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ÇELİK BA, KOÇ V. Skin Cancer-Related Health Behavior Interventions in the Context of the Health Belief Model. PSIKIYATRIDE GUNCEL YAKLASIMLAR - CURRENT APPROACHES IN PSYCHIATRY 2023. [DOI: 10.18863/pgy.1112210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
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.
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Horsham C, Baade P, Kou K, O'Hara M, Sinclair C, Loescher LJ, Soyer HP, Janda M. Optimizing Texting Interventions for Melanoma Prevention and Early Detection: A Latin Square Crossover RCT. Am J Prev Med 2021; 61:348-356. [PMID: 34419232 DOI: 10.1016/j.amepre.2021.03.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 03/24/2021] [Accepted: 03/25/2021] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Text messaging is an effective way to reach large populations with health promotion support. This study aims to establish the optimal text messaging intervention to achieve behavior change in young adults at risk of skin cancer. STUDY DESIGN Latin square crossover RCT. SETTING/PARTICIPANTS Participants were women and men aged 18-40 years living in Queensland, Australia who owned a smartphone and had ≥2 skin cancer risk factors. INTERVENTION Participants were enrolled from December 2018 to February 2019 and completed an eligibility survey. Eligible participants were randomized to 4 different text message interventions using a Latin square design with varying personalization, interactivity, and message frequency (February 2019‒July 2019). Each intervention lasted for 1 month; between interventions, participants had a 1-week washout period in which they completed an online questionnaire. Participants completed a 6-month follow-up online survey in January 2020. MAIN OUTCOME MEASURES Measures included self-reported sun protection habits and sunburns. RESULTS A total of 277 (71.2% response rate) participants completed the 6-month follow-up. The sun protection habits index was significantly higher in all the 4 text messaging interventions (p<0.01 for each intervention) than at baseline, with similar sun protection habits improvements among all interventions (p=0.27). Sunburn rates decreased significantly over time (p<0.01 each intervention), with all the 4 interventions achieving reductions in sunburn rates during the intervention periods (p=0.78). Overall, the sunburn rates decreased from 40.3% at baseline to 7.0% at the end of the intervention, and at 6-month follow-up, it remained significantly below baseline levels at 23.5% (p<0.01). CONCLUSIONS Regular text messaging interventions result in significantly increased sun protection and decreased sunburn in young adults. TRIAL REGISTRATION This study is registered at the Australian and New Zealand Clinical Trials Registry ACTRN12618001299291.
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Affiliation(s)
- Caitlin Horsham
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Peter Baade
- Cancer Council Queensland, Brisbane, Australia
| | - Kou Kou
- Cancer Council Queensland, Brisbane, Australia
| | - Montana O'Hara
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | | | | | - H Peter Soyer
- Dermatology Research Centre, The University of Queensland Diamantina Institute, The University of Queensland, Brisbane, Australia; Department of Dermatology, Princess Alexandra Hospital, Brisbane, Australia
| | - Monika Janda
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia.
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Entringer AC, Brannon LA, Whitaker WK. Educating outdoor workers using tailored and financial messages to encourage safe-sun behaviors. HEALTH EDUCATION RESEARCH 2021; 36:374-383. [PMID: 34037768 DOI: 10.1093/her/cyab008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 02/01/2021] [Indexed: 06/12/2023]
Abstract
Excessive and unsafe sun exposure represents a concerning hazard to the health of individuals. Of particular interest are those who are most susceptible to sun exposure, such as outdoor workers. The current study used a 3 × 2 between-subjects design to investigate the effectiveness of messages that varied the extent of personalization (i.e. generic message; occupation targeted message; individual tailored message) and the inclusion of content regarding financial consequences of skin cancer. Participants (N = 304) were recruited from the USA through Amazon's Mechanical Turk and randomly assigned to view a generic message, occupation targeted message, or individual tailored message. Additionally, participants were randomly assigned to view messages in which financial information was either present or not. Participants responded to questions assessing pre- and post-test sun protection behaviors. Individual tailored messaging was as effective as occupation targeted messaging, with both being more effective than generic messaging. This finding indicates that some degree of personalization is necessary when promoting safe-sun practices to outdoor workers, but that tailoring to individuals may not always be necessary. Inclusion of financial content in messaging resulted in greater intentions to practice sun protection behaviors. Results provide insight into effective methods for promoting sun protection.
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Affiliation(s)
- Aaron C Entringer
- Department of Psychological Sciences, Kansas State University, Manhattan, KS, USA
| | - Laura A Brannon
- Department of Psychological Sciences, Kansas State University, Manhattan, KS, USA
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Horsham C, Dutton-Regester K, Antrobus J, Goldston A, Price H, Ford H, Hacker E. A Virtual Reality Game to Change Sun Protection Behavior and Prevent Cancer: User-Centered Design Approach. JMIR Serious Games 2021; 9:e24652. [PMID: 33764308 PMCID: PMC8294638 DOI: 10.2196/24652] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 01/27/2021] [Accepted: 02/08/2021] [Indexed: 01/30/2023] Open
Abstract
Background Public health sun safety campaigns introduced during the 1980s have successfully reduced skin cancer rates in Australia. Despite this success, high rates of sunburn continue to be reported by youth and young adults. As such, new strategies to reinforce sun protection approaches in this demographic are needed. Objective This study aims to develop a virtual reality (VR) game containing preventive skin cancer messaging and to assess the safety and satisfaction of the design based on end user feedback. Methods Using a two-phase design approach, we created a prototype VR game that immersed the player inside the human body while being confronted with growing cancer cells. The first design phase involved defining the problem, identifying stakeholders, choosing the technology platform, brainstorming, and designing esthetic elements. In the second design phase, we tested the prototype VR experience with stakeholders and end users in focus groups and interviews, with feedback incorporated into refining and improving the design. Results The focus groups and interviews were conducted with 18 participants. Qualitative feedback indicated high levels of satisfaction, with all participants reporting the VR game as engaging. A total of 11% (2/8) of participants reported a side effect of feeling nauseous during the experience. The end user feedback identified game improvements, suggesting an extended multistage experience with visual transitions to other environments and interactions involving cancer causation. The implementation of the VR game identified challenges in sharing VR equipment and hygiene issues. Conclusions This study presents key findings highlighting the design and implementation approaches for a VR health intervention primarily aimed at improving sun protection behaviors. This design approach can be applied to other health prevention programs in the future.
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Affiliation(s)
- Caitlin Horsham
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| | - Ken Dutton-Regester
- QIMR Berghofer Medical Research Institute, Brisbane, Australia.,Excite Science Pty Ltd, Brisbane, Australia
| | - Jodie Antrobus
- Preventive Health Branch, Queensland Health, Brisbane, Australia
| | | | | | - Helen Ford
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| | - Elke Hacker
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
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Horsham C, Antrobus J, Olsen CM, Ford H, Abernethy D, Hacker E. Testing Wearable UV Sensors to Improve Sun Protection in Young Adults at an Outdoor Festival: Field Study. JMIR Mhealth Uhealth 2020; 8:e21243. [PMID: 32936083 PMCID: PMC7531871 DOI: 10.2196/21243] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 07/21/2020] [Accepted: 07/23/2020] [Indexed: 12/13/2022] Open
Abstract
Background Australia and New Zealand have the highest skin cancer incidence rates worldwide, and sun exposure is the main risk factor for developing skin cancer. Sun exposure during childhood and adolescence is a critical factor in developing skin cancer later in life. Objective This study aims to test the effectiveness of wearable UV sensors to increase sun protection habits (SPH) and prevent sunburn in adolescents. Methods During the weeklong school leavers outdoor festival (November 2019) at the Gold Coast, Australia, registered attendees aged 15-19 years were recruited into the field study. Participants were provided with a wearable UV sensor and free sunscreen. The primary outcome was sun exposure practices using the SPH index. Secondary outcomes were self-reported sunburns, sunscreen use, and satisfaction with the wearable UV sensor. Results A total of 663 participants were enrolled in the study, and complete data were available for 188 participants (188/663, 28.4% response rate). Participants provided with a wearable UV sensor significantly improved their use of sunglasses (P=.004) and sunscreen use both on the face (P<.001) and on other parts of the body (P=.005). However, the use of long-sleeve shirts (P<.001) and the use of a hat (P<.001) decreased. During the study period, 31.4% (59/188) of the participants reported receiving one or more sunburns. Satisfaction with the wearable UV sensor was high, with 73.4% (138/188) of participants reporting the UV sensor was helpful to remind them to use sun protection. Conclusions Devices that target health behaviors when outdoors, such as wearable UV sensors, may improve use of sunscreen and sunglasses in adolescents.
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Affiliation(s)
- Caitlin Horsham
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| | - Jodie Antrobus
- Preventive Health Branch, Queensland Health, Queensland Government, Brisbane, Australia
| | - Catherine M Olsen
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Helen Ford
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| | - David Abernethy
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| | - Elke Hacker
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
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Pokharel M, Christy KR, Jensen JD, Giorgi EA, John KK, Wu YP. Do ultraviolet photos increase sun safe behavior expectations via fear? A randomized controlled trial in a sample of U.S. adults. J Behav Med 2019; 42:401-422. [PMID: 30523504 PMCID: PMC6526068 DOI: 10.1007/s10865-018-9997-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 11/27/2018] [Indexed: 10/27/2022]
Abstract
Ultraviolet (UV) photos reveal the world in a different light spectrum, including damage that is caused by UV light. In the context of skin cancer control, UV photos have the potential to communicate fear because they reveal underlying skin damage. U.S. adults (N = 2219) were assigned to a 5 (visual: UV skin damage, sun exposure, sunburn, photoaging, and mole removal) × 3 (replication: three examples of each visual condition) × 4 (efficacy: no efficacy, text only, visual, visual + text) randomized controlled trial. Compared to all other visual conditions combined, UV skin damage visuals generated greater fear which triggered increased sun safe behavior expectations. Compared with other visual conditions separately, only mole removal visuals produced equivalent fear as UV skin damage visuals. Visual efficacy conditions appeared to nullify rather than magnify the indirect path through fear. The results suggest one way UV images impact sun safe behavioral expectations is via fear and that researchers should continue to examine the position of fear in fear appeal theories.
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Affiliation(s)
- Manusheela Pokharel
- Department of Communication, University of Utah, 2618 LNCO, 255 S. Central Campus Drive, Salt Lake City, UT, 84112, USA.
| | - Katheryn R Christy
- School of Journalism and Mass Communication, University of Wisconsin-Madison, Madison, USA
| | - Jakob D Jensen
- Department of Communication, University of Utah, 2618 LNCO, 255 S. Central Campus Drive, Salt Lake City, UT, 84112, USA
- Huntsman Cancer Institute, University of Utah, Salt Lake City, USA
| | - Elizabeth A Giorgi
- Department of Communication, University of Utah, 2618 LNCO, 255 S. Central Campus Drive, Salt Lake City, UT, 84112, USA
| | - Kevin K John
- School of Communications, Brigham Young University, Provo, USA
| | - Yelena P Wu
- Huntsman Cancer Institute, University of Utah, Salt Lake City, USA
- Department of Dermatology, University of Utah, Salt Lake City, USA
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Auerbach MV, Heckman CJ, Darlow S. To protect or not to protect: examining reasons for sun protection among young women at risk for skin cancer. J Behav Med 2018; 41:528-536. [PMID: 29589257 DOI: 10.1007/s10865-018-9920-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Accepted: 03/20/2018] [Indexed: 11/26/2022]
Abstract
We aimed to further the understanding of the low rates of sun protection in young women at risk for skin cancer. Six-hundred-sixty-one daily diary entries were received via text message over 14 days from 56 young women at moderate to high risk of developing skin cancer. Women reported whether or not they used sun protection and also listed what their reasons were for using protection or not using sun protection each day. Multi-level modeling was used to examine the influence of study variables when predicting daily sun protection or lack of protection. The number of days in which sun protection was reported was positively associated with "habit" and "prevention" as reasons for protection and negatively associated with "not-needed" and "unprepared" as reasons for non-protection. Self-reported sun protection increased over the 14-day study period. Results of this study suggest the potential value of interventions aimed at motives for sun-protection behaviors.
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Affiliation(s)
- M V Auerbach
- Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, PA, 19111, USA
- Department of Psychology, Temple University, Philadelphia, PA, 19122, USA
| | - C J Heckman
- Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, PA, 19111, USA.
- Population Science, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, 08903, USA.
| | - S Darlow
- Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, PA, 19111, USA
- National Comprehensive Cancer Network, Fort Washington, PA, 19034, USA
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Aziz SW, Aziz MH. Protective molecular mechanisms of resveratrol in UVR-induced Skin carcinogenesis. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2017; 34:35-41. [DOI: 10.1111/phpp.12336] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/26/2017] [Indexed: 01/11/2023]
Affiliation(s)
- Saba W. Aziz
- Department of Internal Medicine; Division of Endocrinology; James H. Quillen College of Medicine; East Tennessee State University; Johnson City TN USA
| | - Moammir H. Aziz
- Department of Biomedical Sciences; James H. Quillen College of Medicine; East Tennessee State University; Johnson City TN USA
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Darlow S, Heckman C. Results From a Tailored SMS and Behavior-Tracking Pilot Study on Sun-Safe Behaviors in Young Women. HEALTH EDUCATION & BEHAVIOR 2017; 44:937-944. [PMID: 28363246 DOI: 10.1177/1090198117699507] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The elevated rates of ultraviolet radiation (UVR) exposure and low rates of sun protection in young adult women indicate a need for age- and gender-appropriate interventions that address these behaviors. AIMS To examine the effects of daily behavior tracking and individually tailored text messages on sun protection and UVR exposure behaviors in young adult women at moderate to high risk of developing skin cancer. METHOD One hundred and four young adult women at risk of skin cancer were randomized to receive the behavior-tracking intervention only, tailored text messages only, both interventions, or neither. Outcomes were self-reported UVR exposure and sun protection behaviors. RESULTS Those who received the behavior-tracking intervention reported significantly fewer UVR exposure behaviors at 4-week follow-up, relative to those who did not receive behavior tracking. At 4-week follow-up, those who received daily tailored text messages reported significantly greater UVR exposure behaviors but were more likely to report wearing a hat as a form of sun protection, relative to those who did not receive tailored messages. DISCUSSION Daily behavior tracking may be repetitive, but repetition may facilitate cognitive processing and the development of healthy habits. Health messages that are less interactive, on the other hand, need to be adequately tailored and delivered with the most advantageous timing to be impactful. CONCLUSION Future research should continue to examine how these interventions differentially affect behavior and how they can be adapted to apply to other health behaviors.
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Affiliation(s)
- Susan Darlow
- 1 National Comprehensive Cancer Network, Washington, PA, USA
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