applied the Health Belief Model to test the mediating effect of risk perception and coping strategies on the relationship between self-efficacy and mental health problems. Six hundred and eighteen participants aged 17-52 (117 males and 501 females) completed our web-based survey from February 7 to April 10, 2020. 12.6-15.1% of participants were affected by COVID-19 outbreak in varying degrees. The mediating effects of risk perception and active coping were significant, so was the serial mediating effect of risk perception and passive coping. Individuals with higher general self-efficacy were more likely to have lower risk perception, less passive coping strategies, more active coping strategies, and subsequently had less mental health problems. In conclusion, application of the HBM would help understand how mental health problems happen during an infectious disease epidemic, and the relationships among the HBM constructs need further investigation.