A Web-Based Intervention to Reduce Indoor Tanning Motivations in Adolescents: a Randomized Controlled Trial
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Youthful indoor tanning as few as ten sessions can increase the risk of melanoma by two to four times with each additional session adding another 2 % to the risk. Recent research estimates that indoor tanning can be linked to approximately 450,000 cases of skin cancer annually in the USA, Europe, and Australia. Despite these risks, indoor tanning remains popular with adolescents. This study tested the efficacy of a web-based skin cancer prevention intervention designed to reduce indoor tanning motivations in adolescent females. A nationally representative sample of 443 female teens was enrolled from an online panel into a two-arm, parallel group design, randomized controlled trial. Treatment participants received an appearance-focused intervention grounded in established health behavior change models. Controls viewed a teen alcohol prevention website. Outcome variables included willingness and intentions to indoor tan, willingness to sunless tan, and measures of indoor tanning attitudes and beliefs. The intervention decreased willingness and intentions to indoor tan and increased sunless tanning willingness relative to controls. We also examined indirect mechanisms of change through intervening variables (e.g., indoor tanning attitudes, norms, positive and negative expectancies) using the product of coefficient approach. The web-based intervention demonstrated efficacy in changing adolescent indoor tanning motivations and improving their orientation toward healthier alternatives. Results from the intervening variable analyses give guidance to future adolescent skin cancer prevention interventions.
KeywordsMelanoma prevention Web-based intervention Adolescents Indoor tanning National sample
Compliance with Ethical Standards
Research reported in this manuscript was supported by the National Cancer Institute of the National Institutes of Health under award number R01CA134891. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
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.
Conflict of Interest
The authors declare that they have no conflict of interest.
- Aarestrup, C., Bonnesen, C. T., Thygesen, L. C., Krarup, A. F., Waagstein, A. B., Jensen, P. D., & Bentzen, J. (2014). The effect of a school-based intervention on sunbed use in Danish pupils at continuation schools: a cluster-randomized controlled trial. Journal of Adolescent Health, 54, 214–220. doi: 10.1016/j.jadohealth.2013.08.011.CrossRefPubMedGoogle Scholar
- Cust, A. E., Armstrong, B. K., Goumas, C., Jenkins, M. A., Schmid, H., Hopper, J. L., & Mann, G. J. (2011). Sunbed use during adolescence and early adulthood is associated with increased risk of early-onset melanoma. International Journal of Cancer, 128, 2425–2435.CrossRefPubMedPubMedCentralGoogle Scholar
- Fishbein, M., & Ajzen, I. (1975). Belief, attitude, intention, and behavior: an introduction to theory and research. Reading, MA: Addison-Wesley.Google Scholar
- GfK. (2015). GfK KnowledgePanel Design Summary. Retrieved from www.knowledgenetworks.com/ganp/docs/KnowledgePanel(R)-Design-Summary.pdf. Accessed 17 Aug 2016.
- Gibbons, F. X., Gerrard, M., & Lane, D. J. (2009). A social reaction model of adolescent health risk. In Social Psychological Foundations of Health and Illness (pp. 107–136). Malden: Blackwell Publishing Ltd.Google Scholar
- Jaccard, J. (2012). The reasoned action model: directions for future research. Annals of the American Academy of Political and Social Science, 64, 50–80.Google Scholar
- Jaccard, J., & Wood, G. (1986). An idiothetic analysis of consumer decision making. In D. Brinberg & R. Lutz (Eds.), Perspectives on methodology in consumer research. New York: Springer-Verlag.Google Scholar
- Lazovich, D., Choi, K., Rolnick, C., Jackson, J. M., Forster, J., & Southwell, B. (2013). An intervention to decrease adolescent indoor tanning: a multi-method pilot study. Journal of Adolescent Health, 52(5 Suppl), S76–82. doi: 10.1016/j.jadohealth.2012.08.009.CrossRefPubMedPubMedCentralGoogle Scholar
- Muthén, L. K., & Muthén, B. O. (2010). Mplus User’s Guide (6th ed.). Los Angeles, CA: Muthén & Muthén.Google Scholar
- National Cancer Institute. (2015). SEER Cancer Statistics Review, 1975–2012, National Cancer Institute based on November 2014 SEER data submission. Retrieved from http://seer.cancer.gov/csr/1975_2012/. Accessed 17 Aug 2016.
- Partnership for Drug-Free Kids. (2015). Above the influence. Retrieved from http://abovetheinfluence.com/. Accessed 17 Aug 2016.
- Quinn, M., Alamian, A., Hillhouse, J., Scott, C., Turrisi, R., & Baker, K. (2015). Prevalence and correlates of indoor tanning and sunless tanning product use among female teens in the United States. Preventive Medicine Reports, 2, 40–43. doi: 10.1016/j.pmedr.2014.12.004.CrossRefPubMedGoogle Scholar
- Stapleton, J., Turrisi, R., Hillhouse, J., Robinson, J. K., & Abar, B. (2010). A comparison of the efficacy of an appearance-focused skin cancer intervention within indoor tanner subgroups identified by latent profile analysis. Journal of Behavioral Medicine, 33, 181–190. doi: 10.1007/s10865-009-9246-z.CrossRefPubMedGoogle Scholar
- Turrisi, R., Hillhouse, J., Gebert, C. (1998) Examination of cognitive variables relevant to sunbathing. Journal of Behavioral Medicine, 21, 299–313.Google Scholar
- US Department of Health and Human Services. (2014). The Surgeon General’s Call to Action to Prevent Skin Cancer. Retrieved from Washington, DC: http://www.surgeongeneral.gov/library/calls/prevent-skin-cancer/