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Rönsch H, Rocholl M, Ludewig M, Staudt A, Langner M, Steeb T, Wilke A, John SM, Berking C, Beissert S, Bauer A. Sonnenschutz bei Beschäftigten im Freien. Entwicklung und Validierung von standardisierten Fragebögen für Verhalten und Wissen. J Dtsch Dermatol Ges 2024; 22:665-674. [PMID: 38730530 DOI: 10.1111/ddg.15378_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 01/11/2024] [Indexed: 05/13/2024]
Abstract
BACKGROUND AND OBJECTIVES Outdoor workers are at increased risk of developing non-melanoma skin cancer. We aimed to address the lack of validated German-language measurement instruments for outdoor workers' sun safety behavior and knowledge by compiling and validating two questionnaires. PARTICIPANTS AND METHODS By expert consensus, items for the assessment of protective behavior (OccuSun) were compiled based on existing instruments. For knowledge, a translation of the Skin Cancer and Sun Knowledge (SCSK) scale was selected. After a pre-test, a validation study including 68 outdoor workers (62% female) was conducted in 2020. RESULTS The retest reliability was r = 0.93 (95% confidence interval: 0.86-0.96) for the protection score and rs = 0.78 (0.67-0.86) for the knowledge score. Protective behaviors were correlated with respective diary data (0.38 ≤ rs ≤ 0.74, p < 0.001) and skin pigmentation changes (-0.23 ≥ rs ≥ -0.42, 0.007 ≤ p ≤ 0.165) but not with self-reported sunburn frequency (0.21 ≥ rs ≥ -0.04). CONCLUSIONS Among German outdoor workers, two questionnaires for the assessment of sun protection behavior (OccuSun) and knowledge (SCSK) demonstrated good reliability. The OccuSun had generally good validity. Both instruments are fit for subsequent validation to determine their sensitivity to change.
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Affiliation(s)
- Henriette Rönsch
- Klinik für Dermatologie, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden
| | - Marc Rocholl
- Institut für Gesundheitsforschung und Bildung, Abteilung für Dermatologie, Umweltmedizin und Gesundheitstheorie, Universität Osnabrück
- Institut für interdisziplinäre Dermatologische Prävention und Rehabilitation (iDerm) an der Universität Osnabrück
| | - Michaela Ludewig
- Institut für Gesundheitsforschung und Bildung, Abteilung für Dermatologie, Umweltmedizin und Gesundheitstheorie, Universität Osnabrück
- Institut für interdisziplinäre Dermatologische Prävention und Rehabilitation (iDerm) an der Universität Osnabrück
| | - Andreas Staudt
- Institut und Poliklinik für Arbeits- und Sozialmedizin, Medizinische Fakultät, Technische Universität Dresden
- Abteilung für Methoden der Community Medicine, Institut für Community Medicine, Universitätsmedizin Greifswald
| | - Mathias Langner
- Institut für Klinische Chemie und Laboratoriumsmedizin (IKL), Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden
| | - Theresa Steeb
- Klinik für Dermatologie, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Comprehensive Cancer Center Erlangen, Europäische Metropolregion Nürnberg, Erlangen
| | - Annika Wilke
- Institut für Gesundheitsforschung und Bildung, Abteilung für Dermatologie, Umweltmedizin und Gesundheitstheorie, Universität Osnabrück
- Institut für interdisziplinäre Dermatologische Prävention und Rehabilitation (iDerm) an der Universität Osnabrück
| | - Swen Malte John
- Institut für Gesundheitsforschung und Bildung, Abteilung für Dermatologie, Umweltmedizin und Gesundheitstheorie, Universität Osnabrück
- Institut für interdisziplinäre Dermatologische Prävention und Rehabilitation (iDerm) an der Universität Osnabrück
| | - Carola Berking
- Klinik für Dermatologie, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Comprehensive Cancer Center Erlangen, Europäische Metropolregion Nürnberg, Erlangen
| | - Stefan Beissert
- Klinik für Dermatologie, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden
| | - Andrea Bauer
- Klinik für Dermatologie, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden
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Rönsch H, Rocholl M, Ludewig M, Staudt A, Langner M, Steeb T, Wilke A, John SM, Berking C, Beissert S, Bauer A. Sun protection in outdoor workers - Development and validation of standardized questionnaires for behavior and knowledge. J Dtsch Dermatol Ges 2024; 22:665-673. [PMID: 38528320 DOI: 10.1111/ddg.15378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 01/11/2024] [Indexed: 03/27/2024]
Abstract
BACKGROUND AND OBJECTIVES Outdoor workers are at increased risk of developing non-melanoma skin cancer. We aimed to address the lack of validated German-language measurement instruments for outdoor workers' sun safety behavior and knowledge by compiling and validating two questionnaires. PARTICIPANTS AND METHODS By expert consensus, items for the assessment of protective behavior (OccuSun) were compiled based on existing instruments. For knowledge, a translation of the Skin Cancer and Sun Knowledge (SCSK) scale was selected. After a pre-test, a validation study including 68 outdoor workers (62% female) was conducted in 2020. RESULTS The retest reliability was r = 0.93 (95% confidence interval: 0.86-0.96) for the protection score and rs = 0.78 (0.67-0.86) for the knowledge score. Protective behaviors were correlated with respective diary data (0.38 ≤ rs ≤ 0.74, p < 0.001) and skin pigmentation changes (-0.23 ≥ rs ≥ -0.42, 0.007 ≤ p ≤ 0.165) but not with self-reported sunburn frequency (0.21 ≥ rs ≥ -0.04). CONCLUSIONS Among German outdoor workers, two questionnaires for the assessment of sun protection behavior (OccuSun) and knowledge (SCSK) demonstrated good reliability. The OccuSun had generally good validity. Both instruments are fit for subsequent validation to determine their sensitivity to change.
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Affiliation(s)
- Henriette Rönsch
- Department of Dermatology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Marc Rocholl
- Institute for Health Research and Education, Department of Dermatology, Environmental Medicine and Health Theory, Osnabrück University, Osnabrück, Germany
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at Osnabrück University, Osnabrück, Germany
| | - Michaela Ludewig
- Institute for Health Research and Education, Department of Dermatology, Environmental Medicine and Health Theory, Osnabrück University, Osnabrück, Germany
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at Osnabrück University, Osnabrück, Germany
| | - Andreas Staudt
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
- Department of Methods in Community Medicine, Institute of Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Mathias Langner
- Institute for Clinical Chemistry und Laboratory Medicine (IKL), University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Theresa Steeb
- Department of Dermatology, University Hospital Erlangen, Friedrich-Alexander-University (FAU) Erlangen-Nuremberg, Comprehensive Cancer Center Erlangen, European Metropolitan Region of Nuremberg, Erlangen, Germany
| | - Annika Wilke
- Institute for Health Research and Education, Department of Dermatology, Environmental Medicine and Health Theory, Osnabrück University, Osnabrück, Germany
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at Osnabrück University, Osnabrück, Germany
| | - Swen Malte John
- Institute for Health Research and Education, Department of Dermatology, Environmental Medicine and Health Theory, Osnabrück University, Osnabrück, Germany
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at Osnabrück University, Osnabrück, Germany
| | - Carola Berking
- Department of Dermatology, University Hospital Erlangen, Friedrich-Alexander-University (FAU) Erlangen-Nuremberg, Comprehensive Cancer Center Erlangen, European Metropolitan Region of Nuremberg, Erlangen, Germany
| | - Stefan Beissert
- Department of Dermatology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Andrea Bauer
- Department of Dermatology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
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Newnam R, Le-Jenkins U, Rutledge C, Cunningham C. The Association of Skin Cancer Prevention Knowledge, Sun-Protective Attitudes, and Sun-Protective Behaviors in a Navy Population. Mil Med 2024; 189:1-7. [PMID: 36208319 DOI: 10.1093/milmed/usac285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 06/02/2022] [Accepted: 09/14/2022] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION U.S. Navy service members are primarily between the ages of 18 and 30 years and often required to be outside for extended periods of time in geographical locations with increased and often unfamiliar ultraviolet indexes that collectively increase their risk for skin cancer. Skin cancer is the country's most common form of cancer, yet there is a paucity of skin cancer prevention literature, especially within the U.S. Navy. The purpose of this study was to describe skin cancer risk and skin cancer prevention "cues-to-action" and to determine if skin cancer prevention knowledge was associated with sun-protective attitudes (e.g., prevention perceptions, benefits, threats, barriers, and sun-protective behavior self-efficacy) and sun-protective behaviors (e.g., wearing long sleeve shirts and using sunscreen and not deliberately exposing skin for a tan) in a Navy population. MATERIALS AND METHODS A cross-sectional, descriptive, correlational design was utilized, and the study approval was obtained by the Naval Medical Center Portsmouth Institutional Review Board. Two-hundred twenty-nine active duty Navy service members aged 18-30 years who presented to primary care for their periodic health assessment completed the Brief Skin Cancer Risk Assessment and the Skin Cancer Survey. Descriptive statistics were utilized to assess service members' perceptions and knowledge regarding skin cancer prevention along with sociodemographic characteristics. The Spearman rank-order correlation and the Mann-Whitney U test were used to assess associations. P-values <.05 were used to determine statistical significance. RESULTS Skin cancer prevention knowledge was significantly related to sun-protective behavior self-efficacy (r = 0.218, P = .001), benefits (r = 0.271, P ≤ .001), sun protection behaviors (r = 0.152, P = .024), skin cancer risk (r = 0.256, P = .001), current frequency of high-risk sun behavior (r = 0.183, P = .006), past frequency of high-risk sun behavior (r = 0.219, P = .001), sun exposure (U = 4,813.50, P = .005), tanning bed use (U = 3,154.50, P = .031), and training (U = 4,099.50, P = .005). CONCLUSIONS Integrating skin cancer education into primary care visits (i.e., periodic health assessments) may improve Navy service members' modifiable sun-protective attitudes and behaviors and may contribute to lowering future skin cancer rates.
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Affiliation(s)
- Rachel Newnam
- Old Dominion University, Graduate School of Nursing, Norfolk, VA 23529, USA
- Naval Medical Center Portsmouth, Portsmouth, VA 23708, USA
- Naval Hospital Bremerton, Bremerton, WA 98312, USA
| | - Uyen Le-Jenkins
- Old Dominion University, Graduate School of Nursing, Norfolk, VA 23529, USA
| | - Carolyn Rutledge
- Old Dominion University, Graduate School of Nursing, Norfolk, VA 23529, USA
| | - Craig Cunningham
- Old Dominion University, Graduate School of Nursing, Norfolk, VA 23529, USA
- Naval Medical Center Portsmouth, Portsmouth, VA 23708, USA
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Brokmeier LL, Diehl K, Spähn BA, Jansen C, Konkel T, Uter W, Görig T. "Well, to Be Honest, I Don't Have an Idea of What It Might Be"-A Qualitative Study on Knowledge and Awareness Regarding Nonmelanoma Skin Cancer. Curr Oncol 2023; 30:2290-2299. [PMID: 36826138 PMCID: PMC9955472 DOI: 10.3390/curroncol30020177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 02/06/2023] [Accepted: 02/14/2023] [Indexed: 02/17/2023] Open
Abstract
Nonmelanoma skin cancer (NMSC) is the most common cancer type in Western industrialized countries. However, research into the knowledge and awareness in the general population regarding NMSC is still scarce. This qualitative study aims to fill this research gap. Face-to-face, semi-structured interviews with 20 individuals aged 55-85 years were conducted between February and October 2020. Transcribed interviews were analyzed using qualitative content analysis. The term "white skin cancer"-the German colloquial term of NMSC-was well-known, but the incidence was underestimated. None of the participants could give a precise definition of NMSC, and various alterations in the skin were, partially wrongly, stated as potential signs for NMSC. As risk factors for NMSC, solar radiation, and fair skin type were mentioned most often. The perceived individual risk of developing NMSC and risk compared to individuals of the same age and gender were low in our sample. Own knowledge about NMSC was mostly perceived to be insufficient, and the majority of the sample would like to receive more information on NMSC. Our results emphasize a need to inform about the signs and risks of NMSC not only in the studied older age group but also in younger people.
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Affiliation(s)
- Luisa Leonie Brokmeier
- Department of Medical Informatics, Biometry and Epidemiology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany
| | - Katharina Diehl
- Department of Medical Informatics, Biometry and Epidemiology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany
| | | | - Charlotte Jansen
- Medical Faculty Mannheim, Heidelberg University, 68167 Mannheim, Germany
| | - Tobias Konkel
- Department of Medical Informatics, Biometry and Epidemiology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany
| | - Wolfgang Uter
- Department of Medical Informatics, Biometry and Epidemiology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany
| | - Tatiana Görig
- Department of Medical Informatics, Biometry and Epidemiology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany
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Rocholl M, Hannappel J, Ludewig M, John SM. UV-Induced Skin Cancer Knowledge, Sun Exposure, and Tanning Behavior among University Students: Investigation of an Opportunity Sample of German University Students. J Skin Cancer 2021; 2021:5558694. [PMID: 35003809 PMCID: PMC8731302 DOI: 10.1155/2021/5558694] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 12/04/2021] [Accepted: 12/15/2021] [Indexed: 12/03/2022] Open
Abstract
Ultraviolet radiation (UVR) is the most important risk factor for developing skin cancer. University students can be considered as a particularly high-risk group for long- and short-term adverse effects of UVR due to intensive solar UVR exposure and high rates of sunburn. While validated questionnaires for assessing solar UVR exposure and sun protection behavior are available in German, a questionnaire for assessing the level of knowledge about this topic is still missing. We conducted a literature search for cross-sectional studies assessing skin cancer and sun protection knowledge among university students in Medline (via PubMed) and analyzed existing questionnaires and topics contained therein. We chose to translate the "Skin Cancer and Sun Knowledge Scale" referring to the TRAPD method into the German language and pilot-tested the translation with an opportunity sample of German students. The literature search revealed 36 eligible studies. Four major topics were identified within the studies: knowledge on skin cancer, risk factors, UVR, and sun protection measures. One hundred and seven German university students (86.0% female) with a mean age of 26.25 years (SD ± 4.58; range: 19-46) participated in our pilot study. The internal reliability of the scale was KR-20 = 0.624. We discovered an improvable level of knowledge in terms of skin cancer among the study population. Statistical analyses revealed no significant associations between the level of knowledge and UVR exposure or tanning behavior, respectively. The skin cancer and sun protection knowledge of German university students should be examined thoroughly. While the psychometric properties of the SCSK require further thorough investigation, first empirical experiences indicate the suitability of the tool to assess the level of knowledge regarding skin cancer and sun protection.
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Affiliation(s)
- Marc Rocholl
- Institute for Health Research and Education, Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Am Finkenhügel 7a, Osnabrück 49076, Germany
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm), University of Osnabrück, Am Finkenhügel 7a, Osnabrück 49076, Germany
| | - Julia Hannappel
- Institute for Health Research and Education, Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Am Finkenhügel 7a, Osnabrück 49076, Germany
| | - Michaela Ludewig
- Institute for Health Research and Education, Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Am Finkenhügel 7a, Osnabrück 49076, Germany
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm), University of Osnabrück, Am Finkenhügel 7a, Osnabrück 49076, Germany
| | - Swen Malte John
- Institute for Health Research and Education, Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Am Finkenhügel 7a, Osnabrück 49076, Germany
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm), University of Osnabrück, Am Finkenhügel 7a, Osnabrück 49076, Germany
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Heckman CJ, Riley M, Coups EJ, Niu Z, Stapleton JL. Society of Behavioral Medicine Position Statement: promote sun-safety policies and practices for youth in educational, childcare, and recreational settings. Transl Behav Med 2021; 10:498-501. [PMID: 31504986 DOI: 10.1093/tbm/ibz120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Youth should be allowed and encouraged to engage in sun-safe behaviors in educational, childcare, and recreational settings, including use of sunscreen, wide-brimmed hats, other sun-protective clothing, and shade.
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Affiliation(s)
- Carolyn J Heckman
- Population Science, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Mary Riley
- Population Science, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Elliot J Coups
- Population Science, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Zhaomeng Niu
- Population Science, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Jerod L Stapleton
- Population Science, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
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Al-Atif HM. A Cross-Sectional Survey of Knowledge of Skin Cancer in Saudi Arabia. Dermatol Pract Concept 2021; 11:e2021076. [PMID: 34123567 DOI: 10.5826/dpc.1103a76] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/07/2020] [Indexed: 10/31/2022] Open
Abstract
Background Skin cancer has become one of the world's leading health problems, and incidence rates are on the rise. The leading causes of skin cancer are sun exposure, family history and sunburn, and the most agreed-upon preventative behaviors are sunscreen application and sun avoidance. Objectives This study assessed the knowledge of the causes of skin cancer and awareness of preventative measures in Saudi Arabia. Methods A cross-sectional study was conducted among 529 participants in a WhatsApp group over 3 months. Consenting participants completed a validated, 18-item questionnaire. Results Of 529 total participants, nearly 55% of participants reported an awareness of skin cancer, 35% understood its metastasis and 55.1% knew about its spread. However, 44% of participants were unaware of the different types of the disease. Social media was reported to be the most common source of information. The majority of participants were able to identify symptoms of skin cancer and had knowledge of risk factors. Most participants understood proper preventative measures, and reported that they use sunscreen regularly. Conclusions The general knowledge of skin cancer in Saudi Arabia is not high but is increasing. However, sun-protective behaviors are lacking, despite the population's knowledge of the benefits. Awareness campaigns and incentive programs may encourage better preventative behavior. Future studies should explore participants' awareness of more specific aspects of skin cancer using a more diverse and extensive population sample.
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Affiliation(s)
- Hend M Al-Atif
- Department of Internal Medicine, College of Medicine, King Khalid University, Abha, Saudi Arabia
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School-based interventions to improve sun-safe knowledge, attitudes and behaviors in childhood and adolescence: A systematic review. Prev Med 2021; 146:106459. [PMID: 33609617 DOI: 10.1016/j.ypmed.2021.106459] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Revised: 02/06/2021] [Accepted: 02/08/2021] [Indexed: 11/23/2022]
Abstract
Ultraviolet radiation exposure is the leading cause of skin cancer, and childhood and adolescence is a particularly susceptible life period for exposure. This systematic review assessed whether interventions in elementary and secondary school settings reduced sun exposure, sunburns, and development of melanocytic nevi, and improved sun-safe knowledge, attitudes and sun protection behaviors in childhood and adolescence. A systematic search up to June 2020 of MEDLINE, Embase, CINAHL, Cochrane and ProQuest databases was undertaken, for studies conducted among students in an elementary or secondary school setting that compared an intervention group with a pre-intervention or separate control group. Data were summarized using qualitative synthesis. Pooled effects from meta-analysis with random effects were also reported where appropriate. Sixty-five studies were included (22 randomized, 43 non-randomized). Most studies assessed measures of sun-safe behaviors, knowledge and attitudes (57, 48 and 33 studies, respectively), and observed improved sun protection behaviors and sun-safe knowledge, whereas few studies reduced time in the sun. About half improved participants' attitudes towards tanning desirability. Sunburns and nevus counts were less frequently assessed, but about half of these studies observed a reduction. There was substantial heterogeneity for outcomes except attitudes towards the desirability of tanning (pooled odds ratio from 6 studies: 0.81, 95% confidence interval 0.70-0.94). Key positive intervention features included: elementary school settings, interactive features or multiple components, and incorporating social norm influences. Most studies were classified at high risk of bias. In conclusion, school-based sun-related interventions had positive impacts on behaviors and attitudes among elementary and secondary school children.
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Truong A, Forbes B, Zhang M, McFadden M, Klein S. A Sun Safety Pilot Program Using a Tanning Myths–Focused Video Contest for Utah Adolescents: Cross-sectional Analysis. JMIR DERMATOLOGY 2021. [DOI: 10.2196/20192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background
Adolescents are susceptible to excessive ultraviolet exposure due to intentional tanning, outdoor lifestyles, and poor sunscreen adherence. As skin cancer incidence continues to rise in the United States, effective and focused interventions are needed to encourage photoprotective behaviors.
Objective
This study seeks to determine poor photoprotective behavior risk factors in adolescents residing in Utah and whether video contest participants have increased sun-protective knowledge and intentions.
Methods
In this cross-sectional study, we surveyed Utah high school students (n=20) who participated in a tanning myths-themed public service announcement video contest. A control cohort of students who did not participate in the video contest were also surveyed (n=89). Demographics, sun exposure history, intentions to tan, and intentions to use sunscreen were documented. Knowledge of tanning myths was assessed with a 7-question sun safety quiz.
Results
The survey response rate was 93.2% (109/117). Two-thirds reported at least one sunburn, and 47.7% (52/109) reported intentional tanning within the past 2 years. Higher tanning intentions were associated with a personal (P<.001), family (P=.001), and peer (P<.001) history of tanning. Video contest participants had higher sun safety quiz scores (P<.001) and higher sunscreen use intentions (P=.01), but did not have decreased tanning intentions (P=.47) compared to non–video contest participants. Hispanic and Black students were less likely to participate in the video contest (P<.001 and P=.04, respectively). In a comparison of White students to students of color, there were no differences in sun exposure history, but students of color had lower sun safety knowledge (P=.01) and lower sunscreen use intention (P=.02).
Conclusions
Sun safety educational disparities exist, and targeted efforts are needed to encourage photoprotective behaviors in high-risk populations. Our findings suggest that video contest participation may encourage sunscreen use and sun protection awareness.
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Gutiérrez-Manzanedo JV, De Castro-Maqueda G, Caraballo Vidal I, González-Montesinos JL, Vaz Pardal C, Rivas Ruiz F, De Troya-Martín M. Sun-related behaviors, attitudes and knowledge among paralympic sailors. Disabil Health J 2021; 14:101095. [PMID: 33840618 DOI: 10.1016/j.dhjo.2021.101095] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 03/07/2021] [Accepted: 03/12/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND Overexposure to sunlight is the main cause of skin cancer. Outdoor sports increased sun exposure times. Sun protection behaviors and attitudes are utmost importance to reduce sun exposure. AIMS To evaluate sun exposure habits, sun protection practices, and sun-related attitudes and knowledge among paralympic sailors. METHODS This descriptive observational study analysed the answers of a validated self-reported questionnaire of habits, attitudes and knowledge related to sun exposure and skin cancer completed by 56 elite sailors with disabilities from 19 countries which taking part in 2019 Para World Sailing Championships. RESULTS Three in four (76.8%) participants reported a history of sunburn in the previous season. Overall, participants showed an average for sport practice per week of 8.0 h (SD: 4.9). Participants reported a low adherence to sun protection practice, with the exception of using sunglasses (85.7%), sunscreen (83.9%) and hat (75%), having a very low rate (28.6%) of avoidance of midday sun and an inadequate sunscreen reapplication (33.9% reported "do not reapply" and 16.1% "reapply every one or 2 h"). Although 82.1% of participants reported to be worried about can get skin cancer out of the sun, they also presented excessive sun tanning attitudes (42.9% likes sunbathing and 57.1% sunbathing makes them feel well). The average score for sun-related knowledge was low (62.1 out 100 points; SD: 13.6). CONCLUSIONS Awareness campaigns on sun risk are needed specifically directed at this target group, in order to improve their sun protection habits and reduce the rates of sunburn associated with sports practice.
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Affiliation(s)
- J V Gutiérrez-Manzanedo
- Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Cádiz, Spain.
| | - G De Castro-Maqueda
- Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Cádiz, Spain.
| | - I Caraballo Vidal
- GALENO Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Cádiz, Spain; Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, Cádiz, Spain.
| | - J L González-Montesinos
- Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Cádiz, Spain.
| | - C Vaz Pardal
- Andalusian Centre for Sports Medicine, Cádiz, Spain.
| | - F Rivas Ruiz
- Research Unit, REDISSEC, Costa del Sol Sanitary Agency, Marbella, Spain.
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11
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Sun Exposure and Long-Distance Runners on the Spanish Costa del Sol: Habits, Attitudes, and Knowledge. ACTAS DERMO-SIFILIOGRAFICAS 2021. [PMID: 34088482 DOI: 10.1016/j.adengl.2021.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Exposure to UV radiation during the practice of sports in the open air is especially high in sustained recreational activities such as long-distance running. UV exposure increases skin photoaging and the incidence of skin cancer. This study aimed to describe habits and attitudes related to sun exposure among long-distance runners in our area of southern Spain as well as to evaluate the runners' knowledge of exposure. A cross-sectional descriptive study was designed to survey a convenience sample of participants in half marathons in Fuengirola and Marbella in September 2016. We found a high level of sun exposure among participants in this outdoor activity. The prevalence of sunburn was also high, experienced by half of the runners surveyed.
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Bhandari D, Shibanuma A, Kiriya J, Hirachan S, Ong KIC, Jimba M. Factors associated with breast cancer screening intention in Kathmandu Valley, Nepal. PLoS One 2021; 16:e0245856. [PMID: 33481894 PMCID: PMC7822561 DOI: 10.1371/journal.pone.0245856] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 01/10/2021] [Indexed: 12/24/2022] Open
Abstract
Background Breast cancer burden is increasing in low-income countries (LICs). Increasing incidence and delayed presentation of breast cancer are mainly responsible for this burden. Many women do not participate in breast cancer screening despite its effectiveness. Moreover, studies are limited on the barriers associated with low utilization of breast cancer screening in LICs. This study identified breast cancer screening behavior and factors associated with breast cancer screening intention among women in Kathmandu Valley, Nepal. Methods A cross-sectional study was conducted among 500 women living in five municipalities of Kathmandu Valley, Nepal. Data were collected from July to September 2018, using a structured questionnaire. Interviews were conducted among women selected through proportionate random household sampling. This study was conceptualized using the theory of planned behavior, fatalism, perceived susceptibility, and perceived severity. The outcome variables included: the intention to have mammography (MMG) biennially, the intention to have clinical breast examination (CBE) annually, and the intention to perform breast self-examination (BSE) monthly. Analysis was conducted separately for each outcome variable using partial proportional odds model. Results Out of 500 women, 3.4% had undergone MMG biennially, 7.2% CBE annually, and 14.4% BSE monthly. Women with a positive attitude, high subjective norms, and high perceived behavioral control were more likely to have the intention to undergo all three screening methods. Similarly, women were more likely to have intention to undergo CBE and MMG when they perceived themselves susceptible to breast cancer. Conversely, women were less likely to have intention to undergo CBE when they had high fatalistic beliefs towards breast cancer. Conclusion Women in this study had poor screening behavior. The practice of breast self-examination was comparatively higher than clinical breast examination and mammography. Multidimensional culturally sensitive interventions are needed to enhance screening intentions. Efforts should be directed to improve attitude, family support, and fatalistic belief towards cancer. Furthermore, the proper availability of screening methods should be ensured while encouraging women to screen before the appearance of symptoms.
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Affiliation(s)
- Divya Bhandari
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Bunkyo, Japan
| | - Akira Shibanuma
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Bunkyo, Japan
| | - Junko Kiriya
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Bunkyo, Japan
| | | | - Ken Ing Cherng Ong
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Bunkyo, Japan
- * E-mail:
| | - Masamine Jimba
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Bunkyo, Japan
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De Castro-Maqueda G, Lagares Franco C, Gutiérrez-Manzanedo JV, Gobba F, Blázquez Sánchez N, De Troya-Martin M. What Sun Protection Practices Should Be Adopted by Trainee Teachers to Reduce the Risk of Skin Cancer and Other Adverse Outcomes? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:E529. [PMID: 33435239 PMCID: PMC7826784 DOI: 10.3390/ijerph18020529] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 01/03/2021] [Accepted: 01/04/2021] [Indexed: 01/13/2023]
Abstract
Excessive sun exposure and insufficient protection are the main risk factors for the onset of melanoma and non-melanoma skin cancer (the most common types of cancer suffered by fair-skinned populations) and other adverse effects on the skin and eyes. Epidemiological data highlight the scant awareness of this risk among young people and the high rates of sunburn often recorded among this population. The main aim of the present study is to examine sun exposure and protection behavior by university students. A cross-sectional questionnaire-based study was undertaken to investigate sun exposure and protection practices among students of education sciences at a university in southern Spain. The data obtained were used to perform a descriptive, comparative analysis, by groups and by gender, of photoprotection and skin self-examination practices. The reliability and validity of the questionnaire were both tested. Of the 315 students who completed the questionnaire, 74.6% had suffered at least one sunburn during the previous year. Few made frequent use of sunscreen or protective clothing and 89.5% did not self-examine their skin. The metric properties of the questionnaire revealed its excellent reliability and validity. Among the Spanish university students considered, there was little awareness of the risk of excessive sun exposure, self-protection was insufficient, the potential exposure to dangerous levels of ultraviolet radiation was high, and most had suffered one or more sunburns in the last year. Intervention strategies should be implemented to highlight the risks involved and the need for more appropriate sun protection practices. Information campaigns should be conducted in this respect so that, when these students become teachers, they will have adequate knowledge of the risks involved and of the benefits of addressing this problem effectively, and will ultimately transfer these health education competences to their own students.
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Affiliation(s)
- Guillermo De Castro-Maqueda
- Department of Physical Education, Faculty of Education Sciences and University of Cádiz, 11519 Cádiz, Spain;
| | | | - José V. Gutiérrez-Manzanedo
- Department of Physical Education, Faculty of Education Sciences and University of Cádiz, 11519 Cádiz, Spain;
| | - Fabriziomaria Gobba
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41121 Modena, Italy;
| | - Nuria Blázquez Sánchez
- Dermatology Department, Costa del Sol Hospital, 29603 Marbella, Spain; (N.B.S.); (M.D.T.-M.)
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Hábitos, actitudes y conocimientos sobre la exposición solar de corredores de fondo en la Costa del Sol. ACTAS DERMO-SIFILIOGRAFICAS 2021. [DOI: 10.1016/j.ad.2019.11.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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15
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Blázquez-Sánchez N, Rivas-Ruiz F, Bueno-Fernández S, Arias-Santiago S, Fernández-Morano M, de Troya-Martín M. Validación de un cuestionario para el estudio sobre hábitos, actitudes y conocimientos en fotoprotección en la población adultojuvenil: «cuestionario CHACES». ACTAS DERMO-SIFILIOGRAFICAS 2020; 111:579-589. [DOI: 10.1016/j.ad.2020.02.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 01/20/2020] [Accepted: 02/10/2020] [Indexed: 11/27/2022] Open
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Blázquez-Sánchez N, Rivas-Ruiz F, Bueno-Fernández S, Arias-Santiago S, Fernández-Morano M, deTroya-Martín M. Validation of a Questionnaire Designed to Study Knowledge, Attitudes, and Habits Related to Sun Exposure Among Young Adults: The CHACES Questionnaire. ACTAS DERMO-SIFILIOGRAFICAS 2020. [DOI: 10.1016/j.adengl.2020.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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17
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Byrne N, Markham T. Knowledge, attitudes and behaviours in relation to skin cancer prevention. Ir J Med Sci 2020; 189:197-202. [PMID: 31104289 DOI: 10.1007/s11845-019-02033-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 05/02/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND The incidence of malignant melanoma is increasing faster than any other cancer, and it is now the second most common cancer in young adults. Most skin cancer prevention campaigns are based on the hypothesis that improved skin cancer knowledge leads to a change in sun-related behaviour. AIM The aim of this study was to analyse the relationship of good skin cancer knowledge in a high knowledge group-medical students-with sun-related behaviours and tanning attitudes in Ireland. METHODS A cross-sectional survey was conducted on university students studying medicine in a single institution. RESULTS The final analyses included 312 complete questionnaires. Two hundred three (65.27%) were female, and 108 (34.73%) were male. The majority (65.06%) were aged 21-25 years. The mean skin cancer knowledge score was 89.77%. There was a positive attitude to tanning with 201 (64.63%) participants feeling more attractive with a suntan and 174 (55.94%) feeling better about themselves with a suntan. More than half of participants, 196 (54.17%), got a suntan last year, 171 (54.81%) participants sunbathed, 188 (60.26%) got sunburned and 30 (9.61%) reported using sunbeds previously. Those with a positive attitude to tanning were more likely to sunbath, suntan and get sunburned. High skin cancer knowledge scores were positively associated with high-risk sun behaviours (Spearman's rank correlation coefficient = 0.156, P = 0.006). CONCLUSION Urgent action is needed to promote skin cancer prevention. This study adds to the evidence that melanoma prevention strategies should preferentially target tanning attitudes rather than skin cancer knowledge.
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Affiliation(s)
- Niamh Byrne
- Department of Dermatology, University Hospital Galway, Galway, Ireland.
| | - Trevor Markham
- Department of Dermatology, University Hospital Galway, Galway, Ireland
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Tribby CP, Perna FM, Berrigan D. Walking and Sun Protective Behaviors: Cross-Sectional Associations of Beneficial Health Factors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E2361. [PMID: 31277315 PMCID: PMC6651436 DOI: 10.3390/ijerph16132361] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 06/27/2019] [Accepted: 06/29/2019] [Indexed: 01/04/2023]
Abstract
Sun protective behaviors and physical activity have the potential to reduce cancer risk. Walking is the most common type of physical activity in the United States, but it is unclear whether sun protective behaviors differ by categories of walking, such as leisure versus transportation walking. We examined whether sun protective behaviors varied by category or duration of walking in the 2015 National Health Interview Survey (N = 26,632), age ≥ 18 years. We used logistic regression to estimate sunscreen use, sun avoidance, and sun protective clothing use by four categories of walking (no reported walking, transportation only, leisure only, or walking for both) and separately for walking duration for the general population and sun-sensitive individuals. Prevalence of sunscreen use varied across walking categories and the odds of use were higher with longer walking duration for transportation and leisure compared to those who reported no walking. Sun avoidance varied across walking categories and the odds of avoidance were lower with longer duration leisure but not transportation walking. Sun protective clothing varied across walking categories and the odds of use were higher for longer duration transportation, but not leisure walking. Data on the concurrence of walking and sun protection is needed to further understand the relationship between these health behaviors. By examining leisure and transportation walking, we found variations in sun protective behaviors that may provide important insight into strategies to increase sun protection while promoting physical activity.
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Affiliation(s)
- Calvin P Tribby
- Cancer Prevention Fellowship Program, Division of Cancer Prevention, National Cancer Institute, Bethesda, MD 20892, USA.
- Health Behaviors Research Branch, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD 20892, USA.
| | - Frank M Perna
- Health Behaviors Research Branch, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD 20892, USA
| | - David Berrigan
- Health Behaviors Research Branch, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD 20892, USA
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Rendle KA, Sarma EA, Quaife SL, Blake KD, Moser RP, Suls JM, Edwards HM, Kobrin SC. Cancer Symptom Recognition and Anticipated Delays in Seeking Care Among U.S. Adults. Am J Prev Med 2019; 57:e1-e9. [PMID: 31128956 DOI: 10.1016/j.amepre.2019.02.021] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 02/14/2019] [Accepted: 02/15/2019] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Early stage diagnosis strongly predicts cancer survival. Recognition of potential symptoms of cancer may improve survival by reducing time to seeking care. METHODS Telephone interviews with a population-representative sample of English-speaking adults (aged ≥50 years) in the U.S. (N=1,425) were conducted in 2014 using an instrument adapted from the International Cancer Benchmarking Partnership Awareness and Beliefs about Cancer survey. Anticipated time to seeking care for four cancer symptoms (persistent cough, rectal bleeding, mole changes, and breast changes) was assessed, and delay was defined as waiting >2 weeks. Recognition of symptoms as potential cancer signs was assessed dichotomously. Multivariate logistic regression models were used to assess associations between symptom recognition and anticipated delay, adjusting for demographics, cancer experience, self-reported health, and healthcare access. Analyses were weighted and conducted in 2017. RESULTS Symptom recognition varied but was relatively high across all symptoms (76.9%-95.5%). Anticipated delay varied by symptom and was highest for persistent cough (41.2%) and lowest for rectal bleeding (9.1%). For rectal bleeding (AOR=2.65, 95% CI=1.31, 5.36) and mole changes (AOR=3.30, 95% CI=1.48, 7.33), anticipated delay was more likely among individuals who did not recognize the symptom as a warning sign. Adults with lower education levels (p<0.05) and African Americans (p<0.05) were less likely to delay for some symptoms. CONCLUSIONS Lack of symptom recognition was associated with anticipated delay in seeking care for some cancer symptoms. Differences in recognition and delays by symptom could be driven partly by screening messaging or by ambiguity and functional impact of each symptom.
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Affiliation(s)
- Katharine A Rendle
- Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
| | - Elizabeth A Sarma
- Cancer Prevention Fellowship Program, Division of Cancer Prevention, National Cancer Institute, Bethesda, Maryland
| | - Samantha L Quaife
- Department of Behavioral Science and Health, University College London, London, England
| | - Kelly D Blake
- Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland
| | - Richard P Moser
- Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland
| | - Jerry M Suls
- Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland
| | - Heather M Edwards
- Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland
| | - Sarah C Kobrin
- Healthcare Delivery Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland
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Toro-Huamanchumo CJ, Burgos-Muñoz SJ, Vargas-Tineo LM, Perez-Fernandez J, Vargas-Tineo OW, Burgos-Muñoz RM, Zentner-Guevara JA, Bada C. Awareness, behavior and attitudes concerning sun exposure among beachgoers in the northern coast of Peru. PeerJ 2019; 7:e6189. [PMID: 30671297 PMCID: PMC6338095 DOI: 10.7717/peerj.6189] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 11/30/2018] [Indexed: 11/21/2022] Open
Abstract
Background Skin cancer incidence has increased over the last years, becoming a major public health problem. Objective To describe the awareness, behavior and attitudes concerning sun exposure among beachgoers in the northern coast of Peru. Methods We conducted a cross-sectional study in the Pimentel beach, Peru. The “Beach Questionnaire” was used and we surveyed all the beachgoers from 8 a.m. to 4 p.m. and from March 5 to March 19. For the statistical analysis, sun exposure habits, sunburns history, knowledge, attitudes and practices were crossed with sex using the chi2 test. Results We surveyed 410 beachgoers, the most frequent phototype was type III (40.5%). Only the 13.66% of the respondents correctly answered the seven knowledge questions related to sun exposure and skin cancer. Men more frequently agreed that “when they are tanned their clothes looks nicer” (p = 0.048). Likewise, regarding the questions “Sunbathing is relaxing” and “Sunbathing improves my mood”, men agreed or totally agreed with more frequency than women (63.64% vs. 46.15%, p < 0.001; and 61.36% vs 49.15%, p = 0.014, respectively). Regarding sun protection practices, women more frequently used sunshade (p = 0.001) and sunscreen (SPF ≥ 15) (p < 0.001) when compared to the male group. Conclusion Sun exposure is a potentially preventable risk factor for skin cancer. Thus, awareness of the risks of UVR overexposure and adequate sun-protective behaviors and attitudes are essential. Our results, however, are not as favorable as expected. Public health efforts should encourage sun-safety precautions and intervention campaigns should be carried out in recreational settings, such as the beaches.
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Affiliation(s)
- Carlos J Toro-Huamanchumo
- Universidad de San Martín de Porres, Facultad de Medicina, Centro de Investigación en Epidemiología Clínica y Medicina Basada en Evidencias, Lima, Peru
| | | | | | | | | | | | | | - Carlos Bada
- School of Medicine, Universidad de San Martín de Porres, Lima, Peru.,Clínica San Judas Tadeo, Lima, Peru
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Nioi A, Wendelboe-Nelson C, Cowan S, Cowie H, Rashid S, Ritchie P, Cherrie M, Lansdown TC, Cherrie JW. A randomised control crossover trial of a theory based intervention to improve sun-safe and healthy behaviours in construction workers: study protocol. BMC Public Health 2018; 18:259. [PMID: 29448922 PMCID: PMC5815245 DOI: 10.1186/s12889-018-5164-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Accepted: 02/07/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Exposure to sunlight can have both positive and negative health impacts. Excessive exposure to ultra-violet (UV) radiation from the sun can cause skin cancer, however insufficient exposure to sunlight has a detrimental effect on production of Vitamin D. In the construction industry there are onsite proactive behaviours for safety, but sun-safety remains a low priority. There is limited research on understanding the barriers to adopting sun-safe behaviours and the association this may have with Vitamin D production. This paper reports a protocol for an intervention study, using text messaging in combination with a supportive smartphone App. The intervention aims to both reduce UV exposure during months with higher UV levels and promote appropriate dietary changes to boost Vitamin D levels during months with low UV levels. METHOD/DESIGN Approximately 60 construction workers will be recruited across the United Kingdom. A randomised control crossover trial (RCCT) will be used to test the intervention, with randomisation at site level - i.e. participants will receive both the control (no text messages or supportive App support) and intervention (daily text messages and supportive App). Using the Theory of Planned Behaviour (TPB) the intervention focuses on supporting sun-safety and healthy dietary decisions in relation to Vitamin D intake. The intervention emphasises cultivating the perception of normative support in the workplace, increasing awareness of control and self-efficacy in taking sun-protective behaviours, making healthier eating choices to boost Vitamin D, and tackling stigmas attached to image and group norms. Each study epoch will last 21 days with intervention text messages delivered on workdays only. The supportive App will provide supplementary information about sun protective behaviours and healthy dietary choices. The primary outcome measure is 25-hydroxy-Vitamin D [25(OH)D] level (obtained using blood spot sampling), which will be taken pre and post control and intervention periods. Secondary outcome measures are two-fold, (1) using the TPB to detect changes in behaviour, and (2) quantifying UV exposure during the UK peak radiation season (April-September) using body-mounted UV sensors. DISCUSSION This study will provide important information about the effectiveness of a technology-based intervention to promote sun-safety and healthy behaviours in outdoor construction workers. TRIAL REGISTRATION ISRCTN15888934 retrospectively registered 15.01.2018.
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Affiliation(s)
- Amanda Nioi
- Heriot-Watt University, School of Engineering and Physical Sciences, Institute of Biological Chemistry, Biophysics and Bioengineering, Edinburgh, EH14 4AS, UK.
| | - Charlotte Wendelboe-Nelson
- Heriot-Watt University, School of Engineering and Physical Sciences, Institute of Biological Chemistry, Biophysics and Bioengineering, Edinburgh, EH14 4AS, UK
| | - Sue Cowan
- Heriot Watt University, School of Social Sciences, Department of Psychology, Edinburgh, EH14 4AS, UK
| | - Hilary Cowie
- Institute of Occupational Medicine, Research Avenue North, Edinburgh, EH14 4AP, UK
| | - Shahzad Rashid
- Institute of Occupational Medicine, Research Avenue North, Edinburgh, EH14 4AP, UK
| | - Peter Ritchie
- Institute of Occupational Medicine, Research Avenue North, Edinburgh, EH14 4AP, UK
| | - Mark Cherrie
- University of Edinburgh, Centre for Research on Environment, Society and Health, School of Geosciences, Edinburgh, EH8 9XP, UK
| | - Terry C Lansdown
- Heriot Watt University, School of Social Sciences, Department of Psychology, Edinburgh, EH14 4AS, UK
| | - John W Cherrie
- Heriot-Watt University, School of Engineering and Physical Sciences, Institute of Biological Chemistry, Biophysics and Bioengineering, Edinburgh, EH14 4AS, UK.,Institute of Occupational Medicine, Research Avenue North, Edinburgh, EH14 4AP, UK
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Ribeiro N, Moreira L, Almeida AMP, Santos-Silva F. Pilot study of a smartphone-based intervention to promote cancer prevention behaviours. Int J Med Inform 2017; 108:125-133. [DOI: 10.1016/j.ijmedinf.2017.10.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Revised: 10/15/2017] [Accepted: 10/16/2017] [Indexed: 11/29/2022]
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de Troya-Martín M, de Gálvez-Aranda MV, Rivas-Ruiz F, Blázquez-Sánchez N, Fernández-Morano MT, Padilla-España L, Herrera-Ceballos E. Prevalence and predictors of sunburn among beachgoers. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2017; 34:122-129. [DOI: 10.1111/phpp.12354] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/26/2017] [Indexed: 11/28/2022]
Affiliation(s)
| | | | - Francisco Rivas-Ruiz
- Unidad de Investigación; Hospital Costa del Sol; Marbella Spain
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC)
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Fernández-Morano T, Rivas-Ruiz F, de Troya-Martín M, Blázquez-Sánchez N, Ruiz MP, Buendía-Eisman A. Adolescents' Attitudes to Sun Exposure and Sun Protection. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2017; 32:596-603. [PMID: 26781696 DOI: 10.1007/s13187-015-0976-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Adolescents are considered a risk group for the development of skin cancer in later life due to their high rates of sunburn. The aim of this study is to evaluate the association between attitudes to sun exposure and the sociodemographic characteristics of adolescents, their habits, practices and knowledge. As a secondary goal, we describe the magnitude and sign of the correlations between these attitudes. Cross-sectional study of adolescent students from 12 secondary schools in southern Spain, the subjects were asked to complete the 'Beach Questionnaire'. This instrument examines four dimensions of attitudes, with standardised scores of 0-100, related to the sun, sun tanning, sun protection and sun cream. The higher the score, the more positive the attitude. The study population was composed of 270 adolescents. The highest scores were obtained for attitudes towards sun protection practices (mean 66.2; SD 18.6) and towards sun tanning (mean 64.2; SD 21.1). The lowest scores were obtained for attitudes towards using sun cream (mean 50.1; SD 24.6). Significant differences were found for all four attitudes, with a positive sign for the relationship between the number of days of sun exposure and a higher score for attitudes towards sunbathing (27.3 points difference between response extremes) and for attitudes towards suntanning (20 points difference). Favourable attitudes towards sunbathing and sun tanning have most influence on inadequate habits of sun exposure and deficient measures of sun protection. Adolescents should be considered a priority group for targeted interventions to improve sun protection behaviour.
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Affiliation(s)
- Teresa Fernández-Morano
- Dermatology Department, Costa del Sol Hospital, Marbella, Spain.
- Clinical Medicine and Public Health at the University of Granada, Granada, Spain.
| | - Francisco Rivas-Ruiz
- Research Department, Costa del Sol Hospital, Marbella, Spain
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas- REDISSEC, Madrid, Spain
| | - Magdalena de Troya-Martín
- Dermatology Department, Costa del Sol Hospital, Marbella, Spain
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas- REDISSEC, Madrid, Spain
| | | | - Maria Padilla Ruiz
- Research Department, Costa del Sol Hospital, Marbella, Spain
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas- REDISSEC, Madrid, Spain
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Kirk L, Greenfield S. Knowledge and attitudes of UK university students in relation to ultraviolet radiation (UVR) exposure and their sun-related behaviours: a qualitative study. BMJ Open 2017; 7:e014388. [PMID: 28289050 PMCID: PMC5353347 DOI: 10.1136/bmjopen-2016-014388] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Revised: 01/23/2017] [Accepted: 02/13/2017] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To explore whether knowledge about the harms of ultraviolet radiation (UVR) influences UK university students' sun-related behaviours and examine in depth their attitudes towards: sun protection, natural and artificial tanning behaviours. DESIGN Qualitative methodology with 15 semistructured, individual interviews. Thematic analysis using the Framework Method with analyst triangulation and member validation. SETTING One university in the West Midlands, UK. PARTICIPANTS 15 Caucasian male (n=4) and female (n=11) students, aged 18-22 years, from a UK university. Participants were recruited using convenience sampling from the university's main campus followed by purposive sampling for: gender, course and sun-related behaviours. RESULTS Five main themes emerged: (1) knowledge of UVR; (2) sun-protection practices; (3) attitudes towards tanning; (4) external influences and (5) internal influences. All students knew the associated skin cancer risks from the sun and sunbed use, but this did not appear an important influence in their sun-related behaviours. Body image strongly motivated sun-protection practices and the desire to tan naturally or artificially, across both genders. However, participants' final decision-making appeared to be influenced by their beliefs that practising known harmful sun-related behaviours would not affect them or the perceived susceptibility to sunburn. Beliefs about sunbathing and sunscreen use prompted improper use of sun protection and inadvertently caused more harmful practices. Participants' peers, family and the media had dual roles influencing the development of attitudes towards sun protection and tanning, which contributed to how participants behaved in the sun and their engagement in tanning methods. CONCLUSIONS Knowledge about the risk of skin cancer associated with UVR did not strongly influence sun-related behaviours, whereas body image appeared as a key motivator. Attitudes towards sun protection and tanning stemmed from the media, peers and family, and particularly from childhood habits. Public health strategies may benefit from appearance-related skin cancer prevention campaigns, encouraging safer parental sun-related habits and correcting sun-related misconceptions.
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Affiliation(s)
- Lucy Kirk
- College of Medical and Dental Sciences, Birmingham, UK
| | - Sheila Greenfield
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
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Werk RS, Hill JC, Graber JA. Impact of Knowledge, Self-Efficacy, and Perceived Importance on Steps Taken Toward Cancer Prevention Among College Men and Women. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2017; 32:148-154. [PMID: 26847464 DOI: 10.1007/s13187-016-0996-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The incidence of skin, most HPV-related, liver, and lung cancers can be reduced through primary prevention. Morbidity from breast and testicular cancers can be reduced through secondary prevention. Thus, it is important to understand the mechanisms that predict engagement in primary and secondary prevention behaviors for these cancers. We investigated the roles of knowledge of cancer prevention, perceived importance of cancer prevention, and self-efficacy to engage in prevention steps in order to predict college students' actual engagement in cancer prevention behaviors (CPB). Participants were 315 undergraduates who completed an online survey to assess these constructs. Hierarchical linear regression analyses were used to model knowledge, self-efficacy, and perceived importance as predictors of CPB for a range of cancers. Self-efficacy predicted CPB similarly across all cancers such that having a higher level of self-efficacy to prevent the cancer predicted having engaged in more CPB. Increase in knowledge predicted an increase in the frequency of CPB for skin and HPV-related cancers. Perceived importance of prevention predicted skin cancer CPB. These findings can be used to tailor cancer prevention programs for undergraduates to achieve greatest impact.
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Affiliation(s)
- Rachel S Werk
- Department of Psychology, University of Florida, P.O. Box 115911, Gainesville, FL, 32611, USA.
| | - Julie C Hill
- Department of Psychology, University of Florida, P.O. Box 115911, Gainesville, FL, 32611, USA
| | - Julia A Graber
- Department of Psychology, University of Florida, P.O. Box 115911, Gainesville, FL, 32611, USA
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Leske S, Strodl E, Hou XY. Predictors of dieting and non-dieting approaches among adults living in Australia. BMC Public Health 2017; 17:214. [PMID: 28219423 PMCID: PMC5319048 DOI: 10.1186/s12889-017-4131-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2016] [Accepted: 02/13/2017] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND There is a dearth of research comparing why dieting and non-dieting approaches are adopted. A greater understanding of reasons underlying dieting and non-dieting attempts will help to identify target beliefs for interventions to support and motivate adults to attempt whatever approach they are willing and/or able to pursue. We investigated the predictors of dieting and non-dieting approaches in Australian adults using predictors that were identified in a previous qualitative study. METHODS We conducted a prospective study, with two waves of data collection occurring 4 weeks apart. At baseline, participants completed a questionnaire assessing constructs drawn from the theory of planned behaviour (attitude, subjective norm, and self-efficacy), past behaviour, non-planning, attributions for dieting failure, weight control beliefs, and dieting and non-dieting intentions. We used path modelling to analyse responses. RESULTS At baseline, 719 adults (52.2% male) aged between 18 and 76 completed the questionnaire. Four weeks later, 64% of participants (n = 461) reported on their dieting and non-dieting behaviour in the past month. Past behaviour, attitude, subjective norm, and self-identity significantly predicted dieting intentions. Dieting intentions and past behaviour significantly predicted dieting behaviour, while non-planning and self-efficacy did not. The model explained 74.8% of the variance in intention and 52.9% of the variance in behaviour. While most findings were similar for the non-dieting model, subjective norms and self-identity did not predict intention, while self-efficacy and self-identity both predicted non-dieting behaviour directly. The non-dieting model explained 58.2% of the variance in intention and 37.5% of the variance in behaviour. CONCLUSIONS The findings from this study provide support for the application of TPB and identity theory constructs in the context of both dieting and non-dieting behaviour. Self-efficacy and self-identity appear more relevant to non-dieting behaviour than dieting behaviour, while subjective norms was more influential in predicting dieting. Practitioners wishing to encourage either approach in their clients should attempt to modify the constructs that influence each approach.
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Affiliation(s)
- Stuart Leske
- School of Psychology and Counselling, Queensland University of Technology, Victoria Park Road. Kelvin Grove, Brisbane, QLD, 4059, Australia
| | - Esben Strodl
- School of Psychology and Counselling, Queensland University of Technology, Victoria Park Road. Kelvin Grove, Brisbane, QLD, 4059, Australia.
| | - Xiang-Yu Hou
- School of Public Health and Social Work, Queensland University of Technology, Victoria Park Road. Kelvin Grove, Brisbane, QLD, 4059, Australia
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["Snowwhite" to "dark brown": The motives of frequent indoor tanners and how they handle health risks]. ZEITSCHRIFT FUR PSYCHOSOMATISCHE MEDIZIN UND PSYCHOTHERAPIE 2016; 62:239-51. [PMID: 27594601 DOI: 10.13109/zptm.2016.62.3.239] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Predictors of sun protection behaviours and sunburn among Australian adolescents. BMC Public Health 2016; 16:565. [PMID: 27411518 PMCID: PMC4944266 DOI: 10.1186/s12889-016-3197-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Accepted: 06/07/2016] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Excessive sun exposure and sunburn increase individuals' risk of skin cancer. It is especially important to prevent sunburn in childhood due to the higher relative risk of skin cancer across the life span compared to risk associated with sunburn episodes experienced later in life. This study examined demographic and attitudinal factors associated with engagement in a range of sun protection behaviours (wearing a hat, wearing protective clothing, staying in the shade, and staying indoors during the middle of the day) and the frequency of sunburn among Western Australian adolescents to provide insights of relevance for future sun protection campaigns. METHODS Cross-sectional telephone surveys were conducted annually with Western Australians between 2005/06 and 2014/15. The results from 4150 adolescents aged 14-17 years were used to conduct a path analysis of factors predicting various sun protection behaviours and sunburn. RESULTS Significant primary predictors of the sun protection behaviours included in the study were skin type (sun sensitivity), gender, tanning-related attitudes and behaviours, and perceived relevance of public service advertisements that advocate sun protection. Of the four sun protection behaviours investigated, staying in the shade and staying indoors during the middle of the day were associated with a lower frequency of sunburn. CONCLUSION There is a particular need to target sun protection messages at adolescent males who are less likely to engage in the most effective sun protection behaviours and demonstrate an increased propensity to experience sunburn. The results suggest that such future sun protection messages should include a focus on the importance of staying in the shade or indoors during periods of high UV radiation to increase awareness of the efficacy of these methods of avoiding skin cancer.
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Robinson NG, White KM, Hamilton K, Starfelt LC. Predicting the sun-protective decisions of young female Australian beachgoers. J Health Psychol 2016; 21:1718-27. [DOI: 10.1177/1359105314564811] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
We tested the theory of planned behaviour with additional norms to predict the sun-protective decisions of young female beachgoers in Australia. Participants ( N = 336) completed standard theory of planned behaviour measures and additional normative factors (group, image and personal norms). Attitude, subjective norm, and both personal and group norms predicted intention. Intention and group norm predicted follow-up behaviour. These findings provide further evidence that it is the more proximal sources of norms reflecting one’s personal and referent group influences, rather than perceptions of broader societal norms about the attractiveness of tanned images, that are important in determining young women’s sun-protective decisions.
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Affiliation(s)
| | | | - Kyra Hamilton
- Queensland University of Technology, Australia
- Griffith University, Australia
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Social Differentiation of Sun-Protection Behaviors: The Mediating Role of Cognitive Factors. Am J Prev Med 2016; 50:e81-e90. [PMID: 26526161 DOI: 10.1016/j.amepre.2015.07.040] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Revised: 07/27/2015] [Accepted: 08/07/2015] [Indexed: 01/25/2023]
Abstract
INTRODUCTION Adherence to sun-protection guidelines in developed countries is low, especially among people of low SES. Mechanisms underlying this social differentiation are poorly understood. This study aimed to examine the social differentiation of sun-protection behaviors and of two cognitive factors (knowledge about both sun health and behavioral risk factors for cancer) and to determine if these cognitive factors mediate the association between SES and sun-protection behaviors. METHODS Data came from the 2010 Baromètre Cancer survey (analyzed in 2014), a random cross-sectional telephone survey conducted among the French general population (n=3,359 individuals aged 15-75 years). First, bivariate associations between a composite individual SES indicator (based on education level, occupation, and income) and both sun-protection behaviors and cognitive factors were tested with chi-square tests and ANOVA. Then, confirmatory factor analysis and structural equation modeling were used to test the mediating role of cognitive factors with a multiple mediation model including four latent variables. RESULTS In bivariate analyses, the individual SES indicator was positively associated with sun-protection behaviors and both cognitive factors. Multiple mediation analyses showed that both cognitive factors partially mediated the effect of individual SES on sun-protection behaviors. The overall proportion of mediated effects was 48%. The direct effect of SES remained significant. CONCLUSIONS These results suggest that interventions aimed at modifying the knowledge and perceptions of people of low SES might help to reduce social differentiation of sun-protection behaviors. Further qualitative research is needed to better understand these cognitive factors and develop suitable prevention messages.
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Rodgers R, Wilking C, Gottlieb M, Daynard R, Lovering M, Matsumoto A, Luk S, Naab P, Iannuccilli A, Shoemaker H, Convertino A, Franko D. A qualitative study of the decision to engage in tanning behaviors among female college students. EUROPEAN REVIEW OF APPLIED PSYCHOLOGY 2016. [DOI: 10.1016/j.erap.2015.11.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Schalka S, Steiner D, Ravelli FN, Steiner T, Terena AC, Marçon CR, Ayres EL, Addor FAS, Miot HA, Ponzio H, Duarte I, Neffá J, Cunha JAJD, Boza JC, Samorano LDP, Corrêa MDP, Maia M, Nasser N, Leite OMRR, Lopes OS, Oliveira PD, Meyer RLB, Cestari T, Reis VMSD, Rego VRPDA. Brazilian consensus on photoprotection. An Bras Dermatol 2015; 89:1-74. [PMID: 25761256 PMCID: PMC4365470 DOI: 10.1590/abd1806-4841.20143971] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Accepted: 10/28/2014] [Indexed: 12/14/2022] Open
Abstract
Brazil is a country of continental dimensions with a large heterogeneity of climates
and massive mixing of the population. Almost the entire national territory is located
between the Equator and the Tropic of Capricorn, and the Earth axial tilt to the
south certainly makes Brazil one of the countries of the world with greater extent of
land in proximity to the sun. The Brazilian coastline, where most of its population
lives, is more than 8,500 km long. Due to geographic characteristics and cultural
trends, Brazilians are among the peoples with the highest annual exposure to the sun.
Epidemiological data show a continuing increase in the incidence of non-melanoma and
melanoma skin cancers. Photoprotection can be understood as a set of measures aimed
at reducing sun exposure and at preventing the development of acute and chronic
actinic damage. Due to the peculiarities of Brazilian territory and culture, it would
not be advisable to replicate the concepts of photoprotection from other developed
countries, places with completely different climates and populations. Thus the
Brazilian Society of Dermatology has developed the Brazilian Consensus on
Photoprotection, the first official document on photoprotection developed in Brazil
for Brazilians, with recommendations on matters involving photoprotection.
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Affiliation(s)
- Sérgio Schalka
- Photobiology Department, Sociedade Brasileira de Dermatologia, São Paulo, SP, Brazil
| | | | | | | | | | | | - Eloisa Leis Ayres
- Center of Dermatology Prof. Rene Garrido Neves, City Health Foundation, Rio de Janeiro, RJ, Brazil
| | | | | | - Humberto Ponzio
- Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Ida Duarte
- Charity Hospital, Santa Casa de Misericórdia, São Paulo, SP, Brazil
| | - Jane Neffá
- Fluminense Federal University, Niterói, RJ, Brazil
| | | | | | | | | | - Marcus Maia
- Charity Hospital, Santa Casa de Misericórdia, São Paulo, SP, Brazil
| | - Nilton Nasser
- Federal University of Santa Catarina, Blumenau, SC, Brazil
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Abstract
OBJECTIVES To date, tanning prevention programs have led to limited success. The aim of the present study was to investigate potential unexpected prevention effects of completing an online survey focused on tanning attitudes, behaviors, and knowledge among female college tanners. METHODS A sample of 92 female undergraduate students from the USA, mean age = 20.09, SD = 1.41 years, who engaged in indoor tanning completed an online survey assessing awareness of tanning-related health risks, appearance-based motivations to tan and not to tan, media literacy related to tanning marketing, and tanning behaviors in 2013. Four months later, participants were invited to complete a follow-up survey assessing tanning intentions and behaviors since completing the initial survey. RESULTS Fifty-one participants (55%) completed the follow-up questions, of whom 43 (84.3%) reported having decreased or ceased engaging in indoor tanning. In addition participants provided comments indicating that completing the survey had lead to decreases in their tanning behaviors. CONCLUSIONS Our study presents novel and compelling support for using brief online surveys for decreasing health-risk behaviors such as sunbed use. Such measures are extremely cost-effective and easy to disseminate and implement. Replication and extension of these findings are warranted.
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Hutchinson AD, Prichard I, Ettridge K, Wilson C. Skin Tone Dissatisfaction, Sun Exposure, and Sun Protection in Australian Adolescents. Int J Behav Med 2014; 22:435-42. [PMID: 25205420 DOI: 10.1007/s12529-014-9441-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
PURPOSE This study aimed to assess the adoption of sun protection and sun exposure behaviors, the extent to which these behaviors group together, and the relationship between skin tone dissatisfaction and sun-related behaviors in South Australian adolescents (aged 12-17). METHODS A total of 2,875 secondary school students (1,461 male and 1,414 female) completed a questionnaire including questions about sun protection and sun exposure behaviors and skin tone dissatisfaction. RESULTS Regular adoption of sun protection behaviors was low and ranged from 20% (wearing protective clothing) to 44% (sunscreen use). A principal components analysis identified four subgroups of sun-related behaviors: sun protection, appearance enhancement, sun avoidance, and sun exposure. Females had significantly higher skin tone dissatisfaction than males. Skin tone dissatisfaction was associated with decreased sun protection and avoidance and increased appearance enhancement and sun exposure in both males and females. CONCLUSIONS Skin tone dissatisfaction plays an important role in Australian adolescents' sun-related behavior. Appearance-based interventions may be effective in reducing skin cancer risk through reduced sun exposure.
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Affiliation(s)
- Amanda D Hutchinson
- School of Psychology, Social Work & Social Policy, University of South Australia, Adelaide, SA, 5001, Australia,
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Day AK, Wilson C, Roberts RM, Hutchinson AD. The Skin Cancer and Sun Knowledge (SCSK) Scale. HEALTH EDUCATION & BEHAVIOR 2014; 41:440-8. [DOI: 10.1177/1090198114529129] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Increasing public knowledge remains one of the key aims of skin cancer awareness campaigns, yet diagnosis rates continue to rise. It is essential we measure skin cancer knowledge adequately so as to determine the nature of its relationship to sun-related behaviors. This study investigated the psychometric properties of a new measure of skin cancer knowledge, the Skin Cancer and Sun Knowledge (SCSK) scale. A total of 514 Western young adults (females n = 320, males n = 194) aged 18 to 26 years completed measures of skin type, skin cancer knowledge, tanning behavior, sun exposure, and sun protection. Two-week test–retest of the SCSK was conducted with 52 participants. Internal reliability of the SCSK scale was acceptable (KR-20 = .69), test–retest reliability was high ( r = .83, n = 52), and acceptable levels of face, content, and incremental validity were demonstrated. Skin cancer knowledge (as measured by SCSK) correlated with sun protection, sun exposure, and tanning behaviors in the female sample, but not in the males. Skin cancer knowledge appears to be more relevant to the behavior of young women than that of young males. We recommend that future research establish the validity of the SCSK across a range of participant groups.
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Affiliation(s)
- Ashley K. Day
- School of Psychology, University of Adelaide, South Australia, Australia
| | - Carlene Wilson
- Cancer Council South Australia, Australia
- Flinders Centre for Innovation in Cancer, School of Medicine, Flinders University, South Australia, Australia
| | - Rachel M. Roberts
- School of Psychology, University of Adelaide, South Australia, Australia
| | - Amanda D. Hutchinson
- School of Psychology, Social Work & Social Policy, University of South Australia, Australia
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Day AK, Oxlad M, Roberts RM. Predictors of sun-related behaviors among young women: comparisons between outdoor tanners, fake tanners, and tan avoiders. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2013; 61:315-322. [PMID: 23930746 DOI: 10.1080/07448481.2013.806926] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
OBJECTIVE Skin cancer incidence continues to rise as a tanned appearance remains desirable, particularly among young women. Fake tanning provides a tanned appearance without exposure to ultraviolet radiation. In order to advance our understanding of the factors that contribute to long-term behavior change, this study explores determinants associated with different types of tanning. PARTICIPANTS The sample included 162 female students from the University of Adelaide, Australia, aged 18-26 years. Data were collected in July 2010. METHODS The current study measured differences in skin type, skin cancer knowledge, unrealistic optimism, appearance motivation, and sun-protective and sun exposure behaviors amongst outdoor tanners, fake tanners, and tan avoiders through an online survey. RESULTS Differences were observed for skin type, skin cancer knowledge, unrealistic optimism, sun protection, and sun exposure. CONCLUSIONS A "one-size-fits-all" approach to skin cancer prevention may not be appropriate; type of tanning behavior may need to be considered in health promotion work.
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Affiliation(s)
- Ashley K Day
- School of Psychology , University of Adelaide, Adelaide, SA 5005, Australia.
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