Skip to main content

Advertisement

SpringerLink
Log in

Use of the multi-theory model (MTM) in explaining initiation and sustenance of indoor tanning cessation among college students

  • Original Paper
  • Published:
Archives of Dermatological Research Aims and scope Submit manuscript

Abstract

Skin cancer, including melanoma, is the most common cancer worldwide and a significant public health concern. A significant risk factor for melanoma is through increased exposure to ultraviolet (UV) radiation through the use of indoor tanning beds. Although rates of indoor tanning bed use have decreased in recent years, young adults, particularly White, college-age women, comprise the majority of indoor tanning bed users in the United States. The purpose of this cross-sectional study was to explore and explain the initiation and sustenance of indoor tanning cessation among college students using the multi-theory model (MTM) of health behavior change. Data were collected from 254 college students who reported current indoor tanning use using a validated 46-item survey to assess demographics and the MTM constructs. Data were analyzed using multiple linear regression to determine the ability of the MTM constructs to predict the initiation and sustenance of indoor tanning cessation. For initiation of indoor tanning cessation, participatory dialogue: advantages (B = 0.038, p = 0.001), behavioral confidence (B = 0.129, p < 0.001) and changes in the physical environment (B = 0.088, p < 0.001) were significantly associated with indoor tanning cessation following covariate adjustment. For sustenance, only emotional transformation (B = 0.140, p < 0.001) demonstrated a significant relationship with indoor tanning cessation, following adjustment. Findings from this study demonstrate the utility of the MTM in explaining indoor tanning cessation and designing intervention strategies and clinical recommendations to encourage indoor tanning cessation among college students.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Guy GP, Thomas CC, Thompson T, Watson M, Massetti GM, Richardson LC (2015) Vital signs: Melanoma incidence and mortality trends and projections — United States, 1982–2030. Morb Mortal Wkly Rep 64(21):591–596

    Google Scholar 

  2. Machlin SR, Ekwueme DU, Yabroff R (2015) Prevalence and costs of skin cancer treatment in the U.S., 2002–2006 and 2007–2011 gery. Am J Prev Med 48(2):183–187. https://doi.org/10.1016/j.amepre.2014.08.036.Prevalence

    Article  PubMed  Google Scholar 

  3. Stern RS (2010) Prevalence of a history of skin cancer in 2007: Results of an incidence-based model. Arch Dermatol 146(3):279–282. https://doi.org/10.1001/archdermatol.2010.4

    Article  PubMed  Google Scholar 

  4. Bressler NM (2004) From the archives journals. J Am Med Assoc 291(15):1900–1901. https://doi.org/10.1001/jama.291.15.1900

    Article  CAS  Google Scholar 

  5. Rogers HW, Weinstock MA, Feldman SR, Coldiron BM (2015) Incidence estimate of nonmelanoma skin cancer (keratinocyte carcinomas) in the us population, 2012. JAMA Dermatol 151(10):1081–1086. https://doi.org/10.1001/jamadermatol.2015.1187

    Article  PubMed  Google Scholar 

  6. Institute NNC (2020) Cancer Facts & Figures. CA Cancer J Clin 2020:1–76

    Google Scholar 

  7. Siegel RL, Miller KD, Jemal A (2019) Cancer statistics, 2019. CA Cancer J Clin 69(1):7–34. https://doi.org/10.3322/caac.21551

    Article  PubMed  Google Scholar 

  8. Zhang M, Qureshi AA, Geller AC, Frazier L, Hunter DJ, Han J (2012) Use of tanning beds and incidence of skin cancer. J Clin Oncol 30(14):1588–1593. https://doi.org/10.1200/JCO.2011.39.3652

    Article  PubMed  PubMed Central  Google Scholar 

  9. Ting W, Schultz K, Cac NN, Peterson M, Walling HW (2007) Tanning bed exposure increases the risk of malignant melanoma. Int J Dermatol 46(12):1253–1257. https://doi.org/10.1111/j.1365-4632.2007.03408.x

    Article  PubMed  Google Scholar 

  10. Watson M, Seidenberg AB et al (2017) HHS Public Access 76(6):1191–1193. https://doi.org/10.1016/j.jaad.2017.01.022.Trends

    Article  Google Scholar 

  11. Services H (2000) Report on Carcinogens Background Document for Ultraviolet (UV) Radiation

  12. Wehner MR, Chren MM, Nameth D et al (2014) International prevalence of indoor tanning a systematic review and meta-analysis. JAMA Dermatol 150(4):390–400. https://doi.org/10.1001/jamadermatol.2013.6896

    Article  PubMed  PubMed Central  Google Scholar 

  13. Banerjee SC, Hay JL, Geller AC, Gagne JJ, Frazier AL (2014) Quitting the “Cancer Tube”: a qualitative examination of the process of indoor tanning cessation. Transl Behav Med 4(2):209–219. https://doi.org/10.1007/s13142-014-0257-0

    Article  PubMed  PubMed Central  Google Scholar 

  14. Sharma M (2015) Multi-theory model (MTM) for health behavior change. Webmed Central Behav 6(9):WMC004982.

  15. Nahar VK, Wilkerson AH, Patel FC, Kim RW, Stephens PM, Sharma M (2019) Utilizing multi-theory model in determining intentions to smoking cessation among smokers. Tob Use Insights. https://doi.org/10.1177/1179173x19843524

    Article  PubMed  PubMed Central  Google Scholar 

  16. Glanz K, Jordan A, Lazovich D, Bleakley A (2019) Frequent indoor tanners’ beliefs about indoor tanning and cessation. Am J Health Promot 33(2):293–299

    Article  PubMed  Google Scholar 

  17. Brace N, Snelgar R, Kemp R (2016) SPSS for psychologists: And everybody else. Macmillan International Higher Education

  18. Sharma M, Petosa RL (2014) Measurement and evaluation for health educators. Jones & Bartlett Publishers

  19. Faul F, Erdfelder E, Lang AG, Buchner A (2007) G* Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods 39(2):175–191

    Article  PubMed  Google Scholar 

  20. Guy GP Jr, Watson M, Seidenberg AB, Hartman AM, Holman DM, Perna F (2017) Trends in indoor tanning and its association with sunburn among US adults. J Am Acad Dermatol 76(6):1191

    Article  PubMed  PubMed Central  Google Scholar 

  21. Nahar VK, Wilkerson AH, Patel FC, Kim RW, Stephens PM, Sharma M (2019) Utilizing multi-theory model in determining intentions to smoking cessation among smokers. Tobacco Use Insights 12: 1179173X19843524

  22. Sharma M, Khubchandani J, Nahar VK (2017) Applying a new theory to smoking cessation: case of multi-theory model (MTM) for health behavior change. Health Promot Perspect 7(2):102

    Article  PubMed  PubMed Central  Google Scholar 

  23. Bandura A (2004) Health promotion by social cognitive means. Health Educ Behav 31(2):143–164

    Article  PubMed  Google Scholar 

  24. Ajzen I (1991) The theory of planned behavior. Organ Behav Hum Decis Process 50(2):179–211

    Article  Google Scholar 

  25. Nahar VK, Sharma M, Catalano HP, Ickes MJ, Johnson P, Ford MA (2016) Testing multi-theory model (MTM) in predicting initiation and sustenance of physical activity behavior among college students. Health Promot Perspect 6(2):58

    Article  PubMed  PubMed Central  Google Scholar 

  26. Sharma M, Catalano HP, Nahar VK, Lingam V, Johnson P, Ford MA (2016) Using multi-theory model to predict initiation and sustenance of small portion size consumption among college students. Health Promot Perspect 6(3):137

    Article  PubMed  PubMed Central  Google Scholar 

  27. Sharma M, Stephens PM, Nahar VK, Catalano HP, Lingam VC, Ford MA (2018) Using a multitheory model to predict initiation and sustenance of fruit and vegetable consumption among college students. J Am Osteopath Assoc 118(8):507–517

    PubMed  Google Scholar 

  28. Bleakley A, Jordan A, Ellithorpe ME, Lazovich D, Grossman S, Glanz K (2018) A national survey of young women’s beliefs about quitting indoor tanning: Implications for health communication messages. Translational Behavioral Medicine 8(6):898–906

    Article  PubMed  Google Scholar 

  29. Pagoto SL, Lemon SC, Oleski JL, Scully JM, Olendzki GF, Evans MM, Hillhouse JJ (2015) Availability of tanning beds on US college campuses. JAMA Dermatol 151(1):59–63

    Article  PubMed  Google Scholar 

  30. Bartenstein D, Diven D, Allred J, Reed K (2015) Indoor tanning devices in student apartment complexes: A study of 2 Texas university communities. JAMA Dermatol 151(8):905–906

    Article  PubMed  Google Scholar 

  31. Grossman DC, Curry SJ, Owens DK, Barry MJ, Caughey AB, Davidson KW, US Preventive Services Task Force (2018) Behavioral counseling to prevent skin cancer: US Preventive Services Task Force recommendation statement. JAMA 319(11):1134–1142

    Article  PubMed  Google Scholar 

  32. Sheeran P, Goldstein AO, Abraham C, Eaker K, Wright CE, Villegas ME, Noar SM (2020) Reducing exposure to ultraviolet radiation from the sun and indoor tanning: A meta-analysis. Health Psychol 39(7):600

    Article  PubMed  Google Scholar 

  33. Nahar VK, Wilkerson AH, Mayer JE, Gromley Z, Berry D, Nahar L, Brodell RT (2020) Attitudes and practice among dermatologists regarding indoor tanning. Arch Dermatol Res 312(9):681–684

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

Results of this study were presented at the Dermatology Nurses’ Association annual meeting in March, 2019.

Funding

No funding was obtained for this study.

Author information

Authors and Affiliations

  1. Department of Health Science, College of Human Environmental Sciences, The University of Alabama, Tuscaloosa, AL, USA

    Amanda H. Wilkerson

  2. Substance Use and Mental Health Laboratory, Department of Health, Human Performance and Recreation, University of Arkansas, Fayetteville, AR, USA

    Robert E. Davis

  3. Department of Social and Behavioral Health, School of Public Health, University of Nevada, Las Vegas, NV, USA

    Manoj Sharma

  4. Department of Dermatology, School of Medicine, University of Mississippi Medical Center, 2500 North State Street – L216, Jackson, MS, 39216, USA

    Mallory B. Harmon, Hannah K. McCowan, Chelsea S. Mockbee & Vinayak K. Nahar

  5. Department of Health, Exercise Science, and Recreation Management, School of Applied Sciences, University of Mississippi, University, Jackson, MS, USA

    M. Allison Ford

  6. Department of Preventive Medicine, School of Medicine/John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, MS, USA

    Vinayak K. Nahar

Authors
  1. Amanda H. Wilkerson
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Robert E. Davis
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Manoj Sharma
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mallory B. Harmon
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Hannah K. McCowan
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Chelsea S. Mockbee
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. M. Allison Ford
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Vinayak K. Nahar
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Vinayak K. Nahar.

Ethics declarations

Conflict of interest

None.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Amanda H. Wilkerson and Robert E. Davis are co–first authors.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Wilkerson, A.H., Davis, R.E., Sharma, M. et al. Use of the multi-theory model (MTM) in explaining initiation and sustenance of indoor tanning cessation among college students. Arch Dermatol Res 315, 191–199 (2023). https://doi.org/10.1007/s00403-022-02338-y

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00403-022-02338-y

Keywords

Search

Navigation