When Does Perceived Susceptibility to Skin Cancer Influence Indoor Tanning? The Moderating Role of Two Risk Perception Beliefs

A Comparison of Metaphor Modality and Appeals in the Context of Skin Cancer Prevention

Health communication experts continually seek out effective strategies to strengthen persuasive campaigns. While there is evidence that verbal metaphors can improve persuasion, little attention has been given to the potential of visual metaphors to enhance health communication effects. To fill this gap, an experiment was conducted to test the effects of metaphor modality (visual vs. verbal) and type of fear appeal used (death-based or appearance-based) on skin protection intentions. Additionally, the moderating role of an individual characteristic (need for cognition), and the mediating role of two processing outcomes (message elaboration and perceived message effectiveness) were examined. Results indicated that there was no significant difference between the main effects of metaphor modality and type of fear appeal, but these message features interacted making the death-based fear appeal the most effective strategy. Need for cognition directly affected perceptions of effectiveness but did not affect skin protection intentions nor message elaboration. Of the two message processing outcomes examined, only perceived message effectiveness mediated the relationship between metaphor modality and skin protection intentions. Theoretical explanations and practical implications are discussed.

Indoor Tanning Dependence in Young Adult Women

Background: There is mounting evidence that young people can develop a dependence on indoor tanning, but research on factors associated with indoor tanning dependence remains limited.Methods: This cross-sectional study investigated factors associated with indoor tanning dependence in a community sample of 389 non-Hispanic white young adult women ages 18 to 30 who had indoor tanned ≥1 time in the past year. Participants completed measures of indoor tanning dependence, including the modified CAGE and modified Diagnostic and Statistical Manual for Mental Disorders-IV psychiatric screening assessments, indoor tanning behavior and beliefs, and behavioral and psychiatric comorbidity.Results: Overall, 22.6% of the sample screened positive for indoor tanning dependence. In multivariable analyses, indoor tanning dependence was associated with younger age of indoor tanning initiation [adjusted odds ratio (aOR) = 0.79; P = 0.017], indoor tanning ≥20 times in the past year (aOR = 3.03; P = 0.015), stronger beliefs about the benefits of tanning (aOR = 2.15; P = 0.004), greater perceived susceptibility to indoor tanning risks (aOR = 2.72; P < 0.001), stronger beliefs about physical appearance (aOR = 1.73; P = 0.037), and depressive symptoms (aOR = 3.79; P < 0.001).Conclusions: Indoor tanning dependence among young, non-Hispanic white women is associated with behaviors that increase the risk of skin cancer, beliefs favoring the perceived benefits of tanning, and comorbid risks such as stronger beliefs about physical appearance and depressed mood.Impact: Comprehensive skin cancer prevention efforts should address indoor tanning dependence among young women and its leading risk factors. Cancer Epidemiol Biomarkers Prev; 26(11); 1636-43. ©2017 AACR.

The Effects of Gain-, Loss-, and Balanced-Framed Messages for Preventing Indoor Tanning among Young Adult Women

Indoor tanning (IT) increases the risks of skin cancer, but evidence on how to design health education messaging targeting IT among young adult women remains limited. This study investigated the effects of theory-guided gain-, loss-, and balanced-framed IT prevention messages. Young adult women ages 18-30 who indoor tan (n = 552, mean age = 24.9 years [standard deviation = 3.1]) were recruited online, completed pre-exposure measures, and were randomized to view a gain-, loss-, or balanced-framed message. Participants completed post-exposure measures of message response (emotional response, message receptivity), IT risk (perceived severity, susceptibility), and efficacy (self-efficacy, perceived benefits of avoiding IT) beliefs, and IT behavioral intentions. Loss- and balanced-framed messages promoted significantly greater emotional response and message receptivity and lower IT behavioral intentions than gain-framed messages. The effects of loss- and balanced-framed messages on IT behavioral intentions were mediated by greater emotional response and message receptivity compared with the gain-framed message. These results can inform the development of public health education campaigns to prevent and reduce IT among young adult women. Future research can build from these findings by investigating additional message themes and tailoring strategies to maximize their effects, examining the effects of framed messages prospectively, and investigating ways to enhance message receptivity, such as through novel message delivery channels (e.g., mobile devices).

The relative role of cognitive and emotional reactions in mediating the effects of a social comparison sun protection intervention

OBJECTIVE

This experiment examined the cognitive and emotional impact of two social comparison-based sun protection interventions in a sample of Southern California college students (N = 223). One of the interventions employed comparison UV photos of peers who had either much more (downward social comparison) or much less (upward social comparison) skin damage than did participants themselves. The second intervention consisted of descriptive norms information suggesting that a large majority of the participants' peer group regularly protect their skin from the sun.

DESIGN

Participants were randomly assigned to one of eight conditions in a 4 (Social Comparison Information: no photo vs. no comparison photos vs. upward comparison photos vs. downward comparison photos) × 2 (Descriptive Norms Information: Received vs. not received) design.

MAIN OUTCOME MEASURES

Emotional reactions (e.g. worry, embarrassment, relief) and sun-related cognitive reactions (perceived susceptibility, sun protection intentions) were assessed immediately. Sun protection behaviours were assessed in a surprise telephone follow-up five weeks following the intervention.

RESULTS

The results demonstrated that the combination of seeing photos of peers who had very little sun damage and learning that a majority of one's peers engage in regular sun protection resulted in reliably greater subsequent sun protection than all other conditions. Further, there was relatively direct evidence that both negative emotional reactions and sun protection intentions mediated this effect.

CONCLUSIONS

These findings add to the growing literature suggesting the importance of thoroughly examining the role of emotions in health behaviour decisions. Both theory and intervention efficacy would benefit from a better understanding of the relative role of cognitions and emotions in behaviour change.