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To protect or not to protect: examining reasons for sun protection among young women at risk for skin cancer

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Abstract

We aimed to further the understanding of the low rates of sun protection in young women at risk for skin cancer. Six-hundred-sixty-one daily diary entries were received via text message over 14 days from 56 young women at moderate to high risk of developing skin cancer. Women reported whether or not they used sun protection and also listed what their reasons were for using protection or not using sun protection each day. Multi-level modeling was used to examine the influence of study variables when predicting daily sun protection or lack of protection. The number of days in which sun protection was reported was positively associated with “habit” and “prevention” as reasons for protection and negatively associated with “not-needed” and “unprepared” as reasons for non-protection. Self-reported sun protection increased over the 14-day study period. Results of this study suggest the potential value of interventions aimed at motives for sun-protection behaviors.

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References

  • Aiken, L. S., West, S. G., Woodward, C. K., & Reno, R. R. (1994). Health beliefs and compliance with mammography-screening recommendations in asymptomatic women. Health Psychology, 13, 122–129.

    Article  PubMed  CAS  Google Scholar 

  • Aunger, R. (2007). Tooth brushing as routine behaviour. International Dental Journal, 57, 364–376.

    Article  Google Scholar 

  • Aunger, R., Schmidt, W. P., Ranpura, A., Coombes, Y., Maina, P. M., Matiko, C. N., et al. (2010). Three kinds of psychological determinants for hand-washing behaviour in Kenya. Social Science and Medicine, 70, 383–391.

    Article  PubMed  Google Scholar 

  • Bolger, N., Davis, A., & Rafaeli, E. (2003). Diary methods: Capturing life as it is lived. Annual Review of Psychology, 54, 579–616.

    Article  PubMed  Google Scholar 

  • Buller, D. B., Berwick, M., Lantz, K., Buller, M. K., Shane, J., Kane, I., et al. (2015). Smartphone mobile application delivering personalized, real-time sun protection advice: A randomized clinical trial. JAMA Dermatology, 151, 497–504.

    Article  PubMed  PubMed Central  Google Scholar 

  • Buller, D. B., Reynolds, K. D., Yaroch, A., Cutter, G. R., Hines, J. M., Geno, C. R., et al. (2006). Effects of the Sunny Days, Healthy Ways curriculum on students in grades 6 to 8. American Journal of Preventive Medicine, 30, 13–22.

    Article  PubMed  PubMed Central  Google Scholar 

  • Cafri, G., Thompson, J. K., & Jacobsen, P. B. (2006). Appearance reasons for tanning mediate the relationship between media influence and UV exposure and sun protection. Archives of Dermatology, 142, 1065–1086.

    Article  Google Scholar 

  • Cameron, L. D., & Diefenbach, M. A. (2001). Responses to information about psychosocial consequences of genetic testing for breast cancer susceptibility: Influences of cancer worry and risk perceptions. Journal of Health Psychology, 6, 47–59.

    Article  PubMed  CAS  Google Scholar 

  • Carpenter, C. J. (2010). A meta-analysis of the effectiveness of health belief model variables in predicting behavior. Health Communication, 25, 661–669.

    Article  PubMed  Google Scholar 

  • Cokkinides, V., Weinstock, M., Lazovich, D., Ward, E., & Thun, M. (2009). Indoor tanning use among adolescents in the US, 1998 to 2004. Cancer, 115, 190–198.

    Article  PubMed  Google Scholar 

  • Coogan, P. F., Geller, A., Adams, M., Benjes, L. S., & Koh, H. K. (2001). Sun protection practices in preadolescents and adolescents: A school-based survey of almost 25,000 Connecticut school children. Journal of the American Academy of Dermatology, 44, 512–519.

    Article  PubMed  CAS  Google Scholar 

  • Coups, E. J., Manne, S. L., & Heckman, C. J. (2008). Multiple skin cancer risk behaviors in the U.S. population. American Journal of Preventive Medicine, 34, 87–93.

    Article  PubMed  Google Scholar 

  • Daniel, L. C., Heckman, C. J., Kloss, J. D., & Manne, S. L. (2009). Comparing alternative methods of measuring skin color and damage. Cancer Causes and Control, 20, 313–321.

    Article  PubMed  Google Scholar 

  • Darlow, S., & Heckman, C. (2017). Results from a tailored SMS and behavior-tracking pilot study on sun-safe behaviors in young women. Health Education & Behavior. https://doi.org/10.1177/1090198117699507

    Article  Google Scholar 

  • Davati, A., Pirasteh, A., Yahyaei, M., & Shakouri, A. (2013). Skin protective behavior amongst girl students; based on health belief model. Acta Medica Irania, 51, 626–632.

    Google Scholar 

  • Enders, C. K. (2011). Missing not at random models for latent growth curve analyses. Psychological Methods, 16, 1–16.

    Article  PubMed  Google Scholar 

  • Gandini, S., Sera, F., Cattaruzza, M. S., Pasquini, P., Picconi, O., Boyle, P., et al. (2005). Meta-analysis of risk factors for cutaneous melanoma: II. Sun exposure. European Journal of Cancer, 41, 45–60.

    Article  PubMed  Google Scholar 

  • Gautreau, C. M., Sherry, S. B., Sherry, D. L., Birnie, K. A., Mackinnon, S. P., & Stewart, S. H. (2015). Does catastrophizing of bodily sensations maintain health-related anxiety? A 14-day daily diary study with longitudinal follow-up. Behavioural and Cognitive Psychotherapy, 43, 502–512.

    Article  PubMed  Google Scholar 

  • Geller, A. C., Emmons, K. M., Brooks, D. R., Powers, C., Zhang, Z., Koh, H. K., et al. (2006). A randomized trial to improve early detection and prevention practices among siblings of melanoma patients. Cancer, 107, 806–814.

    Article  PubMed  Google Scholar 

  • Glanz, K., Schoenfeld, E. R., & Steffen, A. (2010). A randomized trial of tailored skin cancer prevention messages for adults: Project SCAPE. American Journal of Public Health, 100, 735–741.

    Article  PubMed  PubMed Central  Google Scholar 

  • Glanz, K., Schoenfeld, E., Weinstock, M. A., Layi, G., Kidd, J., & Shigaki, D. M. (2003). Development and reliability of a brief skin cancer risk assessment tool. Cancer Detection and Prevention, 27, 311–315.

    Article  PubMed  Google Scholar 

  • Heckman, C. J., Handorf, E., Darlow, S. D., Yaroch, A. L., & Raivitch, S. (2017). Refinement of measures to assess psychosocial constructs associated with skin cancer risk and protective behaviors of young adults. Journal of Behavioral Medicine. [Epub ahead of print].

  • Horsley, L., Charlton, A., & Waterman, C. (2002). Current action for skin cancer risk reduction in English schools: Pupils’ behaviour in relation to sunburn. Health Education Research, 17, 715–731.

    Article  PubMed  Google Scholar 

  • Ingledew, D. K., Ferguson, E., & Markland, D. (2010). Motives and sun-related behaviour. Journal of Health Psychology, 15, 8–20.

    Article  PubMed  Google Scholar 

  • Jones, S. E., Saraiya, M., Miyamoto, J., & Berkowitz, Z. (2012). Trends in sunscreen use among U.S. high school students: 1999–2009. Journal of Adolescent Health, 50, 304–307.

    Article  PubMed  Google Scholar 

  • Landis, J. R., & Koch, G. G. (1977). The measurement of observer agreement for categorical data. Biometrics, 33, 159–174.

    Article  PubMed  CAS  Google Scholar 

  • Langer, E. J., & Moldoveanu, M. (2000). The construct of mindfulness. Journal of Social Issues, 56, 1–9.

    Article  Google Scholar 

  • Lee, C., Duffy, S. A., Louzon, S. A., Waltje, A. H., Ronis, D. L., Redman, R. W., et al. (2014). The impact of Sun Solutions educational interventions on select health belief model constructs. Workplace Health & Safety, 62, 70–79.

    Article  Google Scholar 

  • McWhirter, J. E., & Hoffman-Goetz, L. (2016). Application of the health belief model to U.S. magazine text and image coverage of skin cancer and recreational tanning (2000–2012). Journal of Health Communication, 21, 424–438.

    Article  PubMed  Google Scholar 

  • Paul, C., Tzelepis, F., Parfitt, N., & Girgis, A. (2008). How to improve adolescents’ sun protection behavior? Age and gender issues. American Journal of Health Behavior, 32, 387–398.

    Article  PubMed  Google Scholar 

  • Robinson, N. G., White, K. M., Young, R. M., Anderson, P. J., Hyde, M. K., Greenbank, S., et al. (2008). Young people and sun safety: The role of attitudes, norms and control factors. Health Promotion Journal of Australia, 19, 45–51.

    Article  PubMed  Google Scholar 

  • Rosenstock, I. M. (1974). Historical origins of the health belief model. Health Education & Behavior, 2, 328–335.

    Google Scholar 

  • Skiveren, J., Mortensen, E. L., & Haedersdal, M. (2010). Sun protective behaviour in renal transplant recipients. A qualitative study based on individual interviews and the Health Belief Model. Journal of Dermatological Treatment, 21, 331–336.

    Article  PubMed  Google Scholar 

  • Stanton, W. R., Moffatt, J., & Clavarino, A. (2005). Community perceptions of adequate levels and reasons for skin protection. Behavioral Medicine, 31, 5–15.

    Article  PubMed  Google Scholar 

  • Wu, X., Groves, F. D., McLaughlin, C. C., Jemal, A., Martin, J., & Chen, V. W. (2005). Cancer incidence patterns among adolescents and young adults in the United States. Cancer Causes and Control, 16, 309–320.

    Article  PubMed  Google Scholar 

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Acknowledgements

The Authors thank the following for their assistance with this project: the staff of MessageBroadcast.com, LLC, for creating and managing the text messaging system; the staff of the Office of Health Communications and Health Disparities at Fox Chase Cancer Center for their assistance with participant recruitment; Alexa Steuer and Leon Villavicencio for their work on data coding; Elizabeth Handorf for consultation on data analysis; and, Teja Munshi for her assistance with project management.

Funding

This study was supported in part by Grants from T32CA009035 (MA and SD), and P30CA006927 (Cancer Center Support Grant). The study was also supported by the Aetna Foundation, a national foundation based in Hartford, Connecticut that supports projects to promote wellness, health and access to high-quality health care for everyone. The views presented here are those of the authors and not necessarily those of the Aetna Foundation, its directors, officers, or staff.

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Correspondence to C. J. Heckman.

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Conflict of interest

M.V. Auerbach, C.J. Heckman, and S. Darlow declare that they have no conflict of interest.

Human and animal rights and Informed consent

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

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Auerbach, M.V., Heckman, C.J. & Darlow, S. To protect or not to protect: examining reasons for sun protection among young women at risk for skin cancer. J Behav Med 41, 528–536 (2018). https://doi.org/10.1007/s10865-018-9920-0

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  • DOI: https://doi.org/10.1007/s10865-018-9920-0

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