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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De Vries E, Bray FI, Coebergh JW, Parkin DM (2003) Changing epidemiology of malignant cutaneous melanoma in Europe 1955-1997: rising trends in incidence and mortality but recent stabilizations in western Europe and decreases in Scandinavia. Int J Cancer 107:119–126
Aceituno-Madera P, Buendía-Eisman A, Arias-Santiago S, Serrano-Ortega S (2010) Evaluación de la incidencia del cáncer de piel en el periodo 1978-2002. Actas Dermosifiliogr 101:39–46
Aguilar-Bernier M, Rivas-Ruiz F, De Troya-Martín M, Blázquez-Sánchez N (2012) Comparative epidemiological study of non-melanoma skin cancer between Spanish and north and central European residents on the Costa del Sol. J Eur Acad Dermatol Venereol 26:41–47
Livingston PM, White V, Hayman J, Dobbinson S (2003) Sun exposure and sun protection behaviours among Australian adolescents: trends over time. Prev Med 37:577–584
Junquera-Llaneza ML, Nosti-Martínez D, Rodríguez Díaz E, Junquera-Llaneza B, Fernández-Bustillo E, Rendueles-Meléndez C, Sánchez del Río J (1998) Conocimientos, actitudes y prácticas de los adolescentes en torno a los efectos nocivos del sol y la fotoprotección. Actas Dermosifiliogr 89:247–252
Fernández-Morano T, De Troya-Martín M, Rivas-Ruiz F, Blázquez-Sánchez N, Del Boz-González J, Fernández-Peñas P, Buendía-Eisman A (2014) Behaviour, attitudes and awareness concerning sun exposure in adolescents on the Costa del Sol. Eur J Dermatol 24(1):85–93
Buendía-Eisman A, Arias-Santiago S, Moreno-Giménez JC, Cabrera-León A, Prieto L, Castillejo I, Conejo-Mir J (2013) An Internet-based programme to promote adequate UV exposure behaviour in adolescents in Spain. J Eur Acad Dermatol Venereol 27(4):442–453
Molgó M, Castillo C, Valdés R, Romero W, Jeanneret V, Cevo T, Torres C, Silva P, Flores L, Riquelme A, Ayala MF, González F, Hasbún MT, Baladrón MJ (2005) Sun exposure behaviors and knowledge among Chileans. Rev Med Chil 133(6):662–666
Rosenstock IM (1974) The Health Belief Model and preventive health behaviour. In M.H. Becker (Ed.), The Health Belief Model and personal health behaviour (pp. 27 59). Thorofare: Charles B Slack
Janz NK, Becker MH (1984) The health belief model: a decade later. Health Educ Q 11(1):1–47
Fernández-Morano T, de Troya-Martín M, Rivas-Ruiz F, Blázquez-Sánchez N, Buendia- Eisman A (2015) Sensitivity to change of the Beach Questionnaire to behaviour, attitudes and knowledge related to sun exposure: quasi-experimental before-after study. BMC Public Health 15:60
Troya-Martín M, Blázquez-Sánches N, Rivas-Ruiz F, Fernández-Canedo I, Rupérez-Sandoval A, Pons-Palliser J, Perea-Milla E (2009) Validación de un cuestionario en español sobre comportamientos, actitudes y conocimientos relacionados con el exposición solar: “Cuestionario a pie de playa”. Actas Dermatosifiliogr 100:586–595
Cercato MC, Ramazzotti V, Sperduti I, Asensio-Pascual A, Ribes I, Guillén C, Nagore E (2015) Sun protection among Spanish beachgoers: knowledge, attitude and behaviour. J Cancer Educ 30(1):4–11
Festinger L (1957) A theory of cognitive dissonance. Stanforf University Press, Stanford
Hayes D, Ross CE (1987) Concern with appearance, health beliefs, and eating habits. J Health Soc Behav 28:120–130
Wichstrøm L (1994) Predictors of Norwegian adolescents’ sunbathing and use of sunscreen. Health Psychol 13(5):412–420
Brandberg Y, Ullen H, Sjoberg L, Holm LE (1998) Sunbathing and sunbed use related to self-image in a randomized sample of Swedish adolescents. Eur J Cancer Prev 7:321–329
Kasparian NH, McLoone JK, Meiser B (2009) Skin cancer-related prevention and screening behaviors: a review of the literature. J Behav Med 32:406–428
Branström R, Brandberg Y, Holm L, Sjöberg L, Ullén H (2001) Beliefs, knowledge and attitudes as predictors of sunbathing habits and use of sun protection among Swedish adolescents. Eur J Cancer Prev 10:337–345
Jones JL, Leary MR (1994) Effects of appearance-based admonitions against sun exposure on tanning intentions in young adults. Health Psychol 13:86–90
Day AK, Wilson CJ, Hutchinson AD, Roberts RM (2014) The role of skin cancer knowledge in sun-related behaviours: a systematic review. J Health Psychol 19(9):1143–1162
Coups EJ, Stapleton JL, Manne SL, Hudson SV, Medina-Forrester A, Rosenberg SA, Gordon M, Tatum KS, Robinson JK, Natale-Pereira A, Goydos JS (2014) Psychosocial correlates of sun protection behaviors among U.S. Hispanic adults. J Behav Med 37:1082–1090
Young AR (2000) More about: Sunscreen use and duration of sun exposure: a double-blind, randomized trial. J Natl Cancer Inst 92:1532–1533
Bränström R, Kasparian NA, Chang YM, Affleck P, Tibben A, Aspinwall LG, Azizi E, Baron-Epel O, Battistuzzi L, Bergman W, Bruno W, Chan M, Cuellar F, Debniak T, Pjanova D, Ertmanski S, Figl A, Gonzalez M, Hayward NK, Hocevar M, Kanetsky PA, Leachman SA, Heisele O, Palmer J, Peric B, Puig S, Schadendorf D, Gruis NA, Newton-Bishop J, Brandberg Y (2010) Predictors of sun protection behaviors and severe sunburn in an international online study. Cancer Epidemiol Biomarkers Prev 19(9):2199–2210
Olson AL, Gaffney CA, Starr P, Dietrich AJ (2008) The impact of an appearance-based educational intervention on adolescent intention to use sunscreen. Health Educ Res 23:763–769
Acknowledgments
The authors thank the directors and teachers of the schools visited and all those students who answered the questionnaires. We thank the research team at the Costa del Sol Hospital for their support. We also thank Glenn Harding for translating the text. We also thank those responsible for the Ph.D. Programme in Clinical Medicine and Public Health at the University of Granada.
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Teresa Fernández-Morano is a Doctoral Student in the Ph.D. Programme at the University of Granada.
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Fernández-Morano, T., Rivas-Ruiz, F., de Troya-Martín, M. et al. Adolescents’ Attitudes to Sun Exposure and Sun Protection. J Canc Educ 32, 596–603 (2017). https://doi.org/10.1007/s13187-015-0976-z
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DOI: https://doi.org/10.1007/s13187-015-0976-z